Zimbabwe Veterinary Journal

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Journal Homepage Image. Zimbabwe Veterinary Journal contains original and review papers on all aspects of animal health in Zimbabwe and SADC countries, including articles by non-veterinarians. This journal did not publish any issues between 2002 and 2015 but has been revived and and it actively accepting papers ...

Can a New Export Promotion Strategy Revitalise Zimbabwe's ...

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After years of political and economic upheavals and disappointing trade performance, Zimbabwe sorely needs to revitalise its economy. An important step towards this outcome is to grow and strengthen the country's export sector. This article looks at whether an export promotion strategy, based on the application of a ...

Preoperative Expectations and Postoperative Outcomes of Visual Functioning among Cataract Patients in Urban Southern China.

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Ziyan Chen

Full Text Available To investigate the relationship between preoperative expectations and actual postoperative outcomes of visual function (VF among patients undergoing first eye cataract surgery.A longitudinal study of 182 patients from hospitals in urban Southern China were surveyed prior to surgery and 3 month after cataract surgery regarding their preoperative, expected postoperative and actual postoperative VF for each of the items on the Catquest-9SF and their satisfaction with cataract surgery. In addition, detailed clinical data were collected preoperatively and postoperatively.The majority of cataract patients in urban Southern China had high expectations for VF outcomes after cataract surgery and in most cases postoperative outcomes achieved the expected level of improvement. The mean (standard deviation, SD preoperative Catquest-9SF score was 15.7 (5.86 and the mean (SD expected postoperative score was 26.3 (2.93. The discrepancy between actual and expected improvement was significantly correlated with patients' health literacy, presence of systemic and ocular comorbidity, preoperative visual acuity of the surgery eye, LOCS III nuclear opalescence and cortical cataract grading.Cataract patients in urban Southern China had high expectations for surgery outcomes. Patients with low level of health literacy and the presence of systemic and ocular comorbidity may need a comprehensive counseling to decrease the discrepancy regarding expected and actual outcomes.

The Relation between Nonverbal IQ and Postoperative CI Outcomes in Cochlear Implant Users: Preliminary Result

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Mina Park

2015-01-01

Full Text Available Objectives. This study assessed the correlation between performance intelligence and the postoperative cochlear implant (CI outcome in Korean-speaking children. In addition, the relationship between the performance intelligence subscales and the post-CI speech outcome was evaluated. Materials and Methods. Thirteen pediatric CI users (five males, eight females; median age at implantation 6.2 (range 1.3–14.2 years; median age at intelligence test 9.3 (range 5–16 years who were tested using the Korean Educational Development Institute-Wechsler Intelligence Scale for children were studied. The correlations between the intelligence scores and 1-2 years postoperative Categories of Auditory Performance (CAP scores and between subscales of performance and 1-2 years postoperative CAP scores were analyzed. Results. There was no correlation between the categories of verbal intelligence quotient (IQ and performance IQ for “mentally retarded” and “average,” respectively (Spearman’s rho = 0.42, P=0.15. There was a strong correlation between performance IQ and the postoperative CAP scale (Spearman’s rho = 0.8977, P=0.0008. “Picture arrangement” and “picture completion,” reflecting social cognition, were strongly correlated with the postoperative CAP scales. Conclusion. Performance intelligence, especially social cognition, was strongly related to the postoperative CI outcome of cochlear implant users. Therefore, auditory rehabilitation, including social rehabilitation, should maximize the postoperative CI outcomes.

Transactions of the Zimbabwe Scientific Association

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The Zimbabwe Scientific Association was founded in Bulawayo in 1899 (called the Rhodesia Scientific Assocation at the time) to promote the study and advancement of science in Zimbabwe and to facilitate the acquisition and dissemination of scientific knowledge. Its journal, Transactions of the Zimbabwe Scientific ...

Association Between State Medical Malpractice Environment and Postoperative Outcomes in the United States.

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Minami, Christina A; Sheils, Catherine R; Pavey, Emily; Chung, Jeanette W; Stulberg, Jonah J; Odell, David D; Yang, Anthony D; Bentrem, David J; Bilimoria, Karl Y

2017-03-01

The US medical malpractice system assumes that the threat of liability should deter negligence, but it is unclear whether malpractice environment affects health care quality. We sought to explore the association between state malpractice environment and postoperative complication rates. This observational study included Medicare fee-for-service beneficiaries undergoing one of the following operations in 2010: colorectal, lung, esophageal, or pancreatic resection, total knee arthroplasty, craniotomy, gastric bypass, abdominal aortic aneurysm repair, coronary artery bypass grafting, or cystectomy. The state-specific malpractice environment was measured by 2010 medical malpractice insurance premiums, state average award size, paid malpractice claims/100 physicians, and a composite malpractice measure. Outcomes of interest included 30-day readmission, mortality, and postoperative complications (eg sepsis, myocardial infarction [MI], pneumonia). Using Medicare administrative claims data, associations between malpractice environment and postoperative outcomes were estimated using hierarchical logistic regression models with hospital random-intercepts. Measures of malpractice environment did not have significant, consistent associations with postoperative outcomes. No individual tort reform law was consistently associated with improved postoperative outcomes. Higher-risk state malpractice environment, based on the composite measure, was associated with higher likelihood of sepsis (odds ratio [OR] 1.22; 95% CI 1.07 to 1.39), MI (OR 1.14; 95% CI 1.06 to 1.23), pneumonia (OR 1.09; 95% CI 1.03 to 1.16), acute renal failure (OR 1.15; 95% CI 1.08 to 1.22), deep vein thrombosis/pulmonary embolism (OR 1.22; 95% CI 1.13 to 1.32), and gastrointestinal bleed (OR 1.18; 95% CI 1.08 to 1.30). Higher risk malpractice environments were not consistently associated with a lower likelihood of surgical postoperative complications, bringing into question the ability of malpractice lawsuits to

Zimbabwe culture before Mapungubwe: new evidence from Mapela Hill, South-Western Zimbabwe.

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Chirikure, Shadreck; Manyanga, Munyaradzi; Pollard, A Mark; Bandama, Foreman; Mahachi, Godfrey; Pikirayi, Innocent

2014-01-01

Across the globe, the emergence of complex societies excites intense academic debate in archaeology and allied disciplines. Not surprisingly, in southern Africa the traditional assumption that the evolution of socio-political complexity began with ideological transformations from K2 to Mapungubwe between CE1200 and 1220 is clouded in controversy. It is believed that the K2-Mapungubwe transitions crystallised class distinction and sacred leadership, thought to be the key elements of the Zimbabwe culture on Mapungubwe Hill long before they emerged anywhere else. From Mapungubwe (CE1220-1290), the Zimbabwe culture was expressed at Great Zimbabwe (CE1300-1450) and eventually Khami (CE1450-1820). However, new fieldwork at Mapela Hill, when coupled with a Bayesian chronology, offers tremendous fresh insights which refute this orthodoxy. Firstly, Mapela possesses enormous prestige stone-walled terraces whose initial construction date from the 11th century CE, almost two hundred years earlier than Mapungubwe. Secondly, the basal levels of the Mapela terraces and hilltop contain élite solid dhaka (adobe) floors associated with K2 pottery and glass beads. Thirdly, with a hilltop and flat area occupation since the 11th century CE, Mapela exhibits evidence of class distinction and sacred leadership earlier than K2 and Mapungubwe, the supposed propagators of the Zimbabwe culture. Fourthly, Mapungubwe material culture only appeared later in the Mapela sequence and therefore post-dates the earliest appearance of stone walling and dhaka floors at the site. Since stone walls, dhaka floors and class distinction are the essence of the Zimbabwe culture, their earlier appearance at Mapela suggests that Mapungubwe can no longer be regarded as the sole cradle of the Zimbabwe culture. This demands not just fresh ways of accounting for the rise of socio-political complexity in southern Africa, but also significant adjustments to existing models.

Influence of yoga on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery.

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Rao, Raghavendra M; Nagendra, H R; Raghuram, Nagarathna; Vinay, C; Chandrashekara, S; Gopinath, K S; Srinath, B S

2008-01-01

Pre- and postoperative distress in breast cancer patients can cause complications and delay recovery from surgery. The aim of our study was to evaluate the effects of yoga intervention on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery. Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited in a randomized controlled trial comparing the effects of a yoga program with supportive therapy and exercise rehabilitation on postoperative outcomes and wound healing following surgery. Subjects were assessed at the baseline prior to surgery and four weeks later. Sociodemographic, clinical and investigative notes were ascertained in the beginning of the study. Blood samples were collected for estimation of plasma cytokines-soluble Interleukin (IL)-2 receptor (IL-2R), tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma. Postoperative outcomes such as the duration of hospital stay and drain retention, time of suture removal and postoperative complications were ascertained. We used independent samples t test and nonparametric Mann Whitney U tests to compare groups for postoperative outcomes and plasma cytokines. Regression analysis was done to determine predictors for postoperative outcomes. Sixty-nine patients contributed data to the current analysis (yoga: n = 33, control: n = 36). The results suggest a significant decrease in the duration of hospital stay (P = 0.003), days of drain retention (P = 0.001) and days for suture removal (P = 0.03) in the yoga group as compared to the controls. There was also a significant decrease in plasma TNF alpha levels following surgery in the yoga group (P < 0.001), as compared to the controls. Regression analysis on postoperative outcomes showed that the yoga intervention affected the duration of drain retention and hospital stay as well as TNF alpha levels. The results suggest possible benefits of yoga in reducing postoperative complications in

Preoperative MRI findings predict two-year postoperative clinical outcome in lumbar spinal stenosis.

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Pekka Kuittinen

Full Text Available To study the predictive value of preoperative magnetic resonance imaging (MRI findings for the two-year postoperative clinical outcome in lumbar spinal stenosis (LSS.84 patients (mean age 63±11 years, male 43% with symptoms severe enough to indicate LSS surgery were included in this prospective observational single-center study. Preoperative MRI of the lumbar spine was performed with a 1.5-T unit. The imaging protocol conformed to the requirements of the American College of Radiology for the performance of MRI of the adult spine. Visual and quantitative assessment of MRI was performed by one experienced neuroradiologist. At the two-year postoperative follow-up, functional ability was assessed with the Oswestry Disability Index (ODI 0-100% and treadmill test (0-1000 m, pain symptoms with the overall Visual Analogue Scale (VAS 0-100 mm, and specific low back pain (LBP and specific leg pain (LP separately with a numeric rating scale from 0-10 (NRS-11. Satisfaction with the surgical outcome was also assessed.Preoperative severe central stenosis predicted postoperatively lower LP, LBP, and VAS when compared in patients with moderate central stenosis (p<0.05. Moreover, severe stenosis predicted higher postoperative satisfaction (p = 0.029. Preoperative scoliosis predicted an impaired outcome in the ODI (p = 0.031 and lowered the walking distance in the treadmill test (p = 0.001. The preoperative finding of only one stenotic level in visual assessment predicted less postoperative LBP when compared with patients having 2 or more stenotic levels (p = 0.026. No significant differences were detected between quantitative measurements and the patient outcome.Routine preoperative lumbar spine MRI can predict the patient outcome in a two-year follow up in patients with LSS surgery. Severe central stenosis and one-level central stenosis are predictors of good outcome. Preoperative finding of scoliosis may indicate worse functional ability.

Zimbabwe Journal of Educational Research

African Journals Online (AJOL)

The Zimbabwe Journal of Educational Research comprised of four sections: Scholarly articles ... A Requiem Too Soon or a Landing Strand Too Far? ... Mathematics (STEM) Education in Zimbabwe Secondary Schools: Access, Quality, Policy ...

Preoperative automated fibre quantification predicts postoperative seizure outcome in temporal lobe epilepsy.

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Keller, Simon S; Glenn, G Russell; Weber, Bernd; Kreilkamp, Barbara A K; Jensen, Jens H; Helpern, Joseph A; Wagner, Jan; Barker, Gareth J; Richardson, Mark P; Bonilha, Leonardo

2017-01-01

Approximately one in every two patients with pharmacoresistant temporal lobe epilepsy will not be rendered completely seizure-free after temporal lobe surgery. The reasons for this are unknown and are likely to be multifactorial. Quantitative volumetric magnetic resonance imaging techniques have provided limited insight into the causes of persistent postoperative seizures in patients with temporal lobe epilepsy. The relationship between postoperative outcome and preoperative pathology of white matter tracts, which constitute crucial components of epileptogenic networks, is unknown. We investigated regional tissue characteristics of preoperative temporal lobe white matter tracts known to be important in the generation and propagation of temporal lobe seizures in temporal lobe epilepsy, using diffusion tensor imaging and automated fibre quantification. We studied 43 patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis and 44 healthy controls. Patients underwent preoperative imaging, amygdalohippocampectomy and postoperative assessment using the International League Against Epilepsy seizure outcome scale. From preoperative imaging, the fimbria-fornix, parahippocampal white matter bundle and uncinate fasciculus were reconstructed, and scalar diffusion metrics were calculated along the length of each tract. Altogether, 51.2% of patients were rendered completely seizure-free and 48.8% continued to experience postoperative seizure symptoms. Relative to controls, both patient groups exhibited strong and significant diffusion abnormalities along the length of the uncinate bilaterally, the ipsilateral parahippocampal white matter bundle, and the ipsilateral fimbria-fornix in regions located within the medial temporal lobe. However, only patients with persistent postoperative seizures showed evidence of significant pathology of tract sections located in the ipsilateral dorsal fornix and in the contralateral parahippocampal white matter bundle

Pre-existing and Postoperative Intimal Hyperplasia and Arteriovenous Fistula Outcomes.

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Tabbara, Marwan; Duque, Juan C; Martinez, Laisel; Escobar, Luis A; Wu, Wensong; Pan, Yue; Fernandez, Natasha; Velazquez, Omaida C; Jaimes, Edgar A; Salman, Loay H; Vazquez-Padron, Roberto I

2016-09-01

The contribution of intimal hyperplasia (IH) to arteriovenous fistula (AVF) failure is uncertain. This observational study assessed the relationship between pre-existing, postoperative, and change in IH over time and AVF outcomes. Prospective cohort study with longitudinal assessment of IH at the time of AVF creation (pre-existing) and transposition (postoperative). Patients were followed up for up to 3.3 years. 96 patients from a single center who underwent AVF surgery initially planned as a 2-stage procedure. Veins and AVF samples were collected from 66 and 86 patients, respectively. Matched-pair tissues were available from 56 of these patients. Pre-existing, postoperative, and change in IH over time. Anatomic maturation failure was defined as an AVF that never reached a diameter > 6mm. Primary unassisted patency was defined as the time elapsed from the second-stage surgery to the first intervention. Maximal intimal thickness in veins and AVFs and change in intimal thickness over time. Pre-existing IH (>0.05mm) was present in 98% of patients. In this group, the median intimal thickness increased 4.40-fold (IQR, 2.17- to 4.94-fold) between AVF creation and transposition. However, this change was not associated with pre-existing thickness (r(2)=0.002; P=0.7). Ten of 96 (10%) AVFs never achieved maturation, whereas 70% of vascular accesses remained patent at the end of the observational period. Postoperative IH was not associated with anatomic maturation failure using univariate logistic regression. Pre-existing, postoperative, and change in IH over time had no effects on primary unassisted patency. The small number of patients from whom longitudinal tissue samples were available and low incidence of anatomic maturation failure, which decreased the statistical power to find associations between end points and IH. Pre-existing, postoperative, and change in IH over time were not associated with 2-stage AVF outcomes. Copyright © 2016 National Kidney Foundation, Inc

Zimbabwe Veterinary Journal: Editorial Policies

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Focus and Scope. Zimbabwe Veterinary Journal contains original and review papers on all aspects of animal health in Zimbabwe and SADC countries, including articles by non-veterinarians. Section Policies. Articles. Checked Open Submissions, Checked Indexed, Checked Peer Reviewed. Publication Frequency.

Influence of yoga on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery

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Rao Raghavendra

2008-01-01

Full Text Available Context : Pre- and postoperative distress in breast cancer patients can cause complications and delay recovery from surgery. Objective : The aim of our study was to evaluate the effects of yoga intervention on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery. Methods : Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited in a randomized controlled trial comparing the effects of a yoga program with supportive therapy and exercise rehabilitation on postoperative outcomes and wound healing following surgery. Subjects were assessed at the baseline prior to surgery and four weeks later. Sociodemographic, clinical and investigative notes were ascertained in the beginning of the study. Blood samples were collected for estimation of plasma cytokines-soluble Interleukin (IL-2 receptor (IL-2R, tumor necrosis factor (TNF-alpha and interferon (IFN-gamma. Postoperative outcomes such as the duration of hospital stay and drain retention, time of suture removal and postoperative complications were ascertained. We used independent samples t test and nonparametric Mann Whitney U tests to compare groups for postoperative outcomes and plasma cytokines. Regression analysis was done to determine predictors for postoperative outcomes. Results : Sixty-nine patients contributed data to the current analysis (yoga: n = 33, control: n = 36. The results suggest a significant decrease in the duration of hospital stay ( P = 0.003, days of drain retention ( P = 0.001 and days for suture removal ( P = 0.03 in the yoga group as compared to the controls. There was also a significant decrease in plasma TNF alpha levels following surgery in the yoga group ( P < 0.001, as compared to the controls. Regression analysis on postoperative outcomes showed that the yoga intervention affected the duration of drain retention and hospital stay as well as TNF alpha levels. Conclusion : The results suggest

Impact of early postoperative enteral nutrition on clinical outcomes in patients with gastric cancer.

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Li, B; Liu, H Y; Guo, S H; Sun, P; Gong, F M; Jia, B Q

2015-06-29

The impact of early enteral nutrition (EEN) on clinical outcomes of gastric cancer patients was investigated. Three hundred pa-tients undergoing gastric cancer surgery from July 2010 to May 2014 were randomly divided into experimental and control groups (n = 150/group). Experimental group patients received enteral nutrition in water during the early postoperative period. Control group patients received conventional perioperative treatment. Patients' clinical outcomes, post-operative immune function, and nutritional statuses were compared, which revealed that the postoperative fever duration (80.2 ± 6.0 vs 88.1 ± 8.1 h, P 0.05]. At postoperative days 3 and 7, the CD3(+), CD4(+), natural killer cell, albumin, and prealbumin levels and CD4(+)/CD8(+) ra-tio were significantly higher in the experimental group than the control group (all P nutritional status and immune function and promote early recovery of intestinal function in patients with gastric cancer.

Is there a threshold level of maternal education sufficient to reduce child undernutrition? Evidence from Malawi, Tanzania and Zimbabwe.

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Makoka, Donald; Masibo, Peninah Kinya

2015-08-22

Maternal education is strongly associated with young child nutrition outcomes. However, the threshold of the level of maternal education that reduces the level of undernutrition in children is not well established. This paper investigates the level of threshold of maternal education that influences child nutrition outcomes using Demographic and Health Survey data from Malawi (2010), Tanzania (2009-10) and Zimbabwe (2005-06). The total number of children (weighted sample) was 4,563 in Malawi; 4,821 children in Tanzania; and 3,473 children in Zimbabwe Demographic and Health Surveys. Using three measures of child nutritional status: stunting, wasting and underweight, we employ a survey logistic regression to analyse the influence of various levels of maternal education on child nutrition outcomes. In Malawi, 45% of the children were stunted, 42% in Tanzania and 33% in Zimbabwe. There were 12% children underweight in Malawi and Zimbabwe and 16% in Tanzania.The level of wasting was 6% of children in Malawi, 5% in Tanzania and 4% in Zimbabwe. Stunting was significantly (p values educational level in all the three countries. Higher levels of maternal education reduced the odds of child stunting, underweight and wasting in the three countries. The maternal threshold for stunting is more than ten years of schooling. Wasting and underweight have lower threshold levels. These results imply that the free primary education in the three African countries may not be sufficient and policies to keep girls in school beyond primary school hold more promise of addressing child undernutrition.

Patients' perception of postoperative pain management: validation of the International Pain Outcomes (IPO) questionnaire.

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Rothaug, Judith; Zaslansky, Ruth; Schwenkglenks, Matthias; Komann, Marcus; Allvin, Renée; Backström, Ragnar; Brill, Silviu; Buchholz, Ingo; Engel, Christoph; Fletcher, Dominique; Fodor, Lucian; Funk, Peter; Gerbershagen, Hans J; Gordon, Debra B; Konrad, Christoph; Kopf, Andreas; Leykin, Yigal; Pogatzki-Zahn, Esther; Puig, Margarita; Rawal, Narinder; Taylor, Rod S; Ullrich, Kristin; Volk, Thomas; Yahiaoui-Doktor, Maryam; Meissner, Winfried

2013-11-01

PAIN OUT is a European Commission-funded project aiming at improving postoperative pain management. It combines a registry that can be useful for quality improvement and research using treatment and patient-reported outcome measures. The core of the project is a patient questionnaire-the International Pain Outcomes questionnaire-that comprises key patient-level outcomes of postoperative pain management, including pain intensity, physical and emotional functional interference, side effects, and perceptions of care. Its psychometric quality after translation and adaptation to European patients is the subject of this validation study. The questionnaire was administered to 9,727 patients in 10 languages in 8 European countries and Israel. Construct validity was assessed using factor analysis. Discriminant validity assessment used Mann-Whitney U tests to detect mean group differences between 2 surgical disciplines. Internal consistency reliability was calculated as Cronbach's alpha. Factor analysis resulted in a 3-factor structure explaining 53.6% of variance. Cronbach's alpha at overall scale level was high (.86), and for the 3 subscales was low, moderate, or high (range, .53-.89). Significant mean group differences between general and orthopedic surgery patients confirmed discriminant validity. The psychometric quality of the International Pain Outcomes questionnaire can be regarded as satisfactory. The International Pain Outcomes questionnaire provides an instrument for postoperative pain assessment and improvement of quality of care, which demonstrated good psychometric quality when translated into a variety of languages in a large European and Israeli patient population. This measure provides the basis for the first comprehensive postoperative pain registry in Europe and other countries. Copyright © 2013. Published by Elsevier Inc.

The Efficacy of Vitamin C on Postoperative Outcomes after Posterior Lumbar Interbody Fusion: A Randomized, Placebo-Controlled Trial.

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Lee, Gun Woo; Yang, Han Seok; Yeom, Jin S; Ahn, Myun-Whan

2017-09-01

Vitamin C has critical features relavant to postoperative pain management and functional improvement; however, no study has yet evaluated the effectiveness of vitamin C on improving the surgical outcomes for spine pathologies. Thus, this study aimed to explore the impact of vitamin C on postoperative outcomes after single-level posterior lumbar interbody fusion (PLIF) for lumbar spinal stenosis in prospectively randomized design. We conducted a 1-year prospective, randomized, placebo-controlled, double-blind study to evaluate the impact of vitamin C on the postoperative outcomes after PLIF surgery. A total of 123 eligible patients were randomly assigned to either group A (62 patients with vitamin C) or group B (61 patients with placebo). Patient follow-up was continued for at least 1 year after surgery. The primary outcome measure was pain intensity in the lower back using a visual analogue scale. The secondary outcome measures were: (1) the clinical outcome assessed using the Oswestry Disability Index (ODI); (2) the fusion rate assessed using dynamic radiographs and computed tomography scans; and (3) complications. Pain intensity in the lower back was significantly improved in both groups compared with preoperative pain intensity, but no significant difference was observed between the 2 groups over the follow-up period. The ODI score of group A at the third postoperative month was significantly higher than the score of group B. After the sixth postoperative month, the ODI score of group A was slightly higher than the score of group B; however, this difference was not significant. The fusion rates at 1 year after surgery and the complication rates were not significantly different between the 2 groups. Postoperative pain intensity, the primary outcome measure, was not significantly different at 1 year after surgery between the 2 groups. However, vitamin C may be associated with improving functional status after PLIF surgery, especially during the first 3

A systematic review of preoperative predictors for postoperative clinical outcomes following lumbar discectomy.

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Wilson, Courtney A; Roffey, Darren M; Chow, Donald; Alkherayf, Fahad; Wai, Eugene K

2016-11-01

Sciatica is often caused by a herniated lumbar intervertebral disc. When conservative treatment fails, a lumbar discectomy can be performed. Surgical treatment via lumbar discectomy is not always successful and may depend on a variety of preoperative factors. It remains unclear which, if any, preoperative factors can predict postsurgical clinical outcomes. This review aimed to determine preoperative predictors that are associated with postsurgical clinical outcomes in patients undergoing lumbar discectomy. This is a systematic review. This systematic review of the scientific literature followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. MEDLINE and PubMed were systematically searched through June 2014. Results were screened for relevance independently, and full-text studies were assessed for eligibility. Reporting quality was assessed using a modified Newcastle-Ottawa Scale. Quality of evidence was assessed using a modified version of Sackett's Criteria of Evidence Support. No financial support was provided for this study. No potential conflict of interest-associated biases were present from any of the authors. The search strategy yielded 1,147 studies, of which a total of 40 high-quality studies were included. There were 17 positive predictors, 20 negative predictors, 43 non-significant predictors, and 15 conflicting predictors determined. Preoperative predictors associated with positive postoperative outcomes included more severe leg pain, better mental health status, shorter duration of symptoms, and younger age. Preoperative predictors associated with negative postoperative outcomes included intact annulus fibrosus, longer duration of sick leave, worker's compensation, and greater severity of baseline symptoms. Several preoperative factors including motor deficit, side and level of herniation, presence of type 1 Modic changes and degeneration, age, and gender had non-significant associations with postoperative clinical

Postoperative Clinical Outcome and Risk Factors for Poor Outcome of Foraminal and Extraforaminal Lumbar Disc Herniation.

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Bae, Jung Sik; Kang, Kyung Hee; Park, Jeong Hyun; Lim, Jae Hyeon; Jang, Il Tae

2016-03-01

We evaluated postoperative outcomes in patients who have lumbar foraminal or extraforaminal disc herniation (FELDH) and suggested the risk factors for poor outcomes. A total of 234 patients were selected for this study. Pre- and post-operative Visual Analogue Scale (VAS) and Korean version Oswestry Disability Index (KODI) were evaluated and the changes of both score were calculated. Outcome was defined as excellent, good, fair, and poor based on Mcnab classification. The percentage of superior facetectomy was calculated by using the Maro-view 5.4 Picture Archiving Communication System (PACS). Paramedian lumbar discectomy was performed in 180 patients and combined lumbar discectomy was performed in 54 patients. Paramedian lumbar discectomy group showed better outcome compared with combined discectomy group. p value of VAS change was 0.009 and KODI was 0.013. The average percentage of superior facetectomy was 33% (range, 0-79%) and it showed negative correlation with VAS and KODI changes (Pearson coefficient : -0.446 and -0.498, respectively). Excellent or good outcome cases (Group I) were 136 (58.1%) and fair or poor outcome cases (Group II) were 98 (41.9%). The percentage of superior facetectomy was 26.5% at Group I and 42.5% at Group II. There was significant difference in superior facetectomy percentage between Group I and II (p=0.000). This study demonstrated that paramedian lumbar discectomy with preservation of facet joints is an effective and good procedure for FELDH. At least 60% of facet should be preserved for excellent or good outcomes.

Postoperative B-Type Natriuretic Peptide as Predictor for Postoperative Outcomes in Patients Implanted With Left Ventricular Assist Devices.

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Yost, Gardner; Bhat, Geetha; Pappas, Patroklos; Tatooles, Antone

2018-04-18

Brain natriuretic peptide (BNP) is a cardiac neurohormone known to correlate with left ventricular (LV) dilation, decreased contractility, and increased stiffness. Consequently, BNP has been used as a prognostic tool to assess the degree of LV unloading for patients supported by continuous-flow LV assist devices (LVADs). We assessed the prognostic value of changes in BNP in the 2 weeks after LVAD implantation. This retrospective study analyzed laboratory findings and outcomes of 189 LVAD patients. Patients were separated into two groups based on whether serum BNP levels had improved from preoperative levels by postoperative day 14. Group 1 had improvement in BNP levels, whereas group 2 had no improvement or worsening in BNP. There were no significant differences between the groups in age, gender, race, body mass index, or comorbidities. Group 1 had preoperative BNP 1,125 ± 1,078.3 pg/dl and postoperative BNP 440.2 ± 267.7 pg/dl (ΔBNP = -693.09 ± 942.4 pg/dl), whereas group 2 had preoperative BNP 346.0 ± 309.1 pg/dl and postoperative BNP 631.57 ± 483.4 pg/dl (ΔBNP = 289.32 ± 329.7 pg/dl). Postoperative survival in group 2 was significantly worse than in group 1. Rates of right ventricular failure (RVF) were significantly higher in group 2 (group 1: 39%, group 2: 52.7%; p = 0.01). In most patients implanted with a LVAD, BNP improves significantly in the postoperative period as the LV is unloaded. Our results indicate that lack of improvement in postoperative BNP is associated with longer length of stay, increased rates of RVF, and is an independent risk factor for reduced postoperative survival.

Arthroscopic suture bridge rotator cuff repair: functional outcome, repair integrity, and preoperative factors related to postoperative outcome.

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Rimmke, Nathan; Maerz, Tristan; Cooper, Ross; Yadavalli, Sailaja; Anderson, Kyle

2016-01-01

To assess the retear rate, retear size and location, the clinical impact of a retear, and preoperative patient factors related to postoperative outcome after arthroscopic suture bridge rotator cuff repair. Fifty six patients with an isolated, full-thickness supraspinatus tendon tear who underwent arthroscopic suture bridge rotator cuff repair were retrospectively identified. Patients were evaluated and rotator cuff integrity was assessed using ultrasonography. Visual analog score (VAS), the American Shoulder and Elbow Surgeon (ASES) score, shoulder range of motion and strength were used for clinical evaluation. Retears were assessed for size and location on ultrasonography. Forty two patients (75%) aged a mean 59.7 ± 8.6 years (range 41-79 years) were available for follow-up at a mean 13.5 months. Postoperative evaluation indicated significant improvements in ASES score (49.76 ± 18.2 to 86.57 ± 13.4, P rotation ROM (44.13° ± 12.0 to 52.09° ± 12.0, P = 0.003). The retear rate was 14.28% (6/42). Patients with retears were not older (P = 0.526) but had a larger preoperative tear size (3.25 cm ± 0.5 vs. 2.05 cm ± 0.48, P rotation ROM (P = 0.002), and internal rotation strength (P = 0.004). Arthroscopic suture bridge repair provides good clinical results with a low retear rate. The duration of preoperative symptoms was associated with postoperative outcome, indicating that delaying surgery may result in inferior outcomes. IV, Case Series.

Postoperative anemia and early functional outcomes after fast-track hip arthroplasty

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Jans, Øivind; Bandholm, Thomas; Kurbegovic, Sorel

2016-01-01

BACKGROUND: Postoperative anemia is prevalent in fast-track hip arthroplasty (THA) where patients are mobilized and discharged early, but whether anemia impairs functional recovery after discharge has not been adequately evaluated previously. This study aimed to evaluate whether postoperative...... anemia influenced recovery of mobility and quality of life (Qol) during the first 2 weeks after discharge from THA. STUDY DESIGN AND METHODS: This was a prospective observational study in 122 THA patients more than 65 years of age. Mobility and Qol were assessed pre- and postoperatively by the 6-minute...... walk test (6MWT; primary outcome), the timed up-and-go test, and the FACT-anemia subscale. Twenty-four-hour mobility at home was assessed by activity monitoring on Days 1 to 6 after discharge. Hemoglobin (Hb) at discharge (HbD) and the Hb decrease from preoperatively (ΔHb) were compared to mobility...

The postoperative clinical outcomes and safety of early enteral nutrition in operated gastric cancer patients.

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Li, Bing; Liu, Hong-Yi; Guo, Shao-Hua; Sun, Peng; Gong, Fang-Ming; Jia, Bao-Qing

2015-01-01

This study investigated the impact of early enteral nutrition (EEN) on the clinical outcomes of gastric cancer patients after radical gastrectomy. Four hundred gastric cancer patients undergoing radical gastrectomy of any extend with D2 nodal dissection were randomly divided into an experimental and a control group with 200 cases in each group. Patients in the control group received postoperative parenteral nutrition (PN), while patients in the experimental group received postoperative EEN. After treatment, the clinical outcomes, postoperative immune function, and nutritional status of the two groups were evaluated. The postoperative fever time, intestinal function recovery time, anal exhaust time, and the length of hospital stay for patients in the experimental group were significantly shorter than those of the control group. We did not find significant differences in anastomotic leak, postoperative ileus and regurgitation between the two groups. The activities of multiple immune cell types, including CD3⁺, CD4⁺, CD4⁺/CD8⁺, and natural killer (NK) cells, were significantly lower in both groups on postoperative day 1 when compared with the preoperative levels (p0.05). After treatment, levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺, and NK cells in the experimental group patients were 35.6 ± 4.2, 42.2 ± 3.0, 1.7 ± 0.3, and 27.3 ± 5.3%, respectively, on postoperative day 7, which were similar to the preoperative levels. The immune cell levels from the control group patients remained significantly lower when compared with preoperative values; in addition, these values were also significantly lower when compared with the EEN patients (pgastric cancer patients undergoing radical gastrectomy, the clinical outcome, immune function and nutritional status after EEN were significantly improved. These data suggest the widespread use of EEN in clinical practice.

Early post-operative psychosocial and weight predictors of later outcome in bariatric surgery: a systematic literature review.

Science.gov (United States)

Hindle, A; de la Piedad Garcia, X; Brennan, L

2017-03-01

This is the first systematic review to synthesize the evidence concerning early post-operative variables predictive of later weight and psychosocial outcomes in bariatric surgery. Eight electronic databases for empirical studies were searched (1954 to 2016). Most of the 39 included studies reported solely on weight outcomes; eating and psychosocial outcomes were less common. A better early weight loss trajectory was the most consistent predictor of more successful medium-term weight outcome (≤24 months); however, its relationship to longer term weight loss maintenance is less certain. Early eating adaptation may be associated with later weight loss, but further research is needed. Evidence is lacking for associations between early adherence or early psychosocial variables and later outcome. In particular, the relationship between early post-operative depression and later weight remains unclear. Little research has considered early prediction of later eating or psychosocial outcomes. Consideration of mediating or moderating relationships is lacking. The body of evidence is limited, and synthesis is hampered by heterogeneity in the type and time at which predictors and outcomes are measured and quality of statistical reporting. Further research on prospective prediction of bariatric surgery outcome is needed to guide early post-operative intervention for those at greatest risk of poor outcomes. © 2017 World Obesity Federation.

Methicillin-resistant Staphylococcus aureus in Zimbabwe ...

African Journals Online (AJOL)

Resistance was high for most widely used drugs in Zimbabwe with high sensitivity to vancomycin, linezolid and teicoplanin. Conclusion: Although there are no recent reports in the literature of the presence of MRSA in Zimbabwe, this study documented a 7.0% prevalence. Resistance to common antibiotics is high and ...

Effects of Intraoperative Fluid Management on Postoperative Outcomes : A Hospital Registry Study

NARCIS (Netherlands)

Shin, Christina H; Long, Dustin R; McLean, Duncan; Grabitz, Stephanie D; Ladha, Karim; Timm, Fanny P; Thevathasan, Tharusan; Pieretti, Alberto; Ferrone, Cristina; Hoeft, Andreas; Scheeren, Thomas W L; Thompson, Boyd Taylor; Kurth, Tobias; Eikermann, Matthias

2017-01-01

OBJECTIVE: Evaluate the dose-response relationship between intraoperative fluid administration and postoperative outcomes in a large cohort of surgical patients. BACKGROUND: Healthy humans may live in a state of fluid responsiveness without the need for fluid supplementation. Goal-directed protocols

Intraoperative performance and postoperative outcomes of microcoaxial phacoemulsification. Observational study.

Science.gov (United States)

Vasavada, Viraj; Vasavada, Vaishali; Raj, Shetal M; Vasavada, Abhay R

2007-06-01

To evaluate the intraoperative performance and postoperative outcomes after microcoaxial phacoemulsification. Iladevi Cataract & IOL Research Centre, Ahmedabad, India. A prospective observational case series comprised 84 eyes with age-related uncomplicated cataract having microcoaxial phacoemulsification through a 2.2 mm clear corneal incision by a standard surgical technique. Phacoemulsification parameters (Infiniti Vision System, Alcon) were microburst width, 30 ms; preset power, 50%; vacuum, 650 mm Hg; aspiration flow rate, 25 cc/minute. A single-piece Alcon AcrySof intraocular lens was implanted with the C cartridge (Alcon) cartridge. The incision was measured at the end of surgery. Observations included surgical time (from commencement of sculpting to end of epinucleus removal), cumulative dissipated energy (CDE), wound burns, intraoperative complications, postoperative increase in mean central corneal thickness (CCT) at 1 day and 1 month, mean % decrease in endothelial cell density (ECD), absolute mean change in coefficient of variation (cv) 3 months, and uncorrected visual acuity (UCVA) at 1 day. Data were analyzed using a 1-sample t test with 95% confidence intervals (CIs). The mean follow up was 3 months +/- 0.3 (SD). The mean incision size at the end of surgery was 2.3 +/- .09 mm; mean surgical time, 4.5 +/- 1.5 minutes; and mean CDE, 2.3 +/- 2.2 seconds. No wound burns or other intraoperative complications occurred. The postoperative CCT increased by a mean of 16 microm at 1 day (95% CI, 8-25; P = .66;) and by a mean of 3.14 microm at 1 month (95% CI, 2.26-4.05; P = .92). The ECD decreased by a mean of 5.8% (95% CI, 6.8-3.5; P = .82) and the mean coefficient of variation, by 3.3 (95% CI, 4.5-2.0; P = .65). At 1 day, the UCVA was 20/20 in 29% of cases, 20/20 to 20/40 in 58%, and 20/40 to 20/50 in 12%. Microcoaxial phacoemulsification was safely and effectively performed, achieving consistent and satisfactory postoperative outcomes.

Retrospective analysis of treatment outcomes after postoperative chemoradiotherapy in advanced gastric cancer

International Nuclear Information System (INIS)

Kim, Sup; Kim, Jun Sang; Jeong, Hyun Yong; Noh, Seung Moo; Kim, Ki Whan; Cho, Moon June

2011-01-01

To evaluate retrospectively the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiotherapy (CRT) in advanced gastric cancer. Between January 2000 and December 2006, 80 patients with advanced gastric cancer who received postoperative concurrent CRT were included. Pathological staging was IB-II in 9%, IIIA in 38%, IIIB in 33%, and IV in 21%. Radiotherapy consisted of 45 Gy of radiation. Concurrent chemotherapy consisted of a continuous intravenous infusion of 5-fluorouracil and leucovorin on the first 4 days and last 3 days of radiotherapy. The median follow-up period was 48 months (range, 3 to 83 months). The 5-year overall survival, disease-free survival, and locoregional recurrence-free survivals were 62%, 59%, and 80%, respectively. In the multivariate analysis, significant factors for disease-free survival were T stage (hazard ratio [HR], 0.278; p = 0.038), lymph node dissection extent (HR, 0.201; p = 0.002), and maintenance oral chemotherapy (HR, 2.964; p = 0.004). Locoregional recurrence and distant metastasis occurred in 5 (6%) and 18 (23%) patients, respectively. Mixed failure occurred in 10 (16%) patients. Grade 3 leukopenia and thrombocytopenia were observed in 4 (5%) and one (1%) patient, respectively. Grade 3 nausea and vomiting developed in 8 (10%) patients. Intestinal obstruction developed in one (1%). The survival outcome of the postoperative CRT in advanced gastric cancer was similar to those reported previously. Our postoperative CRT regimen seems to be a safe and effective method, reducing locoregional failure without severe treatment toxicity in advanced gastric cancer patients.

Postoperative pain

DEFF Research Database (Denmark)

Kehlet, H; Dahl, J B

1993-01-01

also modify various aspects of the surgical stress response, and nociceptive blockade by regional anesthetic techniques has been demonstrated to improve various parameters of postoperative outcome. It is therefore stressed that effective control of postoperative pain, combined with a high degree......Treatment of postoperative pain has not received sufficient attention by the surgical profession. Recent developments concerned with acute pain physiology and improved techniques for postoperative pain relief should result in more satisfactory treatment of postoperative pain. Such pain relief may...

Are the Early Postoperative Outcomes of Coronary Artery Bypass Grafting Surgery in Elderly Women Worse Compared to Men's?

Directory of Open Access Journals (Sweden)

Ahmet Yüksel

Full Text Available Abstract Objective: To investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older undergoing coronary artery bypass grafting surgery. Methods: Between October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender. The patients' medical records were collected, their baseline preoperative characteristics, operative data, and postoperative outcomes were retrospectively reviewed, and the effect of gender difference in the early postoperative outcomes was analyzed. Results: Group 1 (female patients and Group 2 (male patients consisted of 71 and 152 patients, respectively. Mean age of patients was 74.4±3.6 years (range: 70-84 years. The level of EuroSCORE I, the incidence of hypertension and hyperlipidemia were significantly higher in Group 1, while the rate of smoking was significantly higher in Group 2. Mean postoperative intubation time, length of intensive care unit and hospital stay were longer in female patients than in male patients, but these differences were not statistically significant. No statistically significant difference between two groups in terms of the transfusion of blood products was observed. The rates of in-hospital mortality and major postoperative complications were statistically similar between the two groups. Conclusion: In conclusion, the female gender was not associated with worse early postoperative outcomes in elderly patients undergoing coronary artery bypass grafting surgery.

Partial Cutting of Sternothyroid Muscle during Total Thyroidectomy: Impact on Postoperative Vocal Outcomes

Directory of Open Access Journals (Sweden)

Hyoung Shin Lee

2013-01-01

Full Text Available Background. Cutting the sternothyroid (ST muscle is a useful technique to expose the superior pole of thyroid gland during thyroidectomy. In this study, we evaluated the impact of partial cutting of the ST muscle on postoperative vocal outcomes after total thyroidectomy. Methods. A retrospective review of 57 patients who underwent total thyroidectomy with central neck dissection for micropapillary thyroid carcinoma was conducted. Group A (n=26 included those without cutting the ST muscle, while group B (n=31 included patients whose muscle was partially cut at the superior pole. All patients underwent voice analysis before the operation and 2 weeks and 1 month after the surgery, and the outcomes were compared between the two groups. Results. There were no differences between the two groups regarding the outcomes at each time of voice analysis. Group A showed a decrease of maximum frequency 2 weeks after surgery but showed no difference after 1 month. Group B showed a mild decrease in maximum frequency 2 weeks after surgery, but the difference was not significant. Conclusion. Partial cutting of ST muscle during thyroidectomy is useful to expose the superior pole without significant negative impact on postoperative outcomes of vocal analysis.

A General Legislative Analysis of "Torture" as a Human Rights Violation in Zimbabwe

Directory of Open Access Journals (Sweden)

Howard Chitimira

2017-06-01

Full Text Available Several challenges involving torture-related human rights violations have been reported in Zimbabwe from the late 1970s to date. Notably, these torture-related human rights violations were problematic during the liberation war era in Zimbabwe. Regrettably, such violations are allegedly still prevalent, especially prior to and/or during general political elections in Zimbabwe. Accordingly, this article investigates torture as a human rights violation in Zimbabwe, inter alia by focusing on the role of selected law enforcement agencies in the protection of human rights in Zimbabwe. The article also discusses the legal position on torture and the perpetration of torture against ordinary people prior to as well as after independence in Zimbabwe. This is done to investigate the adequacy of the legal framework in Zimbabwe with regard to the combatting of torture. In relation to this, selected regional and international legal frameworks against torture are briefly discussed in order to determine possible measures that could be utilised in Zimbabwe. The authors submit that although the Constitution of Zimbabwe Amendment (No 20 Act, 2013 (Zimbabwe Constitution, 2013 prohibits torture, more may still need to be done to enhance the combatting of torture in Zimbabwe. For instance, apart from the prohibition contained in the Zimbabwe Constitution, 2013, there is no legislation that expressly outlaws torture in Zimbabwe. Moreover, Zimbabwe has not ratified the United Nations (UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment of 1984 (UN Convention against Torture to date. Lastly, concluding remarks and possible recommendations that could be employed to discourage torture-related human rights abuses in Zimbabwe are provided.

Effectiveness of massage therapy on post-operative outcomes among patients undergoing cardiac surgery: A systematic review

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C. Ramesh

2015-09-01

Full Text Available The incidence and prevalence of cardiovascular disease (CVD are increasing rapidly in developing countries. Most patients with CVD do not respond to medical treatment and have to undergo cardiac surgery. This highly stressful experience results in increased levels of anxiety for patients. The objective of this review was to evaluate the efficacy of massage therapy on postoperative outcomes among patients undergoing cardiac surgery. A comprehensive literature search was made on PubMed-Medline, CINAHL, Science Direct, Scopus, Web of Science and the Cochrane library databases for original research articles published between 2000 and 2015. Original articles that reported the efficacy of massage therapy in patients undergoing cardiac surgery were included. The Cochrane data extraction form was used to extract data. A total of 297 studies were identified in the literature search. However, only seven studies were eligible for analysis. Of the seven studies, six studies demonstrated the effects of massage therapy on improving post-operative outcomes of patients, while one study found no evidence of improvement. Although the methods varied considerably, most of the studies included in this review reported positive results. Therefore, there is some evidence that massage therapy can lead to positive postoperative outcomes. Evidence of the effectiveness of massage therapy in patients undergoing cardiac surgery remains inconclusive. Additional research is needed to provide a strong evidence base for the use of massage therapy to improve post-operative outcomes and recovery among cardiac surgery patients

Outcome and quality of life in patients with postoperative delirium during an ICU stay following major surgery.

Science.gov (United States)

Abelha, Fernando J; Luís, Clara; Veiga, Dalila; Parente, Daniela; Fernandes, Vera; Santos, Patrícia; Botelho, Miguela; Santos, Alice; Santos, Cristina

2013-10-29

Delirium is an acute disturbance of consciousness and cognition that has been shown to be associated with poor outcomes, including increased mortality. We aimed to evaluate outcome after postoperative delirium in a cohort of surgical intensive care unit (SICU) patients. This prospective study was conducted over a 10-month period in a SICU. Postoperative delirium was diagnosed in accordance with the Intensive Care Delirium Screening Checklist (ICDSC). The primary outcome was mortality at 6-month follow-up. Hospital mortality and becoming dependent were considered as secondary outcomes, on the basis of the evaluation of the patient's ability to undertake both personal and instrumental activities of daily living (ADL) before surgery and 6 months after discharge from the SICU. For each dichotomous outcome - hospital mortality, mortality at 6-month follow-up, and becoming dependent - a separate multiple logistic regression analysis was performed, which included delirium as an independent variable. Another outcome analyzed was changes in health-related quality of life, as determined using short-form 36 (SF-36), which was administered before and 6 months after discharge from the SICU. Additionally, for each SF-36 domain, a separate multiple linear regression model was used for each SF-36 domain, with changes in the SF-36 domain as a dependent variable and delirium as an independent variable. Of 775 SICU-admitted adults, 562 were enrolled in the study, of which 89 (16%) experienced postoperative delirium. Delirium was an independent risk factor for mortality at the 6-month follow-up (OR = 2.562, P <0.001) and also for hospital mortality (OR = 2.673, P <0.001). Delirium was also an independent risk factor for becoming dependent for personal ADL (P-ADL) after SICU discharge (OR = 2.188, P <0.046). Moreover, patients who experienced postoperative delirium showed a greater decline in SF-36 domains after discharge, particularly in physical function, vitality, and

Child Sexual Abuse in Zimbabwe.

Science.gov (United States)

Mantula, Fennie; Saloojee, Haroon

2016-01-01

Although child sexual abuse is a significant public health problem globally, its incidence, prevention, and management is less well described in resource-poor settings. In poorer settings prevention initiatives assume even more importance since resources for managing abused children are severely limited. This article examines the current status of policy and practice related to the prevention of child sexual abuse in Zimbabwe. It identifies implementation challenges and highlights opportunities that could be embraced to reduce CSA in Zimbabwe, based on evidence synthesized from recent work. Although Zimbabwe has a well-established legal and regulatory framework to protect children from child sexual abuse, implementation of existing policies is weak. Financial, human, and material resource constraints are frequently cited to explain limited prevention activity. Effective strategies for the prevention of child sexual abuse should focus on implementing existing legislation, targeting schoolchildren, and getting community involvement. A dedicated budget would help entrench these strategies, but gains can be achieved even in the absence of this.

What transitional justice in Zimbabwe? Women of Zimbabwe Arise ...

African Journals Online (AJOL)

Originally from Canada, she married a Zimbabwean nationalist in exile in Zambia and ... been frequently subject to abuse by the police, including being beaten, arrested, incarcerated ... 'peace' and 'reconciliation' in the new Zimbabwe. ... the banking system, agricultural production, industry and mining, and even retailing, in ...

Surges and ebbs: National politics and international influence in the formulation and implementation of IWRM in Zimbabwe

Directory of Open Access Journals (Sweden)

Emmanuel Manzungu

2016-10-01

Full Text Available In the 1990s, the Government of Zimbabwe undertook water reforms to redress racially defined inequitable access to agricultural water. This paper analyses how a water reform process, seemingly informed by a clear political economy objective, was hijacked by efforts directed at implementing Integrated Water Resources Management (IWRM. It uses the notion of policy articulation to analyse why and how IWRM 'travelled' to and in Zimbabwe and with what outcomes. The paper shows that attempts at introducing and implementing IWRM in Zimbabwe have had a chequered history. The efforts of Zimbabwe in pioneering implementation of IWRM in southern Africa, have subsequently waned, and prospects for resurrecting IWRM in its original form are low. Introduced in the 1990s when Western donors jumped on the bandwagon of the liberal economic agenda inspired by the IMF/World Bank, it declined between 2000 and 2009 due to a combination of poor economic performance, national-level politics and international isolation. In 2011 IWRM was reintroduced as the country re-engaged with the international community. The re-emergence of IWRM, however, seems to be largely rhetorical as the focus is now on fixing a crisis-ridden water sector, with a new political dispensation adding another layer of complexity. The paper concludes that the development of IWRM in Zimbabwe mirrors broader national-level socio-political processes and their complex relationship with the international community.

Electoral Politics in Zimbabwe: Authoritarianism Versus the People

African Journals Online (AJOL)

sulaiman.adebowale

2006-08-31

Aug 31, 2006 ... ZANU-PF party. Human rights groups in Zimbabwe report that the majority of .... both the Zimbabwe Constitution and the Electoral Act (1990) have been ... The political environment did not accord the eligible voters their basic.

Frailty and postoperative outcomes in patients undergoing surgery for degenerative spine disease.

Science.gov (United States)

Flexman, Alana M; Charest-Morin, Raphaële; Stobart, Liam; Street, John; Ryerson, Christopher J

2016-11-01

Frailty is defined as a state of decreased reserve and susceptibility to stressors. The relationship between frailty and postoperative outcomes after degenerative spine surgery has not been studied. This study aimed to (1) determine prevalence of frailty in the degenerative spine population; (2) describe patient characteristics associated with frailty; and (3) determine the association between frailty and postoperative complications, mortality, length of stay, and discharge disposition. This is a retrospective analysis on a prospectively collected cohort from the National Surgical Quality Improvement Program (NSQIP). A total of 53,080 patients who underwent degenerative spine surgery between 2006 and 2012 were included in the study. A modified frailty index (mFI) with 11 variables derived from the NSQIP dataset was used to determine prevalence of frailty and its correlation with a composite outcome of perioperative complications as well as hospital length of stay, mortality, and discharge disposition. After calculating the mFI for each patient, the prevalence and predictors of frailty were determined for our cohort. The association of frailty with postoperative outcomes was determined after adjusting for known and suspected confounders using multivariate logistic regression. Frailty was present in 2,041 patients within the total population (4%) and in 8% of patients older than 65 years. Frailty severity increased with increasing age, male sex, African American race, higher body mass index, recent weight loss, paraplegia or quadriplegia, American Society of Anesthesiologists (ASA) score, and preadmission residence in a care facility. Frailty severity was an independent predictor of major complication (OR 1.15 for every 0.10 increase in mFI, 95%CI 1.09-1.21, pdegenerative spine surgery. Preoperative recognition of frailty may be useful for perioperative optimization, risk stratification, and patient counseling. Copyright © 2016 Elsevier Inc. All rights reserved.

Prevalence of Sarcopenia and Its Impact on Postoperative Outcome in Patients With Crohn's Disease Undergoing Bowel Resection.

Science.gov (United States)

Zhang, Tenghui; Cao, Lei; Cao, Tingzhi; Yang, Jianbo; Gong, Jianfeng; Zhu, Weiming; Li, Ning; Li, Jieshou

2017-05-01

Sarcopenia has been proposed to be a prognostic factor of outcomes for various diseases but has not been applied to Crohn's disease (CD). We aimed to assess the impact of sarcopenia on postoperative outcomes after bowel resection in patients with CD. Abdominal computed tomography images within 30 days before bowel resection in 114 patients with CD between May 2011 and March 2014 were assessed for sarcopenia as well as visceral fat areas and subcutaneous fat areas. The impact of sarcopenia on postoperative outcomes was evaluated using univariate and multivariate analyses. Of 114 patients, 70 (61.4%) had sarcopenia. Patients with sarcopenia had a lower body mass index, lower preoperative levels of serum albumin, and more major complications (15.7% vs 2.3%, P = .027) compared with patients without sarcopenia. Moreover, predictors of major postoperative complications were sarcopenia (odds ratio [OR], 9.24; P = .04) and a decreased skeletal muscle index (1.11; P = .023). Preoperative enteral nutrition (OR, 0.13; P = .004) and preoperative serum albumin level >35 g/L (0.19; P = .017) were protective factors in multivariate analyses. The prevalence of sarcopenia is high in patients with CD requiring bowel resection. It significantly increases the risk of major postoperative complications and has clinical implications with respect to nutrition management before surgery for CD.

Long-term outcomes following laparoscopic adjustable gastric banding: postoperative psychological sequelae predict outcome at 5-year follow-up.

Science.gov (United States)

Scholtz, Samantha; Bidlake, Louise; Morgan, John; Fiennes, Alberic; El-Etar, Ashraf; Lacey, John Hubert; McCluskey, Sara

2007-09-01

NICE guidelines state that patients with psychological contra-indications should not be considered for bariatric surgery, including Laparoscopic Adjustable Gastric Banding (LAGB) surgery as treatment of morbid obesity, although no consistent correlation between psychiatric illness and long-term outcome in LAGB has been established. This is to our knowledge the first study to evaluate long-term outcomes in LAGB for a full range of DSM-IV defined psychiatric and eating disorders, and forms part of a research portfolio developed by the authors aimed at defining psychological predictors of bariatric surgery in the short-, medium- and long-term. Case notes of 37 subjects operated on between April 1997 and June 2000, who had undergone structured clinical interview during pre-surgical assessment to yield diagnoses of mental and eating disorders according to DSM-IV criteria were analyzed according to a set of operationally defined criteria. Statistical analysis was carried out to compare those with a poor outcome and those considered to have a good outcome in terms of psychiatric profile. In this group of mainly female, Caucasian subjects, ranging in age from 27 to 60 years, one-third were diagnosed with a mental disorder according to DSM-IV criteria. The development of postoperative DSM-IV defined binge eating disorder (BED) or depression strongly predicted poor surgical outcome, but pre-surgical psychiatric factors alone did not. Although pre-surgical psychiatric assessment alone cannot predict outcome, an absence of preoperative psychiatric illness should not reassure surgeons who should be mindful of postoperative psychiatric sequelae, particularly BED. The importance of providing an integrated biopsychosocial model of care in bariatric teams is highlighted.

Overpopulation and unemployment in Zimbabwe.

Science.gov (United States)

Mufuka, K; Iverson, S

1996-02-01

The size of Zimbabwe's African population has grown dramatically over the past 50 years, with 5.7 children on average being born per woman. The following factors are responsible for the rapid population growth in Zimbabwe: the country's economic prosperity during the period of the Central African Federation from 1953 to 1963, and its successful food policy before and after independence; the success of the health system, also in both periods; and the fact that women have not been incorporated into the economy as wage-earners. A brief historical overview is presented, followed by sections on the food policy and health system, reasons for the persistence of large families, and the relationship between wage-earning by women and the birth rate. The author also describes some of the problems caused by overpopulation. Engaging more women in regular wage-earning employment is the key to controlling the birth rate in Zimbabwe. Current government policies encouraging female employment in government services and the economy in general, along with the expansion of contraceptive services, could influence female fertility over the long term.

Nutritional status and postoperative outcomes in patients with gastrointestinal cancer in Vietnam: a retrospective cohort study.

Science.gov (United States)

Loan, Bui Thi Hong; Nakahara, Shinji; Tho, Bui An; Dang, Tran Ngoc; Anh, Le Ngoc; Huy, Nguyen Do; Ichikawa, Masao

2018-04-01

Nutritional support for surgical care is crucial because hospital malnutrition is rather common. However, low- and middle-income countries have not adequately addressed nutritional management of surgical patients. To highlight need for nutritional management in surgical patients, the present study aimed to describe preoperative nutritional status in patients who underwent gastrointestinal cancer surgery in Vietnam and to investigate the relationship between preoperative malnutrition and adverse outcomes, such as postoperative complications and prolonged length of hospital stay. We reviewed medical records of patients who underwent a major curative surgery for gastrointestinal cancer at the national hospital in Ho Chi Minh City, Vietnam. We identified preoperative malnutrition based on body mass index and serum albumin level, and postoperative complications in the first 30 d postoperative. We estimated the relative influence of malnutrition on complications and length of hospital stay using multivariate regression models. Of 459 eligible patients, 63% had colorectal cancer, 33% gastric cancer, and 4% esophageal cancer. The prevalence of malnutrition was 19%. No patients died during hospitalization; however, 26% developed complications after surgery. The average length of hospital stay was 14 d. After controlling for potential confounders, preoperative malnutrition was associated with an increased risk of postoperative complications (odds ratio = 1.97) and prolonged hospital stay (2.8 d). Preoperative malnutrition affects surgical outcomes among patients with gastrointestinal cancer in Vietnam. We recommend implementing preoperative nutritional interventions to achieve better outcomes among surgical cancer patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Association Between Nutritional Status, Inflammatory Condition, and Prognostic Indexes with Postoperative Complications and Clinical Outcome of Patients with Gastrointestinal Neoplasia.

Science.gov (United States)

Costa, Milena Damasceno de Souza; Vieira de Melo, Camila Yandara Sousa; Amorim, Ana Carolina Ribeiro de; Cipriano Torres, Dilênia de Oliveira; Dos Santos, Ana Célia Oliveira

2016-10-01

The aim of this study is to describe and relate nutritional and inflammatory status and prognostic indexes with postoperative complications and clinical outcome of patients with gastrointestinal malignancies. Twenty-nine patients were evaluated; nutritional assessment was carried out by subjective and objective parameters; albumin, pre-albumin, C-reactive protein (CRP), and alpha-1-acid glycoprotein (AGP) were determined. To assess prognosis, the Glasgow scale, the Prognostic Inflammatory Nutritional Index (PINI), and CRP/albumin ratio were used; the clinical outcomes considered were hospital discharge and death. A high Subjective Global Assessment (SGA) score was associated with the occurrence of postoperative complications: 73% of the patients with postoperative complications had the highest SGA score, but only 6% of those without postoperative complications had the highest SGA score (P 1, and Glasgow score 2. There was a positive correlation between weight loss percentage with serum CRP levels (P = 0.002), CRP/albumin (P = 0.002), PINI (P = 0.002), and Glasgow score (P = 0.000). This study provides evidence that the assessment of the nutritional status and the use of prognostic indexes are good tools for predicting postoperative complications and clinical outcome in patients with gastrointestinal neoplasia.

Outcomes and xerostomia after postoperative radiotherapy for oral and oropharyngeal carcinoma.

Science.gov (United States)

Wang, Zhong-He; Yan, Chao; Zhang, Zhi-Yuan; Zhang, Chen-Ping; Hu, Hai-Sheng; Tu, Wen-Yong; Kirwan, Jessica; Mendenhall, William M

2014-10-01

We compared outcomes and xerostomia grade after postoperative intensity-modulated radiation therapy (IMRT) and conventional radiotherapy (RT) in patients with oral and oropharyngeal carcinoma. Eighty-eight patients with oral cavity (n = 77) and oropharyngeal (n = 11) carcinoma underwent postoperative IMRT (n = 44) or conventional RT (n = 44). Outcomes, failure patterns, volume, doses, salivary gland V30, and xerostomia grade were evaluated. The median follow-up was 53 months (range, 48-58 months). The median interval from surgery to RT was 4 weeks (range, 3-6 weeks). Twenty-one patients (7 and 14 for the IMRT and conventional RT groups, respectively) experienced local-regional failure. For the IMRT group, all 7 local-regional failures occurred in the high-dose target volumes. For the conventional RT group, there were 12 in-field failures, 1 at the margin, and 1 out-of-field. Nine patients experienced distant failure (5 and 4 for the IMRT and conventional RT groups, respectively). The 4-year local-regional control, disease-free survival (DFS), overall survival (OS), and distant-metastasis rates for the IMRT and conventional RT groups were 84.1% versus 68.2% (p = .055), 68.2% versus 52.3% (p = .091), 70.5% versus 56.8% (p = .124), and 11.4% versus 9.1% (p = .927), respectively. Xerostomia grade after RT was lower for IMRT compared to conventional RT (p xerostomia grade when compared to conventional RT. The predominant failure pattern was local. No differences were found in survival outcomes between both groups. There was a marginal difference in local-regional control. © 2014 Wiley Periodicals, Inc.

Cholera in Zimbabwe

NARCIS (Netherlands)

Pruyt, E.

2009-01-01

By the end of December 2008, alarming reports and articles concerning the cholera outbreak in Zimbabwe received plenty of international media coverage. By that time nearly 30000 cases of cholera infections and 1600 cholera deaths had been reported. In the first week of January 2009, a System

Early and late postoperative seizure outcome in 97 patients with supratentorial meningioma and preoperative seizures: a retrospective study.

Science.gov (United States)

Zheng, Zhe; Chen, Peng; Fu, Weiming; Zhu, Junming; Zhang, Hong; Shi, Jian; Zhang, Jianmin

2013-08-01

We identified factors associated with early and late postoperative seizure control in patients with supratentorial meningioma plus preoperative seizures. In this retrospective study, univariate analysis and multivariate logistic regression analysis compared 24 clinical variables according to the occurrence of early (≤1 week) or late (>1 week) postoperative seizures. Sixty-two of 97 patients (63.9 %) were seizure free for the entire postoperative follow-up period (29.5 ± 11.8 months), while 13 patients (13.4 %) still had frequent seizures at the end of follow-up. Fourteen of 97 patients (14.4 %) experienced early postoperative seizures, and emergence of new postoperative neurological deficits was the only significant risk factor (odds ratio = 7.377). Thirty-three patients (34.0 %) experienced late postoperative seizures at some time during follow-up, including 12 of 14 patients with early postoperative seizures. Associated risk factors for late postoperative seizures included tumor progression (odds ratio = 7.012) and new permanent postoperative neurological deficits (odds ratio = 4.327). Occurrence of postoperative seizures in patients with supratentorial meningioma and preoperative seizure was associated with new postoperative neurological deficits. Reduced cerebral or vascular injury during surgery may lead to fewer postoperative neurological deficits and better seizure outcome.

Predictors of postoperative outcomes of cubital tunnel syndrome treatments using multiple logistic regression analysis.

Science.gov (United States)

Suzuki, Taku; Iwamoto, Takuji; Shizu, Kanae; Suzuki, Katsuji; Yamada, Harumoto; Sato, Kazuki

2017-05-01

This retrospective study was designed to investigate prognostic factors for postoperative outcomes for cubital tunnel syndrome (CubTS) using multiple logistic regression analysis with a large number of patients. Eighty-three patients with CubTS who underwent surgeries were enrolled. The following potential prognostic factors for disease severity were selected according to previous reports: sex, age, type of surgery, disease duration, body mass index, cervical lesion, presence of diabetes mellitus, Workers' Compensation status, preoperative severity, and preoperative electrodiagnostic testing. Postoperative severity of disease was assessed 2 years after surgery by Messina's criteria which is an outcome measure specifically for CubTS. Bivariate analysis was performed to select candidate prognostic factors for multiple linear regression analyses. Multiple logistic regression analysis was conducted to identify the association between postoperative severity and selected prognostic factors. Both bivariate and multiple linear regression analysis revealed only preoperative severity as an independent risk factor for poor prognosis, while other factors did not show any significant association. Although conflicting results exist regarding prognosis of CubTS, this study supports evidence from previous studies and concludes early surgical intervention portends the most favorable prognosis. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Postoperative adverse outcomes in intellectually disabled surgical patients: a nationwide population-based study.

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Jui-An Lin

Full Text Available BACKGROUND: Intellectually disabled patients have various comorbidities, but their risks of adverse surgical outcomes have not been examined. This study assesses pre-existing comorbidities, adjusted risks of postoperative major morbidities and mortality in intellectually disabled surgical patients. METHODS: A nationwide population-based study was conducted in patients who underwent inpatient major surgery in Taiwan between 2004 and 2007. Four controls for each patient were randomly selected from the National Health Insurance Research Database. Preoperative major comorbidities, postoperative major complications and 30-day in-hospital mortality were compared between patients with and without intellectual disability. Use of medical services also was analyzed. Adjusted odds ratios using multivariate logistic regression analyses with 95% confidence intervals were applied to verify intellectual disability's impact. RESULTS: Controls were compared with 3983 surgical patients with intellectual disability. Risks for postoperative major complications were increased in patients with intellectual disability, including acute renal failure (odds ratio 3.81, 95% confidence interval 2.28 to 6.37, pneumonia (odds ratio 2.01, 1.61 to 2.49, postoperative bleeding (odds ratio 1.35, 1.09 to 1.68 and septicemia (odds ratio 2.43, 1.85 to 3.21 without significant differences in overall mortality. Disability severity was positively correlated with postoperative septicemia risk. Medical service use was also significantly higher in surgical patients with intellectual disability. CONCLUSION: Intellectual disability significantly increases the risk of overall major complications after major surgery. Our findings show a need for integrated and revised protocols for postoperative management to improve care for intellectually disabled surgical patients.

The effect of pre-operative optimization on post-operative outcome in Crohn's disease resections

DEFF Research Database (Denmark)

El-Hussuna, Alaa; Iesalnieks, Igors; Horesh, Nir

2017-01-01

BACKGROUND: The timing of surgical intervention in Crohn's disease (CD) may depend on pre-operative optimization (PO) which includes different interventions to decrease the risk for unfavourable post-operative outcome. The objective of this study was to investigate the effect of multi-model PO on...

"Worse than dogs and pigs?" Attitudes toward homosexual practice in Zimbabwe.

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Shoko, Tabona

2010-01-01

Politicians call them the "festering finger," endangering the body of the nation; churchmen say God wants them dead; the courts send them to jail. Zimbabwe has declared that it will not tolerate homosexuality. Gays and lesbians feel persecuted and their rights are undermined. The controversy that was ignited in 1997 when the Zimbabwean government forced the closure of a fair booth by Gays and Lesbians of Zimbabwe at the Zimbabwe International Book Fair continues to echo. At issue are fundamental questions of the scope of human rights protection in Zimbabwe and other African countries (BBC News, 1998). Such issues have sparked endless debates on homosexuality in religion, politics, and other forums. This article seeks to explore the attitudes of both traditional Shona culture and Christian sectors in Zimbabwe. The goal is to find out if the practice is rooted in Shona tradition or if it can be seen as a new phenomenon emanating from Western political and Judeo-Christian influences on Zimbabwe. The article argues that the Zimbabwean attitudes toward homosexuality combine Christian and traditional morality. Finally, the article will discuss how Christian churches and traditional Shona culture come to terms with homosexual practice today.

The Impact of Obesity on Postoperative Outcomes in Adults with Congenital Heart Disease Undergoing Pulmonary Valve Replacement.

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Buelow, Matthew W; Earing, Michael G; Hill, Garick D; Cohen, Scott B; Bartz, Peter J; Tweddell, James S; Ginde, Salil

2015-01-01

The impact of obesity on surgical morbidity in adults with congenital heart disease is currently unknown. The aim of our study was to investigate the impact of obesity on postoperative outcomes in adults with congenital heart disease undergoing reoperation for pulmonary valve replacement. A retrospective analysis was performed assessing the influence of obesity on surgical outcomes. Obesity was defined as a body mass index ≥30 kg/m2. The mean body mass index of the cohort was 25.9 ± 6.9 kg/m2 . The cohort included 71 patients with 17 patients (24%) being obese. There was no postoperative mortality. Obese patients had a longer hospital length of stay (6.6 vs. 4.7 days; P obesity was independently associated with hospital length of stay >5 days (odds ratio [OR] = 5.2; 95% confidence interval [CI]: 1.5-18.2, P = .01) and with increased postoperative arrhythmias (OR = 4.2; 95% CI: 1.7-40, P Obesity is associated with increased morbidity in adults with congenital heart disease undergoing pulmonary valve replacement, including longer hospitalization and higher risk for postoperative arrhythmias. © 2015 Wiley Periodicals, Inc.

Zimbabwe Journal of Educational Research - Vol 30, No 1 (2018)

African Journals Online (AJOL)

Zimbabwe Journal of Educational Research. ... A Requiem Too Soon or a Landing Strand Too Far? ... and Mathematics (STEM) Education in Zimbabwe Secondary Schools: Access, Quality, Policy · EMAIL FULL TEXT EMAIL FULL TEXT

African Journals Online: Zimbabwe

African Journals Online (AJOL)

Items 1 - 12 of 12 ... SAFERE: Southern African Feminist Review. SAFERE provides women with a writing platform which is feminist in content and ... The Zimbabwe Journal of Educational Research comprised of four sections: Scholarly articles ...

An evaluation of intraoperative and postoperative outcomes of torsional mode versus longitudinal ultrasound mode phacoemulsification: a Meta-analysis

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Pia Leon

2016-06-01

Full Text Available AIM: To evaluate and compare the intraoperative parameters and postoperative outcomes of torsional mode and longitudinal mode of phacoemulsification. METHODS: Pertinent studies were identified by a computerized MEDLINE search from January 2002 to September 2013. The Meta-analysis is composed of two parts. In the first part the intraoperative parameters were considered: ultrasound time (UST and cumulative dissipated energy (CDE. The intraoperative values were also distinctly considered for two categories (moderate and hard cataract group depending on the nuclear opacity grade. In the second part of the study the postoperative outcomes as the best corrected visual acuity (BCVA and the endothelial cell loss (ECL were taken in consideration. RESULTS: The UST and CDE values proved statistically significant in support of torsional mode for both moderate and hard cataract group. The analysis of BCVA did not present statistically significant difference between the two surgical modalities. The ECL count was statistically significant in support of torsional mode (P<0.001. CONCLUSION: The Meta-analysis shows the superiority of the torsional mode for intraoperative parameters (UST, CDE and postoperative ECL outcomes.

An evaluation of intraoperative and postoperative outcomes of torsional mode versus longitudinal ultrasound mode phacoemulsification: a Meta-analysis.

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Leon, Pia; Umari, Ingrid; Mangogna, Alessandro; Zanei, Andrea; Tognetto, Daniele

2016-01-01

To evaluate and compare the intraoperative parameters and postoperative outcomes of torsional mode and longitudinal mode of phacoemulsification. Pertinent studies were identified by a computerized MEDLINE search from January 2002 to September 2013. The Meta-analysis is composed of two parts. In the first part the intraoperative parameters were considered: ultrasound time (UST) and cumulative dissipated energy (CDE). The intraoperative values were also distinctly considered for two categories (moderate and hard cataract group) depending on the nuclear opacity grade. In the second part of the study the postoperative outcomes as the best corrected visual acuity (BCVA) and the endothelial cell loss (ECL) were taken in consideration. The UST and CDE values proved statistically significant in support of torsional mode for both moderate and hard cataract group. The analysis of BCVA did not present statistically significant difference between the two surgical modalities. The ECL count was statistically significant in support of torsional mode (P<0.001). The Meta-analysis shows the superiority of the torsional mode for intraoperative parameters (UST, CDE) and postoperative ECL outcomes.

Patient-reported allergies predict postoperative outcomes and psychosomatic markers following spine surgery.

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Xiong, David D; Ye, Wenda; Xiao, Roy; Miller, Jacob A; Mroz, Thomas E; Steinmetz, Michael P; Nagel, Sean J; Machado, Andre G

2018-05-22

Prior studies have shown that patient-reported allergies can be prognostic of poorer postoperative outcomes. To investigate the correlation between self-reported allergies and outcomes after cervical or lumbar spine surgery. Retrospective cohort study at a single tertiary-care institution. All patients undergoing cervical or lumbar spine surgery from 2009-2014. The primary outcome measure was change in the EuroQol-5 Dimensions (EQ-5D) following surgery. Secondary outcomes included change in the Pain Disability Questionnaire (PDQ) and Patient Health Questionnaire-9 (PHQ-9), achieving the minimal clinically important difference (MCID) in these measures, as well as cost of admission. Prior to and following surgery, EQ-5D, PDQ, and PHQ-9 were recorded for patients with available data. Paired student's t-tests were used to compare change in these measures following surgery. Multivariable linear and logistic regression were used to assess the relationship between the log transformation of the total number of allergies and outcomes. 592 cervical patients and 4,465 lumbar patients were included. The median number of reported allergies was two. The EQ-5D index increased from 0.539 to 0.703 for cervical patients and from 0.530 to 0.676 for lumbar patients (pallergies predicted significantly higher odds of achieving the PDQ MCID (OR = 2.09, 95% CI 1.05-4.15, p=0.02 for cervical patients; OR = 1.30, 95% CI 1.03-1.68, p=0.03 for lumbar patients). However, this relationship was not durable for patients with follow-up exceeding 1 year. The log transformation of number of allergies for lumbar patients predicted significantly increased cost of admission (β=$3,597, pallergies correlate with subjective improvement in pain and disability following spine surgery and may serve as a marker of postoperative outcomes. The relationship between allergies and PDQ improvement may be secondary to the short-term expectation-actuality discrepancy, as this relationship was not durable beyond 1

The impact of frailty and sarcopenia on postoperative outcomes in older patients undergoing gastrectomy surgery: a systematic review and meta-analysis.

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Shen, Yanjiao; Hao, Qiukui; Zhou, Jianghua; Dong, Birong

2017-08-21

Gastric cancer is a major health problem, and frailty and sarcopenia will affect the postoperative outcomes in older people. However, there is still no systematic review to determine the role of frailty and sarcopenia in predicting postoperative outcomes among older patients with gastric cancer who undergo gastrectomy surgery. We searched Embase, Medline through the Ovid interface and PubMed websites to identify potential studies. All the search strategies were run on August 24, 2016. We searched the Google website for unpublished studies on June 1, 2017. The data related to the endpoints of gastrectomy surgery were extracted. Odds ratios (ORs) and their 95% confidence intervals (CIs) were pooled to estimate the association between sarcopenia and adverse postoperative outcomes by using Stata version 11.0. PRISMA guidelines for systematic reviews were followed. After screening 500 records, we identified eight studies, including three prospective cohort studies and five retrospective cohort studies. Only one study described frailty, and the remaining seven studies described sarcopenia. Frailty was statistically significant for predicting hospital mortality (OR 3.96; 95% CI: 1.12-14.09, P = 0.03). Sarcopenia was also associated with postoperative outcomes (pooled OR 3.12; 95% CI: 2.23-4.37). No significant heterogeneity was observed across these pooled studies (Chi 2  = 3.10, I 2  = 0%, P = 0.685). Sarcopenia and frailty seem to have significant adverse impacts on the occurrence of postoperative outcomes. Well-designed prospective cohort studies focusing on frailty and quality of life with a sufficient sample are needed.

Impact of podiatry resident experience level in hallux valgus surgery on postoperative outcomes.

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Fleischer, Adam E; Yorath, Martin C; Joseph, Robert M; Baron, Adam; Nordquist, Thomas; Moore, Braden J; Robinson, Richmond C O; Reilly, Charles H

2014-06-15

Despite modern advancements in transosseous fixation and operative technique, hallux valgus (i.e., bunion) surgery is still associated with a higher than usual amount of patient dissatisfaction and is generally recognized as a complex and nuanced procedure requiring precise osseous and capsulotendon balancing. It stands to reason then that familiarity and skill level of trainee surgeons might impact surgical outcomes in this surgery. The aim of this study was to determine whether podiatry resident experience level influences midterm outcomes in hallux valgus surgery (HVS). Consecutive adults who underwent isolated HVS via distal metatarsal osteotomy at a single US metropolitan teaching hospital from January 2004 to January 2009 were contacted and asked to complete a validated outcome measure of foot health (Manchester-Oxford Foot Questionnaire) regarding their operated foot. Resident experience level was quantified using the surgical logs for the primary resident of record at the time of each case. Associations were assessed using linear and logistic regression analyses. A total of 102 adult patients (n = 102 feet) agreed to participate with a mean age of 46.8 years (standard deviation 13.1, range 18-71) and average length of follow-up 6.2 y (standard deviation 1.4, range 3.6-8.6). Level of trainee experience was not associated with postoperative outcomes in either the univariate (odds ratio 0.99 [95% confidence interval, 0.98-1.01], P = 0.827) or multivariate analyses (odds ratio 1.00 [95% confidence interval, 0.97-1.02], P = 0.907). We conclude that podiatry resident level of experience in HVS does not contribute appreciably to postoperative clinical outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

Impact of Podiatry Resident Experience Level in Hallux Valgus Surgery on Postoperative Outcomes

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Fleischer, Adam E.; Yorath, Martin C.; Joseph, Robert; Baron, Adam; Nordquist, Thomas; Moore, Braden; Robinson, Richmond; Reilly, Charles

2018-01-01

Background Despite modern advancements in transosseous fixation and operative technique, hallux valgus (i.e., bunion) surgery is still associated with a higher than usual amount of patient dissatisfaction, and is generally recognized as a complex and nuanced procedure requiring precise osseous and capsulotendon balancing. It stands to reason then that familiarity and skill level of trainee surgeons might impact surgical outcomes in this surgery. The aim of this study was to determine whether podiatry resident experience level influences mid-term outcomes in hallux valgus surgery. Methods Consecutive adults who underwent isolated hallux valgus surgery via distal metatarsal osteotomy at a single US metropolitan teaching hospital from January 2004 to January 2009 were contacted and asked to complete a validated outcome measure of foot health (Manchester-Oxford Foot Questionnaire) regarding their operated foot. Resident experience level was quantified using the surgical logs for the primary resident of record at the time of each case. Associations were assessed using simple, multiple and logistic regression analyses. Results A total of 102 adult patients (n=102 feet) agreed to participate with a mean age of 46.8 (SD 13.1 years, range 18-71) and average length of follow-up 6.2 years (SD 1.4, range 3.6-8.6). Level of trainee experience was not associated with postoperative outcomes in either the univariate (odds ratio 0.99 [95% CI 0.98-1.01], p = 0.827) or multivariate analyses (odds ratio 1.00 [95% CI 0.97-1.02], p = 0.907). Conclusions We conclude that podiatry resident level of experience in hallux valgus surgery does not contribute appreciably to postoperative clinical outcomes. PMID:24726058

Preoperative Cognitive Impairment As a Predictor of Postoperative Outcomes in a Collaborative Care Model.

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Zietlow, Kahli; McDonald, Shelley R; Sloane, Richard; Browndyke, Jeffrey; Lagoo-Deenadayalan, Sandhya; Heflin, Mitchell T

2018-03-01

To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. Retrospective analysis of individuals enrolled in a quality improvement program. Tertiary academic center. Older adults undergoing surgery and referred to POSH (N = 157). Cognitive impairment was defined as a score less than 25 out of 30 (adjusted for education) on the St. Louis University Mental Status (SLUMS) Examination. Median length of stay (LOS), mean number of postoperative complications, rates of postoperative delirium (POD, %), 30-day readmissions (%), and discharge to home (%) were compared using bivariate analysis. Seventy percent of participants met criteria for cognitive impairment (mean SLUMS score 20.3 for those with cognitive impairment and 27.7 for those without). Participants with and without cognitive impairment did not significantly differ in demographic characteristics, number of medications (including anticholinergics and benzodiazepines), or burden of comorbidities. Participants with and without cognitive impairment had similar LOS (P = .99), cumulative number of complications (P = .70), and 30-day readmission (P = .20). POD was more common in those with cognitive impairment (31% vs 24%), but the difference was not significant (P = .34). Participants without cognitive impairment had higher rates of discharge to home (80.4% vs 65.1%, P = .05). Older adults with and without cognitive impairment referred to the POSH program fared similarly on most postoperative outcomes. Individuals with cognitive impairment may benefit from perioperative geriatric comanagement. Questions remain regarding the validity of available measures of cognition in the preoperative period. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Operative treatment of spontaneous spinal epidural hematomas : a study of the factors determining postoperative outcome

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Groen, R J; van Alphen, H A

OBJECTIVE: We clarify the factors affecting postoperative outcomes in patients who have suffered spontaneous spinal epidural hematomas. METHODS: We review 330 cases of spontaneous spinal epidural hematomas from the international literature and three unpublished cases of our own. Attention was

“Jambanja”: Moral Paralysis and Postcolonial Politics in Zimbabwe ...

African Journals Online (AJOL)

This work focuses on the normative dimension of politics in Zimbabwe over the last decade and draws special interest to the post March 2008 historic harmonised elections, that is, the presidential runoff between president Robert Mugabe of the Zimbabwe African National Union Patriotic Front( ZANU PF) and winner of the ...

The Influence of Preoperative and Postoperative Psychological Symptoms on Clinical Outcome after Shoulder Surgery: A Prospective Longitudinal Cohort Study.

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Koorevaar, Rinco C T; van 't Riet, Esther; Gerritsen, Marleen J J; Madden, Kim; Bulstra, Sjoerd K

2016-01-01

Psychological symptoms are highly prevalent in patients with shoulder complaints. Psychological symptoms in patients with shoulder complaints might play a role in the aetiology, perceived disability and pain and clinical outcome of treatment. The aim of this study was to assess whether preoperative symptoms of distress, depression, anxiety and somatisation were associated with a change in function after shoulder surgery and postoperative patient perceived improvement of pain and function. In addition, the change of psychological symptoms after shoulder surgery was analyzed and the influence of postoperative symptoms of psychological disorders after surgery on the change in function after shoulder surgery and perceived postoperative improvement of pain and function. A prospective longitudinal cohort study was performed in a general teaching hospital. 315 consecutive patients planned for elective shoulder surgery were included. Outcome measures included change of Disabilities of the Arm, Shoulder and Hand (DASH) score and anchor questions about improvement in pain and function after surgery. Psychological symptoms were identified before and 12 months after surgery with the validated Four-Dimensional Symptom Questionnaire (4DSQ). Psychological symptoms were encountered in all the various shoulder diagnoses. Preoperative symptoms of psychological disorders persisted after surgery in 56% of patients, 10% of patients with no symptoms of psychological disorders before surgery developed new psychological symptoms. Preoperative symptoms of psychological disorders were not associated with the change of DASH score and perceived improvement of pain and function after shoulder surgery. Patients with symptoms of psychological disorders after surgery were less likely to improve on the DASH score. Postoperative symptoms of distress and depression were associated with worse perceived improvement of pain. Postoperative symptoms of distress, depression and somatisation were

Postoperative Haematocrit and Outcome in Critically Ill Surgical Patients.

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Lopes, Ana Martins; Silva, Diana; Sousa, Gabriela; Silva, Joana; Santos, Alice; Abelha, Fernando José

2017-08-31

Haematocrit has been studied as an outcome predictor. The aim of this study was to evaluate the correlation between low haematocrit at surgical intensive care unit admission and high disease scoring system score and early outcomes. This retrospective study included 4398 patients admitted to the surgical intensive care unit between January 2006 and July 2013. Acute physiology and chronic health evaluation and simplified acute physiology score II values were calculated and all variables entered as parameters were evaluated independently. Patients were classified as haematocrit if they had a haematocrit < 30% at surgical intensive care unit admission. The correlation between admission haematocrit and outcome was evaluated by univariate analysis and linear regression. A total of 1126 (25.6%) patients had haematocrit. These patients had higher rates of major cardiac events (4% vs 1.9%, p < 0.001), acute renal failure (11.5% vs 4.7%, p < 0.001), and mortality during surgical intensive care unit stay (3% vs 0.8%, p < 0.001) and hospital stay (12% vs 5.9%, p < 0.001). A haematocrit level < 30% at surgical intensive care unit admission was frequent and appears to be a predictor for poorer outcome in critical surgical patients. Patients with haematocrit had longer surgical intensive care unit and hospital stay lengths, more postoperative complications, and higher surgical intensive care unit and hospital mortality rates.

Relation of osteoprotegerin in severe aortic valve stenosis to postoperative outcome and left ventricular function

DEFF Research Database (Denmark)

Dahl, Jordi S; Videbæk, Lars; Poulsen, Mikael K

2013-01-01

Osteoprotegerin (OPG) is a member of the tumor necrosis factor receptor superfamily and is known to be among the mediators of the calcification process that has been shown to increase in patients with aortic stenosis (AS). The aim of this study was to characterize the association of OPG with left......, 41 patients died of a presumed cardiovascular cause or remained in New York Heart Association functional class III or IV. The risk of a poor postoperative outcome after AVR increased with increasing OPG tertiles (15% vs 33% vs 51%, p = 0.002). In a multivariate model containing age, ejection fraction......, N-terminal pro-brain natriuretic peptide and left atrial volume index, OPG was still significantly associated with postoperative outcome. In addition, OPG levels associated with cardiovascular mortality during follow-up. In conclusion, OPG is associated with LV and left atrial remodeling in patients...

Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer.

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Kanda, Mitsuro; Mizuno, Akira; Tanaka, Chie; Kobayashi, Daisuke; Fujiwara, Michitaka; Iwata, Naoki; Hayashi, Masamichi; Yamada, Suguru; Nakayama, Goro; Fujii, Tsutomu; Sugimoto, Hiroyuki; Koike, Masahiko; Takami, Hideki; Niwa, Yukiko; Murotani, Kenta; Kodera, Yasuhiro

2016-06-01

Evidence indicates that impaired immunocompetence and nutritional status adversely affect short-term and long-term outcomes of patients with cancer. We aimed to evaluate the clinical significance of preoperative immunocompetence and nutritional status according to Onodera's prognostic nutrition index (PNI) among patients who underwent curative gastrectomy for gastric cancer (GC).This study included 260 patients with stage II/III GC who underwent R0 resection. The predictive values of preoperative nutritional status for postoperative outcome (morbidity and prognosis) were evaluated. Onodera's PNI was calculated as follows: 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (per mm).The mean preoperative PNI was 47.8. The area under the curve for predicting complications was greater for PNI compared with the serum albumin concentration or lymphocyte count. Multivariate analysis identified preoperative PNI < 47 as an independent predictor of postoperative morbidity. Moreover, patients in the PNI < 47 group experienced significantly shorter overall and disease-free survival compared with those in the PNI ≥ 47 group, notably because of a higher prevalence of hematogenous metastasis as the initial recurrence. Subgroup analysis according to disease stage and postoperative adjuvant treatment revealed that the prognostic significance of PNI was more apparent in patients with stage II GC and in those who received adjuvant chemotherapy.Preoperative PNI is easy and inexpensive to determine, and our findings indicate that PNI served as a significant predictor of postoperative morbidity, prognosis, and recurrence patterns of patients with stage II/III GC.

Challenges of raising road maintenance funds in developing countries: An analysis of road tolling in Zimbabwe

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T. C. Mbara

2010-11-01

Full Text Available The condition of Zimbabwe's roads has been declining due to insufficient maintenance and rehabilitation. Year on year, budget allocations have compared unfavourably with funding considered adequate to maintain highway networks and conduct modest construction work. Road infrastructure shortcomings have manifested themselves in the form of high vehicle operating costs and rampant potholes, leading to a decline in road safety and a deterioration of service levels for those who use roads to deliver goods or connect to international markets. In order to try and stop this vicious cycle of decline, the Government of Zimbabwe, on 8 August 2009, introduced a new policy of road-user charges, which involved the setting-up of 22 toll gates on the trunk road network. The overall objective was to raise revenue in order to close the funding gap, blamed for declining road quality. Although alternative methods of financing road maintenance have been debated for years, a generally accepted understanding is that road users should pay costs for road provisioning. This paper assesses the implementation of a road tolling system in Zimbabwe and describes matters relating to, inter alia, implementation strategy, initial performance outcomes and sustainability.

Preoperative or postoperative self-efficacy : Which is a better predictor of outcome after total hip or knee arthroplasty?

NARCIS (Netherlands)

van den Akker-Scheek, Inge; Stevens, Martin; Groothoff, Johan W.; Bulstra, Sjoerd K.; Zijlstra, Wiebren

Objective: Self-efficacy is considered an important determinant of outcome after total hip or knee arthroplasty. Aim of this study is to evaluate the contributions of preoperative and short-term postoperative self-efficacy in predicting long-term outcome. Methods: Self-efficacy was determined in 103

Preoperative physical therapy treatment did not influence postoperative pain and disability outcomes in patients undergoing shoulder arthroscopy: a prospective study

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Valencia C

2016-07-01

Full Text Available Carolina Valencia,1 Rogelio A Coronado,2 Corey B Simon,3,4 Thomas W Wright,5 Michael W Moser,5 Kevin W Farmer,5 Steven Z George3,6,7 1Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, IN, 2Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, 3Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 4Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville,FL, 5Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, 6Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 7Brooks–PHHP Research Collaboration, Jacksonville, FL, USA Background: There is limited literature investigating preoperative physical therapy (pre-op PT treatment on pain intensity and disability after musculoskeletal surgery. The purposes of the present cohort study were to describe patient characteristics for those who had and did not have pre-op PT treatment and determine whether pre-op PT influenced the length of postoperative physical therapy (post-op PT treatment (number of sessions and 3-month and 6-month postsurgical outcomes, such as pain intensity and disability. Patients and methods: A total of 124 patients (mean age =43 years, 81 males with shoulder pain were observed before and after shoulder arthroscopic surgery. Demographic data, medical history, and validated self-report questionnaires were collected preoperatively and at 3 months and 6 months after surgery. Analysis of variance models were performed to identify differences across measures for patients who had pre-op PT treatment and those who did not and to examine outcome differences at 3 months and 6 months. Alpha was set at the 0.05 level for statistical significance. Results: Males had less participation in pre-op PT than females (P=0.01. In

Gemmology, geology and origin of the Sandawana emerald deposits, Zimbabwe

NARCIS (Netherlands)

Zwaan, J.C.

2006-01-01

As one of the most valuable gemstones, emeralds are known to occur in several countries of the world, such as Colombia, Zambia, Brazil, Pakistan, Afghanistan, Russia, Madagascar and Zimbabwe. The emerald deposits at Sandawana, Zimbabwe, are described, the emeralds from this deposit characterised and

Association between serum lactate and postoperative outcomes following coronary artery bypass graft surgery

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Fatemeh Hasanshiri

2017-02-01

Full Text Available Background: Increased serum lactate during cardio-pulmonary bypass is associated with high mortality and cardiac complications up to 10-20 percent. The aim of this study was to evaluate the effect of serum lactate increase on postoperative outcomes after coronary artery bypass graft (CABG Surgery. Materials and Methods: This descriptive-analytical study was performed on cases (no=116 undergoing CABG at Beheshti hospital in Kashan between 2013-2014. Demographic data, variables related to surgery, serum lactate level and the time of tracheal extubation, length of stay in intensive care unit (ICU and hospital post-surgery left ventricular ejection fraction were collected. These data was compared in two groups: Normal serum lactate ( 2 m mol\\liter group. Results: The postoperative hyperlactatemia was observed in 62.1 % of patients. There were no significant differences between two groups in time of tracheal extubation, length of stay in ICU and hospital. There was a relationship between the mean postoperative serum lactate and blood sugar, bicarbonate, pH, length of cardiopulmonary bypass and the aortic cross clamping time. There was a significant relationship between the serum lactate increment and the left ventricular ejection fraction decrement. Conclusion: Hyperlactatemia is probably associated with such important factors as high blood sugar, longer duration of aortic cross clamp and cardio-pulmonary bypass time. So controlling such factors can reduce the rate of hyperlactatemia and help postoperative recovery.

Postoperative Outcomes in Graves' Disease Patients: Results from the Nationwide Inpatient Sample Database.

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Rubio, Gustavo A; Koru-Sengul, Tulay; Vaghaiwalla, Tanaz M; Parikh, Punam P; Farra, Josefina C; Lew, John I

2017-06-01

Current surgical indications for Graves' disease include intractability to medical and/or radioablative therapy, compressive symptoms, and worsening ophthalmopathy. Total thyroidectomy for Graves' disease may be technically challenging and lead to untoward perioperative outcomes. This study examines outcomes in patients with Graves' disease who underwent total thyroidectomy and assesses its safety for this patient population. A retrospective cross-sectional analysis was performed using the Nationwide Inpatient Sample database from 2006 to 2011. Total thyroidectomy performed in patients with Graves' disease, benign multinodular goiter (MNG), and thyroid cancer was identified. Demographic factors, comorbidities, and postoperative complications were evaluated. Chi-square, one-way analysis of variance, and risk-adjusted multivariable logistic regression were performed. Of 215,068 patients who underwent total thyroidectomy during the study period, 11,205 (5.2%) had Graves' disease, 110,124 (51.2%) MNG, and 93,739 (43.6%) thyroid malignancy. Patients with Graves' disease were younger than MNG and thyroid cancer patients (M age  = 42.8 years vs. 55.5 and 51.0 years; p Graves' disease group included a higher proportion of women (p Graves' disease was independently associated with a higher risk of vocal-cord paralysis (odds ratio [OR] = 1.36 [confidence interval (CI) 1.08-1.69]), tracheostomy (OR = 1.35 [CI 1.1-1.67]), postoperative hypocalcemia (OR = 1.65 [CI 1.54-1.77]), and hematoma requiring reoperation (OR = 2.79 [CI 2.16-3.62]) compared to MNG patients. High-volume centers for total thyroidectomy were independently associated with lower risk of postoperative complications, including in patients with Graves' disease. Despite low overall morbidity following total thyroidectomy, Graves' disease patients are at increased risk of postoperative complications, including bleeding, vocal-cord paralysis, tracheostomy, and hypocalcemia. These risks appear

Comparative effectiveness of prostate cancer surgical treatments: a population based analysis of postoperative outcomes.

Science.gov (United States)

Lowrance, William T; Elkin, Elena B; Jacks, Lindsay M; Yee, David S; Jang, Thomas L; Laudone, Vincent P; Guillonneau, Bertrand D; Scardino, Peter T; Eastham, James A

2010-04-01

Enthusiasm for laparoscopic surgical approaches to prostate cancer treatment has grown despite limited evidence of improved outcomes compared with open radical prostatectomy. We compared laparoscopic prostatectomy with or without robotic assistance vs open radical prostatectomy in terms of postoperative outcomes and subsequent cancer directed therapy. Using a population based cancer registry linked with Medicare claims we identified men 66 years old or older with localized prostate cancer who underwent radical prostatectomy from 2003 to 2005. Outcome measures were general medical/surgical complications and mortality within 90 days after surgery, genitourinary/bowel complications within 365 days, radiation therapy and/or androgen deprivation therapy within 365 days and length of hospital stay. Of the 5,923 men 18% underwent laparoscopic radical prostatectomy. Adjusting for patient and tumor characteristics, there were no differences in the rate of general medical/surgical complications (OR 0.93 95% CI 0.77-1.14) or genitourinary/bowel complications (OR 0.96 95% CI 0.76-1.22), or in postoperative radiation and/or androgen deprivation (OR 0.80 95% CI 0.60-1.08). Laparoscopic prostatectomy was associated with a 35% shorter hospital stay (p <0.0001) and a lower bladder neck/urethral obstruction rate (OR 0.74, 95% CI 0.58-0.94). In laparoscopic cases surgeon volume was inversely associated with hospital stay and the odds of any genitourinary/bowel complication. Laparoscopic prostatectomy and open radical prostatectomy have similar rates of postoperative morbidity and additional treatment. Men considering prostate cancer surgery should understand the expected benefits and risks of each technique to facilitate decision making and set realistic expectations. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Double bypass for inoperable pancreatic malignancy at laparotomy: postoperative complications and long-term outcome

Science.gov (United States)

Ausania, F; Vallance, AE; Manas, DM; Prentis, JM; Snowden, CP; White, SA; Charnley, RM; French, JJ; Jaques, BC

2012-01-01

INTRODUCTION Between 4% and 13% of patients with operable pancreatic malignancy are found unresectable at the time of surgery. Double bypass is a good option for fit patients but it is associated with high risk of postoperative complications. The aim of this study was to identify pre-operatively which patients undergoing double bypass are at high risk of complications and to assess their long-term outcome. METHODS Of the 576 patients undergoing pancreatic resections between 2006 and 2011, 50 patients who underwent a laparotomy for a planned pancreaticoduodenectomy had a double bypass procedure for inoperable disease. Demographic data, risk factors for postoperative complications and pre-operative anaesthetic assessment data including the Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) and cardiopulmonary exercise testing (CPET) were collected. RESULTS Fifty patients (33 men and 17 women) were included in the study. The median patient age was 64 years (range: 39–79 years). The complication rate was 50% and the in-hospital mortality rate was 4%. The P-POSSUM physiology subscore and low anaerobic threshold at CPET were significantly associated with postoperative complications (p=0.005 and p=0.016 respectively) but they were unable to predict them. Overall long-term survival was significantly shorter in patients with postoperative complications (9 vs 18 months). Postoperative complications were independently associated with poorer long-term survival (p=0.003, odds ratio: 3.261). CONCLUSIONS P-POSSUM and CPET are associated with postoperative complications but the possibility of using them for risk prediction requires further research. However, postoperative complications following double bypass have a significant impact on long-term survival and this type of surgery should therefore only be performed in specialised centres. PMID:23131226

An overview of solar and solar-related technologies in Zimbabwe ...

African Journals Online (AJOL)

Zimbabwe, being away from the screening effect of tropical humidity, desert dust, and the clouds of temperate areas receives more sunshine or solar radiation, also known as insolation, than almost any other country in the world (Johnston, 1977). The Zimbabwe Science News Volume 33(1) January-March 1999 ...

Aspheric photorefractive keratectomy for myopia and myopic astigmatism with the SCHWIND AMARIS laser: 2 years postoperative outcomes

Science.gov (United States)

Aslanides, Ioannis M.; Padroni, Sara; Arba-Mosquera, Samuel

2012-01-01

Purpose To evaluate mid-term refractive outcomes and higher order aberrations of aspheric PRK for low, moderate and high myopia and myopic astigmatism with the AMARIS excimer laser system (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). Methods This prospective longitudinal study evaluated 80 eyes of 40 subjects who underwent aspheric PRK. Manifest refractive spherical equivalent (MRSE) of up to −10.00 diopters (D) at the spectacle plane with cylinder up to 3.25 was treated. Refractive outcomes and corneal wavefront data (6 mm pupil to the 7th Zernike order) were evaluated out to 2 years postoperatively. Statistical significance was indicated by P  0.05, both cases). There was a statistical increase in postoperative coma (+0.12 μm) and spherical aberration (+0.14 μm) compared to preoperatively (P < 0.001, both cases). Conclusion Aspheric PRK provides excellent visual and refractive outcomes with induction in individual corneal aberrations but not overall corneal aberrations.

Comparative Effectiveness of Surgical Treatments for Prostate Cancer: A Population-Based Analysis of Postoperative Outcomes

Science.gov (United States)

Lowrance, William T.; Elkin, Elena B.; Jacks, Lindsay M.; Yee, David S.; Jang, Thomas L.; Laudone, Vincent P.; Guillonneau, Bertrand D.; Scardino, Peter T.; Eastham, James A.

2010-01-01

Background Enthusiasm for laparoscopic surgical approaches to prostate cancer treatment has grown, despite limited evidence of improved outcomes compared with open radical prostatectomy. We compared laparoscopic (with or without robotic assistance) versus open radical prostatectomy in terms of postoperative outcomes and subsequent cancer-directed therapy. Materials and Methods Using a population-based cancer registry linked with Medicare claims, we identified men age 66 or older with localized prostate cancer who received a radical prostatectomy from 2003-2005. Outcome measures were general medical/surgical complications and mortality within 90 days following surgery; genitourinary/bowel complications within 365 days; receipt of radiation therapy, androgen deprivation therapy or both within 365 days; length of hospital stay. Results Of the 5,923 men,18% received a laparoscopic radical prostatectomy. Adjusting for patient and tumor characteristics, there were no differences in rates of general medical/surgical complications (OR 0.93; 95% CI: 0.77-1.14) or genitourinary/bowel complications (OR 0.96; 95% CI: 0.76-1.22) or in the use of postoperative radiation, androgen deprivation or both (OR 0.80; 95% CI: 0.60-1.08). Laparoscopic prostatectomy was associated with a 35% shorter hospital stay (p<0.0001) and a lower rate of bladder neck/urethral obstruction (OR 0.74; 95% CI 0.58-0.94). In laparoscopic patients, surgeon volume was inversely associated with length of hospital stay and the odds of any genitourinary/bowel complication. Conclusions Laparoscopic and open radical prostatectomy have similar rates of postoperative morbidity and use of additional treatment. Men considering prostate cancer surgery should understand the expected benefits and risks of each technique to facilitate decision-making and to set realistic expectations. PMID:20188381

Outcome of postoperative radiotherapy following radical prostatectomy: a single institutional experience

Energy Technology Data Exchange (ETDEWEB)

Lee, Sea Won; Chung, Mi Joo; Jeong, Song Mi; Kim, Sung Hwan; Lee, Jong Hoon [Dept.of Radiation Oncology, St. Vincent' s Hospital, The Catholic University of Korea College of Medicine, Suwon (Korea, Republic of); Hwang, Tae Kon; Hong, Sung Hoo; Lee, Ji Youl; Jang, Hong Seok [Seoul St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of); Yoon, Sei Chul [Dept.of Radiation Oncology, Bucheon St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Bucheon (Korea, Republic of)

2014-09-15

This single institutional study is aimed to observe the outcome of patients who received postoperative radiotherapy after radical prostatectomy. A total of 59 men with histologically identified prostate adenocarcinoma who had received postoperative radiation after radical prostatectomy from August 2005 to July 2011 in Seoul St. Mary's Hospital of the Catholic University of Korea, was included. They received 45-50 Gy to the pelvis and boost on the prostate bed was given up to total dose of 63-72 Gy (median, 64.8 Gy) in conventional fractionation. The proportion of patients given hormonal therapy and the pattern in which it was given were analyzed. Primary endpoint was biochemical relapse-free survival (bRFS) after radiotherapy completion. Secondary endpoint was overall survival (OS). Biochemical relapse was defined as a prostate-specific antigen level above 0.2 ng/mL. After median follow-up of 53 months (range, 0 to 104 months), the 5-year bRFS of all patients was estimated 80.4%. The 5-year OS was estimated 96.6%. Patients who were given androgen deprivation therapy had a 5-year bRFS of 95.1% while the ones who were not given any had that of 40.0% (p < 0.01). However, the statistical significance in survival difference did not persist in multivariate analysis. The 3-year actuarial grade 3 chronic toxicity was 1.7% and no grade 3 acute toxicity was observed. The biochemical and toxicity outcome of post-radical prostatectomy radiotherapy in our institution is favorable and comparable to those of other studies.

Effects of posture on postoperative pulmonary function

DEFF Research Database (Denmark)

Nielsen, K G; Holte, Kathrine; Kehlet, H

2003-01-01

effect on postoperative pulmonary function in the sitting or standing position compared with the supine. Thus, avoidance of the supine position may improve postoperative pulmonary function. Three of six studies showed a positive effect on postoperative pulmonary function of the lateral side compared......BACKGROUND: Pulmonary morbidity is still a relevant complication to major surgery despite improvements in surgical technique and anaesthetic methods. Postoperative posture may be a pathogenic factor, but the effects of changes in postoperative posture on pulmonary function have not been reviewed...... with the supine. Thus, the lateral position has limited effects on pulmonary function. CONCLUSION: Changes of postoperative position from supine to sitting or standing are of major importance in the interpretation of postoperative pulmonary outcome studies and in future strategies to improve pulmonary outcome....

The Effect of Anxiety, Depression, and Optimism on Postoperative Satisfaction and Clinical Outcomes in Lumbar Spinal Stenosis and Degenerative Spondylolisthesis Patients: Cohort Study.

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Lee, Jaewon; Kim, Hong-Sik; Shim, Kyu-Dong; Park, Ye-Soo

2017-06-01

The aim of this study is to evaluate the effect of depression, anxiety, and optimism on postoperative satisfaction and clinical outcomes in patients who underwent less than two-level posterior instrumented fusions for lumbar spinal stenosis and degenerative spondylolisthesis. Preoperative psychological status of subjects, such as depression, anxiety, and optimism, was evaluated using the Hospital Anxiety and Depression Scale (HADS) and the Revised Life Orientation Test (LOT-R). Clinical evaluation was determined by measuring changes in a visual analogue scale (VAS) and the Oswestry Disability Index (ODI) before and after surgery. Postoperative satisfaction of subjects assessed using the North American Spine Society lumbar spine questionnaire was comparatively analyzed against the preoperative psychological status. The correlation between patient's preoperative psychological status (depression, anxiety, and optimism) and clinical outcomes (VAS and ODI) was evaluated. VAS and ODI scores significantly decreased after surgery ( p optimism) was not related to the degree of improvement in clinical outcomes (VAS and ODI) after surgery. However, postoperative satisfaction was moderately correlated with optimism. Anxiety and optimism were more correlated with patient satisfaction than clinical outcomes. Accordingly, the surgeon can predict postoperative satisfaction of patients based on careful evaluation of psychological status before surgery.

Postoperative radiotherapy in patients with salivary duct carcinoma. Clinical outcomes and prognostic factors

International Nuclear Information System (INIS)

Shinoto, Makoto; Shioyama, Yoshiyuki; Nakamura, Katsumasa

2013-01-01

This study sought to investigate the clinical outcome and the role of postoperative radiotherapy for patients with salivary duct carcinoma (SDC) who had undergone surgery and postoperative radiotherapy. We performed a retrospective analysis of 25 SDC patients treated between 1998 and 2011 with surgery and postoperative radiotherapy. The median prescribed dose was 60 Gy (range, 49.5-61.4 Gy). The clinical target volume (CTV) was defined as the tumor bed in four patients, the tumor bed and ipsilateral neck in 14 patients, and the tumor bed and bilateral neck in six patients. Local control (LC), disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method, and prognostic variables were analyzed with the log-rank test. The 5-year LC, DFS and OS were 67%, 45% and 47%, respectively. Disease recurrence was found in 12 patients: seven as local, four as regional and eight as distant failure. Perineural and lymphovascular invasion was a significant prognostic factor for LC (P=0.03). Local failure was common, and the presence of local recurrence significantly affected the OS (P<0.05). We conclude that surgery and postoperative radiotherapy is expected to decrease the risk of local failure and contribute to good prognoses for patients with SDC. It might be advisable to have the CTV include the cranial nerves involved and the corresponding parts of the skull base in cases of pathologically positive perineural invasion. (author)

New Zimbabwe Constitution and the Right to Health Campaign 2010

International Development Research Centre (IDRC) Digital Library (Canada)

New Zimbabwe Constitution and the Right to Health Campaign 2010. In September 2008 the three main political parties in Zimbabwe signed a Global Political Agreement (GPA), undertaking to engage in the development of a new democratic constitution of over the next 24 months. This project will feed into that process by ...

Zambezia: The Journal of Humanities of the University of Zimbabwe

African Journals Online (AJOL)

Zambezia is a bi-annual journal of the University of Zimbabwe. Its focus is humanities in Zimbabwe and the surrounding region but specialist articles of a more general interest are also published. Vol 32, No 1 (2005). DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Table of ...

Prognostic nutritional index predicts postoperative complications and long-term outcomes of gastric cancer.

Science.gov (United States)

Jiang, Nan; Deng, Jing-Yu; Ding, Xue-Wei; Ke, Bin; Liu, Ning; Zhang, Ru-Peng; Liang, Han

2014-08-14

To investigate the impact of prognostic nutritional index (PNI) on the postoperative complications and long-term outcomes in gastric cancer patients undergoing total gastrectomy. The data for 386 patients with gastric cancer were extracted and analyzed between January 2003 and December 2008 in our center. The patients were divided into two groups according to the cutoff value of the PNI: those with a PNI ≥ 46 and those with a PNI gastric cancer patients.

Three-year postoperative outcomes between MIS and conventional TLIF in1-segment lumbar disc herniation.

Science.gov (United States)

Lv, You; Chen, Jingyang; Chen, Jinchuan; Wu, Yuling; Chen, Xiangyang; Liu, Yi; Chu, Zhaoming; Sheng, Luxin; Qin, Rujie; Chen, Ming

2017-06-01

The aim of this study is to assess the long-term clinical and radiological outcomes between minimally invasive (MIS) and conventional transforaminal lumbar interbody fusion (TLIF) in treating one-segment lumbar disc herniation (LDH). One-hundred and six patients treated by MIS-TLIF (50 cases) or conventional TLIF (56 cases) were included. Perioperative results were evaluated. Clinical outcomes were compared preoperatively and postoperatively. Radiologic parameters were based on a comparison of preoperative and three-year postoperative lumbar lordosis, segmental lordosis, sacral slope, the cross-sectional area of the paraspinal muscle and fusion rates. MIS TILF had significantly less blood, shorter operation time, mean return to work time and lower intramuscular pressure compared with the conventional group during the operation. VAS scores for lower back pain and ODI in MIS-TLIF were significantly decreased. The mean cross-sectional area of the paraspinal muscle was significantly decreased after surgery in the conventional TLIF group and no significant intragroup differences were established in the MIS-TLIF group. No significant differences were found in fusion rate, lumbar lordosis, segmental lordosis and sacral slope. Both MIS and conventional TLIF were beneficial for patients with LDH. However, MIS-TLIF manifests a great improvement in perioperative outcomes, low back pain, disability and preventing paraspinal muscle atrophy during the follow-up period observation.

Enhancing Schistosomiasis Control Strategy for Zimbabwe: Building on Past Experiences

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Moses J. Chimbari

2012-01-01

Full Text Available Schistosoma haematobium and Schistosoma mansoni are prevalent in Zimbabwe to levels that make schistosomiasis a public health problem. Following three national surveys to map the disease prevalence, a national policy on control of schistosomiasis and soil transmitted helminths is being developed. This paper reviews the experiences that Zimbabwe has in the area of schistosomiasis control with a view to influence policy. A case study approach to highlight key experiences and outcomes was adopted. The benefits derived from intersectoral collaboration that led to the development of a model irrigation scheme that incorporates schistosomiasis control measures are highlighted. Similarly, the benefits of using plant molluscicides and fish and duck biological agents (Sargochromis codringtonii and Cairina moschata are highlighted. Emphasis was also placed on the importance of utilizing locally developed water and sanitation technologies and the critical human resource base in the area of schistosomiasis developed over years. After synthesis of the case studies presented, it was concluded that while there is a need to follow the WHO recommended guidelines for schistosomiasis control it is important to develop a control strategy that is informed by work already done in the country. The importance of having a policy and local guidelines for schistosomiasis control is emphasized.

The impact of obesity on early postoperative outcomes in adults with congenital heart disease.

Science.gov (United States)

Zaidi, Ali N; Bauer, John A; Michalsky, Marc P; Olshove, Vincent; Boettner, Bethany; Phillips, Alistair; Cook, Stephen C

2011-01-01

As the prevalence of obesity continues to increase, it now includes the growing number of patients with congenital heart disease (CHD). This particular obese patient population may pose additional intraoperative as well as postoperative challenges that may contribute to poor outcomes. Our aims were to determine the influence of obesity on morbidity and mortality in adults with CHD undergoing surgical repair at a free standing children's hospital. A retrospective analysis of adult (≥18 years) CHD surgery cases from 2002 to 2008 was performed. Congenital heart lesions were defined as mild, moderate, or complex. Patients were categorized by body mass index (BMI): underweight (BMI obese (BMI ≥ 30 kg/m(2)). Demographics, incidence of mortality, or specific morbidities were statistically compared using Fisher's exact test and analyses of variance (anovas). In this population (n = 165), overweight (29%) and obese (22%) patients were prevalent. Hypertension (HTN) and pre-HTN were more prevalent in obese and overweight patients. Postoperative renal dysfunction was observed in obese patients with complex CHD (P = .04). Mortality was not different among groups. Obesity is becoming increasingly common among adults with CHD. Despite marginal evidence of postoperative renal complications in obese patients with CHD of severe complexity, the overall presence of obesity did not influence mortality or short term postoperative morbidities. © 2011 Copyright the Authors. Congenital Heart Disease © 2011 Wiley Periodicals, Inc.

Rethinking the language of politics in 21st century Zimbabwe: A ...

African Journals Online (AJOL)

The struggle for political supremacy in postcolonial Zimbabwe has of late assumed a new form in which discourse contestations have taken centre-stage. The Zimbabwe African National Union Patriotic Front (ZANU PF) politicians have engaged in discourse construction and discourse manipulation as tools of discrediting, ...

EFFECTIVENESS OF SCHEDULED AMBULATION ON EARLY POSTOPERATIVE OUTCOME AMONG PATIENTS WHO HAVE UNDERGONE ABDOMINAL HYSTERECTOMY

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Rinku Girija

2017-01-01

Full Text Available BACKGROUND Abdominal hysterectomy is one of the most frequently performed surgical procedures in women. The non-ambulatory postoperative period is a high risk period for the development of various complications like wound infection, venous stasis, lower respiratory infection, secondary haemorrhage, deep vein thrombosis, pulmonary embolism, paralytic ileus etc. Prolonged surgery, delayed ambulation and not feeding the patient within 48 hours of surgery are often associated with post-operative morbidity and mortality. This study aims to assess the effectiveness of Scheduled Ambulation on early post-operative outcome among patients undergone abdominal hysterectomy by introduction of Scheduled Ambulation from second day of surgery. MATERIALS AND METHODS Method used is quantitative and quasi experimental post-test control method. Scheduled ambulation technique and pattern were taught pre operatively to 35 patients consecutively selected from general and post-operative ward who formed the experimental group. They were given scheduled ambulation from second to fifth post-operative days and results analysed. Another 35 patients taken as control were given the routine post-operative care. Data Analysis- was performed using SPSS version 17.0. Between group comparisons, quantitative variables analysed by Chisquare test p value >0, 05 considered significant. RESULTS The indication of hysterectomy was fibroid uterus in 80% of the control group and 88, 6% of the experimental group. 51.4% of the hysterectomies were encountered in the age group 40-49 years. There was a statistically significant reduction in the severity of pain, fatigue, postural hypotension and risk for developing Deep vein thrombosis in the experimental group on practicing Scheduled Ambulation from second to fifth post-operative days. CONCLUSION Scheduled ambulation helped the abdominal hysterectomy patients to recover from fatigue, pain, postural hypotension and risk for Deep vein thrombosis

Early Versus Delayed Postoperative Feeding After Major Gynaecological Surgery and its Effects on Clinical Outcomes, Patient Satisfaction, and Length of Stay: A Randomized Controlled Trial.

Science.gov (United States)

Balayla, Jacques; Bujold, Emmanuel; Lapensée, Louise; Mayrand, Marie-Hélène; Sansregret, Andrée

2015-12-01

To compare early versus delayed postoperative feeding in women undergoing major gynaecological surgery with regard to clinical outcomes, duration of postoperative stay, and patient satisfaction. We conducted a parallel-randomized controlled trial at a tertiary care centre in Montreal, Quebec, between June 2000 and July 2001. Patients undergoing major gynaecological surgery were randomized following a 1:1 allocation ratio to receive either early postoperative feeding in which oral clear fluids were begun up to six hours after surgery followed by solid foods as tolerated, or delayed postoperative feeding, in which clear fluids were begun on the first postoperative day and solid foods on the second or third day as tolerated. The primary outcomes analyzed were duration of postoperative stay and patient satisfaction. Secondary outcomes included mean time to appetite, passage of flatus, and bowel movement, as well as the presence of symptoms of paralytic ileus. A total of 119 patients were randomized; 61 patients were assigned to the early feeding group and 58 to the delayed feeding group. Demographic characteristics, including age, weight, smoking status, and prior surgical history were comparable between both groups. There was no difference in length of postoperative stay between the two groups (86.4 ± 21.0 hours in the early feeding group vs. 85.6 ± 26.2 hours in the delayed feeding group; P > 0.05). No significant difference was noted in patient satisfaction (P > 0.05). No difference was found in the frequency of postoperative ileus, mean time to appetite, passage of flatus, or first bowel movement. The introduction of early postoperative feeding appears to be safe and well tolerated by patients undergoing major gynaecological surgery. The duration of postoperative stay, patient satisfaction, and gastrointestinal symptoms are comparable between patients undergoing early or delayed postoperative feeding.

Zimbabwe Journal of Technological Sciences: Submissions

African Journals Online (AJOL)

The editorial policy of the Zimbabwe Journal Technological Sciences is to review and publish high ... attrition and retention in technological institutions and research issues and concerns in technology. ... Chinhoyi University of Technology

Overview | Kowero | Zimbabwe Science News

African Journals Online (AJOL)

Articles presented in this special issue are drawn from research findings of the project “Management of Miombo Woodlands”. This is being implemented in five Southern Africa Development Community (SADC) countries (Zimbabwe, Zambia, Malawi, Mozambique, Tanzania) by the Center for International Forestry Research ...

Introduction of sugammadex as standard reversal agent: Impact on the incidence of residual neuromuscular blockade and postoperative patient outcome

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Thomas Ledowski

2013-01-01

Full Text Available Background: The aim of this prospective audit was to investigate clinical practice related to muscle relaxant reversal and the impact made by the recent introduction of sugammadex on patient outcome at a tertiary teaching hospital. Methods: Data from all patients intubated at our institution during two epochs of seven consecutive days each was collected prospectively. Directly prior to extubation, the train-of-four (TOF ratio was assessed quantitatively by an independent observer. Postoperative outcome parameters were complications in the recovery room and radiological diagnosed atelectasis or pneumonia within 30 days. Results: Data from 146 patients were analysed. Three reversal strategies were used: no reversal, neostigmine or sugammadex. The TOF ratio was less than 0.7 in 17 patients (nine no reversal, eight neostigmine and less than 0.9 in 47 patients (24 no reversal, 19 neostigmine, four sugammadex. Those reversed with sugammadex showed fewer episodes of postoperative oxygen desaturation (15% vs. 33%; P<0.05. TOF ratios of less than 0.7 ( P<0.05 and also <0.9 ( P<0.01 were more likely associated with X-ray results consistent with postoperative atelectasis or pneumonia. Conclusions: Our results suggest a significant impact of residual paralysis on patient outcome. The use of sugammadex resulted in the lowest incidence of residual paralysis.

Zimbabwes vahistati tuhandeid poodnikke / Arko Olesk

Index Scriptorium Estoniae

Olesk, Arko, 1981-

2007-01-01

Ilmunud ka: Postimees : na russkom jazõke 9. august lk. 7. Zimbabwe võimud vahistasid 7600 poodnikku, kes ei allunud valitsuse korraldusele alandada kaupade hindu poole võrra, et ohjeldada hüperinflatsiooni

"We Are Not Really Marketing Mental Health": Mental Health Advocacy in Zimbabwe.

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Reuben Hendler

Full Text Available Few people with mental disorders in low and middle-income countries (LMICs receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs.We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country's mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions.Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy's importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate ("targets", what they advocate for ("asks", how advocates reach their targets ("access", how they make their asks ("arguments", and the results of their advocacy ("outcomes".Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

"We Are Not Really Marketing Mental Health": Mental Health Advocacy in Zimbabwe.

Science.gov (United States)

Hendler, Reuben; Kidia, Khameer; Machando, Debra; Crooks, Megan; Mangezi, Walter; Abas, Melanie; Katz, Craig; Thornicroft, Graham; Semrau, Maya; Jack, Helen

2016-01-01

Few people with mental disorders in low and middle-income countries (LMICs) receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs. We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country's mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions. Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy's importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate ("targets"), what they advocate for ("asks"), how advocates reach their targets ("access"), how they make their asks ("arguments"), and the results of their advocacy ("outcomes"). Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

A three-arm (laparoscopic, hand-assisted, and robotic) matched-case analysis of intraoperative and postoperative outcomes in minimally invasive colorectal surgery.

Science.gov (United States)

Patel, Chirag B; Ragupathi, Madhu; Ramos-Valadez, Diego I; Haas, Eric M

2011-02-01

Robotic-assisted laparoscopic surgery is an emerging modality in the field of minimally invasive colorectal surgery. However, there is a dearth of data comparing outcomes with other minimally invasive techniques. We present a 3-arm (conventional, hand-assisted, and robotic) matched-case analysis of intraoperative and short-term outcomes in patients undergoing minimally invasive colorectal procedures. Between August 2008 and October 2009, 70 robotic cases of the rectum and rectosigmoid were performed. Thirty of these were organized into triplets with conventional and hand-assisted cases based on the following 6 matching criteria: 1) surgeon; 2) sex; 3) body mass index; 4) operative procedure; 5) pathology; and 6) history of neoadjuvant therapy in malignant cases. Demographics, intraoperative parameters, and postoperative outcomes were assessed. Pathological outcomes were analyzed in malignant cases. Data were stratified by postoperative diagnosis and operative procedure. There was no significant difference in intraoperative complications, estimated blood loss (126.1 ± 98.5 mL overall), or postoperative morbidity and mortality among the groups. Robotic technique required longer operative time compared with conventional laparoscopic (P hand-assisted (P robotic approach results in short-term outcomes comparable to conventional and hand-assisted laparoscopic approaches for benign and malignant diseases of the rectum and rectosigmoid. With 3-dimensional visualization, additional freedom of motion, and improved ergonomics, this enabling technology may play an important role when performing colorectal procedures involving the pelvic anatomy.

Zimbabwe Journal of Technological Sciences

African Journals Online (AJOL)

The Zimbabwe Journal of Technological Sciences receives and publishes articles that address issues in Technology as a developmental field in Africa. The aim is to develop new technological knowledge that is geared to enhance the lives of the African people through solving pertinent problems that affect them.

Implementation strategy to reduce environmental impact of energy related activities in Zimbabwe

International Nuclear Information System (INIS)

1997-01-01

In 1992 UNEP-Collaborating Centre on Energy and Environment (UNEP-CCEE), Denmark and Southern Centre for Energy and Environment (SCEE), Zimbabwe, prepared a country report for Zimbabwe on Greenhouse Gas (GHG) Abatement Costing. Abatement technologies for both supply and demand side were identified in order to reduce GHG emission. The present study addresses environmental impacts of the entire energy cycle focusing on coal use in industry and power generation. Zimbabwe has proven coal reserves of more than 700 million tonnes, and the potential of geological coal resources is estimated beyond 30 billion tonnes. The conventional applications of coal include electricity generation, steam traction in railway transport, industrial boilers, tobacco curing and coking. As coal is the major source of energy for Zimbabwe, the present study aims at identification of environmental impacts of the entire coal cycle from mining to end-users of electrical energy. (EG)

Preoperative patient education: evaluating postoperative patient outcomes.

Science.gov (United States)

Meeker, B J

1994-04-01

Preoperative teaching is an important part of patient care and can prevent complications, as well as promote patient fulfillment during hospitalization. A study was conducted at Alton Ochsner Medical Foundation in New Orleans, LA, in 1989, to determine the impact of a preoperative teaching program on the incidence of postoperative atelectasis and patient satisfaction. Results showed no significant difference of postoperative complications and patient gratification after participating in a structured preoperative teaching program. As part of this study, it was identified that a patient evaluation tool for a preoperative teaching class needed to be developed. The phases of this process are explained in the following article.

Zimbabwe | IDRC - International Development Research Centre

International Development Research Centre (IDRC) Digital Library (Canada)

... for research and higher education when we began supporting research there in 1981. ... indigenous vegetables, helping raise awareness of their nutritional value. ... In 2011, Zimbabwe's Ministry of Health and Child Welfare adopted some of ...

TREATMENT OF DIARRHOEA USING TRADITIONAL MEDICINES: CONTEMPORARY RESEARCH IN SOUTH AFRICA AND ZIMBABWE.

Science.gov (United States)

Maroyi, Alfred

2016-01-01

Gastrointestinal disorders, diarrhoea in particular remain a major concern in South Africa and Zimbabwe resulting in high mortality rates when left untreated. This investigation was aimed at documenting herbal medicines used in the treatment of diarrhoea in South Africa and Zimbabwe. A review of literature on plant species used as remedies for diarrhoea in South Africa and Zimbabwe was undertaken by the use of different electronic databases such as Google Scholar, ScienceDirect, Scopus as well as library searches at the University of Fort Hare, South Africa and the National Herbarium of Zimbabwe (SRGH) in Harare, Zimbabwe. This study reported ten plant species most widely used to treat diarrhoea in South Africa and Zimbabwe. Of the lot, Sclerocarya birrea (A. Rich.) Hochst. was the most popular medicinal plant used as antidiarrhoeal remedy (11 literature citations) in South Africa and Zimbabwe, followed by Elephantorrhiza elephantina (Burch.) Skeels and Schotia brachypetala Sond. with eight literature citations each. The roots (47.4%) are the most frequently used plant parts, followed by bark (26.3%), leaves (21.1%) and rhizomes (5.3%). The documented antidiarrhoeal activities of this repository of selected plant species against diarrhoea causing agents such as rotavirus, Escherichia coli , Shigella , Campylobacter , Giardia , Entamoeba histolytica , Salmonella , Yersinia and Vibrio cholerae calls for further investigation aimed at isolating phytochemical compounds responsible for antidiarrhoeal activities, their mode of action, and also establish their safety and efficacy. This cross-cultural acceptance of antidiarrhoeal herbal medicines and the use of the same plant species in different geographical zones serve as an indication of the importance of herbal medicines in primary healthcare of local communities.

Zimbabwe's national AIDS levy: A case study.

Science.gov (United States)

Bhat, Nisha; Kilmarx, Peter H; Dube, Freeman; Manenji, Albert; Dube, Medelina; Magure, Tapuwa

2016-01-01

We conducted a case study of the Zimbabwe National AIDS Trust Fund ('AIDS Levy') as an approach to domestic government financing of the response to HIV and AIDS. Data came from three sources: a literature review, including a search for grey literature, review of government documents from the Zimbabwe National AIDS Council (NAC), and key informant interviews with representatives of the Zimbabwean government, civil society and international organizations. The literature search yielded 139 sources, and 20 key informants were interviewed. Established by legislation in 1999, the AIDS Levy entails a 3% income tax for individuals and 3% tax on profits of employers and trusts (which excluded the mining industry until 2015). It is managed by the parastatal NAC through a decentralized structure of AIDS Action Committees. Revenues increased from inception to 2006 through 2008, a period of economic instability and hyperinflation. Following dollarization in 2009, annual revenues continued to increase, reaching US$38.6 million in 2014. By policy, at least 50% of funds are used for purchase of antiretroviral medications. Other spending includes administration and capital costs, HIV prevention, and monitoring and evaluation. Several financial controls and auditing systems are in place. Key informants perceived the AIDS Levy as a 'homegrown' solution that provided country ownership and reduced dependence on donor funding, but called for further increased transparency, accountability, and reduced administrative costs, as well as recommended changes to increase revenue. The Zimbabwe AIDS Levy has generated substantial resources, recently over US$35 million per year, and signals an important commitment by Zimbabweans, which may have helped attract other donor resources. Many key informants considered the Zimbabwe AIDS Levy to be a best practice for other countries to follow.

Acute postoperative seizures and long-term seizure outcome after surgery for hippocampal sclerosis.

Science.gov (United States)

Di Gennaro, Giancarlo; Casciato, Sara; Quarato, Pier Paolo; Mascia, Addolorata; D'Aniello, Alfredo; Grammaldo, Liliana G; De Risi, Marco; Meldolesi, Giulio N; Romigi, Andrea; Esposito, Vincenzo; Picardi, Angelo

2015-01-01

To assess the incidence and the prognostic value of acute postoperative seizures (APOS) in patients surgically treated for drug-resistant temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS). We studied 139 consecutive patients with TLE-HS who underwent epilepsy surgery and were followed up for at least 5 years (mean duration of follow-up 9.1 years, range 5-15). Medical charts were reviewed to identify APOS, defined as ictal events with the exception of auras occurring within the first 7 days after surgery. Seizure outcome was determined at annual intervals. Patients who were in Engel Class Ia at the last contact were classified as having a favorable outcome. Seizure outcome was favorable in 99 patients (71%). Six patients (4%) experienced APOS and in all cases their clinical manifestations were similar to the habitual preoperative seizures. All patients with APOS had unfavorable long-term outcome, as compared with 35 (26%) of 133 in whom APOS did not occur (pseizure outcome. Given some study limitations, our findings should be regarded as preliminary and need confirmation from future larger, prospective, multicenter studies. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Intraoperative performance and postoperative outcome comparison of longitudinal, torsional, and transversal phacoemulsification machines.

Science.gov (United States)

Christakis, Panos G; Braga-Mele, Rosa M

2012-02-01

To compare the intraoperative performance and postoperative outcomes of 3 phacoemulsification machines that use different modes. Kensington Eye Institute, Toronto, Ontario, Canada. Comparative case series. This chart and video review comprised consecutive eligible patients who had phacoemulsification by the same surgeon using a Whitestar Signature Ellips-FX (transversal), Infiniti-Ozil-IP (torsional), or Stellaris (longitudinal) machine. The review included 98 patients. Baseline characteristics in the groups were similar; the mean nuclear sclerosis grade was 2.0 ± 0.8. There were no significant intraoperative complications. The torsional machine averaged less phacoemulsification needle time (83 ± 33 seconds) than the transversal (99 ± 40 seconds; P=.21) or longitudinal (110 ± 45 seconds; P=.02) machines; the difference was accentuated in cases with high-grade nuclear sclerosis. The torsional machine had less chatter and better followability than the transversal or longitudinal machines (P<.001). The torsional and longitudinal machines had better anterior chamber stability than the transversal machine (P<.001). Postoperatively, the torsional machine yielded less central corneal edema than the transversal (P<.001) and longitudinal (P=.04) machines, corresponding to a smaller increase in mean corneal thickness (torsional 5%, transversal 10%, longitudinal 12%; P=.04). Also, the torsional machine had better 1-day postoperative visual acuities (P<.001). All 3 phacoemulsification machines were effective with no significant intraoperative complications. The torsional machine outperformed the transversal and longitudinal machines, with a lower mean needle time, less chatter, and improved followability. This corresponded to less corneal edema 1 day postoperatively and better visual acuity. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

REFORMATIONS IN ZIMBABWE'S JUVENILE JUSTICE SYSTEM

African Journals Online (AJOL)

Mugumbate

1996-05-23

May 23, 1996 ... The article is based on a desk review of existing literature on juvenile crime in the country. ... that Zimbabwe's juvenile justice system is transforming from being ... recommendations include expanding the Pre-trial Diversion ...

Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy.

Science.gov (United States)

Shi, Hao-Jun; Jin, Chen; Fu, De-Liang

2017-01-14

To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified. High early postoperative fasting blood glucose (FBG) levels (OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels (OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative HbA1c levels over 7% (HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative HbA1c levels over 7% had much poorer overall survival than those with HbA1c levels less than 7% (9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus (HR = 15.019, 95%CI: 1.278-176.211, P = 0.031) and alcohol history (B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively. At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on long-term outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

Teacher Efficacy in Rural Zimbabwe

Science.gov (United States)

Dunham, Judy K.; Song'ony, Daniel

2008-01-01

The need to address contextual variables, such as cultural bias and cultural norms, is a common challenge for researchers in international education. This article highlights societal conditions and cultural issues that could have impacted teacher efficacy data in Zimbabwe, a country known for its ongoing economic crisis, political repression, and…

The Jerusarema Dance of Zimbabwe.

Science.gov (United States)

Asante, Kariamu Welsh

1985-01-01

Traces the historical development of the Jerusarema, a traditional dance of the Shona of Zimbabwe, from its origins as a form of military defense to its present role in recreation and ceremony. Describes the Jerusarema, classifies it in relation to other African dance forms, and discusses how it is learned. (KH)

CHILD SEXUAL ABUSE IN ZIMBABWE: PREVENTION ...

African Journals Online (AJOL)

Jacob Mugumbate

that social workers in Zimbabwe have a role to play at all the three levels of intervention. KEY TERMS: Child sexual abuse (CSA), social work, prevention,. Meili's model. ..... network/2013/mar/19/world-social-work-day-fair-global- · economy1.

Stimulation site within the MRI-defined STN predicts postoperative motor outcome.

Science.gov (United States)

Wodarg, Fritz; Herzog, Jan; Reese, René; Falk, Daniela; Pinsker, Markus O; Steigerwald, Frank; Jansen, Olav; Deuschl, Günther; Mehdorn, H Maximillian; Volkmann, Jens

2012-06-01

High-frequency stimulation of the subthalamic nucleus (STN-HFS) is highly effective in treating motor symptoms in Parkinson's disease (PD) and medication side effects as well as in improving quality of life. Despite preoperative screening for patients as eligible candidates for this treatment, electrode position may furthermore influence treatment quality. Here, we investigated the relationship between the anatomical site of stimulation within the MRI-defined STN and the outcome of PD patients after STN-HFS. In 30 PD patients with bilateral STN stimulation, we retrospectively defined the boundaries of the STN within the axial target plane of the stereotactic T2-weighted MRI and determined the position of the active electrode contact in relation to the border of the STN. The position of the active contact within the STN was the only variable to predict the outcome of STN stimulation. In contrast, covariates such as age, disease duration, symptom severity, and response to levodopa had no effect. The lateral position of the stimulation contact within the STN led to significantly better clinical improvement, lower stimulation parameters, and less need for postoperative dopaminergic medication. The outcome of patients with stimulation contacts within the medial region of the STN was significantly worse. Precise targeting of the lateral region of the STN is essential for achieving sufficient stimulation efficacy. Preoperative T2-weighted MRI might be a useful component of the targeting procedure to improve the outcome of PD patients. Copyright © 2012 Movement Disorder Society.

Pulmonary Perfusion and Ventilation During Cardiopulmonary Bypass Are Not Associated with Improved Postoperative Outcomes After Cardiac Surgery

Directory of Open Access Journals (Sweden)

Yiliam F Rodriguez-Blanco

2016-11-01

Full Text Available ObjectivesClinical trials of either pulmonary perfusion or ventilation during cardiopulmonary bypass are equivocal. We hypothesized that to achieve significant improvement in outcomes both interventions had to be concurrent.DesignRetrospective case-control studySettingsMajor academic tertiary referral medical centerParticipants274 consecutive patients who underwent open heart surgery with cardiopulmonary bypass 2009 - 2013.InterventionsThe outcomes of 86 patients who received pulmonary perfusion and ventilation during cardiopulmonary bypass were retrospectively compared to the control group of 188 patients.Measurements and Main ResultsRespiratory complications rates were similar in both groups (33.7% vs. 33.5%, as were the rates of postoperative pneumonia (4.7% vs. 4.3%, pleural effusions (13.9% vs. 12.2% and re-intubations (9.3% vs. 9.1%. Rates of adverse postoperative cardiac events including ventricular tachycardia (9.3% vs. 8.5% and atrial fibrillation (33.7% vs. 28.2% were equivalent in both groups. Incidence of sepsis (8.1% vs. 5.3%, postoperative stroke (2.3% vs. 2.1%, acute kidney injury (2.3% vs. 3.7% and renal failure (5.8% vs. 3.7% were likewise comparable. Despite similar transfusion requirements, coagulopathy (12.8% vs. 5.3%, p=0.031 and the need for mediastinal re-exploration (17.4% vs. 9.6%, p=0.0633 were observed more frequently in the pulmonary perfusion and ventilation group, but the difference did not reach the statistical significance. ICU and hospital stays, and the ICU readmission rates (7.0% vs. 8.0% were similar in both groups.ConclusionsSimultaneous pulmonary perfusion and ventilation during cardiopulmonary bypass were not associated with improved clinical outcomes.

Cadastral Systems Re-engineering in Urban Zimbabwe

African Journals Online (AJOL)

2015-11-16

Nov 16, 2015 ... 1Geomatics Department, Tshwane University of Technology, Pretoria, South Africa, ... cadastral information system of all municipalities in Zimbabwe with .... various levels of government, private, non-governmental sector and.

ARTHROSCOPIC REPAIR OF LARGE AND MASSIVE ROTATOR CUFF TEARS: CLINICAL OUTCOMES AND POSTOPERATIVE MRI FINDINGS

Directory of Open Access Journals (Sweden)

S. Yu. Dokolin

2017-01-01

Full Text Available Purpose of the study – to identify incidence rate of recurrent rotator cuff (RC tears, to evaluate outcomes of arthroscopic bone-tendon anchor suture, to determine the factors influencing arthroscopic treatment outcomes.Materials and methods. Medical history data, pre-operative x-rays and MRI of shoulder joints of 305 patients (main group who underwent arthroscopic bone-tendon anchor suture repair of large or massive RC tears during 2010-2016 were included in the study. Follow up period ranged from 1 to 6 years postoperatively with mean value of 25,6±4,5 months. Telephone survey of patients was conducted after the surgery as well as a single examination of patients with evaluation by functional scales – UCLA, ASES, CS, VAS, DN4. Preoperative standard x-rays in AP and axial views were done in all patients. Arthropathy severity was evaluated by K.Hamada classification. Comparison of patient specific data, features of RC lesions and surgical treatment was made by Kruskal-Wallis test.Results. Good outcomes by ASES, CS and UCLA functional scales were obtained in 15 (5% of patients, satisfactory – in 213 (69.8%, poor – in 77 (25.2%. Postoperative MRI data provided the following sub-distribution of patients: 49 (41.1% patients with complete repair of RC tendons lesions, 38 (31.9% patients with partial repair and 33 (27.0% patients with recurrent tear of reconstructed tendon. Correlation analysis allowed to establish the limits for achieving good outcomes of arthroscopic bone-tendon anchor suturing for significant association with infraspinatus muscle atrophy (not exceeding 40% and fatty infiltration of supraspinatus muscle (not exceeding 23.5%. 

Postoperative Perfection: Ceiling Effects and Lack of Discrimination With Both SRS-22 and -24 Outcomes Instruments in Patients With Adolescent Idiopathic Scoliosis.

Science.gov (United States)

Bastrom, Tracey P; Bartley, Carrie; Marks, Michelle C; Yaszay, Burt; Newton, Peter O

2015-12-01

Review of a prospective database registry. To compare the Scoliosis Research Society (SRS)-22 and SRS-24 outcomes instruments in terms of scores, rate of ceiling effects, and discriminant ability in patients with pre- and postoperative adolescent idiopathic scoliosis. Despite improvements noted with the SRS-22, the SRS-24 is still occasionally used prospectively and for comparisons with previous studies reporting SRS-24 scores. Previous work has demonstrated that postoperative scores from the 2 versions are not interchangeable. A multicenter prospective registry of patients who underwent surgical correction of adolescent idiopathic scoliosis was queried for preoperative and 2-year postoperative SRS-22 and SRS-24 scores. Scores were compared between versions and ceiling effects were identified. Groups of deformity severity were created to evaluate discriminant ability. 829 patients were identified. The SRS-22 scores for pain and general function were significantly greater than SRS-24 scores (P self-image (P self-image domain was able to discriminate between large (29°+) and small (≤11°) residual curves (P < 0.05). Scores obtained by the SRS-22 and the SRS-24 are not translatable despite shared domains. Whereas both versions demonstrated preoperative discriminant ability, postoperative discrimination of residual deformity is lacking in both. Patient-reported outcomes of treatment are crucial in advancing treatment, and improvement in the ability to assess subjective outcomes is essential. 3.

Preoperative alcoholism and postoperative morbidity

DEFF Research Database (Denmark)

Tonnesen, H; Kehlet, H

1999-01-01

BACKGROUND: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. METHODS: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity...... in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... to postoperative morbidity. CONCLUSION: Alcohol consumption should be included in the preoperative assessment of likely postoperative outcome. Reduction of postoperative morbidity in alcohol abusers may include preoperative alcohol abstinence to improve organ function, or perioperative alcohol administration...

Derivative Market: An Integral Part Of The Zimbabwe Stock Exchange

OpenAIRE

Kosmas Njanike

2010-01-01

The study assesses the need for a derivative market as an integral of Zimbabwe Stock Exchange. It also aims to evaluate the feasibility of establishing a derivative market as an essential element of Zimbabwe Stock Exchange. The research identifies factors that need to be addressed to facilitate such a market. Views of various fund managers, financial analysts and dealers drawn from asset management firms were used. Changes in market trends are influenced by hyper inflation and acute financial...

Electricity from bagasse in Zimbabwe

International Nuclear Information System (INIS)

Mbohwa, C.; Fukuda, S.

2003-01-01

Zimbabwe has suffered electrical power shortages resulting in electrical energy imports rising to between 40% and 50% of total energy needs. Electricity generation capacity has stagnated at around 2000 Megawatts (MW e ) since 1985, when two thermal units totaling 440 MW e were completed at Hwange. The effective capacity is 1.75 GW e . The current plan is to increase capacity by installing 600 MW e at Hwange at a cost of at least US $ 600 million. Raising this level of capital is difficult hence over the last 15 years there has been a failure to increase capacity. This article is based on a study of bagasse cogeneration in Zimbabwe and Mauritius conducted over a two-year period. It discusses technology improvements that can be made in the sugar sector to improve process and energy efficiency for the purposes of becoming an independent power producer that supplies power to the grid continuously throughout the year. Power plant investment in the sugar industry offers a bridging and realizable alternative for electricity generation in Zimbabwe. Investment in a 35 MW e bagasse (moisturized fiber left when sugar has been extracted from sugarcane) system would require a capital of about US$ 35 million using modern technology based on experiences in Mauritius and Reunion. A technical and economic evaluation and analysis reveals that bagasse power development is technically and economically feasible if electricity is priced at the long-term marginal cost. At current import prices, financial assistance from the global environment facility and/or the clean development mechanism of the Kyoto protocol would be necessary. The solving of the current political and economic problems in the country would pave the way for attracting a technical partner and development, of bagasse power using domestic and international financing

Radiographic Outcomes of Postoperative Taping Following Hallux Valgus Correction.

Science.gov (United States)

Ponzio, Danielle Y; Pedowitz, David I; Verma, Kushagra; Maltenfort, Mitchell G; Winters, Brian S; Raikin, Steven M

2015-07-01

Traditionally, hallux valgus operative correction has been accompanied by serial spica taping of the great toe during the postoperative period. We retrospectively reviewed 187 adult patients who underwent proximal first metatarsal osteotomy with a modified McBride procedure in 2008-2009 (n = 83) and 2011-2012 (n = 104). Postoperatively, to maintain the corrected position of the hallux, patients from 2008 through 2009 underwent weekly spica taping, while patients from 2011 through 2012 utilized a toe separator. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured using anteroposterior weight-bearing preoperative, 2-week postoperative non-weight-bearing, and 3-month weight-bearing final follow-up radiographs. A mixed-effects linear regression model identified differences between the treatment groups over time, and a t test compared actual radiographic differences at final follow-up. The mixed-effects model revealed no significant difference in the HVA over time when comparing patients taped to those not taped at the preoperative (33 ± 6 vs 33 ± 6), 2-week postoperative (10 ± 7 vs 9 ± 6), and 3-month follow-up (14 ± 6 vs 11 ± 7) visits (P = .08). At final follow-up, the HVA was lower for the group that was not taped, but the difference (2.5 degrees) was below the minimal clinically important difference (MCID) (P = .015, 95% CI 0.5-4.5). For IMA, there was improved maintenance of correction over time in the patients that were not taped compared to those taped at the preoperative (15 ± 3 vs 15 ± 3), 2-week postoperative (2 ± 2 vs 3 ± 3), and 3-month follow-up (5 ± 4 vs 7 ± 4) visits (P = .002). At final follow-up, the IMA was lower for the group that was not taped, but the difference (1.7 degrees) was below the MCID (P = .004, 95% CI 0.7-2.9). We report no radiographic benefit of postoperative taping after hallux valgus correction. The present study challenges the previous dogma of postoperative spica taping as the protocol is cost and

Brand equity and willingness to pay for condoms in Zimbabwe.

Science.gov (United States)

Evans, W Douglas; Taruberekera, Noah; Longfield, Kim; Snider, Jeremy

2011-10-26

Zimbabwe suffers from one of the greatest burdens of HIV/AIDS in the world that has been compounded by social and economic instability in the past decade. However, from 2001 to 2009 HIV prevalence among 15-49 year olds declined from 26% to approximately 14%. Behavior change and condom use may in part explain this decline.PSI-Zimbabwe socially markets the Protector Plus (P+) branded line of condoms. When Zimbabwe converted to a dollar-based economy in 2009, the price of condoms was greatly increased and new marketing efforts were undertaken. This paper evaluates the role of condom marketing, a multi-dimensional scale of brand peceptions (brand equity), and price in condom use behavior. We randomly sampled sexually active men age 15-49 from 3 groups - current P+ users, former users, and free condom users. We compared their brand equity and willingness to pay based on survey results. We estimated multivariable logistic regression models to compare the 3 groups. We found that the brand equity scale was positive correlated with willingness to pay and with condom use. Former users also indicated a high willingness to pay for condoms. We found differences in brand equity between the 3 groups, with current P+ users having the highest P+ brand equity. As observed in previous studies, higher brand equity was associated with more of the targeted health behavior, in this case and more consistent condom use. Zimbabwe men have highly positive brand perceptions of P+. There is an opportunity to grow the total condom market in Zimbabwe by increasing brand equity across user groups. Some former users may resume using condoms through more effective marketing. Some free users may be willing to pay for condoms. Achieving these objectives will expand the total condom market and reduce HIV risk behaviors.

Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Lee, Ja Young; Kim, Sung Hwan; Kim, Ki Won; Park, Dong Choon; Yoon, Joo Hee; Yoon, Sei Chul [St. Vincent' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of); Yu, Mina [St. Mary' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

2012-03-15

To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

Predictive images of postoperative levator resection outcome using image processing software.

Science.gov (United States)

Mawatari, Yuki; Fukushima, Mikiko

2016-01-01

This study aims to evaluate the efficacy of processed images to predict postoperative appearance following levator resection. Analysis involved 109 eyes from 65 patients with blepharoptosis who underwent advancement of levator aponeurosis and Müller's muscle complex (levator resection). Predictive images were prepared from preoperative photographs using the image processing software (Adobe Photoshop ® ). Images of selected eyes were digitally enlarged in an appropriate manner and shown to patients prior to surgery. Approximately 1 month postoperatively, we surveyed our patients using questionnaires. Fifty-six patients (89.2%) were satisfied with their postoperative appearances, and 55 patients (84.8%) positively responded to the usefulness of processed images to predict postoperative appearance. Showing processed images that predict postoperative appearance to patients prior to blepharoptosis surgery can be useful for those patients concerned with their postoperative appearance. This approach may serve as a useful tool to simulate blepharoptosis surgery.

Radiographic sarcopenia predicts postoperative infectious complications in patients undergoing pancreaticoduodenectomy.

Science.gov (United States)

Takagi, Kosei; Yoshida, Ryuichi; Yagi, Takahito; Umeda, Yuzo; Nobuoka, Daisuke; Kuise, Takashi; Fujiwara, Toshiyoshi

2017-05-26

Recently, skeletal muscle depletion (sarcopenia) has been reported to influence postoperative outcomes after certain procedures. This study investigated the impact of sarcopenia on postoperative outcomes following pancreaticoduodenectomy (PD). We performed a retrospective study of consecutive patients (n = 219) who underwent PD at our institution between January 2007 and May 2013. Sarcopenia was evaluated using preoperative computed tomography. We evaluated postoperative outcomes and the influence of sarcopenia on short-term outcomes, especially infectious complications. Subsequently, multivariate analysis was used to assess the impact of prognostic factors (including sarcopenia) on postoperative infections. The mortality, major complication, and infectious complication rates for all patients were 1.4%, 16.4%, and 47.0%, respectively. Fifty-five patients met the criteria for sarcopenia. Sarcopenia was significantly associated with a higher incidence of in-hospital mortality (P = 0.004) and infectious complications (P sarcopenia (odds ratio = 3.43; P Sarcopenia is an independent preoperative predictor of infectious complications after PD. Clinical assessment combined with sarcopenia may be helpful for understanding the risk of postoperative outcomes and determining perioperative management strategies.

Postoperative spine infections

Directory of Open Access Journals (Sweden)

Paolo Domenico Parchi

2015-09-01

Full Text Available Postoperative spinal wound infection is a potentially devastating complication after operative spinal procedures. Despite the utilization of perioperative prophylactic antibiotics in recent years and improvements in surgical technique and postoperative care, wound infection continues to compromise patients’ outcome after spinal surgery. In the modern era of pending health care reform with increasing financial constraints, the financial burden of post-operative spinal infections also deserves consideration. The aim of our work is to give to the reader an updated review of the latest achievements in prevention, risk factors, diagnosis, microbiology and treatment of post-operative spinal wound infections. A review of the scientific literature was carried out using electronic medical databases Pubmed, Google Scholar, Web of Science and Scopus for the years 1973-2012 to obtain access to all publications involving the incidence, risk factors, prevention, diagnosis, treatment of postoperative spinal wound infections. We initially identified 119 studies; of these 60 were selected. Despite all the measures intended to reduce the incidence of surgical site infections in spine surgery, these remain a common and potentially dangerous complication.

Social protection initiatives for Zimbabwe's vulnerable groups ...

African Journals Online (AJOL)

Saharan African region. ... especially for vulnerable groups. At independence in 1980, Zimbabwe pledged to promote a viable social protection system that would be predicated on the principles of social justice and equality of opportunity.

Impact of tricuspid valve surgery at the time of left ventricular assist device insertion on postoperative outcomes.

Science.gov (United States)

Dunlay, Shannon M; Deo, Salil V; Park, Soon J

2015-01-01

Tricuspid regurgitation (TR) is common in patients with heart failure undergoing left ventricular assist device (LVAD) implantation. Whether the TR should be surgically managed at the time of LVAD surgery is controversial. We searched SCOPUS, Web of Science, Ovid EMBASE, and Ovid MEDLINE (through May 10, 2014) for randomized controlled trials and observational studies comparing postoperative outcomes in patients treated with LVAD with concomitant tricuspid valve surgery (TVS) compared with LVAD alone. Six observational studies including 3,249 patients compared outcomes following LVAD + TVS versus LVAD. Four studies were single-center and most did not adjust for potential confounders. Addition of TVS prolonged cardiopulmonary bypass times by an average of 31 minutes (three studies, 95% CI 20-42). There was no difference in need for right ventricular assist device (six studies, HR 1.42, 95% CI 0.54-3.76), acute renal failure (four studies, HR 1.07, 95% CI 0.55-2.10), or early mortality (six studies, HR 1.28, 95% CI 0.78-2.08) in patients treated with LVAD + TVS versus LVAD alone. TVS prolongs cardiopulmonary bypass times, but available data demonstrate no significant association with early postoperative outcomes. However, differences in baseline risk of patients treated with TVS versus not limit our ability to draw conclusions.

Post-operative sleep disturbance: causes, factors and effects on outcome

DEFF Research Database (Denmark)

Rosenberg, J; Rosenberg-Adamsen, S; Kehlet, H

1995-01-01

Post-operative sleep disturbance, with suppression of rapid eye movement sleep and slow wave sleep followed by a subsequent rebound, seems to be related to the magnitude of trauma and thereby to the surgical stress response. In this context, cortisol, autonomic stimulation, and certain cytokines...... may lead to abnormal sleep. Furthermore, the environment, pain and the administration of analgesics seem to be important factors in the precipitation of sleep abnormalities. Post-operative sleep disturbance may contribute to the development of episodic hypoxaemia, haemodynamic instability and altered...... mental status, all of which have an influence on post-operative morbidity and mortality. Prevention or reduction of the post-operative sleep disturbance may be achieved by minimizing surgical trauma, changing the conventional nursing procedures, avoiding opioids and treating pain with non...

Geoarchaeology of water management at Great Zimbabwe

DEFF Research Database (Denmark)

Sulas, Federica; Pikirayi, Innocent; Sagiya, Munyaradzi Elton

In Africa, research on water management in urban contexts has often focussed rainfall, and the occurrence floods and droughts, whereas small-scale catchment systems and soil moisture regimes have received far less attention. This paper sets out to re-address the issue by examining the occurrence......, distribution and use of multiple water resources at the ancient urban landscape of Great Zimbabwe. Here, the rise and demise of the urban site have been linked to changing rainfall in the 1st mill. AD. Accordingly, rainfall shortages and consequent droughts eventually leading to the decline and abandonment...... of Great Zimbabwe at around 1550 AD. However, new research findings suggest a different scenario. Combining geoarchaeolological investigations, soil micromorphology and geochemistry with the study of historical sources and ethnographic records, new datasets indicate prolonged availability and diversified...

Limits and opportunities of marketeering tertiary education in post-colonial Zimbabwe

OpenAIRE

Patrick Sibanda

2016-01-01

This paper intended to assess the impact of marketeering tertiary education in Zimbabwe. The paper revealed that marketeering of tertiary education in Zimbabwe has drastically impacted on access to higher education and training. Poor and vulnerable students have found it difficult to access tertiary education due to escalating commercialized fees. Literature indicates that, even in developed countries like UK, marketeering tertiary education has led to decreased enrolments, diminishing prospe...

An Optimal Cost Effectiveness Study on Zimbabwe Cholera Seasonal Data from 2008–2011

Science.gov (United States)

Sardar, Tridip; Mukhopadhyay, Soumalya; Bhowmick, Amiya Ranjan; Chattopadhyay, Joydev

2013-01-01

Incidence of cholera outbreak is a serious issue in underdeveloped and developing countries. In Zimbabwe, after the massive outbreak in 2008–09, cholera cases and deaths are reported every year from some provinces. Substantial number of reported cholera cases in some provinces during and after the epidemic in 2008–09 indicates a plausible presence of seasonality in cholera incidence in those regions. We formulate a compartmental mathematical model with periodic slow-fast transmission rate to study such recurrent occurrences and fitted the model to cumulative cholera cases and deaths for different provinces of Zimbabwe from the beginning of cholera outbreak in 2008–09 to June 2011. Daily and weekly reported cholera incidence data were collected from Zimbabwe epidemiological bulletin, Zimbabwe Daily cholera updates and Office for the Coordination of Humanitarian Affairs Zimbabwe (OCHA, Zimbabwe). For each province, the basic reproduction number () in periodic environment is estimated. To the best of our knowledge, this is probably a pioneering attempt to estimate in periodic environment using real-life data set of cholera epidemic for Zimbabwe. Our estimates of agree with the previous estimate for some provinces but differ significantly for Bulawayo, Mashonaland West, Manicaland, Matabeleland South and Matabeleland North. Seasonal trend in cholera incidence is observed in Harare, Mashonaland West, Mashonaland East, Manicaland and Matabeleland South. Our result suggests that, slow transmission is a dominating factor for cholera transmission in most of these provinces. Our model projects cholera cases and cholera deaths during the end of the epidemic in 2008–09 to January 1, 2012. We also determine an optimal cost-effective control strategy among the four government undertaken interventions namely promoting hand-hygiene & clean water distribution, vaccination, treatment and sanitation for each province. PMID:24312540

Influence of fragment size and postoperative joint congruency on long-term outcome of posterior malleolar fractures.

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Drijfhout van Hooff, Cornelis Christiaan; Verhage, Samuel Marinus; Hoogendoorn, Jochem Maarten

2015-06-01

One of the factors contributing to long-term outcome of posterior malleolar fractures is the development of osteoarthritis. Based on biomechanical, cadaveric, and small population studies, fixation of posterior malleolar fracture fragments (PMFFs) is usually performed when fragment size exceeds 25-33%. However, the influence of fragment size on long-term clinical and radiological outcome size remains unclear. A retrospective cohort study of 131 patients treated for an isolated ankle fracture with involvement of the posterior malleolus was performed. Mean follow-up was 6.9 (range, 2.5-15.9) years. Patients were divided into groups depending on size of the fragment, small (25%, n = 25), and presence of step-off after operative treatment. We have compared functional outcome measures (AOFAS, AAOS), pain (VAS), and dorsiflexion restriction compared to the contralateral ankle and the incidence of osteoarthritis on X-ray. There were no nonunions, 56% of patients had no radiographic osteoarthritis, VAS was 10 of 100, and median clinical score was 90 of 100. More osteoarthritis occurred in ankle fractures with medium and large PMFFs compared to small fragments (small 16%, medium 48%, large 54%; P = .006). Also when comparing small with medium-sized fragments (P = .02), larger fragment size did not lead to a significantly decreased function (median AOFAS 95 vs 88, P = .16). If the PMFF size was >5%, osteoarthritis occurred more frequently when there was a postoperative step-off ≥1 mm in the tibiotalar joint surface (41% vs 61%, P = .02) (whether the posterior fragment had been fixed or not). In this group, fixing the PMFF did not influence development of osteoarthritis. However, in 42% of the cases with fixation of the fragment a postoperative step-off remained (vs 45% in the group without fixation). Osteoarthritis is 1 component of long-term outcome of malleolar fractures, and the results of this study demonstrate that there was more radiographic osteoarthritis in

Impact of Cervical Spine Deformity on Preoperative Disease Severity and Postoperative Outcomes Following Fusion Surgery for Degenerative Cervical Myelopathy: Sub-analysis of AOSpine North America and International Studies.

Science.gov (United States)

Kato, So; Nouri, Aria; Wu, Dongjin; Nori, Satoshi; Tetreault, Lindsay; Fehlings, Michael G

2018-02-15

Sub-analysis of the prospective AOSpine CSM North America and International studies. The aim of this study was to investigate the impact of cervical spine deformity on pre- and postoperative outcomes in fusion surgeries for degenerative cervical myelopathy. The associations between cervical alignment and patient outcomes have been reported but are not well established in a myelopathy cohort. The impact of deformity correction in this population also needs to be elucidated. A total of 757 patients were enrolled in two prospective international multicenter AOSpine studies. Among those who underwent anterior or posterior fusion surgeries, pre- and 1-year postoperative upright neutral lateral radiographs of cervical spine were investigated to measure C2-7 Cobb angle and C2-7 sagittal vertical axis (SVA). Patient outcome measures included the modified Japanese Orthopedic Association score for myelopathy severity, Neck Disability Index (NDI), and Short-form 36 (SF-36). These scores were compared between patients with and without cervical deformity, which was defined as C2-7 Cobb >10° kyphosis and/or SVA >40 mm. A total of 178 patients were included with complete pre- and postoperative radiographs. SVA significantly increased postoperatively (27.4 vs. 30.7 mm, P = 0.004). All outcome measurement showed significant improvements above minimal clinically important differences. 23.6% of the patients had cervical deformity preoperatively; preoperative deformity was associated with worse preoperative NDI scores (45.7 vs. 38.9, P = 0.04). Postoperatively, those with deformity exhibited significantly lower SF-36 physical component scores (37.2 vs. 41.4, P = 0.048). However, when focusing on the preoperatively deformed cohort, we did not find any significant differences in the postoperative outcome scores between those with and without residual deformity. There was a significant association between cervical deformity and both preoperative disease severity and

Instituting dispute resolution procedures in the Apostolic Faith Mission in Zimbabwe church

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Norman Chivasa

2018-01-01

Full Text Available The need to institute dispute resolution procedures in the Apostolic Faith Mission (AFM in Zimbabwe church informs this study. Remarkably, one of the most critical problems facing the AFM in Zimbabwe church is intrachurch disputes, which manifest in diverse forms such as pastors’ transfers disputes, election disputes and pastors’ performance disputes. Such disputes have produced undesirable consequences not only for pastors but also for the wellbeing of the church in general. Intrachurch disputes require internal mechanisms to manage them so that constructive rather than destructive results are achieved. To do this, internal dispute resolution procedures become critical as they provide a framework for the constructive resolution of disputes. The lived experience of disputes in the AFM in Zimbabwe church confirms the appropriateness of systems theory, which states that social institutions are vulnerable to disharmony owing to differing interacting elements. To mitigate the negative impact associated with disputes, this study proposes the need to institute dispute resolution procedures in the AFM in Zimbabwe, because the church currently relies only on disciplinary procedures to address disputes. The study further emphasises that instituting dispute resolution procedures will help the church handle disputes from within its ranks without necessarily involving local courts, which may have negative financial and relationship implications. Finally, the study develops a model for dispute resolution procedures as an instrument that can assist local churches in AFM in Zimbabwe church to handle disputes as and when they arise.

Do post-operative changes of neck-shaft angle and femoral component anteversion have an effect on clinical outcome following uncemented total hip arthroplasty?

Science.gov (United States)

Müller, M; Abdel, M P; Wassilew, G I; Duda, G; Perka, C

2015-12-01

The accurate reconstruction of hip anatomy and biomechanics is thought to be important in achieveing good clinical outcomes following total hip arthroplasty (THA). To this end some newer hip designs have introduced further modularity into the design of the femoral component such that neck-shaft angle and anteversion, which can be adjusted intra-operatively. The clinical effect of this increased modularity is unknown. We have investigated the changes in these anatomical parameters following conventional THA with a prosthesis of predetermined neck-shaft angle and assessed the effect of changes in the hip anatomy on clinical outcomes. In total, 44 patients (mean age 65.3 years (standard deviation (SD) 7); 17 male/27 female; mean body mass index 26.9 (kg/m²) (SD 3.1)) underwent a pre- and post-operative three-dimensional CT scanning of the hip. The pre- and post-operative neck-shaft angle, offset, hip centre of rotation, femoral anteversion, and stem alignment were measured. Additionally, a functional assessment and pain score were evaluated before surgery and at one year post-operatively and related to the post-operative anatomical changes. The mean pre-operative neck-shaft angle was significantly increased by 2.8° from 128° (SD 6.2; 119° to 147°) to 131° (SD 2.1; 127° to 136°) (p = 0.009). The mean pre-operative anteversion was 24.9° (SD 8; 7.9 to 39.1) and reduced to 7.4° (SD 7.3; -11.6° to 25.9°) post-operatively (p shaft angles was found with a significant decrease of the post-operative anteversion and slight increase of the neck-shaft angles, but without any impact on clinical outcome. ©2015 The British Editorial Society of Bone & Joint Surgery.

Deconstructing the dichotomies of solar photovoltaic (PV) dissemination trajectories in Ghana, Kenya and Zimbabwe from the 1960s to 2007

International Nuclear Information System (INIS)

Bawakyillenuo, Simon

2012-01-01

The profuse dissemination and utilisation of solar PV technology in the world is indispensable, especially in this era of climate change. However, in the African continent, between 1960 and 2007 Kenya and Zimbabwe were among countries with the highest PV dissemination, while Ghana was among countries with the least disseminations. Analysing empirical data through the lens of the Social Construction of Technology (SCOT) theory, the article aims to uncover the drivers underpinning the disparate dissemination trends of PV in the three countries within the stated period and to tease out lessons apropos replicating the successes within Kenya and Zimbabwe in Ghana. SCOT theory is chosen because it provides an excellent framework for analysing the social shaping of PV's development and diffusion processes in these countries. This theory posits that the shape and meanings of a technology do not reside in it, but are acquired through the heterogeneity of social interactions. Findings in the paper reveal that a gamut of socio-economic and political antecedents informed the varied dissemination outcomes of the technology in these countries. Premised on these findings, the paper recommends critical steps, which Ghana needs to undertake to enhance the replication of the Kenyan and Zimbabwean PV success stories. - Highlights: ► I examined the disparate disseminations of PV in Kenya, Zimbabwe and Ghana. ► Kenya's PV market successes not down to private sector alone. ► Varied antecedents underpin the dissimilar disseminations of PV in these countries. ► Replication of Kenya and Zimbabwe success stories in Ghana demands certain factors.

World Small Hydropower Development Report 2013 - Zimbabwe

CSIR Research Space (South Africa)

Jonker Klunne, W

2013-01-01

Full Text Available in 2006. With the current economic and political situation in Zimbabwe improving, the drive by the Government to encourage independent power producers, the prospects for the development of small hydropower are promising....

Yield gap analysis and resource footprints of Irish potato production systems in Zimbabwe

NARCIS (Netherlands)

Svubure, O.; Struik, P.C.; Haverkort, A.J.; Steyn, J.M.

2015-01-01

Irish potato is the third most important carbohydrate food crop in Zimbabwe after maize and wheat. In 2012, the Government of Zimbabwe declared it a strategic national food security crop. In this study, we examine the country's potential for increasing Irish potato yield and help ease the nation's

Zimbabwe's Exodus: Crisis, Migration, Survival | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

2010-07-01

Jul 1, 2010 ... ... of exile and return, we can glimpse the extraordinary people behind the ... The book explores the relationship between Zimbabwe's economic and ... partnering on a new initiative, aimed at reducing the emerging risk that.

Postoperative irradiation of incompletely excised gemistocytic astrocytomas. Clinical outcome and prognostic factors

International Nuclear Information System (INIS)

Nowak-Sadzikowska, J.; Glinski, B.; Szpytma, T.; Pluta, E.

2005-01-01

Background and purpose: although gemistocytic astrocytomas are considered slow-growing tumors, they often behave aggressively and carry the least favorable prognosis among low-grade astrocytomas. The aim of this study is to evaluate the outcomes and prognostic factors of patients with incompletely excised gemistocytic astrocytomas irradiated postoperatively. Patients and methods: records of 48 patients with incompletely excised gemistocytic astrocytoma, irradiated between 1976 and 1998 at the department of radiation oncology, Maria Sklodowska-curie Memorial Cancer Center, Cracow, Poland, were reviewed. The total dose ranged from 50 to 60 Gy (mean: 59.35, median: 60 Gy) delivered in daily fractions of 2 Gy, 5 days a week. The treatment volume covered the residual tumor with a margin of 1-2 cm. Results: toxicity was acceptable. The overall actuarial survival rates at 5 and 10 years were 30% and 17%, respectively. Age and gender had an influence on overall survival by univariate and multivariate analysis (p < 0.05). Patients ≤ 35 years of age and female patients carried the best prognosis. Conclusion: in most patients with gemistocytic astrocytoma, combined surgery and postoperative radiotherapy result in only short-term survival. Older age is the most important unfavorable prognostic factor in patients with gemistocytic astrocytoma. (orig.)

Assessment of Postoperative Analgesic Drug Efficacy

DEFF Research Database (Denmark)

Andersen, Lars Peter Kloster; Gögenur, Ismail; Torup, Henrik

2017-01-01

BACKGROUND: Pain intensity ratings and opioid consumption (OC) are ubiquitous indicators of pain in postoperative trials of the efficacy of interventional procedures. Unfortunately, consensus on the appropriate statistical handling of these outcomes has not been reached. The aim of this article was......, therefore, to reexamine original data obtained from a postoperative analgesic drug trial, applying a collection of standard statistical methods in analgesic outcome assessments. Furthermore, a modified integrated assessment method of these outcomes was evaluated. METHODS: Data from a randomized, double...... also included an integrated assessment of longitudinally measured pain intensity and opioid consumption (PIOC0-6/0-24 h). Also, estimation of effect size, generalized odds ratio of the individual analgesic outcome variables was performed. RESULTS: Sixty-one patients were included in the final data...

The Functions of Selected Human Rights Institutions and Related Role-Players in the Protection of Human Rights in Zimbabwe

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Howard Chitimira

2016-12-01

Full Text Available Various violations of the human rights of ordinary people and human rights defenders have been reported in Zimbabwe since the late 1980s. It is widely acknowledged that such violations have been perpetrated mostly by the government through its different organs for political and other related reasons. Human rights violations were also easily committed against ordinary people and human rights defenders because there was no Constitution that adequately protected such people's fundamental human rights (including their civil and political rights and their socio-economic rights in Zimbabwe. Given this background, the article discusses the protection of human rights in Zimbabwe, in the light of the Zimbabwe Constitution Amendment Act 20 of 2013 (Zimbabwe Constitution 2013. This is done in order to investigate whether the promotion, protection, enforcement and respect for human rights in Zimbabwe has now improved. To this end, the functions of selected national human rights institutions and other related role-players, namely civil society, the judiciary, the law enforcement organs and the Zimbabwe Human Rights Commission, are briefly discussed first. Secondly, the functions of selected regional and international institutions, namely the Southern African Development Community, the African Union and the United Nations are discussed in relation to the protection of human rights in Zimbabwe. Thereafter, concluding remarks and possible recommendations that could be utilised to combat human rights violations and enhance the protection of human rights in Zimbabwe are provided.

3 Tesla MRI-negative focal epilepsies: Presurgical evaluation, postoperative outcome and predictive factors.

Science.gov (United States)

Kogias, Evangelos; Klingler, Jan-Helge; Urbach, Horst; Scheiwe, Christian; Schmeiser, Barbara; Doostkam, Soroush; Zentner, Josef; Altenmüller, Dirk-Matthias

2017-12-01

To investigate presurgical diagnostic modalities, clinical and seizure outcome as well as predictive factors after resective epilepsy surgery in 3 Tesla MRI-negative focal epilepsies. This retrospective study comprises 26 patients (11 males/15 females, mean age 34±12years, range 13-50 years) with 3 Tesla MRI-negative focal epilepsies who underwent resective epilepsy surgery. Non-invasive and invasive presurgical diagnostic modalities, type and localization of resection, clinical and epileptological outcome with a minimum follow-up of 1year (range 1-11 years, mean 2.5±2.3years) after surgery as well as outcome predictors were evaluated. All patients underwent invasive video-EEG monitoring after implantation of intracerebral depth and/or subdural electrodes. Ten patients received temporal and 16 extratemporal or multilobar (n=4) resections. There was no perioperative death or permanent morbidity. Overall, 12 of 26 patients (46%) were completely seizure-free (Engel IA) and 65% had a favorable outcome (Engel I-II). In particular, seizure-free ratio was 40% in the temporal and 50% in the extratemporal group. In the temporal group, long duration of epilepsy correlated with poor seizure outcome, whereas congruent unilateral FDG-PET hypometabolism correlated with a favorable outcome. In almost two thirds of temporal and extratemporal epilepsies defined as "non-lesional" by 3 Tesla MRI criteria, a favorable postoperative seizure outcome (Engel I-II) can be achieved with accurate multimodal presurgical evaluation including intracranial EEG recordings. In the temporal group, most favorable results were obtained when FDG-PET displayed congruent unilateral hypometabolism. Copyright © 2017 Elsevier B.V. All rights reserved.

Predictive images of postoperative levator resection outcome using image processing software

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Mawatari Y

2016-09-01

Full Text Available Yuki Mawatari,1 Mikiko Fukushima2 1Igo Ophthalmic Clinic, Kagoshima, 2Department of Ophthalmology, Faculty of Life Science, Kumamoto University, Chuo-ku, Kumamoto, Japan Purpose: This study aims to evaluate the efficacy of processed images to predict postoperative appearance following levator resection.Methods: Analysis involved 109 eyes from 65 patients with blepharoptosis who underwent advancement of levator aponeurosis and Müller’s muscle complex (levator resection. Predictive images were prepared from preoperative photographs using the image processing software (Adobe Photoshop®. Images of selected eyes were digitally enlarged in an appropriate manner and shown to patients prior to surgery.Results: Approximately 1 month postoperatively, we surveyed our patients using questionnaires. Fifty-six patients (89.2% were satisfied with their postoperative appearances, and 55 patients (84.8% positively responded to the usefulness of processed images to predict postoperative appearance.Conclusion: Showing processed images that predict postoperative appearance to patients prior to blepharoptosis surgery can be useful for those patients concerned with their postoperative appearance. This approach may serve as a useful tool to simulate blepharoptosis surgery. Keywords: levator resection, blepharoptosis, image processing, Adobe Photoshop® 

The Zimbabwe student movement: Love-hate relationship with government?

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Blessing Makunike

2015-10-01

Full Text Available The purpose of the article is to trace the development of student unionism in Zimbabwe.On the basis of a discussion of the nature of the university, the article argues that becausethe university environment tolerates and promotes academic freedom and liberal values, itprovides an environment conducive to critical thought and oppositional politics, while theuniversity quite often itself becomes the target for student attack. Student representationduring the pre-independence period in Zimbabwe sought to engage the institution in itseffort to re-order society at a time of racial struggle and class conflict. After independence,student representation was in support of government efforts to create a better Zimbabweand to consolidate the gains of independence. However, after the first decade ofindependence, the relationship between students and government soured due to students’opposition to the one-party system as well as the University of Zimbabwe AmendmentBill, among other issues. This article thus documents and analyses the relationship betweenstudents and government with reference to three periods and two key moments: the 1973protests against racial discrimination in the pre-independence phase and the post-1990developments in Zimbabwean national and university politics.

Hypertension management in Zimbabwe - awareness, treatment ...

African Journals Online (AJOL)

Hypertension management in Zimbabwe - awareness, treatment and blood pressure control. A community-based study. J A Matenga, T J Allain, A 0 Wilson, D J Adamchak,. B 5enzanje, E Mushangi, Z Gomo. Objective. To evaluate the level of awareness of hypertension, treatment and blood pressure control in rural and ...

Implementing new public management in Zimbabwe: Challenges and obstacles

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Daniel Chigudu

2014-06-01

Full Text Available This paper is an exploratory study of the new public management (NPM’s implementation in Zimbabwe. The data presented is a review of the government’s policy initiatives and research publications. Findings suggest fragmented implementation of NPM reforms without requisite administrative skills, lack of resources, ill timing, and political inertia. This research’s underlying significance is that it provides insights to improve NPM and future public sector reforms. It contributes to relevant literature by filling gaps in the research on NPM in Zimbabwe The paper provides policy recommendations necessary for addressing public sector reforms in developing economies particularly in African countries that have a history of political instability.

Postoperative delirium in intensive care patients: risk factors and outcome.

Science.gov (United States)

Veiga, Dalila; Luis, Clara; Parente, Daniela; Fernandes, Vera; Botelho, Miguela; Santos, Patricia; Abelha, Fernando

2012-07-01

Postoperative delirium (POD) in Surgical Intensive Care patients is an important independent outcome determinant. The purpose of our study was to evaluate the incidence and determinants of POD. Prospective cohort study conducted during a period of 10 months in a Post-Anesthesia Care Unit (PACU) with five intensive care beds. All consecutive adult patients submitted to major surgery were enrolled. Demographic data, perioperative variables, length of stay (LOS) and the mortality at PACU, hospital and at 6-months follow-up were recorded. Postoperative delirium was evaluated using the Intensive Care Delirium Screening Checklist (ICDSC). Descriptive analyses were conducted and the Mann-Whitney test, Chi-square test or Fisher's exact test were used for comparisons. Logistic regression analysis evaluated the determinants of POD with calculation of odds ratio (OR) and its confidence interval 95% (95% CI). There were 775 adult PACU admissions and 95 patients had exclusion criteria. Of the remaining 680 patients, 128 (18.8%) developed POD. Independent determinants of POD identified were age, ASA-PS, emergency surgery and total amount of fresh frozen plasma administered during surgery. Patients with delirium had higher mortality rates, were more severely ill and stayed longer at the PACU and in the hospital. POD was an independent risk factor for hospital mortality There was a high incidence of delirium had a high incidence in intensive care surgical patients. POD was associated with worse severity of disease scores, longer LOS in hospital, and in PACU and higher mortality rates. The independent risk factors for POD were age, ASAPS, emergency surgery and the amount of plasma administered during surgery. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

Co-registered perfusion SPECT/CT: Utility for prediction of improved postoperative outcome in lung volume reduction surgery candidates

International Nuclear Information System (INIS)

Takenaka, Daisuke; Ohno, Yoshiharu; Koyama, Hisanobu; Nogami, Munenobu; Onishi, Yumiko; Matsumoto, Keiko; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Sugimura, Kazuro

2010-01-01

Purpose: To directly compare the capabilities of perfusion scan, SPECT, co-registered SPECT/CT, and quantitatively and qualitatively assessed MDCT (i.e. quantitative CT and qualitative CT) for predicting postoperative clinical outcome for lung volume reduction surgery (LVRS) candidates. Materials and methods: Twenty-five consecutive candidates (19 men and six women, age range: 42-72 years) for LVRS underwent preoperative CT and perfusion scan with SPECT. Clinical outcome of LVRS for all subjects was also assessed by determining the difference between pre- and postoperative forced expiratory volume in 1 s (FEV 1 ) and 6-min walking distance (6MWD). All SPECT examinations were performed on a SPECT scanner, and co-registered to thin-section CT by using commercially available software. On planar imaging, SPECT and SPECT/CT, upper versus lower zone or lobe ratios (U/Ls) were calculated from regional uptakes between upper and lower lung fields in the operated lung. On quantitatively assessed CT, U/L for all subjects was assessed from regional functional lung volumes. On qualitatively assessed CT, planar imaging, SPECT and co-registered SPECT/CT, U/Ls were assessed with a 4-point visual scoring system. To compare capabilities of predicting clinical outcome, each U/L was statistically correlated with the corresponding clinical outcome. Results: Significantly fair or moderate correlations were observed between quantitatively and qualitatively assessed U/Ls obtained with all four methods and clinical outcomes (-0.60 ≤ r ≤ -0.42, p < 0.05). Conclusion: Co-registered perfusion SPECT/CT has better correlation with clinical outcome in LVRS candidates than do planar imaging, SPECT or qualitatively assessed CT, and is at least as valid as quantitatively assessed CT.

Co-registered perfusion SPECT/CT: Utility for prediction of improved postoperative outcome in lung volume reduction surgery candidates

Energy Technology Data Exchange (ETDEWEB)

Takenaka, Daisuke [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.j [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Koyama, Hisanobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Nogami, Munenobu [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Division of Image-Based Medicine, Institute of Biomedical Research and Innovation, 2-2, Minatojima Minamimachi Chuo-ku, Kobe, Hyogo, 650-0047 (Japan); Onishi, Yumiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Matsumoto, Keiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan); Department of Radiology, University of Yamanashi, 1110 Shimogato, Chuo, Yamanashi, 409-3898 (Japan); Yoshikawa, Takeshi; Matsumoto, Sumiaki; Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017 (Japan)

2010-06-15

Purpose: To directly compare the capabilities of perfusion scan, SPECT, co-registered SPECT/CT, and quantitatively and qualitatively assessed MDCT (i.e. quantitative CT and qualitative CT) for predicting postoperative clinical outcome for lung volume reduction surgery (LVRS) candidates. Materials and methods: Twenty-five consecutive candidates (19 men and six women, age range: 42-72 years) for LVRS underwent preoperative CT and perfusion scan with SPECT. Clinical outcome of LVRS for all subjects was also assessed by determining the difference between pre- and postoperative forced expiratory volume in 1 s (FEV{sub 1}) and 6-min walking distance (6MWD). All SPECT examinations were performed on a SPECT scanner, and co-registered to thin-section CT by using commercially available software. On planar imaging, SPECT and SPECT/CT, upper versus lower zone or lobe ratios (U/Ls) were calculated from regional uptakes between upper and lower lung fields in the operated lung. On quantitatively assessed CT, U/L for all subjects was assessed from regional functional lung volumes. On qualitatively assessed CT, planar imaging, SPECT and co-registered SPECT/CT, U/Ls were assessed with a 4-point visual scoring system. To compare capabilities of predicting clinical outcome, each U/L was statistically correlated with the corresponding clinical outcome. Results: Significantly fair or moderate correlations were observed between quantitatively and qualitatively assessed U/Ls obtained with all four methods and clinical outcomes (-0.60 {<=} r {<=} -0.42, p < 0.05). Conclusion: Co-registered perfusion SPECT/CT has better correlation with clinical outcome in LVRS candidates than do planar imaging, SPECT or qualitatively assessed CT, and is at least as valid as quantitatively assessed CT.

Health-related quality of life outcome for oral cancer survivors after surgery and postoperative radiotherapy

International Nuclear Information System (INIS)

Fang, Fu-Min; Chien, Chih-Yen; Wang, Chong-Jong; Tsai, Wen-Ling; Chiu, Herng-Chia

2004-01-01

Health-related quality of life (HRQL) data are becoming an important supplement to information pertaining to treatment outcome for cancer patients. The purpose of this study was to evaluate the HRQL outcome for oral cancer survivors after surgery plus postoperative radiotherapy (RT) and to investigate the variables associated with their HRQL. Sixty-six oral cancer patients with cancer-free survival after surgery plus postoperative RT of >2 years were enrolled. The Short Form-36 (SF-36) questionnaire in the Taiwan Chinese version was self-reported by all participants at the clinics. The linear regression model was used to analyze the socio-demographic and medical-related variables correlated with the physical component summary (PCS) and mental component summary (MCS) in SF-36. The mean scores of the eight functional domains in the SF-36 were markedly lower for oral cancer survivors compared with the Taiwanese and US norms. Those with older age, lower annual family income, more advanced cancer stage and flap reconstruction had significantly worse PCS, and those with lower annual family income, unemployment and more advanced cancer stage reported significantly worse MCS. This model accounts for 63% of variance in PCS, and 51% in MCS. These results provided patient-reported evidence that oral cancer survivors lived with a worse HRQL compared with the general Taiwanese population. Socio-economic factors and cancer stage were important factors correlated with their HRQL. (authors)

Entrepreneurial Careers of Women in Zimbabwe

Science.gov (United States)

Ncube, Lisa B.; Greenan, James P.

2003-01-01

The purpose of this study was to investigate the pathways of entrepreneurial career development and the processes involved for women to become entrepreneurs in Zimbabwe. Women entrepreneurs were studied to gain an understanding of why women chose self-employment and how local enterprise programs should be designed to benefit them. The study…

Moving Zimbabwe Forward : an Evidence Based Policy Dialogue ...

International Development Research Centre (IDRC) Digital Library (Canada)

Moving Zimbabwe Forward : an Evidence Based Policy Dialogue ... levels of poverty, unemployment, inflation and poor service provision in the areas of education, ... International Water Resources Association, in close collaboration with IDRC, ...

Managing Vandalism in Day Secondary Schools in Zimbabwe ...

African Journals Online (AJOL)

Zimbabwe Journal of Educational Research ... contributing factors as leads to management strategies to reduce vandalism in day secondary schools. ... window panes, door handles, classroom furniture and writing on toilet walls and furniture.

Are women with history of pre-eclampsia starting a new pregnancy in good nutritional status in South Africa and Zimbabwe?

Science.gov (United States)

Cormick, Gabriela; Betrán, Ana Pilar; Harbron, Janetta; Dannemann Purnat, Tina; Parker, Catherine; Hall, David; Seuc, Armando H; Roberts, James M; Belizán, José M; Hofmeyr, G Justus

2018-06-15

Maternal nutritional status before and during pregnancy is an important contributor to pregnancy outcomes and early child health. The aim of this study was to describe the preconceptional nutritional status and dietary intake during pregnancy in high-risk women from South Africa and Zimbabwe. This is a prospective observational study, nested to the CAP trial. Anthropometric measurements before and during pregnancy and dietary intake using 24-h recall during pregnancy were assessed. The Intake Distribution Estimation software (PC-SIDE) was used to evaluate nutrient intake adequacy taking the Estimated Average Requirement (EAR) as a cut-off point. Three hundred twelve women who had pre-eclampsia in their last pregnancy and delivered in hospitals from South Africa and Zimbabwe were assessed. 73.7 and 60.2% women in South Africa and Zimbabwe, respectively started their pregnancy with BMI above normal (BMI ≥ 25) whereas the prevalence of underweight was virtually non-existent. The majority of women had inadequate intakes of micronutrients. Considering food and beverage intake only, none of the micronutrients measured achieved the estimated average requirement. Around 60% of pregnant women reported taking folic acid or iron supplements in South Africa, but almost none did so in Zimbabwe. We found a high prevalence of overweight and obesity and high micronutrient intake inadequacy in pregnant women who had the previous pregnancy complicated with pre-eclampsia. The obesity figures and micronutrient inadequacy are issues of concern that need to be addressed. Pregnant women have regular contacts with the health system; these opportunities could be used to improve diet and nutrition. PACTR201105000267371 . Registered 06 December 2010.

Debate on the legalization of abortion in Zimbabwe.

Science.gov (United States)

1994-01-01

In Zimbabwe, where over 70,000 illegal abortions are performed each year and complications from clandestine abortion are a leading cause of maternal mortality, the abortion law debate has been re-opened. Under the present law, abortion is legal only to save the life of the mother and women who undergo illegal abortion face strict criminal sanctions. Timothy Stamps, the Minister of Health and Child Welfare, has stated, "The first rights of a child are to be desired, to be wanted, and to be planned." Dr. Illiff, of the University of Zimbabwe's Department of Obstetrics and Gynecology, has noted, "We cannot stop abortion. The choice is how safe it is." Illiff pointed out that urban Zimbabwe women run a 262 times greater risk of dying of abortion complications than their counterparts in the UK where abortion is legal. As the Women's Action Group has observed, men have dominated the current debate on abortion. The group has issued an appeal to women to enter into this debate that concerns their bodies to ensure that another law is not imposed on them. The group's appeal for action states: "We as Women's Action Group believe that every woman should decide what's right and what's wrong in her life. She and only she should be the master of her destiny. Her voice should be heard louder than anyone else's."

[QUIPS: quality improvement in postoperative pain management].

Science.gov (United States)

Meissner, Winfried

2011-01-01

Despite the availability of high-quality guidelines and advanced pain management techniques acute postoperative pain management is still far from being satisfactory. The QUIPS (Quality Improvement in Postoperative Pain Management) project aims to improve treatment quality by means of standardised data acquisition, analysis of quality and process indicators, and feedback and benchmarking. During a pilot phase funded by the German Ministry of Health (BMG), a total of 12,389 data sets were collected from six participating hospitals. Outcome improved in four of the six hospitals. Process indicators, such as routine pain documentation, were only poorly correlated with outcomes. To date, more than 130 German hospitals use QUIPS as a routine quality management tool. An EC-funded parallel project disseminates the concept internationally. QUIPS demonstrates that patient-reported outcomes in postoperative pain management can be benchmarked in routine clinical practice. Quality improvement initiatives should use outcome instead of structural and process parameters. The concept is transferable to other fields of medicine. Copyright © 2011. Published by Elsevier GmbH.

The Trend of Women in Nuclear Security in Zimbabwe

International Nuclear Information System (INIS)

Sithole, P.; Chipuru, J.

2015-01-01

With the increase in the use of radiation technologies, each country now has a potential risk from nuclear related offenses or malicious use of radioactive material. Despite the major advancements women have made in becoming a significant part of the workforce in all the other fields, women in the field of Nuclear Security are underrepresented in Zimbabwe. Nuclear security contributes to global security and there are a number of things that constitute this field. In the past 10 years, in developing countries, a few women have been taking part in Nuclear Security activities at Major Public events. Less than 1% of women in Zimbabwe are employed and take part in Nuclear Security related work. This study provides the trend in statistics of women employed in the field of Nuclear Security in Zimbabwe and it has identified possible factors why women are underrepresented in that field. It shows the trend of women taking part in Nuclear Security related activities for the past 10 years. Women’s experiences of employment and career development in nuclear security were studied. The factors which hinder or support the career development of women employees in Nuclear Security or related work were identified. Practices which encourage and support women’s involvement in Nuclear Security were explored. A statistical analysis of local authority employment, using the Ministry of Labour, census of women in science and nuclear security related studies in the Population of Zimbabwe, and other relevant sources was carried out. This was to describe the wider context of women’s employment in Nuclear Security. A self-completion questionnaire to get information on personal attributes, age and preferred career paths for women was used. Solutions to the trend are suggested in the study. (author)

Prospects for tobacco control in Zimbabwe: a historical perspective.

Science.gov (United States)

Woelk, G; Mtisi, S; Vaughan, J P

2001-09-01

Using a historical and political economy perspective, this paper explores the prospects for tobacco control in Zimbabwe, the world's sixth largest producer and third largest tobacco exporter. Tobacco production, which first began in the former Rhodesia in the early 1900s, is closely associated with colonial history and land occupation by white settlers. The Zimbabwe (formerly Rhodesia) Tobacco Association was formed in 1928 and soon became a powerful political force. Although land redistribution has always been a central issue, it was not adequately addressed after independence in 1980, largely due to the need for Zimbabwe to gain foreign currency and safeguard employment. However, by the mid-1990s political pressures forced the government to confront the mainly white, commercial farmers with a new land acquisition policy, but intense national and international lobbying prevented its implementation. With advent of global economic changes, and following the start of a structural adjustment programme in 1991, manufacturing began to decline and the government relied even more on the earnings from tobacco exports. Thus strengthening tobacco control policies has always had a low national and public health priority. Recent illegal occupation of predominantly white owned farms, under the guise of implementing the former land redistribution policy, was politically motivated as the government faced its first major challenge at the general elections in June 2000. It remains unclear whether this will lead to long term reductions in tobacco production, although future global declines in demand could weaken the tobacco lobby. However, since Zimbabwe is only a minor consumer of tobacco, a unique opportunity does exist to develop controls on domestic cigarette consumption. To achieve this the isolated ministry of health would need considerable support from international agencies, such as the World Health Organisation and World Bank.

Tissue inhibitor of metalloproteinases-1 in the postoperative monitoring of colorectal cancer

DEFF Research Database (Denmark)

Holten-Andersen, Mads Nikolaj; Nielsen, Hans Jørgen; Sørensen, Steen

2006-01-01

antigen (CEA) in corresponding serum samples were measured and correlated with patient outcome (death, local recurrence (LR) and distant metastases (DM)). The results showed that the course of plasma TIMP-1 from pre- to postoperative levels correlated with patient outcome (P=0.005). However, postoperative...... plasma TIMP-1 alone was strongly associated with patient outcome, high TIMP-1 predicting short survival (P=0.002). Combining postoperative TIMP-1 and CEA demonstrated that high TIMP-1 and CEA levels predicted poor outcome (Panalysis identifying both parameters as strong prognostic...

Consumption Response to Diaspora Remittances in Zimbabwe ...

African Journals Online (AJOL)

This paper explores the impact of remittances on private consumption in Zimbabwe for the period 1980 to 2007. An augmented Keynesian consumption function which incorporates income, remittances, exchange rate, taxation, inflation and an economic and political instability dummy variable is postulated for this purpose.

Potential for solar water heating in Zimbabwe

NARCIS (Netherlands)

Batidzirai, B.; Lysen, E.H.; van Egmond, S.; van Sark, W.G.J.H.M.

2009-01-01

This paper discusses the economic, social and environmental benefits from using solar water heating (SWH) in Zimbabwe. By comparing different water heating technology usage in three sectors over a 25-year period, the potential of SWH is demonstrated in alleviating energy and economic problems that

Strategies of smallholder irrigation management in Zimbabwe

NARCIS (Netherlands)

Manzungu, E.

1999-01-01

The smallholder irrigation sub-sector in Zimbabwe, according to literature sources, is under threat due to what are called management problems. Poor water management and low crop yields have been cited, as has also been poor financial and economic viability, resulting in heavy government

Comparison of postoperative coagulation profiles and outcome for sugammadex versus pyridostigmine in 992 living donors after living-donor hepatectomy.

Science.gov (United States)

Moon, Young-Jin; Kim, Sung-Hoon; Kim, Jae-Won; Lee, Yoon-Kyung; Jun, In-Gu; Hwang, Gyu-Sam

2018-03-01

Donor safety is the major concern in living donor liver transplantation, although hepatic resection may be associated with postoperative coagulopathy. Recently, the use of sugammadex has been gradually increased, but sugammadex is known to prolong prothrombin time (PT) and activated partial thromboplastin time (aPTT). We compared the postoperative coagulation profiles and outcomes of sugammadex versus pyridostigmine group in donors receiving living donor hepatectomy.Consecutive donor hepatectomy performed between September 2013 and August 2016 was retrospectively analyzed. For reversal of rocuronium-induced neuromuscular blockade, donors received sugammadex 4 mg/kg or pyridostigmine 0.25 mg/kg. The primary end-points were laboratory findings (PT, aPTT, hemoglobin, platelet count) and clinically evaluated postoperative bleeding (relaparotomy for bleeding, cumulative volume collected in drains). Secondary outcomes were anesthesia time, postoperative hospital day.Of 992 donors, 383 treated with sugammadex and 609 treated with pyridostigmine for the reversal of neuromuscular blockade. There were no significant differences between both groups for drop in hemoglobin and platelet, prolongation in PT, aPTT, and the amount of 24-h drain volume. Bleeding events within 24 h were reported in 2 (0.3%) for pyridostigmine group and 0 (0%) for sugammadex group (P = .262). Anesthesia time was significantly longer in pyridostigmine group than that in sugammadex group (438.8 ± 71.4 vs. 421.3 ± 62.3, P sugammadex group (P = .002).Sugammadex 4 mg/kg was not associated with increased bleeding tendency, but associated with reduced anesthesia time and hospital stay. Therefore, sugammadex may be safely used and will decrease morbidity in donor undergoing living-donor hepatectomy.

Enumeration of CD4 and CD8 T-cells in HIV infection in Zimbabwe using a manual immunocytochemical method

DEFF Research Database (Denmark)

Gomo, E; Ndhlovu, P; Vennervald, B J

2001-01-01

OBJECTIVES: To enumerate CD4 and CD8 T-cells using the simple and cheap immuno-alkaline phosphatase (IA) method and to compare it with flow cytometry (FC); and to study the effects of duration of sample storage on the IA method results. DESIGN: Method comparison study. SETTING: Blair Research...... Laboratory, Harare, Zimbabwe. SUBJECTS: 41 HIV positive and 11 HIV negative men and women from Harare participating in HIV studies at Blair Research Laboratory, Zimbabwe. MAIN OUTCOME MEASURES: CD4 and CD8 T-cell counts by FC and the IA method. RESULTS: The IA method and FC were highly correlated for CD4...... counts (Spearman rs = 0.91), CD4 percentage (rs = 0.84), CD8 count (rs = 0.83), CD8 percentage (rs = 0.96) and CD4/CD8 ratio (rs = 0.89). However, CD4 cell counts and percentage measured by the IA method were (mean difference +/- SE) 133 +/- 24 cells/microL [corrected] and 6.7 +/- 1.1% higher than those...

Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients

DEFF Research Database (Denmark)

Foss, Nicolai B; Kristensen, Morten T; Kehlet, Henrik

2006-01-01

To validate the cumulated ambulation score as an early postoperative predictor of short-term outcome in hip fracture patients.......To validate the cumulated ambulation score as an early postoperative predictor of short-term outcome in hip fracture patients....

Postoperative pain outcomes after transvaginal mesh revision.

Science.gov (United States)

Danford, Jill M; Osborn, David J; Reynolds, W Stuart; Biller, Daniel H; Dmochowski, Roger R

2015-01-01

Although the current literature discusses mesh complications including pain, as well as suggesting different techniques for removing mesh, there is little literature regarding pain outcomes after surgical removal or revision. The purpose of this study is to determine if surgical removal or revision of vaginal mesh improves patient's subjective complaints of pelvic pain associated with original placement of mesh. After obtaining approval from the Vanderbilt University Medical Center Institutional Review Board, a retrospective review of female patients with pain secondary to previous mesh placement who underwent excision or revision of vaginal mesh from January 2000 to August 2012 was performed. Patient age, relevant medical history including menopause status, previous hysterectomy, smoking status, and presence of diabetes, fibromyalgia, interstitial cystitis, and chronic pelvic pain, was obtained. Patients' postoperative pain complaints were assessed. Of the 481 patients who underwent surgery for mesh revision, removal or urethrolysis, 233 patients met our inclusion criteria. One hundred and sixty-nine patients (73 %) reported that their pain improved, 19 (8 %) reported that their pain worsened, and 45 (19 %) reported that their pain remained unchanged after surgery. Prior history of chronic pelvic pain was associated with increased risk of failure of the procedure to relieve pain (OR 0.28, 95 % CI 0.12-0.64, p = 0.003). Excision or revision of vaginal mesh appears to be effective in improving patients' pain symptoms most of the time. Patients with a history of chronic pelvic pain are at an increased risk of no improvement or of worsening pain.

An Information Management Framework for the Support of E-Government in Zimbabwe

Directory of Open Access Journals (Sweden)

Mehluli Masuku

2017-02-01

Full Text Available It has come as a fact that the use of Information and Communication Technologies has come to stay in this world. It aids the implementation of the emerging and irresistible e-government concept that seems to be the in-thing the world over. Zimbabwe has also joined the world by ascertaining its commitment to e-government as witnessed by its promulgation of various e-government services. However, despite the government of Zimbabwe having committed itself to e-government, it is of concern to note that up to this day, the country is operating without a clear information management policy or strategy that will guide and direct all the information management practitioners in the country. This comes as a great weakness in this day and age when the government of Zimbabwe has declared its intentions to subscribe to the e-government concept both in principle and in practice. Although the country has managed to survive without a clearly defined information policy in the pre e-government era, chances of it rolling out an effective and sustainable e-government policy on the same foundation are very slim, given the importance of well managed information as a pillar of sound e-government. The paper employed document analysis as its methodology in which Zimbabwe National Information and Communication Policy (ICT Policy Framework of 2005 and the Ministry of Information Communication Technology’s (MICT Strategic Plan (2010-2014 were reviewed and assessed the extent to which they sufficed to serve as information management frameworks that can support e-governance in Zimbabwe. The study revealed that there are ICT policies that are meant to serve as ICT strategies for the country but none of them has been put to test and such policies are very piecemeal at best as far as their coverage of information management is concerned. The first policy of such nature was the Zimbabwe National Information and Communication Policy (ICT Policy Framework of 2005 that was

Effects of urinary bladder retroflexion and surgical technique on postoperative complication rates and long-term outcome in dogs with perineal hernia: 41 cases (2002-2009).

Science.gov (United States)

Grand, Jean-Guillaume; Bureau, Stéphane; Monnet, Eric

2013-11-15

To evaluate the effects of urinary bladder retroflexion (UBR) and surgical technique on postoperative complication rates and long-term outcome in dogs with perineal hernia. Retrospective case series. 41 client-owned dogs with perineal hernia that underwent surgery between November 2002 and November 2009. Medical records were reviewed for information on dog signalment, history, physical examination findings, ultrasonographic findings, surgical techniques, intraoperative complications, duration of hospital stay, postoperative complications, and long-term outcome. 31 dogs had no UBR, and 10 dogs had UBR. Internal obturator muscle transposition (IOMT) was performed in 20 dogs, and a cystopexy or colopexy was performed before the IOMT (LapIOMT) in 21. Postoperative complications included tenesmus (n = 8) and urinary incontinence (1). Rates of postoperative complications were not significantly different between the no-UBR and UBR groups or between the IOMT and LapIOMT groups. Thirty-two dogs were free of clinical signs at the time of the study. The median disease-free interval did not differ significantly between dogs in the no-UBR and UBR groups, but it was significantly lower in the LapIOMT group than in the IOMT group. None of the 7 dogs with UBR that were treated without cystopexy developed recurrence of UBR. UBR was not associated with an increased rate of postoperative complications relative to no UBR and had no effect on the long-term outcome in dogs with perineal hernia. The use of IOMT alone may be recommended for clinical use because LapIOMT offered no clear advantage.

Options for wastewater management in Harare, Zimbabwe

NARCIS (Netherlands)

Nhapi, I.

2004-01-01

The capital city of Zimbabwe, has adopted an urban water cycle that is geared towards high level service provision. Water supply and sewerage/sanitation coverage amounts to over 98%, which makes Harare with the highest coverage. The city's high volume of water abstraction from its main water

zimbabwe children's act alignment with international and domestic

African Journals Online (AJOL)

User

and Welfare of the Child (ACRWC), Child Protection Model Law, Constitution of ... This Act's foci include providing care and protection to all children in Zimbabwe and establishing .... Kaseke (1993:12) notes the introduction of school fees in.

Towards a Citizenship Education for Zimbabwe | Mavhunga ...

African Journals Online (AJOL)

This paper examines post independence Zimbabwe's attempts to introduce a form of citizenship education in the nation's education curricula, first in the name of Political Economy introduced at secondary school level shortly after independence in the early 1980s but abandoned soon afterwards, only to resurface as ...

Early postoperative physical therapy for improving short-term gross motor outcome in infants with cyanotic and acyanotic congenital heart disease.

Science.gov (United States)

Haseba, Sumihito; Sakakima, Harutoshi; Nakao, Syuhei; Ohira, Misaki; Yanagi, Shigefumi; Imoto, Yutaka; Yoshida, Akira; Shimodozono, Megumi

2018-07-01

We analysed the gross motor recovery of infants and toddlers with cyanotic and acyanotic congenital heart disease (CHD) who received early postoperative physical therapy to see whether there was any difference in the duration to recovery. This study retrospectively evaluated the influence of early physical therapy on postoperative gross motor outcomes of patients with CHD. The gross motor ability of patients with cyanotic (n = 25, average age: 376.4 days) and acyanotic (n = 26, average age: 164.5 days) CHD was evaluated using our newly developed nine-grade mobility assessment scale. Physical therapy was started at an average of five days after surgery, during which each patient's gross motor ability was significantly decreased compared with the preoperative level. Patients (who received early postoperative physical therapy) with cyanotic (88.0%) and acyanotic CHD (96.2%) showed improved preoperative mobility grades by the time of hospital discharge. However, patients with cyanotic CHD had a significantly prolonged recovery period compared to those with acyanotic CHD (p congenital heart disease are likely at greater risk of gross motor delays and have a prolonged recovery period of gross motor ability compared to those with acyanotic congenital heart disease. Early postoperative physical therapy for patients with congenital heart disease after cardiac surgery promoted gross motor recovery. The postoperative recovery period to preoperative mobility grade was affected by pre-, intra-, and postoperative factors. Rehabilitation experts should consider the risk of gross motor delays of patients with congenital heart disease after cardiac surgery and the early postoperative physical therapy to promote their gross motor recovery.

Community Tourism Entrepreneurship for Sustainable Tourism Management in Southern Africa: Lessons from Zimbabwe

OpenAIRE

Simon Chiutsi; Boycen Kumira Mudzengi

2012-01-01

Zimbabwe tourism development has suffered the pitfalls of uneven development often producing disproportionate distribution of returns. While tourism has been promulgated as a panacea to the socio-economic development challenges Zimbabwe is facing, local and often marginalized rural communities have not meaningfully reaped the benefits through tourism income. In this paper community tourism entrepreneurship is suggested as a viable option to promote sustainable tourism as it places the local c...

Simplified prediction of postoperative cardiac surgery outcomes with a novel score: R2CHADS2.

Science.gov (United States)

Peguero, Julio G; Lo Presti, Saberio; Issa, Omar; Podesta, Carlos; Parise, Helen; Layka, Ayman; Brenes, Juan C; Lamelas, Joseph; Lamas, Gervasio A

2016-07-01

To compare the accuracy of R2CHADS2, CHADS2, and CHA2DS2-VASc scores vs the Society of Thoracic Surgeons (STS) score as predictors of morbidity and mortality after cardiovascular surgery. All patients who underwent cardiothoracic surgery at our institution from January 2008 to July 2013 were analyzed. Only those patients who fulfilled the criteria for STS score calculation were included. The R2CHADS2 score was computed as follows: 2 points for GFR < 60 mL/min/1.73 m(2) (R2), prior stroke or TIA (S2); 1 point for history of congestive heart failure (C), hypertension (H), age ≥75 years (A), or diabetes (D). Area under the curve (AUC) analysis was used to estimate the accuracy of the different scores. The end point variables included operative mortality, permanent stroke, and renal failure as defined by the STS database system. Of the 3,492 patients screened, 2,263 met the inclusion criteria. These included 1,160 (51%) isolated valve surgery, 859 (38%) coronary artery bypass graft surgery, and 245 (11%) combined procedures. There were 147 postoperative events: 75 (3%) patients had postoperative renal failure, 48 (2%) had operative mortality, and 24 (1%) had permanent stroke. AUC analysis revealed that STS, R2CHADS2, CHADS2, and CHA2DS2-VASc reliably estimated all postoperative outcomes. STS and R2CHADS2 scores had the best accuracy overall, with no significant difference in AUC values between them. The R2CHADS2 score estimates postoperative events with acceptable accuracy and if further validated may be used as a simple preoperative risk tool calculator. Copyright © 2016 Elsevier Inc. All rights reserved.

A Framework for Monitoring Electricity theft in Zimbabwe using Mobile Technologies

Directory of Open Access Journals (Sweden)

Samuel Musungwini

2016-07-01

Full Text Available The capabilities of mobile technology paradigm have indicated that almost every infrastructure, system or device has the potential to capture data and report it to the back-end system in real-time. Utilities need to deliver operational analytics by knowing what is happening across their entire infrastructure. The purpose of the study was to develop a framework for mobile technologies in monitoring electricity theft in Zimbabwe. Using a qualitative research in conjunction with the design science paradigm, data was collected through semi-structured interviews, participant observation, document review and qualitative questionnaire. The findings of the study revealed that the power utility in Zimbabwe uses very basic methods and techniques in detecting and countering electricity theft. This has made it difficult to deal with all the possible electricity theft strategies that are employed by the consumers. This study recommends that the power utility in Zimbabwe should use a framework for mobile technologies to monitor electricity theft in order to reduce revenue leakages caused by electricity theft.

Gender Discrimination in Educational Personnel: A Case Study of Gweru Urban District Secondary Schools, Zimbabwe

Science.gov (United States)

Matope, Nogget

2012-01-01

Gender discrimination in educational institutions persists, despite the vigorous pursuit of policies and programmes to reduce the varying degrees of gender inequity in Zimbabwe. Zimbabwe is a signatory to international agreements and conventions which promote gender equity with a thrust towards increased access to education for girls and females.…

Contemporary Development Issues: The Women of Zimbabwe.

Science.gov (United States)

Rucks, Doris

This preliminary report of a research project in progress briefly outlines Zimbabwe's historical, geographic, and cultural heritage and describes the methodology being used. Traditionally, Zimbabwean women are viewed as inferior and subordinate in a patriarchal society. They perform much of the work but have no political power. This study seeks to…

SOCIAL WORK WITH REFUGEES IN ZIMBABWE Johanne ...

African Journals Online (AJOL)

Mugumbate

Therefore, this paper provides an overview of the social work practice with refugees. ... Legal statutes that govern refugee protection in Zimbabwe .... More often than not, unaccompanied minors have been forced out of school at a tender age because of the war .... of this strategy is to achieve gender and age equality.

Risk Factors for Postoperative Fibrinogen Deficiency after Surgical Removal of Intracranial Tumors.

Directory of Open Access Journals (Sweden)

Naili Wei

Full Text Available Higher levels of fibrinogen, a critical element in hemostasis, are associated with increased postoperative survival rates, especially for patients with massive operative blood loss. Fibrinogen deficiency after surgical management of intracranial tumors may result in postoperative intracranial bleeding and severely worsen patient outcomes. However, no previous studies have systematically identified factors associated with postoperative fibrinogen deficiency. In this study, we retrospectively analyzed data from patients who underwent surgical removal of intracranial tumors in Beijing Tiantan Hospital date from 1/1/2013to12/31/2013. The present study found that patients with postoperative fibrinogen deficiency experienced more operative blood loss and a higher rate of postoperative intracranial hematoma, and they were given more blood transfusions, more plasma transfusions, and were administered larger doses of hemocoagulase compared with patients without postoperative fibrinogen deficiency. Likewise, patients with postoperative fibrinogen deficiency had poorer extended Glasgow Outcome Scale (GOSe, longer hospital stays, and greater hospital expenses than patients without postoperative fibrinogen deficiency. Further, we assessed a comprehensive set of risk factors associated with postoperative fibrinogen deficiency via multiple linear regression. We found that body mass index (BMI, the occurrence of postoperative intracranial hematoma, and administration of hemocoagulasewere positively associated with preoperative-to-postoperative plasma fibrinogen consumption; presenting with a malignant tumor was negatively associated with fibrinogen consumption. Contrary to what might be expected, intraoperative blood loss, the need for blood transfusion, and the need for plasma transfusion were not associated with plasma fibrinogen consumption. Considering our findings together, we concluded that postoperative fibrinogen deficiency is closely associated with

Cost-effectiveness of community vegetable gardens for people living with HIV in Zimbabwe.

Science.gov (United States)

Puett, Chloe; Salpéteur, Cécile; Lacroix, Elisabeth; Zimunya, Simbarashe Dennis; Israël, Anne-Dominique; Aït-Aïssa, Myriam

2014-01-01

There is little evidence to date of the potential impact of vegetable gardens on people living with HIV (PLHIV), who often suffer from social and economic losses due to the disease. From 2008 through 2011, Action Contre la Faim France (ACF) implemented a project in Chipinge District, eastern Zimbabwe, providing low-input vegetable gardens (LIGs) to households of PLHIV. Program partners included Médecins du Monde, which provided medical support, and Zimbabwe's Agricultural Extension Service, which supported vegetable cultivation. A survey conducted at the end of the program found LIG participants to have higher Food Consumption Scores (FCS) and Household Dietary Diversity Scores (HDDS) relative to comparator households of PLHIV receiving other support programs. This study assessed the incremental cost-effectiveness of LIGs to improve FCS and HDDS of PLHIV compared to other support programs. This analysis used an activity-based cost model, and combined ACF accounting data with estimates of partner and beneficiary costs derived using an ingredients approach to build an estimate of total program resource use. A societal perspective was adopted to encompass costs to beneficiary households, including their opportunity costs and an estimate of their income earned from vegetable sales. Qualitative methods were used to assess program benefits to beneficiary households. Effectiveness data was taken from a previously-conducted survey. Providing LIGs to PLHIV cost an additional 8,299 EUR per household with adequate FCS and 12,456 EUR per household with HDDS in the upper tertile, relative to comparator households of PLHIV receiving other support programs. Beneficiaries cited multiple tangible and intangible benefits from LIGs, and over 80% of gardens observed were still functioning more than one year after the program had finished. Cost outcomes were 20-30 times Zimbabwe's per capita GDP, and unlikely to be affordable within government services. This analysis concludes that

Postoperative management of pulmonary endarterectomy and outcome

Directory of Open Access Journals (Sweden)

Narayana Iyengar Ramakrishna

2010-01-01

Full Text Available Pulmonary artery thromboendarterectomy (PTE has been regarded as a promising, potentially curative surgical procedure. However, PTE is associated with specific postoperative complications, such as reperfusion pulmonary edema and right heart failure leading to a considerable mortality of 7-24%. Despite its limitations PTE is a better surgical alternative to lung transplantation which carries high morbidity and mortality. The aim of the study is to analyze the efficacy, safety, morbidity and survival associated in the postoperative period and quality of life after six months of PTE in Indian patients. Forty-one patients with surgically correctable chronic thromboembolic pulmonary hypertension underwent pulmonary endarterectomy. All patients were in New York Heart Association (NYHA Class II, III or IV. Preoperative mean pulmonary artery pressure was 40.98 ± 9.29 mmHg and mean pulmonary vascular resistance was 418.39 ± 95.88 dynes/sec/cm -5 . All patients were followed up to six months and a telephonic survey was conducted using a standard questionnaire. They were assessed and classified as per NYHA grading. There was a significant reduction in the mean pulmonary artery pressure (from 40.98 ± 9.29 mmHg to 24.13 ± 7.36 mmHg, P < 0.001 and pulmonary vascular resistance (from 418.39 ± 95.88 dynes/sec/cm -5 to 142.45 ± 36.27 dynes/sec/cm -5 , P < 0.001 with a concomitant increase in the cardiac index (from 1.99 ± 0.20 L/min/m 2 to 3.28 ± 0.56 L/min/m 2 , P < 0.001 during the postoperative period. The mortality rate in our study was 12.19% (five patients. Ninety per cent of the patients reported a significant improvement in the quality of life and exercise tolerance after surgery compared to the preoperative state. Pulmonary endarterectomy is an effective and potentially curative surgical treatment for patients with severe chronic thromboembolic pulmonary hypertension. The current techniques of operation make the procedure relatively safe and

Special Education Professional Development Needs in Zimbabwe

Science.gov (United States)

Chitiyo, Morgan; Hughes, Elizabeth M.; Changara, Darlington M.; Chitiyo, George; Montgomery, Kristen M.

2017-01-01

Since 1980 when Zimbabwe obtained political independence, special education has not received the same priority as the entire education system. One of the manifestations of this discrepancy is the shortage of qualified special education teachers in the country. In order to address this trend and promote the development of special education,…

Review Essay : Music in Zimbabwe | Chitando | Zambezia: The ...

African Journals Online (AJOL)

Zambezia: The Journal of Humanities of the University of Zimbabwe. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 29, No 1 (2002) >. Log in or Register to get access to full text downloads.

Zimbabwe Veterinary Journal - Vol 35, No 2 (2017)

African Journals Online (AJOL)

Prevalence of intestinal helminth parasites in stray dogs in urban Harare and selected rural areas in Zimbabwe · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Ashley-Kate Davidson, Kalnisha Bhikha, George D. Vassilev, Solomon Dhliwayo ...

Postoperative complications and mortality after major gastrointestinal surgery

DEFF Research Database (Denmark)

Jakobson, Triin; Karjagin, Juri; Vipp, Liisa

2014-01-01

BACKGROUND AND OBJECTIVE: The incidence of postoperative complications and death is low in the general population, but a subgroup of high-risk patients can be identified amongst whom adverse postoperative outcomes occur more frequently. The present study was undertaken to describe the incidence o...

The casual, naturalised and invasive alien flora of Zimbabwe based on herbarium and literature records

Directory of Open Access Journals (Sweden)

Alfred Maroyi

2012-10-01

Conservation implications: This research provides baseline information and historical invasion patterns of casual, naturalised and invasive alien flora in Zimbabwe. This inventory is a crucial starting point in trying to understand and initiate the management of biological invasions. This is also important for monitoring new introductions and management of existing alien plants in Zimbabwe.

Term-creation strategies used by Ndebele translators in Zimbabwe ...

African Journals Online (AJOL)

Term-creation strategies used by Ndebele translators in Zimbabwe in the health sector: A corpus-based approach. ... strategies employed by Ndebele translators from a corpus-based approach using ParaConc, ... AJOL African Journals Online.

Technique, postoperative complications, and visual outcomes of phacoemulsification cataract surgery in 21 penguins (27 eyes): 2011-2015.

Science.gov (United States)

Church, Melanie L; Priehs, Daniel R; Denis, Heidi; Croft, Lara; DiRocco, Stacy; Davis, Michelle

2018-02-06

To describe surgical technique, postoperative complications, and visual outcome in penguins after phacoemulsification lens extraction surgery. Twenty-one penguins (27 eyes) that had phacoemulsification from 2011 to 2015 at Animal Eye Associates. Species included are as follows: 14 southern Rockhopper (18 eyes, 66.6%), 4 Gentoo (4 eyes, 19%), 2 King (3 eyes, 9.5%), and 1 Chinstrap penguin (2 eyes, 4.8%). Eleven of the penguins were females, and 10 were males with average age at the time of surgery being 27.5 years (range of 22-31 years). This is a retrospective study of phacoemulsification cataract surgery patients from 2011 to 2015. Visual outcome was evaluated by veterinary ophthalmologists at postoperative recheck examinations and subjectively by penguin keepers using individual bird surveys and paired t tests for statistical analysis. All eyes were functionally visual after surgery and at the time of last follow-up. Based on keeper surveys, 81% (17/21) of penguins showed immediate improvements in overall quality of life and 90% (19/21) of penguins exhibited improvement in mobility and behavior within their exhibit following cataract removal. Of the 14 penguins that received 1:5 intracameral atracurium during surgery, 10 (71.4%) had moderate mydriasis, 1 (7.1%) had minimal mydriasis, and 3 (21.4%) showed no effect to the pupil. Seventy percent of the cases had phacoemulsification times less than 60 seconds/eye; the mean time was 72 seconds. Sixteen eyes (59.3%) underwent anterior capsulotomy only, planned anterior and posterior capsulotomies were performed in 3 eyes (11.1%), and the entire lens capsule was removed due to capsular fibrosis and wrinkling in 8 eyes (29.6%). The most common short-term postoperative complication was temporary mild blepharospasm and/or epiphora, reported in 8 eyes (29.6%) from 7 penguins (33.3%). Long-term complications, 2-6 years postoperatively, included posterior synechiation resulting in dyscoria (10 of 24 eyes, 41.7%) and

An Assessment of Zimbabwe Secondary School Teachers’ Attitudes towards the Use of Smart Phones in the Classroom: A Case of Midlands Province, Zimbabwe

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Dhliwayo Alice

2017-09-01

Full Text Available While technology has been embraced by most of the people, use of smart phones in the classroom has been received with mixed feelings. Some say it enhances learning while others complain that it disturbs instruction. This research wanted to find out the stance of secondary school teachers on this issue in Zimbabwe. A sample of 50 randomly selected teachers from 10 randomly selected secondary schools in Gweru District, Midlands Province in Zimbabwe was used. Data from self-constructed questionnaires were analyzed by SPSS mainly on descriptive statistics and correlation. Findings showed that teachers possess smart phones which they use for researching and other instructional purposes with moderate expertise. Teachers consider smart phones as hand-held computers that can enhance learning for they have high engagement potential and they extend classroom walls allowing students to engage with the global village. A correlation computation showed that there is a significant relationship between perceived problems of smart phones and smart phones integration factors. However, respondents felt that smart phones can cause lower levels of attention during lessons and allows cheating and copying during exams. They also concurred that teachers’ technical skills lag behind those of digital native students. Thus, they foresaw instructional problems on the part of the teachers on the use of smart phones in the classroom and were against their use. They doubted if the use of smart phones can improve the pass rate and whether they wanted their students to bring cell phones and use them during lessons for they perceived problems in controlling students using them. They also doubted if schools in Zimbabwe would ever benefit if students are allowed to use their phones in class. The study concluded that teachers in Zimbabwe are not yet prepared to have students use smart phone in the classroom and recommended for further research on the potential benefits of using

Reformations in Zimbabwe's juvenile justice system | Ruparanganda ...

African Journals Online (AJOL)

Children in conflict with the law are often stigmatized and shunned by society as they are perceived as a threat to society. Historically, Zimbabwe's juvenile justice system has been retributive and focused on punishing the juvenile offender. As a result, it has been criticised from a number of viewpoints, including the need to ...

Sewage discharges and nutrient levels in Marimba River, Zimbabwe ...

African Journals Online (AJOL)

Sewage discharges and nutrient levels in Marimba River, Zimbabwe. ... Population distribution, land-use, industrial activity, urban agricultural ... River, one of the major inflow rivers into the Lake Chivero, Harare city\\'s main water supply source.

The marketing landscape of universities in Zimbabwe: Perspectives ...

African Journals Online (AJOL)

The paper synthesizes findings based on a wide ranging research on university marketing in Zimbabwe. The research was primarily aimed at determining university Vice Chancellors' and internal marketers' perceptions of marketing, how the marketing function was organized and how specific university customer groups ...

Towards improvement of ethics in the public sector in Zimbabwe

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Daniel Chigudu

2015-03-01

Full Text Available In Zimbabwe reports of abuse of public office have manifested in various forms resulting in public outcry; poor service delivery, and government losing millions of dollars. This study aims to undertake a reflective inquiry on the ethical conduct in the Zimbabwean public sector through content and process analysis in order to provide intervention mechanisms to the problem. Statistical analysis of corruption level is made to benefit the study. Results indicated some legislative gaps and an incapacitated Anti-Corruption Commission which has been unable to execute its mandate fully. Most senior public officials and politicians appear to have too much power and authority with no checks and balances in place. Practical implications of the widespread unethical practices call for the government to plug the glaring legislative gaps; take stern measures against offenders; empowering the Anti-Corruption Commission; term limits for senior public officials as well as for political appointments; and motivating political will to uphold ethical leadership. The recommendations will open a window for the Zimbabwean government and administrators to view how some advanced economies have propped up ethical behaviour in the public sector. It is the way to go for ailing economies like Zimbabwe. The paper demonstrated the importance of ethical awareness in another political and economic setting-Zimbabwe.

The potential for energy production from crop residues in Zimbabwe

Energy Technology Data Exchange (ETDEWEB)

Jingura, R.M.; Matengaifa, R. [School of Engineering Sciences and Technology, Chinhoyi University of Technology, P. Bag 7724, Chinhoyi (Zimbabwe)

2008-12-15

There is increasing interest in Zimbabwe in the use of renewable energy sources as a means of meeting the country's energy requirements. Biomass provides 47% of the gross energy consumption in Zimbabwe. Energy can be derived from various forms of biomass using various available conversion technologies. Crop residues constitute a large part of the biomass available from the country's agriculture-based economy. The potential for energy production of crop residues is examined using data such as estimates of the quantities of the residues and their energy content. The major crops considered are maize, sugarcane, cotton, soyabeans, groundnuts, wheat, sorghum, fruits and forestry plantations. Quantities of residues are estimated from crop yields by using conversion coefficients for the various crops. Long-term crop yields data from 1970 to 1999 were used. Total annual residue yields for crops, fruits and forestry plantations are 7.805 Mt, 378 kt and 3.05 Mt, respectively. The crops, fruits and forestry residues have energy potential of 81.5, 4.9 and 44.3 PJ per year, respectively. This represents about 44% of the gross energy consumption in Zimbabwe. The need to balance use of crop residues for both energy purposes and other purposes such as animal feeding and soil fertility improvement is also highlighted. (author)

Do postoperative radiographically verified technical success, improved cosmesis, and trunk shift corroborate with patient-reported outcomes in Lenke 1C adolescent idiopathic scoliosis?

Science.gov (United States)

Sharma, Shallu; Bünger, Cody Eric; Andersen, Thomas; Sun, Haolin; Wu, Chunsen; Hansen, Ebbe Stender

2015-07-01

To examine correlation between postoperative radiographic and cosmetic improvements in Lenke 1C adolescent idiopathic scoliosis (AIS) with patients' self-rated outcomes of health and disability at follow-up as determined by the Scoliosis Research Society questionnaire (SRS-30), Oswestry Disability Index score (ODI) and measure of overall health quality Euroqol-5d (EQ-5D). 24 Lenke 1C scoliosis patients, mean age 16.5 (12.8-38.1) years, treated with posterior pedicle screw-only construct, were included. The coronal profile indices (radiographic and cosmetic) regarding magnitude of spinal deformity and truncal balance were measured preoperatively, postoperatively and at final follow-up. A comprehensive index of overall back symmetry was also measured by means of the Posterior Trunk Symmetry Index (POTSI). Pearson's correlation analysis determined the association between the radiographic-cosmetic indices and patient-rated outcomes. Mean follow-up for the cohort was 4.4 (±1.86) years. The thoracic apical vertebra-first thoracic vertebra horizontal distance (AV-TI) correction had significant correlation with function, self-image, and mental health SRS-30 scores (0.55, 0.54, 0.66). Similarly, thoracic apical vertebra horizontal translation from central sacral vertical line (AV-CSVL) correction at follow-up had significant correlation with self-image and management domains (0.57, 0.50). Follow-up POTSI correlated well with SRS-30 and EQ-5D scores (r = -0.64, -0.54). Postoperative leftward trunk shift/spinal imbalance did not influence overall cosmesis and outcomes; significant spinal realignment was evident in follow-up resulting in physiological balance and acceptable cosmesis and outcomes. Significant, but less than "perfect" correlations were observed between the radiographic, cosmetic measures and patient-rated outcomes. Thoracic AV-CSVL, AV-T1 correction and POTSI associated significantly with SRS-30 scores. Whereas, thoracic Cobb angle, Cobb correction, and

The Bright Lights Grow Fainter - livelihoods, migration and a small town in Zimbabwe

OpenAIRE

Andersson, Agnes

2002-01-01

The Aids pandemic and structural adjustment policies (SAP) have had effects on lower income households in Zimbabwe which have been devastating and people have been required to adapt their livelihood strategies. Small towns meahnwhile are growing rapidly in Zimbabwe and mobility towards these towns may be connected with the changes being forged by SAP on the economic landscape. This study seeks to establish how the individual migrant uses mobility tot negotiate this landscape. This involves mo...

Women of Zimbabwe Arise (WOZA) prepares for popular participation

African Journals Online (AJOL)

justice had been more developed when Zimbabwe gained independence almost .... as well as targeted victims, not only to participate in any truth-seeking .... have been broken apart, whose breadwinners have died of AIDS due to neglect.

Does preoperative physiotherapy improve postoperative, patient-based outcomes in older adults who have undergone total knee arthroplasty? A systematic review.

Science.gov (United States)

Chesham, Ross Alexander; Shanmugam, Sivaramkumar

2017-01-01

Knee osteoarthritis (OA) is a leading cause of disability in older adults (≥60) in the UK. If nonsurgical management fails and if OA severity becomes too great, knee arthroplasty is a preferred treatment choice. Preoperative physiotherapy is often offered as part of rehabilitation to improve postoperative patient-based outcomes. Systematically review whether preoperative physiotherapy improves postoperative, patient-based outcomes in older adults who have undergone total knee arthroplasty (TKA) and compare study interventions to best-practice guidelines. A literature search of Randomized Controlled Trials (RCTs), published April 2004-April 2014, was performed across six databases. Individual studies were evaluated for quality using the PEDro Scale. Ten RCTs met the full inclusion/exclusion criteria. RCTs compared control groups versus: preoperative exercise (n = 5); combined exercise and education (n = 2); combined exercise and acupuncture (n = 1); neuromuscular electrical stimulation (NMES; n = 1); and acupuncture versus exercise (n = 1). RCTs recorded many patient-based outcomes including knee strength, ambulation, and pain. Minimal evidence is presented that preoperative physiotherapy is more effective than no physiotherapy or usual care. PEDro Scale and critical appraisal highlighted substantial methodological quality issues within the RCTs. There is insufficient quality evidence to support the efficacy of preoperative physiotherapy in older adults who undergo total knee arthroplasty.

Outcomes of WHO Grade I Meningiomas Receiving Definitive or Postoperative Radiotherapy

International Nuclear Information System (INIS)

Tanzler, Emily; Morris, Christopher G.; Kirwan, Jessica M.; Amdur, Robert J.; Mendenhall, William M.

2011-01-01

Purpose: We analyzed long-term local control and complications in patients with either pathologically confirmed or clinical World Health Organization Grade I meningiomas treated with definitive or postoperative radiotherapy (RT) at the University of Florida. Methods: Between 1984 and 2006, 146 patients were treated with definitive (n = 88) or postoperative RT after subtotal resection (n = 57) or gross total resection (n = 1). Patients were treated with conventional (n = 41), stereotactic (n = 103), or intensity-modulated RT (n = 2) to a median dose of 52.7 Gy and followed for a median of 7.3 years (range, 0.6-22.0 years) Results: The local control rates at 5 and 10 years were as follows: definitive RT, 99% and 99%; postoperative RT, 96% and 93%; and overall, 97% and 96%, respectively. The 5- and 10-year cause-specific survival rates were as follows: definitive RT 94% and 94%, postoperative RT, 100% and 96%; and overall, 96% and 95%, respectively. The 5- and 10-year overall survival rates were as follows: definitive RT, 81% and 75%; postoperative RT, 96% and 85%; and overall, 87% and 79%, respectively. Severe RT complications occurred in 6.8% of patients; severe surgery-related complications occurred in 10 (17%) of 58 patients treated surgically. Conclusions: The likelihood of cure after definitive RT or following subtotal resection is excellent. However, a small population of patients experience severe complications, even at the moderate dose used for this disease.

Post-operative delirium is associated with increased 5-year mortality.

Science.gov (United States)

Moskowitz, Eliza E; Overbey, Douglas M; Jones, Teresa S; Jones, Edward L; Arcomano, Todd R; Moore, John T; Robinson, Thomas N

2017-12-01

Post-operative delirium is associated with increased short term morbidity and mortality. Limited data exists on long term outcomes for older adults with postoperative delirium. We hypothesize that postoperative delirium is associated with increased 5-year mortality. Patients ≥50 years undergoing elective operations with planned intensive care unit (ICU) admissions were prospectively enrolled. The Confusion Assessment Method ICU (CAM-ICU) was used to diagnose delirium. The primary outcome variable was 5-year mortality. 172 patients were enrolled with an average age of 64 years. The overall incidence of delirium was 44% (75/172). At 5-years post-operatively, mortality was higher (59%, 41/70) in patients with delirium compared to patients without delirium (13%, 12/94, p delirium were 7.35 fold greater (95% CI: 1.49-36.18). Postoperative delirium is associated with increased long term mortality. Published by Elsevier Inc.

Informal sector labour demand: Evidence from Zimbabwe's urban ...

African Journals Online (AJOL)

Siphambe H (Prof)

during the country's economic structural adjustment programme (ESAP) and the ... The study of informal labour demand is important for Zimbabwe which faces .... is assumed to be identically and independently distributed, that is, ..... The labour demand equation's low Chi-square statistic (1.91) and its probability value of.

UNEP greenhouse gas abatement costing studies. Zimbabwe country study. Phase 1

Energy Technology Data Exchange (ETDEWEB)

Shakespeare Maya, R. [Southern Centre for Energy and Environment (Zimbabwe); Muguti, E. [Ministry of Transport and Energy. Department of Energy (Zimbabwe); Fenhann, J.; Morthorst, P.E. [Risoe National Laboratory. Systems Analysis Department (Denmark)

1992-08-01

The UNEP (United Nations Environment Programme) programme of Greenhouse Gas Abatement Costing Studies is intended to clarify the economic issues involved in assessing the costs of limiting emissions of greenhouse gases and to propose approaches to comparable costing studies. Phase 1 of the Zimbabwe country study describes the current energy situation in Zimbabwe related to the national economy, energy supply and demand and amounts of greenhouse gas emissions. Factors regarding the geography, (including a map illustrating the degree and character of land degradation by erosion) population, politics, international relations, land-use and management of the energy sector are dealt with in detail and the text is illustrated with data compiled from the study. It is estimated that Zimbabwe consumed 270.4 Tj of energy during 1988 and emitted 21.7 tonnes of carbon dioxide. An emission intensity of 80.2 tonnes/Tj for the whole economy and 63.6 tonnes/Tj for electric power generation alone was calculated. Forecasting for the year 2020 estimated carbon dioxide emission intensities of 73.5 tonnes/Tj for the whole economy and 43.7 tonnes for power generation. Net carbon dioxide emissions are predicted to be 30-42 tonnes during 2020. (AB).

Prevalence of postoperative pain in adolescent idiopathic scoliosis and the association with preoperative pain.

Science.gov (United States)

Bastrom, Tracey P; Marks, Michelle C; Yaszay, Burt; Newton, Peter O

2013-10-01

Review of a prospective database registry of surgical patients with adolescent idiopathic scoliosis (AIS). The purpose of this study was to examine the prevalence of postoperative pain and its impact on patient-reported postoperative outcomes using the Scoliosis Research Society (SRS)-22 outcomes questionnaire. Although reportedly rare, postoperative pain can be a devastating situation for the patient with AIS. Most recent studies examining outcomes in AIS surgical treatment use the SRS Pain domain score to assess pain in this population. A prospectively enrolled multicenter database was queried. Patients with minimum 2-year follow-up and 2-year SRS scores were included. Postoperative pain after the acute phase of recovery when reported by the patient to the treating surgeon/clinical team in follow-up is recorded as a complication in the database. Patients included in this series were grouped as either reporting pain or not to the surgeon/clinical team postoperatively. Pre- and postoperative SRS scores were then compared between these 2 groups using analysis of variance (P imaging). These 41 patients had significantly decreased 2-year SRS scores in the domains of Pain, Self-image, Mental health, and Total score (P 0.05). Unexplained pain after the 6-month postoperative period occurred in 7% of the cohort. The results indicate that patients reporting pain to their surgeons/clinical team postoperatively have lower pain scores on a subjective outcome instrument thus further validating the SRS-22 outcome tool. This reported pain seems to be associated with decreases in other SRS-22 domains. Interestingly, these patients also have lower preoperative pain scores than those without postoperative pain. Study into causes of pain in AIS and whether preoperative education and expectations targeted at this population would positively impact outcomes is warranted, especially because on average patients after AIS surgery have less pain. 3.

Retrospective comparison of the effects of epidural anesthesia versus peripheral nerve block on postoperative outcomes in elderly Chinese patients with femoral neck fractures

Directory of Open Access Journals (Sweden)

Jin JW

2015-08-01

Full Text Available Jianwen Jin,1 Gang Wang,2 Maowei Gong,3 Hong Zhang,3 Junle Liu21Department of Clinical Medicine, Fujian Health College, Fuzhou, 2Department of Anesthesiology, Chinese People’s Liberation Army 105 Hospital, Hefei, 3Anesthesia and Operation Center, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of ChinaBackground: Geriatric patients with femoral neck fracture (FNF have unacceptably high rates of postoperative complications and mortality. The purpose of this study was to compare the effects of epidural anesthesia versus peripheral nerve block (PNB on postoperative outcomes in elderly Chinese patients with FNF.Methods: This retrospective study explored mortality and postoperative complications in geriatric patients with FNF who underwent epidural anesthesia or PNB at the Chinese People’s Liberation Army General Hospital from January 2008 to December 2012. The electronic database at the Chinese People’s Liberation Army General Hospital includes discharge records for all patients treated in the hospital. Information on patient demographics, preoperative comorbidity, postoperative complications, type of anesthesia used, and in-hospital, 30-day, and 1-year mortality after surgery was obtained from this database.Results: Two hundred and fifty-eight patients were identified for analysis. The mean patient age was 79.7 years, and 71.7% of the patients were women. In-hospital, 30-day, and 1-year postoperative mortality was 4.3%, 12.4%, and 22.9%, respectively, and no differences in mortality or cardiovascular complications were found between patients who received epidural anesthesia and those who received PNB. More patients with dementia or delirium were given PNB. No statistically significant differences were found between groups for other comorbidities or intraoperative parameters. The most common complications were acute cardiovascular events (23.6%, electrolyte disturbances (20.9%, and hypoxemia (18.2%. Patients

Factors associated with acute postoperative pain following breast reconstruction

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Anita R. Kulkarni

2017-03-01

Conclusions: This study identifies patients at risk for severe acute postoperative pain following breast reconstruction. These findings will allow plastic surgeons to better tailor postoperative care to improve patient comfort, reduce clinical morbidity, and enhance patient satisfaction with their surgical outcome.

DNA sequence analyses reveal co-occurrence of novel haplotypes of Fasciola gigantica with F. hepatica in South Africa and Zimbabwe.

Science.gov (United States)

Mucheka, Vimbai T; Lamb, Jennifer M; Pfukenyi, Davies M; Mukaratirwa, Samson

2015-11-30

The aim of this study was to identify and determine the genetic diversity of Fasciola species in cattle from Zimbabwe, the KwaZulu-Natal and Mpumalanga provinces of South Africa and selected wildlife hosts from Zimbabwe. This was based on analysis of DNA sequences of the nuclear ribosomal internal transcribed spacer (ITS1 and 2) and mitochondrial cytochrome oxidase 1 (CO1) regions. The sample of 120 flukes was collected from livers of 57 cattle at 4 abattoirs in Zimbabwe and 47 cattle at 6 abattoirs in South Africa; it also included three alcohol-preserved duiker, antelope and eland samples from Zimbabwe. Aligned sequences (ITS 506 base pairs and CO1 381 base pairs) were analyzed by neighbour-joining, maximum parsimony and Bayesian inference methods. Phylogenetic trees revealed the presence of Fasciola gigantica in cattle from Zimbabwe and F. gigantica and Fasciola hepatica in the samples from South Africa. F. hepatica was more prevalent (64%) in South Africa than F. gigantica. In Zimbabwe, F. gigantica was present in 99% of the samples; F. hepatica was found in only one cattle sample, an antelope (Hippotragus niger) and a duiker (Sylvicapra grimmia). This is the first molecular confirmation of the identity Fasciola species in Zimbabwe and South Africa. Knowledge on the identity and distribution of these liver flukes at molecular level will allow disease surveillance and control in the studied areas. Copyright © 2015 Elsevier B.V. All rights reserved.

Experiences of a feasibility study of children with albinism in Zimbabwe: a discussion paper.

Science.gov (United States)

Taylor, Julie S; Lund, Patricia

2008-08-01

Feasibility studies are often a helpful prelude to constructing fundable research proposals. Where the intended research is in a foreign country, focuses on a vulnerable population, and is aggravated by political and pragmatic challenges, feasibility studies become essential. Albinism, a genetic condition of reduced melanin synthesis, is a major public health issue in southern Africa. Whilst much is known about the health needs of children with albinism, little is understood about how to address these effectively in low income countries. Further, the child care and protection needs of children with albinism are largely unexplored. Zimbabwe's current political and economic climate presents additional challenges to research on the topic. The technical, economic, legal, collaborative, operational, schedule and political feasibilities (acronym TELCOSP) to undertaking a study on children with albinism in Zimbabwe were explored over a six week period of fieldwork in the country. Using the TELSCOSP framework allowed a deconstruction of each challenge to provide innovative solutions. The economic and legal feasibility aspects presented some difficulties that will require flexibility and perseverance to overcome. With the assistance of the local communities and people with albinism in Zimbabwe, the obstacles appear surmountable. The feasibility study provided a productive framework for addressing potential challenges in studying the needs of Zimbabwe's children living with albinism.

The impact of current visa regime policy on tourism recovery and development in Zimbabwe

Directory of Open Access Journals (Sweden)

Nelson Zengeni

2012-12-01

Full Text Available This paper reports the results on the impact of the current visa regime policy on tourism recovery and development in Zimbabwe. The focus was on finding out how the visa regime could impact on efforts to bring into the country more visitors following the decline in visitor inflows from 2000 to 2008. Data was collected from selected visitors from different member states which require visas to enter into the county in the period between January 2010 and July 2010.The findings shows that visa restrictions play a small part in discouraging visitors to visit Zimbabwe. The visa regime policy was designed in such a way that it was easy for passport holders from traditional markets to have relatively easy passage into Zimbabwe. It was also discovered that visa restrictions were part of international travel conditions but how to get the visa became the competitive advantage or disadvantage a destination can have compared with its competitors. Zimbabwe’s traditional markets believed that the visa was not difficult to get nor was it too expensive as to scare away visitors. However, the emerging markets such as China who are in Group C had problems getting the visa as they were required to apply for the visa before traveling to Zimbabwe.

TRANSFORMING RURAL SECONDARY SCHOOLS IN ZIMBABWE THROUGH TECHNOLOGY: LIVED EXPERIENCES OF STUDENT COMPUTER USERS

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Gomba Clifford

2016-04-01

Full Text Available A technological divide exists in Zimbabwe between urban and rural schools that puts rural based students at a disadvantage. In Zimbabwe, the government, through the president donated computers to most rural schools in a bid to bridge the digital divide between rural and urban schools. The purpose of this phenomenological study was to understand the experiences of Advanced Level students using computers at two rural boarding Catholic High Schools in Zimbabwe. The study was guided by two research questions: (1 How do Advanced level students in the rural areas use computers at their school? and (2 What is the experience of using computers for Advanced Level students in the rural areas of Zimbabwe? By performing this study, it was possible to understand from the students’ experiences whether computer usage was for educational learning or not. The results of the phenomenological study showed that students’ experiences can be broadly classified into five themes, namely worthwhile (interesting experience, accessibility issues, teachers’ monopoly, research and social use, and Internet availability. The participants proposed teachers use computers, but not monopolize computer usage. The solution to the computer shortage may be solved by having donors and government help in the acquisitioning of more computers.

Four Cases of Postoperative Pneumothorax Among 2814 Consecutive Laparoscopic Gynecologic Surgeries: A Possible Correlation Between Postoperative Pneumothorax and Endometriosis.

Science.gov (United States)

Hirata, Tetsuya; Nakazawa, Akari; Fukuda, Shinya; Hirota, Yasushi; Izumi, Gentaro; Takamura, Masashi; Harada, Miyuki; Koga, Kaori; Wada-Hiraike, Osamu; Fujii, Tomoyuki; Osuga, Yutaka

2015-01-01

To evaluate the frequency of pneumothorax after laparoscopic surgery and to identify possible correlations to endometriosis. Retrospective review. Tokyo University Hospital between 2006 and 2013. Four patients among a total of 2814 patients with a postoperative pneumothorax. Laparoscopic surgery for gynecologic benign disease. The main outcome was the clinical frequency and characteristics of the patients with postoperative pneumothorax. We observed 4 (0.14%) cases of postoperative pneumothorax after laparoscopic surgery, all of whom were diagnosed with endometriomas and developed a right-sided pneumothorax. The incidence of postoperative pneumothorax in 1097 patients with endometriomas was 0.36%, which was significantly higher than those without endometriomas. The presence of endometrioma should be considered a risk factor for postoperative pneumothorax in gynecologic laparoscopic surgery. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Zimbabwe Veterinary Journal - Vol 30, No 3 (1999)

African Journals Online (AJOL)

Seroprevalence of leptospiral antibodies in commercial pigs in the Mashonaland East Province of Zimbabwe · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. M Mavenyengwa, E Keller, T Munyombwe, 85-92. http://dx.doi.org/10.4314/zvj.v30i3.5349 ...

The persistence of gender inequality in Zimbabwe: factors that ...

African Journals Online (AJOL)

The persistence of gender inequality in Zimbabwe: factors that impede the ... Specifically, we sought to identify the factors perceived by women school heads to be causes ... all other roles; and lack of support from the home and the workplace.

Zimbabwe Journal of Educational Research - Vol 20, No 3 (2008)

African Journals Online (AJOL)

Classroom Tuckshop' Phenomenon In Zimbabwean Urban Primary Schools In Norton ... Information and Communication Technology (ICT) Skills for Bachelor of Education Degree Students at the University of Zimbabwe: Implications for University ...

Customers’ adoption of electronic banking: An investigation on the commercial banking industry in Zimbabwe.

OpenAIRE

Makosana, Musa

2014-01-01

The advent of electronic banking offers banking firms a new frontier of opportunities and challenges. This study investigates how social factors, awareness, consumer perceptions and attitudes towards electronic banking influence the adoption of electronic banking in Zimbabwe. In Zimbabwe little is known and understood about the emergence of electronic banking, this is because electronic banking is new, and so consumer acceptance and use of electronic banking is still limited. This study has r...

Area Handbook Series: Zimbabwe: A Country Study

Science.gov (United States)

1982-08-01

vii Relations-RELIGIOUS LIFE-Christians, Missions, and Independent Churches-Indigenous Religions - EDUCATION-HEALTH Chapter 3. The Economy...continues in Mozambique as Portuguese protectorate. ca. 1820 Migrations begin, resulting from Zulu ascendancy in Natal. 1822 Mzilikazi leads Ndebele out of...Natal after quarrel with Zulu king. ca. 1835 Great Zimbabwe sacked by Ngoni ( Zulu -spealdng group) moving north. 1838 Branch of Ndebele under Kaliphi

Esophagogastric junction distensibility measurements during Heller myotomy and POEM for achalasia predict postoperative symptomatic outcomes

Science.gov (United States)

Teitelbaum, Ezra N.; Soper, Nathaniel J.; Pandolfino, John E.; Kahrilas, Peter J.; Hirano, Ikuo; Boris, Lubomyr; Nicodème, Frédéric; Lin, Zhiyue; Hungness, Eric S.

2015-01-01

Background The functional lumen imaging probe (FLIP) is a novel diagnostic tool that can be used to measure esophagogastric junction (EGJ) distensibility. In this study we performed intraoperative FLIP measurements during laparoscopic Heller myotomy (LHM) and peroral esophageal myotomy (POEM) for treatment of achalasia and evaluated the relationship between EGJ distensibility and postoperative symptoms. Methods Distensibility index (DI) (defined as the minimum cross-sectional area at the EGJ divided by distensive pressure) was measured with FLIP at two time points during LHM and POEM: 1) at baseline after induction of anesthesia, and 2) after operation completion. Results Measurements were performed in 20 patients undergoing LHM and 36 undergoing POEM. Both operations resulted in an increase in DI, although this increase was larger with POEM (7±3.1 vs. 5.1±3.4mm2/mmHg, p3mm2/mmHg. When all patients were divided into thirds based on final DI, none in the lowest DI group (7), as compared with 20% in the middle third (6–9mm2/mmHg) and 36% in the highest third (>9mm2/mmHg). Patients within an “ideal” final DI range (4.5–8.5 mm2/mmHg) had optimal symptomatic outcomes (i.e. Eckardt≤1 and GerdQ≤7) in 88% of cases, compared with 47% in those with a final DI above or below that range (p<.05). Conclusions Intraoperative EGJ distensibility measurements with FLIP were predictive of postoperative symptomatic outcomes. These results provide initial evidence that FLIP has the potential to act as a useful calibration tool during operations for achalasia. PMID:25055891

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - an observational study in 29 countries

NARCIS (Netherlands)

Kroell, Wolfgang; Metzler, Helfried; Struber, Gerd; Wegscheider, Thomas; Gombotz, Hans; Hiesmayr, Michael; Schmid, Werner; Urbanek, Bernhard; Leva, Brigitte; Damster, Sandrine; Plichon, Benoit; Kahn, David; Momeni, Mona; Pospiech, Audrey; Lois, Fernande; Forget, Patrice; Grosu, Irina; Poelaert, Jan; van Mossevelde, Veerle; van Malderen, Marie-Claire; Dylst, Dimitri; van Melkebeek, Jeroen; Beran, Maud; de Hert, Stefan; de Baerdemaeker, Luc; Heyse, Bjorn; van Limmen, Jurgen; Wyffels, Piet; Jacobs, Tom; Roels, Nathalie; de Bruyne, Ann; van de Velde, Stijn; Juros-Zovko, Marina; Djonoviċ-Omanoviċ, Dejana; Serpa Neto, Ary; Pernar, Selma; Zunic, Josip; Miskovic, Petar; Zilic, Antonio; Kvolik, Slavica; Ivic, Dubravka; Azenic-Venzera, Darija; Skiljic, Sonja; Vinkovic, Hrvoje; Oputric, Ivana; Juricic, Kazimir; Frkovic, Vedran; Kopic, Jasminka; Mirkovic, Ivan; Karanovic, Nenad; Carev, Mladen; Dropulic, Natasa; Pavičić-Šarić, Jadranka; Erceg, Gorjana; Bogdanović Dvorščak, Matea; Mazul-Sunko, Branka; Pavicic, Anna Marija; Goranovic, Tanja; Maldini, Branka; Radocaj, Tomislav; Gavranovic, Zeljka; Mladic-Batinica, Inga; Sehovic, Mirna; Stourac, Petr; Harazim, Hana; Smekalova, Olga; Kosinova, Martina; Kolacek, Tomas; Hudacek, Kamil; Drab, Michal; Brujevic, Jan; Vitkova, Katerina; Jirmanova, Katerina; Volfova, Ivana; Dzurnakova, Paula; Liskova, Katarina; Dudas, Radovan; Filipsky, Radek; El Kafrawy, Samir; Hosny Abdelwahab, Hisham; Metwally, Tarek; Abdel-Razek, Ahmed; El-Shaarawy, Ahmed Mostafa; Fathy Hasan, Wael; Gouda Ahmed, Ahmed; Yassin, Hany; Magdy, Mohamed; Abdelhady, Mahdy; Mahran, Mohamed; Herodes, Eiko; Kivik, Peeter; Oganjan, Juri; Aun, Annika; Sormus, Alar; Sarapuu, Kaili; Mall, Merilin; Karjagin, Juri; Futier, Emmanuel; Petit, Antoine; Gerard, Adeline; Marret, Emmanuel; Solier, Marc; Jaber, Samir; Prades, Albert; Putensen, Christian; Krassler, Jens; Merzky, Simone; Gama de Abreu, Marcelo; Uhlig, Christopher; Kiss, Thomas; Bundy, Anette; Bluth, Thomas; Güldner, Andreas; Spieth, Peter; Scharffenberg, Martin; Tran Thiem, Denny; Koch, Thea; Treschan, Tanja; Schaefer, Maximilian; Bastin, Bea; Geib, Johann; Weiss, Martin; Kienbaum, Peter; Pannen, Benedikt; Gottschalk, Andre; Konrad, Mirja; Westerheide, Diana; Schwertfeger, Ben; Wrigge, Hermann; Simon, Philipp; Reske, Andreas; Nestler, Christian; Valsamidis, Dimitrios; Stroumpoulis, Konstantinos; Anthopoulos, Georgios; Andreaou, Antonis; Karapanos, Dimitris; Theodoraki, Kassiani; Gkiokas, Georgios; Ttasoulis, Marios-Konstantinos; Sidiropoulou, Tatiana; Zafeiropoulou, Foteini; Florou, Panagiota; Pandazi, Aggeliki; Tsaousi, Georgia; Nouris, Christos; Pourzitaki, Chryssa; Bystritski, Dmitri; Pizov, Reuven; Eden, Arieh; Pesce, Caterina Valeria; Campanile, Annamaria; Marrella, Antonella; Grasso, Salvatore; de Michele, Michele; Bona, Francesco; Giacoletto, Gianmarco; Sardo, Elena; Giancarlo, Luigi; Sottosanti, Vicari; Solca, Maurizio; Volta, Carlo Alberto; Spadaro, Savino; Verri, Marco; Ragazzi, Riccardo; Zoppellari, Roberto; Cinnella, Gilda; Raimondo, Pasquale; La Bella, Daniela; Mirabella, Lucia; D'Antini, Davide; Pelosi, Paolo; Molin, Alexandre; Brunetti, Iole; Gratarola, Angelo; Pellerano, Giulia; Sileo, Rosanna; Pezzato, Stefano; Montagnani, Luca; Pasin, Laura; Landoni, Giovanni; Zangrillo, Alberto; Beretta, Luigi; Di Parma, Ambra Licia; Tarzia, Valentina; Dossi, Roberto; Sassone, Marta Eugenia; Sances, Daniele; Tredici, Stefano; Spano, Gianluca; Castellani, Gianluca; Delunas, Luigi; Peradze, Sopio; Venturino, Marco; Arpino, Ines; Sher, Sara; Tommasino, Concezione; Rapido, Francesca; Morelli, Paola; Vargas, Maria; Servillo, Giuseppe; Cortegiani, Andrea; Raineri, Santi Maurizio; Montalto, Francesca; Russotto, Vincenzo; Giarratano, Antonino; Baciarello, Marco; Generali, Michela; Cerati, Giorgia; Leykin, Yigal; Bressan, Filippo; Bartolini, Vittoria; Zamidei, Lucia; Brazzi, Luca; Liperi, Corrado; Sales, Gabriele; Pistidda, Laura; Severgnini, Paolo; Brugnoni, Elisa; Musella, Giuseppe; Bacuzzi, Alessandro; Muhardri, Dalip; Gecaj-Gashi, Agreta; Sada, Fatos; Bytyqi, Adem; Karbonskiene, Aurika; Aukstakalniene, Ruta; Teberaite, Zivile; Salciute, Erika; Tikuisis, Renatas; Miliauskas, Povilas; Jurate, Sipylaite; Kontrimaviciute, Egle; Tomkute, Gabija; Xuereb, John; Bezzina, Maureen; Borg, Francis Joseph; Hemmes, Sabrine; Schultz, Marcus; Hollmann, Markus; Wiersma, Irene; Binnekade, Jan; Bos, Lieuwe; Boer, Christa; Duvekot, Anne; In 't Veld, Bas; Werger, Alice; Dennesen, Paul; Severijns, Charlotte; de Jong, Jasper; Hering, Jens; van Beek, Rienk; Ivars, Stefan; Jammer, Ib; Breidablik, Alena; Skirstad Hodt, Katharina; Fjellanger, Frode; VicoAvalos, Manuel; Mellin-Olsen, Jannicke; Andersson, Elisabeth; Shafi-Kabiri, Amir; Molina, Ruby; Wutai, Stanley; Morais, Erick; Tareco, Glo Ria; Ferreira, Daniel; Amaral, Joana; Gonçalves Castro, Maria de Lurdes; Cadilha, Susana; Appleton, Sofia; Parente, Suzana; Correia, Mariana; Martins, Diogo; Monteirosa, Angela; Ricardo, Ana; Rodrigues, Sara; Horhota, Lucian; Grintescu, Ioana Marina; Mirea, Liliana; Grintescu, Ioana Cristina; Corneci, Dan; Negoita, Silvius; Dutu, Madalina; Popescu Garotescu, Ioana; Filipescu, Daniela; Prodan, Alexandru Bogdan; Droc, Gabriela; Fota, Ruxandra; Popescu, Mihai; Tomescu, Dana; Petcu, Ana Maria; Tudoroiu, Marian Irinel; Moise, Alida; Guran, Catalin-Traian; Gherghina, Iorel; Costea, Dan; Cindea, Iulia; Copotoiu, Sanda-Maria; Copotoiu, Ruxandra; Barsan, Victoria; Tolcser, Zsolt; Riciu, Magda; Septimiu, Gheorghe Moldovan; Veres, Mihaly; Gritsan, Alexey; Kapkan, Tatyana; Gritsan, Galina; Korolkov, Oleg; Kulikov, Alexander; Lubnin, Andrey; Ovezov, Alexey; Prokoshev, Pavel; Lugovoy, Alexander; Anipchenko, Natalia; Babayants, Andrey; Komissarova, Irina; Zalina, Karginova; Likhvantsev, Valery; Fedorov, Sergei; Lazukic, Aleksandra; Pejakovic, Jasmina; Mihajlovic, Dunja; Kusnierikova, Zuzana; Zelinkova, Maria; Bruncakova, Katarina; Polakovicova, Lenka; Sobona, Villiam; Novak-Supe, Barbka; Pekle-Golez, Ana; Jovanov, Miroljub; Strazisar, Branka; Markovic-Bozic, Jasmina; Novak-Jankovic, Vesna; Voje, Minca; Grynyuk, Andriy; Kostadinov, Ivan; Spindler-Vesel, Alenka; Moral, Victoria; Unzueta, Carmen; Puigbo, Carlos; Fava, Josep; Canet, Jaume; Moret, Enrique; Rodriguez Nunez, Mo Nica; Sendra, Mar; Brunelli, Andrea; Rodenas, Frederic; Monedero, Pablo; Hidalgo Martinez, Francisco; Yepes Temino, Maria Jose; Marti Nez Simon, Antonio; de Abajo Larriba, Ana; Lisi, Alberto; Perez, Gisela; Martinez, Raquel; Granell, Manuel; Tatay Vivo, Jose; Saiz Ruiz, Cristina; de Andre S Iban Ez, Jose Antonio; Pastor, Ernesto; Soro, Marina; Ferrando, Carlos; Defez, Mario; Aldecoa Alvares-Santullano, Cesar; Pere, Rocio; Rico, Jesus; Jawad, Monir; Saeed, Yousif; Gillberg, Lars; Hedenstierna, Göran; Kazak Bengisun, Zuleyha; Kansu Kazbek, Baturay; Coskunfirat, Nesil; Boztug, Neval; Sanli, Suat; Yilmaz, Murat; Hadimioglu, Necmiye; Senturk, Nuzhet Mert; Camci, Emre; Kucukgoncu, Semra; Sungur, Zerrin; Sivrikoz, Nukhet; Ustalar Ozgen, Serpil; Toraman, Fevzi; Selvi, Onur; Senturk, Ozgur; Yildiz, Mine; Kuvaki, Bahar; Gunenc, Ferim; Kucukguclu, Semih; Ozbilgin, S. Ule; Maral, Jale; Canli, Seyda; Arun, Oguzhan; Saltali, Ali; Aydogan, Eyup; Akgün, Fatma Nur; Sanlikarip, Ceren; Mine Karaman, Fatma; Mazur, Andriy; Vorotyntsev, Sergiy; Rousseau, Guy; Barrett, Colin; Stancombe, Lucia; Shelley, Ben; Scholes, Helen; Limb, James; Rafi, Amir; Wayman, Lisa; Deane, Jill; Rogerson, David; Williams, John; Yates, Susan; Rogers, Elaine; Pulletz, Mark; Moreton, Sarah; Jones, Stephanie; Venkatesh, Suresh; Burton, Maudrian; Brown, Lucy; Goodall, Cait; Rucklidge, Matthew; Fuller, Debbie; Nadolski, Maria; Kusre, Sandeep; Lundberg, Michael; Everett, Lynn; Nutt, Helen; Zuleika, Maka; Carvalho, Peter; Clements, Deborah; Creagh-Brown, Ben; Watt, Philip; Raymode, Parizade; Pearse, Rupert; Mohr, Otto; Raj, Ashok; Creary, Thais; Chishti, Ahmed; Bell, Andrea; Higham, Charley; Cain, Alistair; Gibb, Sarah; Mowat, Stephen; Franklin, Danielle; West, Claire; Minto, Gary; Boyd, Nicholas; Mills, Gary; Calton, Emily; Walker, Rachel; Mackenzie, Felicity; Ellison, Branwen; Roberts, Helen; Chikungwa, Moses; Jackson, Clare; Donovan, Andrew; Foot, Jayne; Homan, Elizabeth; Montgomery, Jane; Portch, David; Mercer, Pauline; Palme, Janet; Paddle, Jonathan; Fouracres, Anna; Datson, Amanda; Andrew, Alyson; Welch, Leanne; Rose, Alastair; Varma, Sandeep; Simeson, Karen; Rambhatla, Mrutyunjaya; Susarla, Jaysimha; Marri, Sudhakar; Kodaganallur, Krishnan; Das, Ashok; Algarsamy, Shivarajan; Colley, Julie; Davies, Simon; Szewczyk, Margaret; Smith, Thomas; Fernandez-Bustamante, Ana; Luzier, Elizabeth; Almagro, Angela; Vidal Melo, Marcos; Fernando, Luiz; Sulemanji, Demet; Sprung, Juraj; Weingarten, Toby; Kor, Daryl; Scavonetto, Federica; Tze, Yeo

2017-01-01

BACKGROUNDLimited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients.OBJECTIVESTo determine the incidence of surgical patients at increased risk

HIV testing uptake and retention in care of HIV-infected pregnant and breastfeeding women initiated on 'Option B+' in rural Zimbabwe.

Science.gov (United States)

Dzangare, Janet; Takarinda, Kudakwashe C; Harries, Anthony D; Tayler-Smith, Katie; Mhangara, Mutsa; Apollo, Tsitsi Mutasa; Mushavi, Angela; Chimwaza, Anesu; Sithole, Ngwarai; Magure, Tapiwa; Mpofu, Amon; Dube, Freeman; Mugurungi, Owen

2016-02-01

Zimbabwe has started to scale up Option B+ for the prevention of mother-to-child transmission of HIV, but there is little published information about uptake or retention in care. This study determined the number and proportion of pregnant and lactating women in rural districts diagnosed with HIV infection and started on Option B+ along with six-month antiretroviral treatment (ART) outcomes. This was a retrospective record review of women presenting to antenatal care or maternal and child health services at 34 health facilities in Chikomba and Gutu rural districts, Zimbabwe, between January and March 2014. A total of 2728 women presented to care of whom 2598 were eligible for HIV testing: 76% presented to antenatal care, 20% during labour and delivery and 4% while breastfeeding. Of 2097 (81%) HIV-tested women, 7% were HIV positive. Lower HIV testing uptake was found with increasing parity, late presentation to antenatal care, health centre attendance and in women tested during labour. Ninety-one per cent of the HIV-positive women were started on Option B+. Six-month ART retention in care, including transfers, was 83%. Loss to follow-up was the main cause of attrition. Increasing age and gravida status ≥2 were associated with higher six-month attrition. The uptake of HIV testing and Option B+ is high in women attending antenatal and post-natal clinics in rural Zimbabwe, suggesting that the strategy is feasible for national scale-up in the country. © 2015 John Wiley & Sons Ltd.

Agroforestry Systems in Zimbabwe: Promoting Trees in Agriculture.

Science.gov (United States)

Vukasin, Helen L., Ed.

Agroforestry has been defined as a sustainable crop management system which combines the production of forest crops with field crops. In June, 1987, an agroforestry workshop took place in Nyanga, Manicaland, Zimbabwe. This document was prepared to share the information presented at this workshop with other non-government organizations around the…

Rangelands in Zimbabwe's initial resettlement schemes: Spatial and ...

African Journals Online (AJOL)

Change in size and extent of cultivation and vegetation cover was analysed in three villages of an initial resettlement scheme in Zimbabwe using change detection depicted on serial aerial photographs taken at eight-year intervals from inception in 1981 to 1997. A geographic information system was used as an analytical ...

Zimbabwe Children's act alignment with international and domestic ...

African Journals Online (AJOL)

This paper identifies shortfalls in the Children's Act (Zimbabwe) which reduce its alignment with the international and domestic legal instruments such as the United Nations Convention on the Rights of the Child (UNCRC), the African Charter on the Rights and Welfare of the Child (ACRWC), Child Protection Model Law, ...

Electoral Politics in Zimbabwe: Authoritarianism Versus the People ...

African Journals Online (AJOL)

The majority of Zimbabweans are now accustomed to electoral fraud as practised by the ruling Zimbabwe African National Union-Patriotic Front (ZANU-PF) led by President Mugabe. Elections are generally not conducted in a manner that can be deemed to be free, fair and transparent. The major electoral malpractices ...

AfSBT Congress Abstracts: Zimbabwe 2014 | Adewuyi | Africa ...

African Journals Online (AJOL)

AfSBT Congress Abstracts: Zimbabwe 2014. James Ola-Banji Adewuyi. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

Patient retention, clinical outcomes and attrition-associated factors of HIV-infected patients enrolled in Zimbabwe's National Antiretroviral Therapy Programme, 2007-2010.

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Tsitsi Mutasa-Apollo

Full Text Available Since establishment of Zimbabwe's National Antiretroviral Therapy (ART Programme in 2004, ART provision has expanded from <5,000 to 369,431 adults by 2011. However, patient outcomes are unexplored.To determine improvement in health status, retention and factors associated with attrition among HIV-infected patients on ART.A retrospective review of abstracted patient records of adults ≥ 15 years who initiated ART from 2007 to 2009 was done. Frequencies and medians were calculated for rates of retention in care and changes in key health status outcomes at 6, 12, 24 and 36 months respectively. Cox proportional hazards models were used to determine factors associated with attrition.Of the 3,919 patients, 64% were female, 86% were either WHO clinical stage III or IV. Rates of patient retention at 6, 12, 24 and 36 months were 90.7%, 78.1%, 68.8% and 64.4%, respectively. After ART initiation, median weight gains at 6, 12, and 24 months were 3, 4.5, and 5.0 kgs whilst median CD4+ cell count gains at 6, 12 and 24 months were 122, 157 and 279 cells/µL respectively. Factors associated with an increased risk of attrition included male gender (AHR 1.2; 95% CI, 1.1-1.4, baseline WHO stage IV (AHR 1.7; 95% CI, 1.1-2.6, lower baseline body weight (AHR 2.0; 95% CI, 1.4-2. 8 and accessing care from higher level healthcare facilities (AHR 3.5; 95% 1.1-11.2.Our findings with regard to retention as well as clinical and immunological improvements following uptake of ART, are similar to what has been found in other settings. Factors influencing attrition also mirror those found in other parts of sub-Saharan Africa. These findings suggest the need to strengthen earlier diagnosis and treatment to further improve treatment outcomes. Whilst decentralisation improves ART coverage it should be coupled with strategies aimed at improving patient retention.

Prospective Evaluation of Two iStent® Trabecular Stents, One iStent Supra® Suprachoroidal Stent, and Postoperative Prostaglandin in Refractory Glaucoma: 4-year Outcomes.

Science.gov (United States)

Myers, Jonathan S; Masood, Imran; Hornbeak, Dana M; Belda, Jose I; Auffarth, Gerd; Jünemann, Anselm; Giamporcaro, Jane Ellen; Martinez-de-la-Casa, Jose M; Ahmed, Iqbal Ike K; Voskanyan, Lilit; Katz, L Jay

2018-03-01

This study evaluates long-term outcomes of two trabecular micro-bypass stents, one suprachoroidal stent, and postoperative prostaglandin in eyes with refractory open angle glaucoma (OAG). Prospective ongoing 5-year study of 80 eligible subjects (70 with 4-year follow-up) with OAG and IOP ≥ 18 mmHg after prior trabeculectomy and while taking 1-3 glaucoma medications. Subjects received two iStent ® trabecular micro-bypass stents, one iStent Supra ® suprachoroidal stent, and postoperative travoprost. Postoperative IOP was measured with medication and annually following medication washouts. Performance was measured by the proportion of eyes with ≥ 20% IOP reduction on one medication (the protocol-specified prostaglandin) versus preoperative medicated IOP (primary outcome); and the proportion of eyes with postoperative IOP ≤ 15 and ≤ 18 mmHg on one medication (secondary outcome). Additional clinical and safety data included medications, visual field, pachymetry, gonioscopy, adverse events, visual acuity, and slit-lamp and fundus examinations. Preoperatively, mean medicated IOP was 22.0 ± 3.1 mmHg on 1.2 ± 0.4 medications, and mean unmedicated IOP was 26.4 ± 2.4 mmHg. Postoperatively, among eyes without later cataract surgery, mean medicated IOP at all visits through 48 months was ≤ 13.7 mmHg (≥ 37% reduction), and annual unmedicated IOP was ≤ 18.4 mmHg (reductions of ≥ 30% vs. preoperative unmedicated IOP and ≥ 16% vs. preoperative medicated IOP). At all postoperative visits among eyes without additional surgery or medication, ≥ 91% of eyes had ≥ 20% IOP reduction on one medication versus preoperative medicated IOP. At month 48, 97 and 98% of eyes achieved IOP ≤ 15 and ≤ 18 mmHg, respectively, on one medication. Six eyes required additional medication, no eyes required additional glaucoma surgery, and safety measurements were favorable throughout follow-up. IOP control was achieved safely with two

Language in education and language development in Zimbabwe ...

African Journals Online (AJOL)

This article analyses the language in education policy of Zimbabwe. It attempts to highlight the factors that informed the formulation of this policy, as well as the challenges and constraints that have affected its implementation. The country's language in education policy can be traced back to the colonial history of the country, ...

Internal Displacement and Forced Migration within Zimbabwe: An ...

African Journals Online (AJOL)

This paper argues that, contrary to the picture portrayed by the government of Zimbabwe, internal displacement, as one form of (forced) migration within a country's borders, is more prevalent in the country than is at first discernable. The paper offers an overview of the current scholarship on the forced mobility of particular ...

The effect of hospital organizational characteristics on postoperative complications.

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Knight, Margaret

2013-12-01

To determine if there is a relationship between the risk of postoperative complications and the nonclinical hospital characteristics of bed size, ownership structure, relative urbanicity, regional location, teaching status, and area income status. This study involved a secondary analysis of 2006 administrative hospital data from a number of U.S. states. This data, gathered annually by the Agency for Healthcare Research and Quality (AHRQ) via the National Inpatient Sample (NIS) Healthcare Utilization Project (HCUP), was analyzed using probit regressions to measure the effects of several nonclinical hospital categories on seven diagnostic groupings. The study model included postoperative complications as well as additional potentially confounding variables. The results showed mixed outcomes for each of the hospital characteristic groupings. Subdividing these groupings to correspond with the HCUP data analysis allowed a greater understanding of how hospital characteristics' may affect postoperative outcomes. Nonclinical hospital characteristics do affect the various postoperative complications, but they do so inconsistently.

Zimbabwe Journal of Educational Research - Vol 30, No 1 (2018)

African Journals Online (AJOL)

Promoting Sustainable Development through the New/Revised Design and Technology Curriculum in Zimbabwe: With Specific Reference to Food Security · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. P. Kwaira ...

Hydrological modelling of fine sediments in the Odzi River, Zimbabwe

African Journals Online (AJOL)

Hydrological modelling of fine sediments in the Odzi River, Zimbabwe. ... An analysis of the model structure and a comparison with the rating curve function ... model validation through split sample and proxy basin comparison was performed.

Weighing the legal basis for housing rights in Zimbabwe | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2016-12-13

Dec 13, 2016 ... Weighing the legal basis for housing rights in Zimbabwe ... through the Safe and Inclusive Cities partnership with the UK's Department for International Development. ... Transforming the slum: The case of Mumbai's M-Ward.

Minilaparoscopic versus standard laparoscopic hysterectomy for uteri ≥ 16 weeks of gestation: surgical outcomes, postoperative quality of life, and cosmesis.

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Uccella, Stefano; Cromi, Antonella; Casarin, Jvan; Bogani, Giorgio; Serati, Maurizio; Gisone, Baldo; Pinelli, Ciro; Fasola, Maddalena; Ghezzi, Fabio

2015-05-01

Hysterectomy for enlarged uteri is a surgical challenge. Our aim was to compare perioperative outcomes, cosmesis, and postoperative quality of life following laparoscopic hysterectomy for large uteri using minilaparoscopic 3-mm versus conventional laparoscopic 5-mm instruments. We prospectively enrolled women with a uterus between 16 and 20 weeks of gestation at the preoperative examination. These patients underwent laparoscopic procedures using either 3-mm (minilaparoscopy group) or 5-mm (standard laparoscopy group) instruments. Five months after surgery, patients were called back to fill out the validated Italian translation of the Short Form 12-item Health Survey. Data about the cosmetic outcome of the procedure were also collected, using a Numeric Rating Scale (NRS) from 0 to 10. Seventy-eight women were included (27 in the 3-mm and 51 in the 5-mm groups). Perioperative characteristics were comparable between groups. The median uterus weight was 575 (range, 440-1050) g and 550 (400-1000) g in the 3-mm and 5-mm groups, respectively. No minilaparoscopic procedure was converted to standard 5-mm or to an open approach. One (2%) conversion to open abdominal surgery was needed in the conventional laparoscopy group. A better subjective cosmetic outcome was found in the 3-mm (NRS, 9.7 ± 0.4) versus the 5-mm (NRS, 8.9 ± 1.2) group (P=.01). Postoperative quality of life was comparable between groups. Minilaparoscopic hysterectomy is feasible, even in the case of an enlarged-size uterus. Moreover, it is associated with a better cosmetic outcome, compared with conventional laparoscopy.

Postoperative quality of life outcome and employment in patients undergoing resection of epileptogenic lesions detected by magnetic resonance imaging

International Nuclear Information System (INIS)

Moritake, Kouzo; Akiyama, Yasuhiko; Nagai, Hidemasa; Maruyama, Nobuyuki; Takada, Daikei; Daisu, Mitsuhiro; Nagasako, Noriko; Mikuni, Nobuhiro; Hashimoto, Nobuo

2009-01-01

The long-term postoperative improvement of quality of life (QOL) and employment were investigated in patients undergoing resection of epileptogenic lesions detected by magnetic resonance (MR) imaging to identify the associated preoperative factors. Thirty of 47 patients who underwent lesionectomy between 1987-2001 replied to questionnaires. Patients with extratemporal resection outnumbered those with temporal lobe resection. The mean follow-up period was 12.4±3.7 years. An arbitrary score for quantitatively assessing QOL was assigned. The mean increases in QOL score points were significantly higher in the late childhood onset group than those in the early childhood onset group, and were also significantly higher in the temporal resection group and extratemporal resection of non-dysplastic cortical pathology group than in the extratemporal resection of dysplastic cortical pathology group. Postoperative QOL improvement and occupational status of patients depended on the completeness of seizure control. Resection of lesions detected by MR imaging in patients with intractable epilepsy resulted in effective long-term QOL improvement and postoperative occupational status. Favorable outcome was related mainly to the pathology of the epileptogenic lesions, whether the lesion site was temporal or extratemporal, and the completeness of seizure control. (author)

Gender as a risk factor for adverse intraoperative and postoperative outcomes of elective pancreatectomy.

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Mazmudar, Aditya; Vitello, Dominic; Chapman, Mackenzie; Tomlinson, James S; Bentrem, David J

2017-02-01

Patient selection remains paramount when developing and adopting quality-based assessment and reimbursement models, and enhanced recovery protocols. Gender is a patient characteristic known before surgery which can inform risk stratification. Our aim was to evaluate the effect of gender on intraoperative blood transfusions, operative time, length of hospital stay, estimated blood loss (EBL) as well as postoperative surgical site infections (SSIs), and mortality. Patients undergoing elective pancreatectomy from 2005 to 2013 were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and Northwestern institutional databases. Multivariable analyses were conducted to identify the association between gender and these outcomes. Analyses demonstrated that male gender was independently associated with blood transfusion (OR 1.23), operative time >6 hr (OR 1.76), length of stay greater than 11 days (OR 1.17), and all-type SSIs (OR 1.17), especially superficial SSIs (OR 1.15) and organ space SSIs (OR 1.18). Analysis of the institutional cohort found that male gender was independently associated with increased odds of EBL > 1 L for Whipple procedures (OR 2.85). Male gender is a significant predictor of increased operative time, length of stay, transfusions, EBL > 1L, as well as postoperative organ space surgical site infections in these patients. J. Surg. Oncol. 2017;115:131-136. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Analysis of postoperative biochemical values and clinical outcomes after adrenalectomy for primary aldosteronism.

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Swearingen, Andrew J; Kahramangil, Bora; Monteiro, Rosebel; Krishnamurthy, Vikram; Jin, Judy; Shin, Joyce; Siperstein, Allan; Berber, Eren

2018-04-01

Primary aldosteronism causes hypertension and hypokalemia and is often surgically treatable. Diagnosis includes elevated plasma aldosterone, suppressed plasma renin activity, and elevated aldosterone renin ratio. Adrenalectomy improves hypertension and hypokalemia. Postoperative plasma aldosterone and plasma renin activity may be useful in documenting cure or failure. A retrospective analysis of patients who underwent adrenalectomy for primary aldosteronism from 2010 to 2016 was performed, analyzing preoperative and postoperative plasma aldosterone, plasma renin activity, hypertension, and hypokalemia. The utility of postoperative testing was assessed. Clinical cure was defined as improved hypertension control and resolution of potassium loss. Biochemical cure was defined as aldosterone renin ratio reduction to <23.6. Forty-four patients were included; 20 had plasma aldosterone and plasma renin activity checked on postoperative day 1. In the study, 40/44 (91%) were clinically cured. All clinical failures had of biochemical failure at follow-up. Postoperative day 1aldosterone renin ratio <23.6 had PPV of 95% for clinical cure. Cured patients had mean plasma aldosterone drop of 33.1 ng/dL on postoperative day 1; noncured patient experienced 3.9 ng/dL increase. A cutoff of plasma aldosterone decrease of 10 ng/dL had high positive predictive value for clinical cure. Changes in plasma aldosterone and plasma renin activity after adrenalectomy correlate with improved hypertension and hypokalemia. The biochemical impact of adrenalectomy manifests as early as postoperative day 1. We propose a plasma aldosterone decrease of 10 ng/dL as a criterion to predict clinical cure. Copyright © 2017 Elsevier Inc. All rights reserved.

Private Universities in Zimbabwe: The Case of Africa University ...

African Journals Online (AJOL)

Whilst many of these challenges are shared with other private universities in Zimbabwe, a few are peculiar to Africa University. This paper discusses Africa University's experience with regard to establishment, nature, institutional marketing and student recruitment, programmes, governance, finding and other external factors ...

Brain aneurysm patients seen in Harare, Zimbabwe: cases review ...

African Journals Online (AJOL)

Setting: Parirenyatwa Group of Hospitals and Avenues Clinic, Harare, Zimbabwe. Subjects: Adult intracranial aneurysm patients. Interventions: Craniotomy and aneurysm clipping. Results: Seventeen patients were seen during the period of study. Twelve were female patients while five were male with a male to female ratio ...

The casual, naturalised and invasive alien flora of Zimbabwe based on herbarium and literature records

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Alfred Maroyi

2012-01-01

Full Text Available Zimbabwe’s casual, naturalised and invasive alien plant species were analysed with regard to their habit, origin, mode or purpose of introduction and their invasion status in the country. This alien flora of 391 taxa belonged to 239 genera and 73 families, corresponding to 6.6% of the total flora of Zimbabwe. Of these, 153 (39.1% plant species were casual aliens, 154 (39.4% were naturalised and 84 (21.5% were invasive species. Most invasions in terms of numbers of alien species were in the central and eastern parts of the country. Asteraceae (53 species, Poaceae (48 species and Fabaceae sensu lato (49 species families were prominent in all the floristic regions of the country. Annual and perennial herbaceous species formed the majority of life forms of the casual, naturalised and invasive alien flora of Zimbabwe. Genera with the highest number of alien species were Ipomoea with nine species, Acacia and Euphorbia with eight species each, Chenopodium and Senna with seven species each, Eucalyptus with six species, Oenothera, Physalis and Solanum with five species each. More than 49.6% of the alien plants in Zimbabwe originated primarily from South, Central and North America, followed by Europe (24.6%, Asia (23.8%, Africa (10.5% and Australasia (5.9%.Conservation implications: This research provides baseline information and historical invasion patterns of casual, naturalised and invasive alien flora in Zimbabwe. This inventory is a crucial starting point in trying to understand and initiate the management of biological invasions. This is also important for monitoring new introductions and management of existing alien plants in Zimbabwe.

Managing public records in Zimbabwe: the road to good governance ...

African Journals Online (AJOL)

MARIA

Government officers rely on information that is accurate ... to realise their goals of chief amongst them to improve the ... Financial. Management. Information Systems (IFMIS) in Zimbabwe ... records and information play a critical role in fighting ...

Zimbabwe Journal of Educational Research - Vol 27, No 3 (2015)

African Journals Online (AJOL)

The Importance of Play in Early Childhood Development: Implications on Design ... to Ban the use of Contraceptives and Lowering the Age of Consent in Zimbabwe ... Navigating New Horizons: An Analysis of Factors that Influence Computer ...

Measuring the second economy in Zimbabwe Albert Makochekanwa

African Journals Online (AJOL)

SIPHAMBE, H.K. (PROF.)

of the informal production activities to Zimbabwe's GDP has been growing over the ... respect to the informal sector it can be argued that GDP figures for the country are biased .... on tax audits and voluntary responses, among other sources of data ..... and average tax rate (ATR) data series were obtained from the Reserve ...

Division of overall duration of stay into operative stay and postoperative stay improves the overall estimate as a measure of quality of outcome in burn care.

Directory of Open Access Journals (Sweden)

Islam Abdelrahman

Full Text Available Surgically managed burn patients admitted between 2010-14 were included. Operative stay was defined as the time from admission until the last operation, postoperative stay as the time from the last operation until discharge. The difference in variation was analysed with F-test. A retrospective review of medical records was done to explore reasons for extended postoperative stay. Multivariable regression was used to assess factors associated with operative stay and postoperative stay.Operative stay/TBSA% showed less variation than total duration/TBSA% (F test = 2.38, p<0.01. The size of the burn, and the number of operations, were the independent factors that influenced operative stay (R2 0.65. Except for the size of the burn other factors were associated with duration of postoperative stay: wound related, psychological and other medical causes, advanced medical support, and accommodation arrangements before discharge, of which the two last were the most important with an increase of (mean 12 and 17 days (p<0.001, R2 0.51.Adjusted operative stay showed less variation than total hospital stay and thus can be considered a more accurate outcome measure for surgically managed burns. The size of burn and number of operations are the factors affecting this outcome measure.

Lung transplantation for idiopathic pulmonary arterial hypertension on intraoperative and postoperatively prolonged extracorporeal membrane oxygenation provides optimally controlled reperfusion and excellent outcome.

Science.gov (United States)

Moser, Bernhard; Jaksch, Peter; Taghavi, Shahrokh; Muraközy, Gabriella; Lang, Georg; Hager, Helmut; Krenn, Claus; Roth, Georg; Faybik, Peter; Bacher, Andreas; Aigner, Clemens; Matilla, José R; Hoetzenecker, Konrad; Hacker, Philipp; Lang, Irene; Klepetko, Walter

2018-01-01

Lung transplantation for idiopathic pulmonary arterial hypertension has the highest reported postoperative mortality of all indications. Reasons lie in the complexity of treatment of these patients and the frequent occurrence of postoperative left ventricular failure. Transplantation on intraoperative extracorporeal membrane oxygenation support instead of cardiopulmonary bypass and even more the prolongation of extracorporeal membrane oxygenation into the postoperative period helps to overcome these problems. We reviewed our experience with this concept. All patients undergoing bilateral lung transplantation for idiopathic pulmonary arterial hypertension on intraoperative extracorporeal membrane oxygenation with or without prophylactic extracorporeal membrane oxygenation prolongation into the postoperative period between January 2000 and December 2014 were retrospectively analysed. Forty-one patients entered the study. Venoarterial extracorporeal membrane oxygenation support was prolonged into the postoperative period for a median of 2.5 days (range 1-40). Ninety-day, 1-, 3- and 5-year survival rates for the patient collective were 92.7%, 90.2%, 87.4% and 87.4%, respectively. When compared with 31 patients with idiopathic pulmonary arterial hypertension transplanted in the same period of time without prolongation of extracorporeal membrane oxygenation into the postoperative period, the results compared favourably (83.9%, 77.4%, 77.4%, and 77.4%; P = 0.189). Furthermore, these results are among the best results ever reported for this particularly difficult patient population. Bilateral lung transplantation for idiopathic pulmonary arterial hypertension with intraoperative venoarterial extracorporeal membrane oxygenation support seems to provide superior outcome compared with the results reported about the use of cardiopulmonary bypass. Prophylactic prolongation of venoarterial extracorporeal membrane oxygenation into the early postoperative period provides

Inflation dynamics in a dollarised economy: The case of Zimbabwe ...

African Journals Online (AJOL)

During the local currency era, inflation dynamics in Zimbabwe were ... era was attributed to excess money supply growth, lagged infl ation and political factors. ... an impact on price formation, might not be applicable in a dollarised economy.

Challenges of communicating integrated water resource management in Zimbabwe

NARCIS (Netherlands)

Marimbe, S.; Manzungu, E.

2003-01-01

With the promulgation of the 1998 Water Act the Government of Zimbabwe took a decisive step to reform the country's water sector, to bring it in line with contemporary socio-political realities obtaining in the country, and in tune with the philosophy of integrated water resources management.

Traditional processing of masau fruits (Ziziphus mauritiana) in Zimbabwe

NARCIS (Netherlands)

Nyanga, L.K.; Nout, M.J.R.; Gadaga, T.H.; Boekhout, T.; Zwietering, M.H.

2008-01-01

A survey of the traditional processing techniques of masau was conducted using a questionnaire and two focus group discussions in Mudzi, Mt. Darwin, and Muzarabani districts in Zimbabwe. Masau fruits form part of the family diet and generate additional income by selling at local markets. Surplus

Admission haematological abnormalities and postoperative ...

African Journals Online (AJOL)

Admission haematological abnormalities and postoperative outcomes in neonates with acute surgical conditions in Alexandria, Egypt. HL Wella, SMM Farahat. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals ...

Current Status of Mycotoxin Contamination of Food Commodities in Zimbabwe

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Nancy Nleya

2018-05-01

Full Text Available Agricultural products, especially cereal grains, serve as staple foods in sub-Saharan Africa. However, climatic conditions in this region can lead to contamination of these commodities by moulds, with subsequent production of mycotoxins posing health risks to both humans and animals. There is limited documentation on the occurrence of mycotoxins in sub-Saharan African countries, leading to the exposure of their populations to a wide variety of mycotoxins through consumption of contaminated foods. This review aims at highlighting the current status of mycotoxin contamination of food products in Zimbabwe and recommended strategies of reducing this problem. Zimbabwe is one of the African countries with very little information with regards to mycotoxin contamination of its food commodities, both on the market and at household levels. Even though evidence of multitoxin occurrence in some food commodities such as maize and other staple foods exist, available published research focuses only on Aspergillus and Fusarium mycotoxins, namely aflatoxins, deoxynivalenol (DON, trichothecenes, fumonisins, and zearalenone (ZEA. Occurrence of mycotoxins in the food chain has been mainly associated with poor agricultural practices. Analysis of mycotoxins has been done mainly using chromatographic and immunological methods. Zimbabwe has adopted European standards, but the legislation is quite flexible, with testing for mycotoxin contamination in food commodities being done voluntarily or upon request. Therefore, the country needs to tighten its legislation as well as adopt stricter standards that will improve the food safety and security of the masses.

Current Status of Mycotoxin Contamination of Food Commodities in Zimbabwe.

Science.gov (United States)

Nleya, Nancy; Adetunji, Modupeade Christianah; Mwanza, Mulunda

2018-05-03

Agricultural products, especially cereal grains, serve as staple foods in sub-Saharan Africa. However, climatic conditions in this region can lead to contamination of these commodities by moulds, with subsequent production of mycotoxins posing health risks to both humans and animals. There is limited documentation on the occurrence of mycotoxins in sub-Saharan African countries, leading to the exposure of their populations to a wide variety of mycotoxins through consumption of contaminated foods. This review aims at highlighting the current status of mycotoxin contamination of food products in Zimbabwe and recommended strategies of reducing this problem. Zimbabwe is one of the African countries with very little information with regards to mycotoxin contamination of its food commodities, both on the market and at household levels. Even though evidence of multitoxin occurrence in some food commodities such as maize and other staple foods exist, available published research focuses only on Aspergillus and Fusarium mycotoxins, namely aflatoxins, deoxynivalenol (DON), trichothecenes, fumonisins, and zearalenone (ZEA). Occurrence of mycotoxins in the food chain has been mainly associated with poor agricultural practices. Analysis of mycotoxins has been done mainly using chromatographic and immunological methods. Zimbabwe has adopted European standards, but the legislation is quite flexible, with testing for mycotoxin contamination in food commodities being done voluntarily or upon request. Therefore, the country needs to tighten its legislation as well as adopt stricter standards that will improve the food safety and security of the masses.

Zambezia: The Journal of Humanities of the University of Zimbabwe ...

African Journals Online (AJOL)

Democratic discourse? Realising alternatives in Zimbabwe political discourse · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. A. Love, 27-46. http://dx.doi.org/10.4314/zjh.v27i1.6742 ...

Utility of screening questionnaire and polysomnography to predict postoperative outcomes in children.

Science.gov (United States)

Kako, Hiromi; Tripi, Jennifer; Walia, Hina; Tumin, Dmitry; Splaingard, Mark; Jatana, Kris R; Tobias, Joseph D; Raman, Vidya T

2017-11-01

The prevalence of pediatric obstructive sleep apnea (OSA) has increased concurrently with the increasing prevalence of obesity. We have previously validated a short questionnaire predicting the occurrence of OSA on polysomnography (PSG). This follow-up study assessed the utility of the questionnaire in predicting postoperative outcomes. Children undergoing surgery and completing a sleep study were prospectively screened for OSA using a short questionnaire. Procedures within 1 year of PSG were included in the analysis. Questionnaires were scored according to a cutoff previously deemed optimal for predicting OSA (apnea-hypopnea index ≥ 5) on the sleep study. Postoperative outcomes included prolonged (>60 min) length of stay (LOS) in the post-anesthesia care unit (PACU) and oxygen requirement in the PACU. The study cohort included 185 patients (100/85 male/female) age 8 ± 4 years, undergoing adenotonsillectomy (n = 109), other ear, nose, and throat (ENT) procedures (n = 18), or non-ENT procedures (n = 58). There were 45 patients with OSA documented by PSG and 122 patients identified as likely to have OSA according to questionnaire responses (89% sensitivity, 41% specificity). PACU LOS was prolonged in 55/181 (30%) cases and supplemental oxygen was used in the PACU in 29/181 (16%) cases. In separate multivariable models, supplemental oxygen use in the PACU was more common if a patient scored ≥2/6 points on the short questionnaire scale (OR = 5.0; 95% CI: 1.3, 19.9; p = 0.023) or if the patient was diagnosed with OSA on PSG (OR = 4.6; 95% CI: 1.6, 13.5; p = 0.005). Neither OSA on PSG nor questionnaire score ≥2/6 were associated with prolonged PACU stay. Both OSA diagnosis based on the AHI and the questionnaire scale achieved comparable predictive value for the need for oxygen use in the PACU. The utility of the questionnaire in predicting rare adverse events (e.g., unplanned admission or rapid response team activation) remains to be determined

Determinants of women's non-family work in Ghana and Zimbabwe

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Kofi D. Benefo

2003-12-01

Full Text Available One objective of this paper is to evaluate the determinants of female non-family work in Africa. Selected labor force participation theories are tested using demographic and health survey data. The traditional kinship-oriented family organization in Africa, along with high fertility, have long been seen as factors that constrain women’s participation in the labor force, particularly in seeking formal sector employment. We use demographic and health survey data from two African countries, Ghana and Zimbabwe. Education emerges as the most important determinant of non-family work. Even if female education levels increase, single women may not gain easy entry into the informal economy managed by kinship-based social networks. A large proportion of these educated women may not find jobs if the formal economy does not expand. Results from Ghana and Zimbabwe are compared.

Serosurvey for canine distemper virus exposure in dogs in communal lands in Zimbabwe

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P.J. Kelly

2005-06-01

Full Text Available Sera from 173 apparently healthy, unvaccinated dogs from 4 widely separated communal lands in Zimbabwe were tested by ELISA for antibodies against canine distemper virus. Overall, 82 % were positive with high prevalences found in each communal land. The highest seroprevalence was in dogs between 1 and 2 years of age (91 %; 49/54. These results show dogs in the communal lands of Zimbabwe are commonly exposed to canine distemper virus and that a substantial number survive infection. The role that the virus might play in the high mortality rate of the dog population on communal land warrants further investigation.

Conflict management strategies in settling workplace disputes: The case of air Zimbabwe

Directory of Open Access Journals (Sweden)

Sandiso Ngcobo

2015-09-01

Full Text Available The aim of this article is to conduct the analysis of the conflict management strategies that Air Zimbabwe, a service delivery company in Zimbabwe in Southern Africa, employs in settling workplace disputes between it and its employees. The research approach relies mainly on a survey questionnaire that is completed by both the employees and management. The analysis of data is descriptive. The respondents indicate that strategies can move from a positive to a negative approach within a short space of time. The results are often detrimental to the quality of service that the company provides to its clientele. It is recommended that the parties should rely on negotiation and mediation to arrest conflicts before they escalate.

Antimicrobial resistence of Shigella species isolated during 2004 and 2005 from selected sites in Zimbabwe.

Science.gov (United States)

Ndlovu, N; Tarupiwa, A; Mudzori, J T

2006-01-01

To determine the predominant serotype and antibiotic sensitivity pattern of Shigella isolates during 2004 and 2005 in Zimbabwe. Cross sectional study. National Microbiology Reference Laboratory (NMRL), Harare, Zimbabwe. 259 clinical isolates of Shigella species isolated during 2004 and 2005 in Zimbabwe were studied. These samples had been referred to the NMRL for further testing. Serotype and antibiotic sensitivity pattern of Shigella species. Of the 259 clinical isolates of Shigella tested the following species were serotyped; 141 (54.4%) were S. flexneri; 70 (27%) S. sonnei; 38 (14.7%) S. dysenteriae and 10 (3.9%) S. boydii. About 4% of all Shigella isolates tested showed full sensitivity to commonly used antibiotics, 20.8% were resistant to one antibiotic only while 75.3% were resistant to at least two antibiotics. The most common resistance among Shigella species was to cotrimoxazole (89%), tetracycline (73%), ampicillin (49%) and chloramphenicol (41%). High susceptibility among Shigella species was observed to nalidixic acid (86%), ciprofloxacin (99%) and ceftazidine (99%). There was a low drug resistance of Shigella species to nalidixic acid, a drug of choice in Zimbabwe, except among Shigella dysenteriae type 1 strains. Continuous monitoring of the susceptibility patterns of Shigella species is important in order to detect the emergence of drug resistance and to update guidelines for antibiotic treatment in shigellosis.

Reduced CBF recovery detected by longitudinal 3D-SSP SPECT analyses predicts outcome of postoperative patients after subarachnoid haemorrhage.

Science.gov (United States)

Mutoh, Tatsushi; Totsune, Tomoko; Takenaka, Shunsuke; Tatewaki, Yasuko; Nakagawa, Manabu; Suarez, Jose I; Taki, Yasuyuki; Ishikawa, Tatsuya

2018-02-01

The aim of this study was to evaluate the impact of cerebral blood flow (CBF) recovery obtained from brain single-photon emission computed tomography (SPECT) images on postoperative outcome after aneurysmal subarachnoid haemorrhage (SAH). Twenty-nine patients who had undergone surgical clipping for ruptured anterior communicating artery aneurysms were analyzed prospectively. Routine measurements of CBF were performed using technetium-99 m hexamethyl propyleneamine oxine SPECT on days 4 and 14 after SAH. Regional voxel data analyzed by three dimensional stereotactic surface projection (3D-SSP) were compared between patients and age-matched normal database (NDB). In 3D-SSP analysis of all patients, cortical hypoperfusion around the surgical site in bilateral frontal lobes was evident on day 4 (P SSP SPECT image analyses can be a potential predictor of poor prognosis in postoperative patients after SAH. © 2017 John Wiley & Sons Australia, Ltd.

Impact of exercise pulmonary hypertension on postoperative outcome in primary mitral regurgitation.

Science.gov (United States)

Magne, Julien; Donal, Erwan; Mahjoub, Haifa; Miltner, Beatrice; Dulgheru, Raluca; Thebault, Christophe; Pierard, Luc A; Pibarot, Philippe; Lancellotti, Patrizio

2015-03-01

The management of asymptomatic patients with mitral regurgitation (MR) remains controversial. Exercise-induced pulmonary hypertension (ExPHT) was recently reported as a strong predictor of rapid onset of symptoms. We hypothesised that ExPHT is a predictor of postoperative cardiovascular events in patients with primary MR. One hundred and two patients with primary MR, no or mild symptoms (New York heart association (NYHA) ≤2), and no LV dysfunction/dilatation, were prospectively recruited in 3 centres and underwent exercise-stress echocardiography. The presence of ExPHT was defined as an exercise systolic pulmonary arterial pressure >60 mm Hg. All patients were closely followed up and operated on when indication for surgery was reached. Postoperative events were defined as the occurrence of atrial fibrillation (AF), stroke, cardiac-related hospitalisation or death. Among the 102 patients included, 59 developed ExPHT (58%). These patients were significantly older than those without ExPHT (p=0.01). During a mean postoperative follow-up of 50±23 months, 28 patients (26%) experienced a predefined cardiovascular event. Patients with ExPHT had significantly higher rate of postoperative events (39% vs 12%, p=0.005); the rate of events was still higher in these patients (32% vs 9%, p=0.013), even when excluding early postoperative AF (ie, within 48 h). Event-free survival was significantly lower in the ExPHT group (all events: 5-year: 60±8% vs 88±5%, p=0.007, events without early AF: 5-year: 67±7% vs 90±4%, p=0.02). Using Cox multivariable analysis, ExPHT remained independently associated with higher risk of postoperative events in all models (all p≤0.04). ExPHT is associated with increased risk of adverse cardiac events following mitral valve surgery in patients with primary MR. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Managing public records in Zimbabwe: the road to good governance ...

African Journals Online (AJOL)

The ability by government departments to attain effective service delivery, accountability and good governance is largely determined by their records management practices. Delays and failure to access services due to missing or misplaced records from public institutions is a common challenge in Zimbabwe.

Profiles of blood and blood component transfusion recipients in Zimbabwe

NARCIS (Netherlands)

Mafirakureva, Nyashadzaishe; Khoza, Star; Hassall, Oliver; Faragher, Brian E.; Kajja, Isaac; Mvere, David A.; Emmanuel, Jean C.; Postma, Maarten J.; van Hulst, Marinus

2015-01-01

Background. There are limited published data on the characteristics of blood transfusion recipients in sub-Saharan Africa. This study describes the demographic characteristics of blood transfusion recipients and patterns of blood and blood component use in Zimbabwe. Materials and methods. Data on

The Determinants of the Compliance to Public Procurement Policy Requirements among Public Enterprises in Zimbabwe

OpenAIRE

Maxwell Sandada; Portia Kambarami

2016-01-01

Many public entities in Zimbabwe are operating in a very volatile environment characterised by public procurement systems open to abuse. Zimbabwe is one of the first countries in Africa to have a Procurement Act however non-compliance issues are still a challenge. Public procurement scandals have been a hot topic with the media and also with the Report of the Auditor General for the financial year ended December 31, 2014 having picked on a lot of issues relating to non-complian...

Postoperative hypocalcemia after thyroidectomy for Graves' disease.

Science.gov (United States)

Pesce, Catherine E; Shiue, Zita; Tsai, Hua-Ling; Umbricht, Christopher B; Tufano, Ralph P; Dackiw, Alan P B; Kowalski, Jeanne; Zeiger, Martha A

2010-11-01

It is believed that patients who undergo thyroidectomy for Graves' disease are more likely to experience postoperative hypocalcemia than patients undergoing total thyroidectomy for other indications. However, no study has directly compared these two groups of patients. The aim of this study was to determine whether there was an increased incidence or severity of postoperative hypocalcemia in patients who underwent thyroidectomy for Graves' disease. An institutional review board-approved database was created of all patients who underwent thyroidectomy from 1998 to 2009 at the Johns Hopkins Hospital. There were a total of 68 patients with Graves' disease who underwent surgery. Fifty-five patients who underwent total thyroidectomy were randomly selected and served as control subjects. An analysis was conducted that examined potential covariates for postoperative hypocalcemia, including age, gender, ethnicity, preoperative alkaline phosphatase level, size of goiter, whether parathyroid tissue or glands were present in the specimen, and the reason the patient underwent surgery. Specific outcomes examined were calcium levels on postoperative day 1, whether or not patients experienced symptoms of hypocalcemia, whether or not Rocaltrol was required, the number of calcium tablets prescribed upon discharge, whether or not postoperative tetany occurred, and calcium levels 1 month after discharge. Each outcome was analyzed using a logistic regression. Graves' disease patients had a significantly (p-value Graves' disease and no patient in the control group were readmitted with tetany (p = 0.033). There was a trend, though not significant, toward patients with Graves' disease having a higher prevalence of hypocalcemia the day after thyroidectomy and 1 month later. Patients with Graves' disease are more likely to require increased dosages of calcium as well as experience tetany postoperatively than patients undergoing total thyroidectomy for other indications. This suggests that

Single night postoperative prone posturing in idiopathic macular hole surgery.

LENUS (Irish Health Repository)

2012-02-01

Purpose. To evaluate the role of postoperative prone posturing for a single night in the outcome of trans pars plana vitrectomy (TPPV) with internal limiting membrane (ILM) peel and 20% perfluoroethane (C2F6) internal tamponade for idiopathic macular hole. Methods. This prospective trial enrolled 14 eyes in 14 consecutive patients with idiopathic macular hole. All eyes underwent TPPV with vision blue assisted ILM peeling with and without phacoemulsification and intraocular lens (IOL) for macular hole. Intraocular gas tamponade (20% C2F6) was used in all cases with postoperative face-down posturing overnight and without specific posturing afterwards. LogMAR visual acuity, appearance by slit-lamp biomicroscopy, and ocular coherence tomography (OCT) scans were compared preoperatively and postoperatively to assess outcome. Results. Among 14 eyes recruited, all eyes were phakic; 50% of patients underwent concurrent phacoemulsification with IOL. The macular holes were categorized preoperatively by OCT appearance, 4 (28.57%) were stage 2, 7 (50%) were stage 3, and 3 (21.43%) were stage 4. Mean macular hole size was 0.35 disk diameters. Symptoms of macular hole had been present for an average of 6.5 months. All holes (100%) were closed 3 and 6 months postoperatively. Mean visual acuity (logMAR) was improved to 0.61 at 3 months and was stable at 6 months after the surgery. None of the eyes had worse vision postoperatively. Conclusions. Vitrectomy with ILM peeling and 20% C2F6 gas with a brief postoperative 1 night prone posturing regimen is a reasonable approach to achieve anatomic closure in idiopathic macular hole. Concurrent cataract extraction did not alter outcomes and was not associated with any additional complications.

Drug adherence behavior among hypertensive out-patients at a tertiary health institution in Manicaland province, Zimbabwe, 2011

OpenAIRE

Mukora-Mutseyekwa, Fadzai NN; Chadambuka, Elizabeth M

2013-01-01

Fadzai NN Mukora-Mutseyekwa, Elizabeth M ChadambukaFaculty of Health Sciences, Africa University, Mutare, ZimbabweObjectives: This study investigated the level of drug adherence among hypertensive outpatients at a tertiary hospital in Zimbabwe. Specific objectives included measurement of blood pressure (BP) control achievement, estimating prevalence of drug adherence behavior, and establishing the association between drug adherence behavior and achievement of BP control.Methods and materials:...

Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection. An international audit by ESCP and S-ECCO

DEFF Research Database (Denmark)

2018-01-01

and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. MethodThis was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who...... to produce odds ratios and 95% confidence intervals. ResultsIn all, 375 resections in 375 patients were included. The median age was 37 and 57.1% were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95% CI 1.10-4.97), urgent...

Home-based care for people living with AIDS in Zimbabwe ...

African Journals Online (AJOL)

Similar to the healthcare systems of other resource-constrained countries with a high prevalence of HIV and AIDS, Zimbabwe's healthcare system encourages communities and non-governmental organisations (NGOs) to support the public healthcare sector by initiating home-based care activities and training volunteers to ...

Cognitive function is linked to adherence to bariatric postoperative guidelines.

Science.gov (United States)

Spitznagel, Mary Beth; Galioto, Rachel; Limbach, Kristen; Gunstad, John; Heinberg, Leslie

2013-01-01

Impairment in cognitive function is found in a significant subset of individuals undergoing bariatric surgery, and recent work shows this impairment is associated with smaller postoperative weight loss. Reduced cognitive function could contribute to poorer adherence to postoperative guidelines, although this has not been previously examined. The present study examined the relationship between cognitive function and adherence to bariatric postoperative guidelines. We expected that higher cognitive function would be associated with better adherence to postoperative guidelines. Thirty-seven bariatric surgery patients completed cognitive testing and a self-report measure of adherence to postoperative bariatric guidelines during their 4- to 6-week postoperative appointment. Strong correlations were observed between adherence to postoperative guidelines and cognitive indices of attention, executive function, and memory. Results show that cognitive performance is strongly associated with adherence to postoperative guidelines shortly after bariatric surgery. Further work is needed to clarify whether this relationship is present at later postoperative stages and the degree to which this relationship mediates postoperative weight loss outcomes. Copyright © 2013 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Intelligent postoperative morbidity prediction of heart disease using artificial intelligence techniques.

Science.gov (United States)

Hsieh, Nan-Chen; Hung, Lun-Ping; Shih, Chun-Che; Keh, Huan-Chao; Chan, Chien-Hui

2012-06-01

Endovascular aneurysm repair (EVAR) is an advanced minimally invasive surgical technology that is helpful for reducing patients' recovery time, postoperative morbidity and mortality. This study proposes an ensemble model to predict postoperative morbidity after EVAR. The ensemble model was developed using a training set of consecutive patients who underwent EVAR between 2000 and 2009. All data required for prediction modeling, including patient demographics, preoperative, co-morbidities, and complication as outcome variables, was collected prospectively and entered into a clinical database. A discretization approach was used to categorize numerical values into informative feature space. Then, the Bayesian network (BN), artificial neural network (ANN), and support vector machine (SVM) were adopted as base models, and stacking combined multiple models. The research outcomes consisted of an ensemble model to predict postoperative morbidity after EVAR, the occurrence of postoperative complications prospectively recorded, and the causal effect knowledge by BNs with Markov blanket concept.

Incidence, predictors and outcomes of postoperative coma: an observational study of 858,606 patients.

Science.gov (United States)

Newman, Jessica; Blake, Kathryn; Fennema, Jordan; Harris, David; Shanks, Amy; Avidan, Michael S; Kelz, Max B; Mashour, George A

2013-08-01

Coma is a state of profound unresponsiveness that can occur as a serious perioperative complication. The study of risk factors for, and sequelae of, postoperative coma has been limited due to the rarity of the event. To determine the incidence, risk factors and impact of postoperative coma in a large patient population. Observational study using a prospectively gathered national dataset. Data from 858 606 patients were analysed. The incidence of postoperative coma of more than 24-h duration was identified. Logistic regression was used to identify independent predictors and develop a risk model of postoperative coma in derivation and validation cohorts; 30-day mortality was also analysed. The incidence of postoperative coma was 0.06%. Multivariate analysis revealed the following independent predictors: liver disease, systemic sepsis, age at least 63 years, renal disease, emergency operation, cardiac disease, hypertension, prior neurological disease, diabetes mellitus and BMI 25 to 29.99 kg m (protective). These predictors were incorporated into a risk index classification; odds ratios for postoperative coma increased from 2.5 with one risk factor to 18.4 with three. Coma was associated with 74.2% all-cause mortality; coma associated with cardiac arrest had a 1.9-fold higher mortality. This is the largest study of postoperative coma ever reported and will be useful for determining risk of coma of more than 24 h duration when evaluating an unresponsive patient following surgery. Data on prognosis will aid medical and ethical decision-making for the comatose surgical patient.

Neuraxial block and postoperative epidural analgesia

DEFF Research Database (Denmark)

Leslie, K; McIlroy, D; Kasza, J

2016-01-01

BACKGROUND: We assessed associations between intraoperative neuraxial block and postoperative epidural analgesia, and a composite primary outcome of death or non-fatal myocardial infarction, at 30 days post-randomization in POISE-2 Trial subjects. METHODS: 10 010 high-risk noncardiac surgical pat...

CONFRONTING THE RECKLESS GAMBLING WITH PEOPLE’S HEALTH AND LIVES: URBAN SOLID WASTE MANAGEMENT IN ZIMBABWE

OpenAIRE

Enock C.Makwara; Snodia Magudu

2013-01-01

Litter has become a common sight along high ways and in many urban and peri-urban communities in Zimbabwe. In spite of the numerous clean-up and anti-litter campaigns that have been initiated by different individuals and organizations coupled with the tremendous effort that has been put in making the public aware of the disadvantages associated with littering, endemic and insistent filth engulfs Zimbabwe as people continue to litter. Zimbabwe’s waste management has virtually collapsed, trigge...

Tectonic setting of the Great Dyke, Chembadzi, Chewore and Atchiza layered complexes in Zimbabwe and Mozambique

International Nuclear Information System (INIS)

Master, S.

1990-01-01

The Great Dyke of Zimbabwe is one of the largest ultramafic-mafic layered igneous complexexs in the world. Because of the economic importance of large layered intrusions like the Great Dyke, their tectonic setting is of great interest. The Chembadzi complex is a 14 km long, dyke-like layered intrusion up to 800m wide. The Chewore complex, which was thought to have the structure of an irregular lopolith, outcrops over an area of about 200 km in horst blocks in the lower Zambezi Valley in northern Zimbabwe. The Atchiza complex is situated just north of the Cahora Bassa lake and the Zambezi River valley in Mozambique. In considering the tectonic setting of the Great Dyke and its correlatives, most attention has been focussed on events in the Limpopo Mobile Belt, which were responsible for producing the fractures in the Zimbabwe craton that is occupied by the intrusives. 39 refs

Cost-effectiveness of school support for orphan girls to prevent HIV infection in Zimbabwe.

Science.gov (United States)

Miller, Ted; Hallfors, Denise; Cho, Hyunsan; Luseno, Winnie; Waehrer, Geetha

2013-10-01

This cost-effectiveness study analyzes the cost per quality-adjusted life year (QALY) gained in a randomized controlled trial that tested school support as a structural intervention to prevent HIV risk factors among Zimbabwe orphan girl adolescents. The intervention significantly reduced early marriage, increased years of schooling completed, and increased health-related quality of life. By reducing early marriage, the literature suggests the intervention reduced HIV infection. The intervention yielded an estimated US$1,472 in societal benefits and an estimated gain of 0.36 QALYs per orphan supported. It cost an estimated US$6/QALY gained, about 1 % of annual per capita income in Zimbabwe. That is well below the maximum price that the World Health Organization (WHO) Commission on Macroeconomics and Health recommends paying for health gains in low and middle income countries. About half the girls in the intervention condition were boarded when they reached high school. For non-boarders, the intervention's financial benefits exceeded its costs, yielding an estimated net cost savings of $502 per pupil. Without boarding, the intervention would yield net savings even if it were 34 % less effective in replication. Boarding was not cost-effective. It cost an additional $1,234 per girl boarded (over the 3 years of the study, discounted to present value at a 3 % discount rate) but had no effect on any of the outcome measures relative to girls in the treatment group who did not board. For girls who did not board, the average cost of approximately 3 years of school support was US$973.

In memoriam. Stuart Kenneth Hargreaves, DVM, 1946-2012. The humanist veterinarian from Zimbabwe who was committed to the improvement of animal health in Africa

OpenAIRE

Anon.

2012-01-01

Zimbabwe Society for Animal Production Gold Medal Award for outstanding contribution to the livestock industryJ F Kapnek Charitable Trust Award for exceptional managerial commitment to the Zimbabwe Veterinary Journal and contributions to the veterinary professionCommercial Farmers’ Union Farming Oscar for outstanding contribution to the livestock industry and in particular ensuring continued beef exportsResearch Council of Zimbabwe award for distinguished contribution to the agricultural sect...

Zimbabwe's Human Resources for health Information System (ZHRIS)-an assessment in the context of establishing a global standard.

Science.gov (United States)

Waters, Keith P; Zuber, Alexandra; Simbini, Tungamirirai; Bangani, Zwashe; Krishnamurthy, Ramesh S

2017-04-01

There have been numerous global calls to action to utilize human resources information systems (HRIS) to improve the availability and quality of data for strengthening the regulation and deployment of health workers. However, with no normative guidance in existence, the development of HRIS has been inconsistent and lacking in standardization, hindering the availability and use of data for health workforce planning and decision making (Riley et al., 2012). CDC and WHO partnered with the Ministry of Health in several countries to conduct HRIS functional requirements analyses and establish a Minimum Data Set (MDS) of elements essential for a global standard HRIS. As a next step, CDC advanced a study to examine the alignment of one of the HRIS it supports (in Zimbabwe) against this MDS. For this study, we created a new data collection and analysis tool to assess the extent to which Zimbabwe's CDC-supported HRIS was aligned with the WHO MDS. We performed systematic "gap analyses" in order to make prioritized recommendations for addressing the gaps, with the aim of improving the availability and quality of data on Zimbabwe's health workforce. The majority of the data elements outlined in the WHO MDS were present in the ZHRIS databases, though they were found to be missing various applicable elements. The lack of certain elements could impede functions such as health worker credential verification or equitable in-service training allocation. While the HRIS MDS treats all elements equally, our assessment revealed that not all the elements have equal significance when it comes to data utilization. Further, some of the HRIS MDS elements exceeded the current needs of regulatory bodies and the Ministry of Health and Child Care (MOHCC) in Zimbabwe. The preliminary findings of this study helped inspire the development of a more recent HRH Registry MDS subset, which is a shorter list of priority data elements recommended as a global standard for HRIS. The field-tested assessment

Multimodal approach to postoperative recovery

DEFF Research Database (Denmark)

Kehlet, Henrik

2009-01-01

PURPOSE OF REVIEW: To provide updated information on recent developments within individual components of multimodal interventions to improve postoperative outcome (fast-track methodology). RECENT FINDINGS: The value of the fast-track methodology to improve recovery and decrease hospital stay...... and morbidity has been firmly consolidated, especially in colorectal procedures. An increasing amount of data from other procedures supports the value of the fast-track concept across procedures. Fast-track programs should be based on the analysis of procedure-specific factors that may influence outcome...

An assessment of illegal fishing in Gonarezhou National Park, Zimbabwe

NARCIS (Netherlands)

Gandiwa, E.; Zisadza-Gandiwa, P.; Mutandwa, M.; Sandram, S.

2012-01-01

Illegal fishing is a worldwide problem. In this study we present the first assessment of illegal fishing in Gonarezhou National Park (GNP), Zimbabwe. Information on illegal fishing was gathered from a total of 39 illegal fishers who were arrested within GNP between February and October 2011. Data

A hotspot of large branchiopod diversity in south-eastern Zimbabwe ...

African Journals Online (AJOL)

Large branchiopods are considered threatened across much of their global range. However, because several regions, including Zimbabwe in general and its south-eastern lowveld in particular, remain largely unstudied, interpretations of species distribution patterns are often based on limited data. A detailed study of large ...

Zimbabwe Journal of Technological Sciences - Vol 1, No 1 (2010)

African Journals Online (AJOL)

Employee Identification and their Perceived Customer Satisfaction: A 2008 Case Study of Chinhoyi University Hotel – Zimbabwe. EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. F Chimutingiza, 31-44. http://dx.doi.org/10.4314/zjts.v1i1.65217 ...

Short- to Medium-term Outcomes After a Modified Broström Repair for Lateral Ankle Instability With Immediate Postoperative Weightbearing.

Science.gov (United States)

Petrera, Massimo; Dwyer, Tim; Theodoropoulos, John S; Ogilvie-Harris, Darrell J

2014-07-01

Anatomic techniques of ankle ligament repair have the advantage of restoring the anatomy and kinematics of the joint. This study presents a technique for anatomic reconstruction of the lateral ligament complex by way of lateral ligament advancement using suture anchors associated with immediate protected full weightbearing; 2- to 5-year clinical outcomes are reported. This technique of providing an anatomic reconstruction with a secure fixation will enable early rehabilitation with immediate, protected weightbearing, with favorable outcomes. Case series; Level of evidence, 4. Fifty-five patients with chronic lateral ankle instability who failed nonoperative management underwent modified Broström repair (lateral ligament fibular advancement) between 2005 and 2008. The anterior talofibular ligament and calcaneofibular ligament were released from the fibula and advanced using 2 double-loaded metallic suture anchors (3.5 mm). Full weightbearing in a walking boot was allowed from the first postoperative day. Patients were assessed preoperatively and at a minimum 2-year follow-up using the Foot and Ankle Outcome Score. Complication, failure (recurrent instability), and return-to-sport rates were also recorded. Six patients (11%) were lost to follow-up, leaving a study group of 49 patients (23 men, 26 women). The mean age at the time of surgery was 25 years (range, 18-37 years), with a mean duration of symptoms of 1.8 years (range, 6 months to 5 years). The mean follow-up time was 42 months (range, 24-60 months). Significant improvement was seen in the Foot and Ankle Outcome Score from preoperatively to postoperatively (from 36 to 75.4, P ankle-related quality of life subscale from 35 to 78 (P anchor fixation is an effective procedure for the treatment of chronic lateral ankle instability and allows immediate weightbearing. © 2014 The Author(s).

Crop diversification and livelihoods of smallholder farmers in Zimbabwe: adaptive management for environmental change.

Science.gov (United States)

Makate, Clifton; Wang, Rongchang; Makate, Marshall; Mango, Nelson

2016-01-01

This paper demonstrates how crop diversification impacts on two outcomes of climate smart agriculture; increased productivity (legume and cereal crop productivity) and enhanced resilience (household income, food security, and nutrition) in rural Zimbabwe. Using data from over 500 smallholder farmers, we jointly estimate crop diversification and each of the outcome variables within a conditional (recursive) mixed process framework that corrects for selectivity bias arising due to the voluntary nature of crop diversification. We find that crop diversification depends on the land size, farming experience, asset wealth, location, access to agricultural extension services, information on output prices, low transportation costs and general information access. Our results also indicate that an increase in the rate of adoption improves crop productivity, income, food security and nutrition at household level. Overall, our results are indicative of the importance of crop diversification as a viable climate smart agriculture practice that significantly enhances crop productivity and consequently resilience in rural smallholder farming systems. We, therefore, recommend wider adoption of diversified cropping systems notably those currently less diversified for greater adaptation to the ever-changing climate.

The political economy of power generation in Zimbabwe since 1980

International Nuclear Information System (INIS)

Soederholm, P.

1999-01-01

This article presents a historical analysis of the power generation choices in Zimbabwe since independence in 1980; their causes and consequences. In the early 1980s, the electricity supply choices of the country were dictated by a policy of self-sufficiency, and least-cost supply options (e.g. imports and hydropower) were rejected at a not negligible economic cost. At the end of the 1980s, a new political environment and pressures from the World Bank prompted substantial changes towards least-cost alternatives. In the early 1990s, security of supply motives still played an important role and financial constraints were severe. At present, however, there is little evidence that imported power is still as cheap a source of electricity as it was about 15 years ago. This situation together with the ongoing trend towards higher discount rates imply that thermal power, in particular coal-fired power, will dominate future electricity supply investments in Zimbabwe. (author)

The Zimbabwe Exiles Forum: Campaigning for freedom in the ...

International Development Research Centre (IDRC) Digital Library (Canada)

2011-01-31

Jan 31, 2011 ... Complicating the prospects for peaceful change is the fact that Mugabe has appointed not one but two vice-presidents, which raises the spectre of political chaos in the event of a sudden handover of power. “Such a cauldron of potential explosion!” says Shumba with a wry laugh. Should Zimbabwe collapse ...

Acute pain control and accelerated postoperative surgical recovery

DEFF Research Database (Denmark)

Kehlet, H

1999-01-01

Postoperative pain relief continues to demand our awareness, and surgeons should be fully aware of the potential physiologic benefits of effective dynamic pain relief regimens and the great potential to improve postoperative outcome if such analgesia is used for rehabilitation. To achieve advanta...... to recent knowledge within surgical pathophysiology. Such efforts must be expected to lead to improved quality of care for patients, with less pain and reduced morbidity leading to cost efficiency....

When did HIV incidence peak in Harare, Zimbabwe? Back-calculation from mortality statistics.

Directory of Open Access Journals (Sweden)

Ben Lopman

2008-03-01

Full Text Available HIV prevalence has recently begun to decline in Zimbabwe, a result of both high levels of AIDS mortality and a reduction in incident infections. An important component in understanding the dynamics in HIV prevalence is knowledge of past trends in incidence, such as when incidence peaked and at what level. However, empirical measurements of incidence over an extended time period are not available from Zimbabwe or elsewhere in sub-Saharan Africa. Using mortality data, we use a back-calculation technique to reconstruct historic trends in incidence. From AIDS mortality data, extracted from death registration in Harare, together with an estimate of survival post-infection, HIV incidence trends were reconstructed that would give rise to the observed patterns of AIDS mortality. Models were fitted assuming three parametric forms of the incidence curve and under nine different assumptions regarding combinations of trends in non-AIDS mortality and patterns of survival post-infection with HIV. HIV prevalence was forward-projected from the fitted incidence and mortality curves. Models that constrained the incidence pattern to a cubic spline function were flexible and produced well-fitting, realistic patterns of incidence. In models assuming constant levels of non-AIDS mortality, annual incidence peaked between 4 and 5% between 1988 and 1990. Under other assumptions the peak level ranged from 3 to 8% per annum. However, scenarios assuming increasing levels of non-AIDS mortality resulted in implausibly low estimates of peak prevalence (11%, whereas models with decreasing underlying crude mortality could be consistent with the prevalence and mortality data. HIV incidence is most likely to have peaked in Harare between 1988 and 1990, which may have preceded the peak elsewhere in Zimbabwe. This finding, considered alongside the timing and location of HIV prevention activities, will give insight into the decline of HIV prevalence in Zimbabwe.

Surgical outcome of tuberculous meningitis hydrocephalus treated by endoscopic third ventriculostomy: prognostic factors and postoperative neuroimaging for functional assessment of ventriculostomy.

Science.gov (United States)

Chugh, Ashish; Husain, Mazhar; Gupta, Rakesh K; Ojha, Bal K; Chandra, Anil; Rastogi, Manu

2009-05-01

Endoscopic third ventriculostomy (ETV) is increasingly being used as an alternative treatment for post-tuberculous meningitis (TBM) hydrocephalus. The aim of this study was to affirm the role of ETV in patients with TBM hydrocephalus and also to study the usefulness of cine phase-contrast MR imaging (cine MR imaging) for functional assessment of the ETV stoma. An additional goal was to identify factors that influence the outcome of ETV, so as to define patients with TBM hydrocephalus in whom ETV is warranted. Twenty-six patients with TBM hydrocephalus treated with ETV were evaluated clinically and with cine MR imaging postoperatively. The duration of follow-up ranged from 1 to 15 months. The authors evaluated flow void changes in the floor of the third ventricle and analyzed parameters from the preoperative data, which they then used as a basis for comparison between endoscopically successful and endoscopically unsuccessful cases. The overall success rate of ETV in TBM hydrocephalus was 73.1% in this case series. Cine MR imaging showed a sensitivity of 94.73% and specificity of 71.42% for the functional assessment of third ventriculostomy in these patients, with the efficacy being maintained during follow-up. The outcome of ETV showed a statistically significant correlation with the stage of illness and presence of intraoperative cisternal exudates. Although duration of symptoms and duration of preoperative antituberculous therapy (ATT) appeared to influence the outcome, their correlation with outcome was not statistically significant. Endoscopic third ventriculostomy should be considered as the first surgical option for CSF diversion (that is, before shunt surgery) in patients with TBM hydrocephalus. Cine MR imaging is a highly effective noninvasive tool for the postoperative functional assessment of stomata. Patients who presented with a history of longer duration and those who were administered preoperative ATT for a longer period had a better outcome of

Plants of Zimbabwe used as anti-fertility agents. | Sewani-Rusike ...

African Journals Online (AJOL)

Ethnomedicine has gained a lot of recognition in post-independence Zimbabwe and yet little research on anti-fertility medicines has been done. Information on plants used as anti-fertility medicines was obtained by interviewing women, men, traditional healers and traditional midwives in urban Harare and surrounding rural ...

The costs of producing a unit of blood in Zimbabwe

NARCIS (Netherlands)

Mafirakureva, Nyashadzaishe; Nyoni, Herbert; Nkomo, Sisodwa Z; Jacob, Jeffery S; Chikwereti, Radhi; Musekiwa, Zamile; Khoza, Star; Mvere, David A; Emmanuel, Jean C; Postma, Maarten J; van Hulst, Marinus

2015-01-01

BACKGROUND: There is lack of published data on the costs of blood and blood transfusion in sub-Saharan Africa. This study aimed to assess the unit costs of producing blood in Zimbabwe using an activity-based costing (ABC) method. STUDY DESIGN AND METHODS: A management accounting approach, based on

The Future of Higher Education in Zimbabwe: A Constantly Moving ...

African Journals Online (AJOL)

The common brick and mortar institutions associated with modern education are now disrupted and at the same time complemented by new technologies. This disruption began with open distance learning. This article proffers insights into how the higher education (HE) system in Zimbabwe should continuously tap into this ...

Analysis of the potato (Solanum tuberosum L.) value chain in Zimbabwe

NARCIS (Netherlands)

Svubure, O.; Struik, P.C.; Haverkort, A.J.; Steyn, J.M.

2017-01-01

The performance of the Irish potato sector in Zimbabwe is not well understood. Using value chain analysis, this article evaluated the potato industry using quantitative data gathered from stakeholders using structured questionnaires, field observations, local knowledge and expert consultation.

Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review

OpenAIRE

Brian M. Radvansky; Khushbu Shah; Anant Parikh; Anthony N. Sifonios; Vanny Le; Jean D. Eloy

2015-01-01

Objectives. The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involved testing ketamine’s effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain ...

The burden of disease in Zimbabwe in 1997 as measured by disability-adjusted life years lost

DEFF Research Database (Denmark)

Chapman, Glyn; Hansen, Kristian Schultz; Jelsma, Jennifer

2006-01-01

Objective To rank health problems contributing most to the burden of disease in Zimbabwe using Disability-Adjusted Life Years as the population health measure. Methods Epidemiological information was derived from multiple sources. Population size and total number of deaths by age and sex for the ...... pattern of Zimbabwe differed substantially from regional estimates for sub-Saharan Africa justifying the need for countries to develop their own burden of disease estimates.......Objective To rank health problems contributing most to the burden of disease in Zimbabwe using Disability-Adjusted Life Years as the population health measure. Methods Epidemiological information was derived from multiple sources. Population size and total number of deaths by age and sex...... for the year 1997 were taken from a nationwide census. The cause of death pattern was determined based on data from the Vital Registration System, which was adjusted for underreporting of human immunodeficiency virus (HIV) and reallocation of ill-defined causes. Non-fatal disease figures were estimated based...

Facility-level association of preoperative stress testing and postoperative adverse cardiac events.

Science.gov (United States)

Valle, Javier A; Graham, Laura; Thiruvoipati, Thejasvi; Grunwald, Gary; Armstrong, Ehrin J; Maddox, Thomas M; Hawn, Mary T; Bradley, Steven M

2018-06-22

Despite limited indications, preoperative stress testing is often used prior to non-cardiac surgery. Patient-level analyses of stress testing and outcomes are limited by case mix and selection bias. Therefore, we sought to describe facility-level rates of preoperative stress testing for non-cardiac surgery, and to determine the association between facility-level preoperative stress testing and postoperative major adverse cardiac events (MACE). We identified patients undergoing non-cardiac surgery within 2 years of percutaneous coronary intervention in the Veterans Affairs (VA) Health Care System, from 2004 to 2011, facility-level rates of preoperative stress testing and postoperative MACE (death, myocardial infarction (MI) or revascularisation within 30 days). We determined risk-standardised facility-level rates of stress testing and postoperative MACE, and the relationship between facility-level preoperative stress testing and postoperative MACE. Among 29 937 patients undergoing non-cardiac surgery at 131 VA facilities, the median facility rate of preoperative stress testing was 13.2% (IQR 9.7%-15.9%; range 6.0%-21.5%), and 30-day postoperative MACE was 4.0% (IQR 2.4%-5.4%). After risk standardisation, the median facility-level rate of stress testing was 12.7% (IQR 8.4%-17.4%) and postoperative MACE was 3.8% (IQR 2.3%-5.6%). There was no correlation between risk-standardised stress testing and composite MACE at the facility level (r=0.022, p=0.81), or with individual outcomes of death, MI or revascularisation. In a national cohort of veterans undergoing non-cardiac surgery, we observed substantial variation in facility-level rates of preoperative stress testing. Facilities with higher rates of preoperative stress testing were not associated with better postoperative outcomes. These findings suggest an opportunity to reduce variation in preoperative stress testing without sacrificing patient outcomes. © Article author(s) (or their employer(s) unless otherwise

Tariffs and subsidies in Zimbabwe's reforming electricity industry: steering a utility through turbulent times

International Nuclear Information System (INIS)

Mangwengwende, S.E.

2002-01-01

In 1991, the Government of Zimbabwe adopted a public enterprise reform strategy as part of a World Bank driven Economic Structural Adjustment Programme (ESAP). For the electricity sector, the Government adopted a two-pronged programme of reform - a performance improvement programme (PIP) for the national utility, the Zimbabwe Electricity Supply Authority (ZESA), and a legal and regulatory reform programme for the electricity sector in general. Ten years later, significant success has been achieved in improving the utility's performance in technical operations and customer service. However, there has been very little progress on the legal and regulatory front. This has adversely affected the utility's financial performance, as well as frustrating the Government's efforts in attracting private sector investment. The centrality of the tariff question reflects the importance of the customer or end-user to the power sector reform process. This article outlines the power sector reform experiences in Zimbabwe with special focus on the tariff question. The paper suggests, from the perspective of a utility executive, reasons for the mixed results at ZESA, and lessons for other countries in the region undertaking similar reforms. (Author)

The turbulent liquid fuel industry in Zimbabwe: options for resolving the crisis and improving supply to the poor

International Nuclear Information System (INIS)

Mashange, Krispen

2002-01-01

Towards the end of the last decade, supplies in petroleum fuel have been erratic to the extent that Zimbabwe has at times operated with as low as 40% of normal supplies. These shortages were attributed mainly to foreign exchange shortages and alleged mismanagement and corruption at the National Oil Company of Zimbabwe (NOCZIM). As shortages intensified, problems of product shortage began to unfold, which adversely impacted on the urban poor. The public began to question the industry's policies on the sustainability of the liquid fuel sector policies in Zimbabwe. Of particular concern was policies regarding regulatory mechanisms, pricing, distribution, utilisation of storage facilities, supply routes and NOCZIM management. This paper evaluates the challenges facing the Zimbabwean petroleum sector and presents recommendations that could assist in ensuring a robust and functional national fuel sector. (Author)

The contribution of schools to supporting the well being of children affected by HIV in eastern Zimbabwe

DEFF Research Database (Denmark)

Pufall, Erica L.; Gregson, Simon; Eaton, Jeffrey W.

2014-01-01

Objectives:Schools are often cited as a source of support for orphans and children affected by HIV/AIDS in populations experiencing generalized HIV epidemics and severe poverty. Here we investigate the success of schools at including and supporting the well being of vulnerable children in rural Z...... quality may enhance the well being of primary school-age children in eastern Zimbabwe. Local community context also plays an important role in child well being....... measures of school quality (one general and one HIV-specific) and use multivariable regression to test whether these were associated with improved educational outcomes and well being for vulnerable children. Results:School quality was not associated with primary or secondary school attendance...

A call to establish a child-centred disaster management framework in Zimbabwe

Directory of Open Access Journals (Sweden)

Ramphal M. Sillah

2015-06-01

Full Text Available Disasters have increased in intensity and frequency in recent times. However, disasters do not affect all groups in a society in a similar manner. This article, based mainly on qualitative desk research and document analysis, aims to illuminate the specific vulnerability of children to hazards and disasters. The research showed that owing to their special physiological, psychological, emotional and economic stature, children are an inherently vulnerable group. The paper advocates for existing disaster management structures and systems in Zimbabwe to elevate reduction of disaster risk amongst children within the scope of child protection, which aims to create a protective environment that shelters children from any form of harm or abuse. The paper proffers recommendations on how to design disaster management programmes in Zimbabwe with the needs of children in mind.

Inflammation-based prognostic score, prior to neoadjuvant chemoradiotherapy, predicts postoperative outcome in patients with esophageal squamous cell carcinoma.

Science.gov (United States)

Kobayashi, Takashi; Teruya, Masanori; Kishiki, Tomokazu; Endo, Daisuke; Takenaka, Yoshiharu; Tanaka, Hozumi; Miki, Kenji; Kobayashi, Kaoru; Morita, Koji

2008-11-01

Recent studies have revealed that Glasgow prognostic score (GPS), an inflammation-based prognostic score, is associated with poor outcome in a variety of tumors. However, few studies have investigated whether GPS measured prior to neoadjuvant chemoradiotherapy (nCRT) is useful for postoperative prognosis of patients with advanced esophageal squamous cell carcinoma (ESCC). GPS was calculated on the basis of admission data as follows: patients with both an elevated C-reactive protein (>10 mg/L) and hypoalbuminaemia (L) were allocated a GPS score of 2. Patients in whom only 1 of these biochemical abnormalities was present were allocated a GPS score of 1, and patients with a normal C-reactive protein and albumin were allocated a score of 0. All patients underwent radical en-bloc resection 3-4 weeks after nCRT. A total of 48 patients with clinical TNM stage II/III were enrolled. Univariate analyses revealed that there were significant differences in cancer-specific survival in relation to grade of response to nCRT (P = .004), lymph node status (P = .0065), lymphatic invasion (P = .0002), venous invasion (P = .0001), pathological TNM classification (P = .015), and GPS (P GPS classification showed a close relationship with lymphatic invasion, venous invasion, and number of lymph node (P = .0292, .0473, and .0485, respectively). GPS was found to be the only independent predictor of cancer-specific survival (odds ratio, 0.17; 95% confidence interval, 0.06-0.52; P = .0019). GPS, measured prior to nCRT, is an independent novel predictor of postoperative outcome in patients with advanced ESCC.

The Lion and the Snake: A Strategic View of South Africa and Zimbabwe

National Research Council Canada - National Science Library

Peters, Ralph

2003-01-01

.... A decade ago, the situation appeared to be reversed, with South Africa bleeding from the tribal and political violence of Apartheid's death throes, while Zimbabwe was portrayed internationally...

Zambezia: The Journal of Humanities of the University of Zimbabwe ...

African Journals Online (AJOL)

Zambezia: The Journal of Humanities of the University of Zimbabwe: Advanced Search ... Combine multiple words with OR to find articles containing either term; e.g., education OR research; Use parentheses to create more complex queries; e.g., archive ((journal OR conference) NOT theses); Search for an exact phrase by ...

The Etiology of Vaginal Discharge Syndrome in Zimbabwe Results from the Zimbabwe STI Etiology Study.

Science.gov (United States)

Chirenje, Z Mike; Dhibi, Nicholas; Handsfield, H Hunter; Gonese, Elizabeth; Barr, Beth Tippett; Gwanzura, Lovemore; Latif, Ahmed S; Maseko, Dumisili Venessa; Kularatne, Ranmini S; Tshimanga, Mufuta; Kilmarx, Peter H; Machiha, Anna; Mugurungi, Owen; Rietmeijer, Cornelis A

2017-11-29

Symptomatic vaginal discharge is a common gynecological condition managed syndromically in most developing countries. In Zimbabwe, women presenting with symptomatic vaginal discharge are treated with empirical regimens that commonly cover both sexually transmitted infections (STI) and reproductive tract infections, typically including a combination of an intramuscular injection of kanamycin, and oral doxycycline and metronidazole regimens. This study was conducted to determine the current etiology of symptomatic vaginal discharge and assess adequacy of current syndromic management guidelines. We enrolled 200 women with symptomatic vaginal discharge presenting at 6 STI clinics in Zimbabwe. Microscopy was used to detect bacterial vaginosis and yeast infection. Nucleic acid amplifications tests were used to detect Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and Mycoplasma genitalium. In addition, serologic testing was performed to detect HIV infection. Of the 200 women, 146 (73%) had an etiology detected, including bacterial vaginosis (24.7%); N. gonorrhoeae (24.0%); yeast infection (20.7%); T. vaginalis (19.0%); C. trachomatis (14.0%) and M. genitalium (7.0%). Among women with STIs (N=90), 62 (68.9%) had a single infection, 18 (20.0%) had a dual infection and 10 (11.1%) had three infections.Of 158 women who consented to HIV testing, 64 (40.5%) were HIV infected.The syndromic management regimen covered 115 (57.5%) of the women in the sample who had gonorrhea, chlamydia, M. genitalium, or bacterial vaginosis, while 85 (42.5%) of women were treated without such diagnosis. Among women presenting with symptomatic vaginal discharge, bacterial vaginosis was the most common etiology and gonorrhea was the most frequently detected STI. The current syndromic management algorithm is suboptimal for coverage of women presenting with symptomatic vaginal discharge; addition of point of care testing could compliment the effectiveness of the syndromic approach.

Mapping of arithmetic processing by navigated repetitive transcranial magnetic stimulation in patients with parietal brain tumors and correlation with postoperative outcome.

Science.gov (United States)

Ille, Sebastian; Drummer, Katharina; Giglhuber, Katrin; Conway, Neal; Maurer, Stefanie; Meyer, Bernhard; Krieg, Sandro M

2018-03-26

Preserving functionality is of significant importance during neurosurgical resection of brain tumors. Specialized centers also map further brain functions apart from motor and language functions, such as arithmetic processing (AP). The mapping of AP by navigated repetitive transcranial magnetic stimulation (nrTMS) in healthy volunteers has been demonstrated. The present study aimed to correlate the results of mapping AP with functional patient outcomes. We included 26 patients with parietal brain tumors. Due to preoperative impairment of AP, mapping was not possible in 8 patients (31%). We stimulated 52 cortical sites by nrTMS while patients performed a calculation task. Pre- and postoperatively, patients underwent a standardized number-processing and calculation test (NPCT). Tumor resection was blinded to nrTMS results, and the change in NPCT performance was correlated to resected AP-positive spots as identified by nrTMS. The resection of AP-positive sites correlated with a worsening of the postoperative NPCT result in 12 cases. In 3 cases, no AP-positive sites were resected and the postoperative NPCT result was similar to or better than preoperatively. Also, in 3 cases, the postoperative NPCT result was better than preoperatively, although AP-positive sites were resected. Despite only presenting a low number of cases, nrTMS might be a useful tool for preoperative mapping of AP. However, the reliability of the present results has to be evaluated in a larger series and by intraoperative mapping data. Copyright © 2018 Elsevier Inc. All rights reserved.

Evaluation of the Predictive Value of Intraoperative Changes in Motor-Evoked Potentials of Caudal Cranial Nerves for the Postoperative Functional Outcome.

Science.gov (United States)

Kullmann, Marcel; Tatagiba, Marcos; Liebsch, Marina; Feigl, Guenther C

2016-11-01

The predictive value of changes in intraoperatively acquired motor-evoked potentials (MEPs) of the lower cranial nerves (LCN) IX-X (glossopharyngeal-vagus nerve) and CN XII (hypoglossal nerve) on operative outcomes was investigated. MEPs of CN IX-X and CN XII were recorded intraoperatively in 63 patients undergoing surgery of the posterior cranial fossa. We correlated the changes of the MEPs with postoperative nerve function. For CN IX-X, we found a correlation between the amplitude of the MEP ratio and uvula deviation (P = 0.028) and the amplitude duration of the MEP and gag reflex function (P = 0.027). Patients with an MEP ratio of the glossopharyngeal-vagus amplitude ≤1.47 μV had a 3.4 times increased risk of developing a uvula deviation. Patients with a final MEP duration of the CN IX-X ≤11.6 milliseconds had a 3.6 times increased risk for their gag reflex to become extinct. Our study greatly contributes to the current knowledge of intraoperative MEPs as a predictor for postoperative cranial nerve function. We were able to extent previous findings on MEP values of the facial nerve on postoperative nerve function to 3 additional cranial nerves. Finding reliable predictors for postoperative nerve function is of great importance to the overall quality of life for a patient undergoing surgery of the posterior cranial fossa. Copyright © 2016 Elsevier Inc. All rights reserved.

Postoperative Radiotherapy for Maxillary Sinus Cancer: Long-Term Outcomes and Toxicities of Treatment

International Nuclear Information System (INIS)

Bristol, Ian J.; Ahamad, Anesa; Garden, Adam S.; Morrison, William H.; Hanna, Ehab Y.; Papadimitrakopoulou, Vassiliki A.; Rosenthal, David I.; Ang, K. Kian

2007-01-01

Purpose: To determine the effects of three changes in radiotherapy technique on the outcomes for patients irradiated postoperatively for maxillary sinus cancer. Methods and Materials: The data of 146 patients treated between 1969 and 2002 were reviewed. The patients were separated into two groups according to the date of treatment. Group 1 included 90 patients treated before 1991 and Group 2 included 56 patients treated after 1991, when the three changes were implemented. The outcomes were compared between the two groups. Results: No differences were found in the 5-year overall survival, recurrence-free survival, local control, nodal control, or distant metastasis rates between the two groups (51% vs. 62%, 51% vs. 57%, 76% vs. 70%, 82% vs. 83%, and 28% vs. 17% for Groups 1 and 2, respectively). The three changes were to increase the portals to cover the base of the skull in patients with perineural invasion, reducing their risk of local recurrence; the addition of elective neck irradiation in patients with squamous or undifferentiated histologic features, improving the nodal control, distant metastasis, and recurrence-free survival rates (64% vs. 93%, 20% vs. 3%, and 45% vs. 67%, respectively; p < 0.05 for all comparisons); and improving the dose distributions within the target volume, reducing the late Grade 3-4 complication rates (34% in Group 1 vs. 8% in Group 2, p = 0.014). Multivariate analysis revealed advancing age, the need for enucleation, and positive margins as independent predictors of worse overall survival. The need for enucleation also predicted for worse local control. Conclusion: The three changes in radiotherapy technique improved the outcomes for select patients as predicted. Despite these changes, little demonstrable overall improvement occurred in local control or survival for these patients and additional work must be done

Base line definitions and methodological lessons from Zimbabwe

International Nuclear Information System (INIS)

Maya, R.S.

1995-01-01

The UNEP Greenhouse Gas Abatement Costing Studies carried out under the management of the UNEP Collaborating Centre On Energy and Environment at Risoe National Laboratories in Denmark has placed effort in generating methodological approaches to assessing the cost of abatement activities to reduce CO 2 emissions. These efforts have produced perhaps the most comprehensive set of methodological approaches to defining and assessing the cost of greenhouse gas abatement. Perhaps the most importance aspect of the UNEP study which involved teams of researchers from ten countries is the mix of countries in which the studies were conducted and hence the representation of views and concepts from researchers in these countries particularly those from developing countries namely, Zimbabwe, India, Venezuela, Brazil, Thailand and Senegal. Methodological lessons from Zimbabwe, therefore, would have benefited from the interactions with methodological experiences form the other participating countries. Methodological lessons from the Zimbabwean study can be placed in two categories. One relates to the modelling of tools to analyze economic trends and the various factors studied in order to determine the unit cost of CO 2 abatement. The other is the definition of factors influencing the levels of emissions reducible and those realised under specific economic trends. (au)

How does a combined pre-operative and post-operative rehabilitation program influence the outcome of ACL reconstruction 2 years after surgery? A comparison between patients in the Delaware-Oslo ACL Cohort and the Norwegian Knee Ligament Registry

Science.gov (United States)

Grindem, H.; Granan, LP.; Risberg, MA.; Engebretsen, L.; Snyder-Mackler, L.; Eitzen, I.

2014-01-01

Background Preoperative knee function is associated with successful postoperative outcome after ACL reconstruction (ACLR). However, there are few longer-term studies of patients who underwent progressive preoperative and postoperative rehabilitation compared to usual care Objectives To compare preoperative and 2 year postoperative patient-reported outcomes (PROs) in patients undergoing progressive preoperative and postoperative rehabilitation at a sports medicine clinic compared with usual care Methods We included patients aged 16–40 years undergoing primary unilateral ACLR. The preoperative and 2 year postoperative KOOS of 84 patients undergoing progressive pre- and postoperative rehabilitation at a sports medicine clinic (Norwegian Research Center for Active Rehabilitation [NAR] cohort) were compared with the scores of 2690 patients from the Norwegian Knee Ligament Registry (NKLR). The analyses were adjusted for sex, age, months from injury to surgery, and cartilage/meniscus injury at ACLR. Results The NAR cohort had significantly better preoperative KOOS in all subscales, with clinically relevant differences (>10 points) observed in KOOS Pain, ADL, Sports and Quality of Life. At 2 years, the NAR cohort still had significantly better KOOS with clinically relevant differences in KOOS Symptoms, Sports and Quality of Life. At 2 years, 85.7–94.0 % of the patients in the NAR cohort scored within the normative range of the different KOOS subscales, compared to 51.4–75.8 % of the patients in the NKLR cohort. Conclusion Patients in a prospective cohort who underwent progressive pre- and postoperative rehabilitation at a sports medicine clinic showed superior patient-reported outcomes both preoperatively and 2 year postoperatively compared to patients in the Norwegian Knee Ligament Registry who received usual care. PMID:25351782

Handling of pastoral misconduct and discipline: Evidence from the Apostolic Faith Mission in Zimbabwe church

Directory of Open Access Journals (Sweden)

Norman Chivasa

2017-07-01

Full Text Available Misconduct has permeated almost every community across the globe and Christian churches have not been spared either. The two basic questions that the current study addresses were what are some of the reported behaviours of male pastors that constitute misconduct in the Apostolic Faith Mission (AFM in Zimbabwe church?; and is there any policy framework in the AFM in Zimbabwe designed to repair distressed relationships between offending pastors and the church? Results showed that in the AFM in Zimbabwe, pastoral misconduct is seen as a negative force that militates against sustaining harmony in the church. As such, whenever a male pastor commits an act of misconduct, disciplinary action is taken against him. It was also found that constructive dialogue to address misconduct is still a blind spot in the church under review. And because there is no policy framework to amend distressed relationships after administering discipline, social interactions between offending pastors and the church remain antagonistic. In view of the identified problem, this study proposed that the AFM in Zimbabwe might need to embrace a peace building framework because it has the propensity to repair broken relationships and to build friendships, social networks and trust between people. This framework can be instrumental in repairing distressed relations between offending pastors and the church at large. The strength of peace building lies in the values of brotherly love, forgiveness, reconciliation and relationship building, which are compatible with Christianity.

Impact of Zimbabwe - South Africa Trade Relations: A Bilateral, Regional, or Multilateral Approach?

National Research Council Canada - National Science Library

Mayihlome, Levi

1997-01-01

.... Whereas a functional bilateral trade agreement or a regional customs union culminating in a common market might improve Zimbabwe's regional competitiveness in the short run' due to South Africa's...

Upholding the Rastafari religion in Zimbabwe: Farai Dzvova v Minister of Education, Sports and Culture and Others

OpenAIRE

Mhango, Mtendeweka Owen

2008-01-01

This discussion deals with a unanimous decision by the Supreme Court of Zimbabwe, ruling that the expulsion of six year-old Farai Dzvova from the Ruvheneko Government Primary School because of his expression of his religious belief through wearing dreadlocks is a contravention of section 19 of the Constitution of Zimbabwe. This contribution argues that the judgment in Farai is progressive and should be welcomed. It further argues that the reasoning by Cheda J, demonstrating why Rastafari qual...

A framework for creating an ICT knowledge hub in Zimbabwe: A holistic approach in fostering economic growth

Directory of Open Access Journals (Sweden)

Gilbert Mahlangu

2018-01-01

Full Text Available ICT knowledge hubs are important resources for a country to grow towards an innovative economy. Their growth has been viewed as a node point for techno-prenuership development and economic sustainability by many countries. The purpose of this study was to establish how Zimbabwe as a developing country should move towards the creation of an ICT knowledge hub that will promote economic growth in line with the Zimbabwe Agenda for Sustainable Socio-Economic Transformation (ZimAsset economic blueprint crafted in 2013. A qualitative research design was used whereby literature was conducted to establish models for ICT Knowledge hub creation while two focus group discussions were held with academia, research agents and software developers to achieve face validity and in-depth interviews were held with officials from The Ministry of ICT Postal and Courier services. The consensus was reached on the need for creating a focal point which will act as a cyber-port where ICT driven solutions can be obtained based on the industry needs. The focus group discussions settled for four components in creating an ICT knowledge hub. These are planning function, development function, management function and co-ordinating function. The research also established that the Ministry of ICT and Courier services in Zimbabwe has set up an innovation fund to encourage and reward innovation and craftsmanship in Zimbabwe mainly targeted at the youths. The government acquired the high-performance computing facility which is stationed at the University of Zimbabwe. The ICT hub should be used to facilitate access and use of this resource. Every country should therefore strive to create its own centre of innovation which enables it to gain maximum utility from its indigenous people in order to fully utilise ICTs for industry development and spearhead economic growth. The study recommends that there is need for establishing an ICT Knowledge hub in the country.

New Zimbabwe Constitution and the Right to Health Campaign 2010

International Development Research Centre (IDRC) Digital Library (Canada)

In September 2008 the three main political parties in Zimbabwe signed a Global Political Agreement (GPA), undertaking to engage in the development of a new democratic constitution of over the next 24 months. This project will feed into that process by promoting the inclusion of right to health in the new constitution.

Outpatient outcomes and satisfaction in pediatric population: data from the postoperative phone call.

Science.gov (United States)

Brenn, B Randall; Choudhry, Dinesh K; Sacks, Karen

2016-02-01

Quality and patient/parent satisfaction are goals for pediatric perioperative services. As part of the implementation of our operating room electronic medical record (EMR), a postoperative phone call questionnaire was developed to assess patients discharged after outpatient surgery. The goal of this initiative was to determine the rate of common postoperative complications and understand reasons for patient/parent dissatisfaction. Institutional Review Board approval was obtained for chart review. The postoperative phone call survey was attempted by our postanesthesia care unit nursing staff on all pediatric outpatients. The call was attempted for 3 days. From 2009 to 2013, more than 37 000 phone records existed in our EMR, Epic Optime (Epic Systems, Verona, WI). These data were extracted to a business intelligence (BI) program, QlikView (Qliktech, Radnor, PA, USA). A BI dashboard was constructed to obtain phone call results for any given time frame from monthly to spanning several years. Complications were logged as 4-point severity rating scales (none, mild, moderate, severe) with descriptions for each level. The BI dashboard calculated the overall and rates by severity for the following: (i) nausea, (ii) vomiting, (iii) pain, (iv) bleeding, (v) hoarseness, and (vi) difficulty eating. Of 42 688 outpatient cases, 37 620 postoperative phone calls were completed for an overall response rate of 88%. Pain, at 11.1%, was the highest reported postoperative complication. The rate of dissatisfaction was reported to be 0.31%. Most patients reporting dissatisfaction (62%) did not report any complications. Contingency coefficient showed that there was little relationship between satisfaction and presence of complications. A postoperative phone survey is cost-effective and appreciated by patients. We found that satisfaction with our perioperative services was not related to the rates of reported complications. Although reducing complications is of utmost importance

[Postoperative pain management. Aims and organization of a strategy for postoperative acute pain therapy].

Science.gov (United States)

Nolli, M; Nicosia, F

2000-09-01

The Health Services, not only the Italian one, is under pressure because of request for improving treatment quality and the financial need for reorganization and cost-saving. It's required a rationalization of intervention, together with a careful choice of the best and cheapest techniques and the demonstration of their efficacy. The anaesthesia service activity, in a period of cost rationalization and funds restriction should be aimed to appropriate outcome measures corrected by both patient's risk factors and surgical-anaesthesiological case-mix. The development of a complete strategy for surgical pain management might run into two phases. The first phase, internal and mono-specialistic, should develop like the creation of an Acute Pain Team. The main processes are: focusing the problem (charge of the care), training, information, teaching methodology (timing, methods, drugs, techniques, etc.) and the audit (before and after changes). The main aims are the evaluation of the level of analgesia and pain relief or patient's satisfaction which are partial endpoints useful to demonstrate the improvement and the efficacy of the new pain management strategies. The second phase, multidisciplinary, is directed toward the creation of a Postoperative Evaluation Team. The main objective is to set up a collaborative clinical group able to identify the criteria for quality, efficacy and safety. The major purpose is the evaluation of major outcome measures: surgical outcome, morbidity, mortality and length of hospitalization. The improvement in the quality of postoperative pain treatment goes through a better organization and a progressive increase of the already available therapy. The achievement of the result and the quality projects depend on the interaction among staff members with different behaviours and settings. Internal teaching and training, continuous education for doctors and nurses, and external information, marketing and improvement of attractive capability of

Some insights into the intersection of physical planning and governance in Zimbabwe

CSIR Research Space (South Africa)

Chakwizira, J

2008-04-01

Full Text Available This paper presents some insights into the intersection of physical planning and governance in Zimbabwe. It argues that the major theoretical, policy and practice discourses - explaining the intersection of physical planning and governance - relate...

The impact of prenatal care quality on neonatal, infant and child mortality in Zimbabwe: evidence from the demographic and health surveys.

Science.gov (United States)

Makate, Marshall; Makate, Clifton

2017-04-01

The impact of the quality of prenatal care on child mortality outcomes has received less attention in sub-Saharan Africa. This study endeavoured to explore the effect of the quality of prenatal care and its individual components on neonatal, infant and under-five mortality. The empirical analysis uses data from the three most recent waves of the nationally representative Demographic and Health Survey for Zimbabwe conducted in 1999, 2005/06 and 2010/11. The results indicate that a one-unit increase in the quality of prenatal care lowers the prospect of neonatal, infant and under-five mortality by approximately 42.33, 30.86 and 28.65%, respectively. These findings remained roughly the same even after adjusting for potential mediating factors. Examining the effect of individual prenatal care components on child mortality revealed that women who receive information on possible complications arising during pregnancy are less liable to experience a neonatal death. Similarly, women who had blood pressure checks and tetanus immunizations were less likely to experience an infant or under-five death. We did not find any statistically meaningful impact on child mortality outcomes of blood and urine sample checks, iron tablet consumption, and the receipt of malarial tablets. Overall, our results suggest the need for public health policymakers to focus on ensuring high-quality prenatal care to enhance the survival prospects of Zimbabwe's infants. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The association between incentive spirometry performance and pain in postoperative thoracic epidural analgesia.

Science.gov (United States)

Harris, David J; Hilliard, Paul E; Jewell, Elizabeth S; Brummett, Chad M

2015-01-01

Effective use of postoperative incentive spirometry improves patient outcomes but is limited by pain after thoracic and upper abdominal surgery. Thoracic epidurals are frequently used to provide analgesia and attenuate postoperative pulmonary dysfunction. We hypothesized that, in patients with thoracic epidurals for thoracic and abdominal surgery, high pain scores would be associated with poorer incentive spirometry performance, even when accounting for other variables. Retrospective study of 468 patients who underwent upper abdominal or thoracic surgery using postoperative thoracic epidural analgesia between June 1, 2009, and August 31, 2013, at a single tertiary academic center. The association between incentive spirometry performance and pain was assessed as the primary outcome. Other independent predictors of incentive spirometry performance were also identified. Postoperative incentive spirometry performance was found to be inversely proportional to pain score, which correlated significantly stronger with deep breathing pain compared with pain at rest (-0.33 vs -0.14 on postoperative day 1; -0.23 vs -0.12 on postoperative day 2). Pain with deep breathing was independently associated with poorer incentive spirometry performance in the multivariable linear regression model (P spirometry performance could be used as another indicator of thoracic epidural efficacy. This may be particularly useful in patients reporting high pain scores postoperatively.

Socio-economic status and health care utilization in rural Zimbabwe: findings from Project Accept (HPTN 043).

Science.gov (United States)

Kevany, Sebastian; Murima, Oliver; Singh, Basant; Hlubinka, Daniel; Kulich, Michal; Morin, Stephen F; Sweat, Michael

2012-03-07

Zimbabwe's HIV epidemic is amongst the worst in the world, and disproportionately effects poorer rural areas. Access to almost all health services in Zimbabwe includes some form of cost to the client. In recent years, the socio-economic and employment status of many Zimbabweans has suffered a serious decline, creating additional barriers to HIV treatment and care. We aimed to assess the impact of i) socio-economic status (SES) and ii) employment status on the utilization of health services in rural Zimbabwe. Data were collected from a random probability sample household survey conducted in the Mutoko district of north-western Zimbabwe in 2005. We selected variables that described the economic status of the respondent, including: being paid to work, employment status, and SES by assets. Respondents were also asked about where they most often utilized healthcare when they or their family was sick or hurt. Of 2,874 respondents, all forms of healthcare tended to be utilized by those of high or medium-high SES (65%), including private (65%), church-based (61%), traditional (67%), and other providers (66%) (P=0.009). Most respondents of low SES utilized government providers (74%) (P=0.009). Seventy-one percent of respondents utilizing health services were employed. Government (71%), private (72%), church (71%), community-based (78%) and other (64%) health services tended to be utilized by employed respondents (P=0.000). Only traditional health services were equally utilized by unemployed respondents (50%) (P=0.000). A wide range of health providers are utilized in rural Zimbabwe. Utilization is strongly associated with SES and employment status, particularly for services with user fees, which may act as a barrier to HIV treatment and care access. Efforts to improve access in low-SES, high HIV-prevalence settings may benefit from the subsidization of the health care payment system, efforts to improve SES levels, political reform, and the involvement of traditional

Church, mission and reconstruction: Being a church with integrity in reconstruction discourse in post-colonial Zimbabwe

Directory of Open Access Journals (Sweden)

Canon B. Shambare

2018-05-01

Full Text Available The church in Africa, like its counterparts elsewhere in the world, is called to fulfil the mission of God as expressed in the call ‘Missio Dei’ and influentially remains with the integrity of the mission of Christ (Missio Christos, which is liberative and practical. For Christ was not only concerned with the spiritual needs of the people, but also with their material well-being. The following question therefore arises: how can the church in Africa, in general, and in Zimbabwe, in particular, actively do God’s mission and remain with integrity in the midst of the reality of suffering. Furthermore, how can the church for mission and reconstruction be understood in a post-colonial Zimbabwe given the contextual realities of political crises, corruption, poverty, moral decadence, defined or censored truth, leadership crises and no freedom of expression? This article argues that, although the church is faced with these arduous realities, it remains called by God to do God’s mission. While in post-colonial Zimbabwe the socio-political, socio-economic and socio-religious situation might seem hopeless, the church has remained vibrant and alive for reconstruction theology. The transformation of society is possible given the authority and mission mandate of the church. This article argues that the church is a key player in reconstruction theology and in the transformation of society. For transformation to be possible, the church should witness to the gospel of Christ without fear of being labelled, castrated and persecuted. The article asserts that the spirit of the Bible should be revived in a time of reconstruction in Zimbabwe. The assumption in this article is that Zimbabwe is ready for reconstruction discourse. For this to happen, the researchers argue that the church as a critical relevant player in reconstruction needs to ‘be church’ in its missional mandates. Integrity is essential if a church wants to be relevantly missional and

Postoperative outcome after oesophagectomy for cancer: Nutritional status is the missing ring in the current prognostic scores.

Science.gov (United States)

Filip, B; Scarpa, M; Cavallin, F; Cagol, M; Alfieri, R; Saadeh, L; Ancona, E; Castoro, C

2015-06-01

Several prognostic scores were designed in order to estimate the risk of postoperative adverse events. None of them includes a component directly associated to the nutritional status. The aims of the study were the evaluation of performance of risk-adjusted models for early outcomes after oesophagectomy and to develop a score for severe complication prediction with special consideration regarding nutritional status. A comparison of POSSUM and Charlson score and their derivates, ASA, Lagarde score and nutritional index (PNI) was performed on 167 patients undergoing oesophagectomy for cancer. A logistic regression model was also estimated to obtain a new prognostic score for severe morbidity prediction. Overall morbidity was 35.3% (59 cases), severe complications (grade III-V of Clavien-Dindo classification) occurred in 20 cases. Discrimination was poor for all the scores. Multivariable analysis identified pulse, connective tissue disease, PNI and potassium as independent predictors of severe morbidity. This model showed good discrimination and calibration. Internal validation using standard bootstrapping techniques confirmed the good performance. Nutrition could be an independent risk factor for major complications and a nutritional status coefficient could be included in current prognostic scores to improve risk estimation of major postoperative complications after oesophagectomy for cancer. Copyright © 2015. Published by Elsevier Ltd.

Population and development problems: a critical assessment of conventional wisdom. The case of Zimbabwe.

Science.gov (United States)

Sibanda, A E

1988-01-01

Conventional wisdom, as reflected in reports by the World Bank and the Whitsun Foundation, maintains that control of population growth is the key strategy for stimulating socioeconomic development and ending widespread poverty. The Witsun Foundation has criticized the Government of Zimbabwe for failing to include specific policies for population control in its National Transitional Development Plan. the report further expressed alarm about future availability of land to contain Zimbabwe's growing population. Communal areas are designed for a maximum of 325,000 families yet presently contain 700-800,000 families. This Malthusian, deterministic emphasis on population growth as the source of social ills ignores the broader, complex set of socioeconomic, historical, and political factors that determine material life. Any analysis of population that fails to consider the class structure of society, the type of division of labor, and forms of property and production can produce only meaningless abstractions. For example, consideration of crowding in communal areas must include consideration of inequitable patterns of land ownership in sub-Saharan Africa. Unemployment must be viewed within the context of a capitalist economic structure that relies on an industrial reserve army of labor to ensure acceptance of low wages and labor-intensive conditions. While it is accepted that population growth is creating specific and real problems in Zimbabwe and other African countries, these problems could be ameliorated by land reform and restructuring of the export-oriented colonial economies. Similarly, birth control should not be promoted as the solution to social problems, yet family planning services should be available to raise the status of women. Literacy, agrarian reform, agricultural modernization, and industrialization campaigns free from the dominance of Western capitalism represent the true solutions to Zimbabwe's problems.

Postoperative symbiotic in patients with head and neck cancer: a double-blind randomised trial.

Science.gov (United States)

Lages, Priscilla C; Generoso, Simone V; Correia, Maria Isabel T D

2018-01-01

Studies on the 'gut origin of sepsis' have suggested that stressful insults, such as surgery, can affect intestinal permeability, leading to bacterial translocation. Symbiotics have been reported to be able to improve gut permeability and modulate the immunologic system, thereby decreasing postoperative complications. Therefore we aimed to evaluate the postoperative use of symbiotics in head and neck cancer surgical patients for intestinal function and permeability, as well as the postoperative outcomes. Patients were double-blind randomised into the symbiotic (n 18) or the control group (n 18). Samples were administered twice a day by nasoenteric tube, starting on the 1st postoperative day until the 5th to 7th day, and comprised 109 colony-forming units/ml each of Lactobacillus paracasei, L. rhamnosus, L. acidophilus, and Bifidobacterium lactis plus 6 g of fructo-oligosaccharides, or a placebo (6 g of maltodextrin). Intestinal function (day of first evacuation, total stool episodes, stool consistency, gastrointestinal tract symptoms and gut permeability by diamine oxidase (DAO) enzyme) and postoperative complications (infectious and non-infectious) were assessed. Results of comparison of the pre- and postoperative periods showed that the groups were similar for all outcome variables. In all, twelve patients had complications in the symbiotic group v. nine in the control group (P>0·05), and the preoperative-postoperative DAO activity ranged from 28·5 (sd 15·4) to 32·7 (sd 11·0) ng/ml in the symbiotic group and 35·2 (sd 17·7) to 34·1 (sd 12·0) ng/ml in the control group (P>0·05). In conclusion, postoperative symbiotics did not impact on intestinal function and postoperative outcomes of head and neck surgical patients.

Gender, culture and changing attitudes: experiences of HIV in Zimbabwe.

Science.gov (United States)

O'Brien, Stephen; Broom, Alex

2013-01-01

This paper draws on a series of qualitative interviews with 60 people living in economically poor communities of Harare, the capital of Zimbabwe, to provide new insight into the cultural landscape of HIV. While there has been extensive exploration of gender, sexuality, culture and HIV in Zimbabwe, there is a need to revisit these issues given the country's recent political and economic history. These questions have shaped the meanings that have been created around HIV (i.e., notions of HIV-as-death and as being produced by promiscuity) and the gendered mediation of cultural practices (i.e., forms of sexual expression and treatment uptake). Drawing on the accounts from a group directly affected by HIV, we illustrate the persistence of gendered and spiritualised ideas about 'blame', 'transmission' and 'treatment' and the disproportionate burden that still falls on Zimbabwean women. We conclude with an exploration of how everyday understandings of HIV may be shifting and the ways in which marginality, discrimination and stigma may be being challenged by openness, dialogue and attitude change.

Informal waste harvesting in Victoria Falls town, Zimbabwe: Socio-economic benefits

NARCIS (Netherlands)

Masocha, M.

2006-01-01

Waste harvesting, which occurs mostly but not exclusively at open waste dumps in Zimbabwe, constitutes one of the most important survival options for the urban poor. This paper analyses and discusses socio-economic benefits of informal waste harvesters in Victoria Falls town. Victoria Falls town has

The Army of Zimbabwe: A Role Model for Namibia

Science.gov (United States)

1990-03-02

centuries. A limited sense of nationhood started to exist. Further south on the African continent Zulu dissidents broke from the main empire and in...International Crises: Lessons from Zimbabwe. Muscatine: The Stanley Foundation, 1983. 31. Day, John. "The Insignificance of Tribe in the African Politics of...40 Early Years .... .............. 40 The Europeans .... ............. 40 African Nationalism .. .......... 42 The United Nations and the West .... 43

Causes and management of postoperative enterocutaneous fistulas

International Nuclear Information System (INIS)

Memon, A.S.; Siddiqui, F.G

2004-01-01

Objective: To identify the causes of postoperative enterocutaneous fistulas and to evaluate the results of conservative and operative treatment including the effectiveness of octreotide in the management of these fistulas. Subjects and Methods: Forty patients with postoperative fistula were studied. Demographic variables, causes and management outcome was observed and recorded. Results: There were 25 males and 15 females with 50% of the patients being in age group of 21-30 years. Emergency surgery for typhoid perforation(45%) and intestinal tuberculosis (30%) were the commonest causes. Ileum and jejunum were the commonest sites of fistulation found in 85% cases. Twenty-one patients were started on conservative treatment with spontaneous closure occurring in 15 (71.4%) patients. Nineteen patients were operated within three days of admission due to generalized peritonitis (73.7%) and local intra-abdominal collections (26.3%). Wound infection was the commonest complication in the operative group. The mortality rate in this series was 7.5%. All the deaths occurred following surgery. Conclusion: Postoperative enterocutaneous fistula has a high morbidity and a significant mortality. Sepsis in the peritoneal cavity is the major cause of mortality. Conservative treatment has a good outcome for these fistulas. The use of octreotide is highly recommended as it definitely converts high output fistulas to low output fistulas. (author)

Why Do They Stay: Factors Influencing Teacher Retention in Rural Zimbabwe

Directory of Open Access Journals (Sweden)

Clifford Gomba

2015-07-01

Full Text Available The attraction and retention of teachers in Zimbabwe is a problem not only unique to Zimbabwean schools, but all over the world. The problem is more pronounced in rural areas where resources are scarce, hence the tendency to repel teachers. Although the problem of teacher turnover is real, there are teachers who have remained in the profession for many years. The aim of the study is to find the factors that have influenced teachers to remain in teaching in rural Zimbabwe. Participants (n = 6 in the study were all practicing as teachers, having taught in the rural areas for at least ten years. Data was collected through interviews which were audio-taped and transcribed. The results from this basic interpretive qualitative study showed that teachers remained in the profession because of need to support their families, job security, unmarketable, support from colleagues and administration, and self-sacrifice leadership by principals.

Cost-effectiveness analysis of a postoperative clinical care pathway in head and neck surgery with microvascular reconstruction.

Science.gov (United States)

Dautremont, Jonathan F; Rudmik, Luke R; Yeung, Justin; Asante, Tiffany; Nakoneshny, Steve C; Hoy, Monica; Lui, Amanda; Chandarana, Shamir P; Matthews, Thomas W; Schrag, Christiaan; Dort, Joseph C

2013-12-19

The objective of this study is to evaluate the cost-effectiveness of a postoperative clinical care pathway for patients undergoing major head and neck oncologic surgery with microvascular reconstruction. This is a comparative trial of a prospective treatment group managed on a postoperative clinical care pathway and a historical group managed prior to pathway implementation. Effectiveness outcomes evaluated were total hospital days, return to OR, readmission to ICU and rate of pulmonary complications. Costing perspective was from the government payer. 118 patients were included in the study. All outcomes demonstrated that the postoperative pathway group was both more effective and less costly, and is therefore a dominant clinical intervention. The overall mean pre- and post-pathway costs are $22,733 and $16,564 per patient, respectively. The incremental cost reduction associated with the postoperative pathway was $6,169 per patient. Implementing the postoperative clinical care pathway in patients undergoing head and neck oncologic surgery with reconstruction resulted in improved clinical outcomes and reduced costs.

Vulnerability and resilience of competing land-based livelihoods in south eastern Zimbabwe

NARCIS (Netherlands)

Murungweni, C.

2011-01-01

Key words: vulnerability; resilience; livelihood; drought; Great Limpopo Transfrontier Conservation Area; south eastern Zimbabwe.

Vulnerability and resilience have emerged as powerful analytical concepts in the study of socio-ecological systems. In this research these concepts are used

Cumulative incidence of postoperative severe pain at Hospital Universitario San Jose, Popayan. Preliminar report

Directory of Open Access Journals (Sweden)

Ingrid Muñoz

2013-12-01

Full Text Available Introduction: Postoperative pain remains as a problem. National studies report incidences of 31% for moderate and 22% for severe pain. Inadequate analgesia is related to dissatisfaction and adverse outcomes. The aim of this study was to describe the incidence and characteristics of the postoperative pain in the post-anesthesia care unit (PACU at Hospital Universitario San José of Popayán (HUSJ in patients undergoing general anesthesia during the first postoperative hour. Methods: Cohort study. We recruited patients attending PACU and undergoing procedures using general anesthesia, between 18 and 70 years. Using a standardized collection form medical history, demographic data, medical history, anesthetic management, intraoperative analgesia and postoperative pain assessment by verbal and numerical pain scale (1-10 were recorded. Postoperative outcome data were also collected in the PACU. Results: The incidence of severe postoperative pain at 10 minutes was 12.3% 95%CI [7.1-18.2] (19 patients. Within 30 minutes of assessment 4.5% 95%CI [1.3-8.4] (7 patients and 1.9% 60 minutes 95%CI [0-4.5] (3 patients. 48.7% required rescue analgesic at PACU. Incidence of postoperative nausea and vomiting (PONV was significantly different in patients requiring rescue analgesic. Conclusion: The incidence of severe postoperative pain in the first postoperative hour at HUSJ is close to 12% and it decreases as time goes by. Patients requiring rescue analgesic have a higher incidence of postoperative complications such as PONV.

Effect of Aspirin in Postoperative Management of Adult Ischemic Moyamoya Disease.

Science.gov (United States)

Zhao, Yahui; Zhang, Qian; Zhang, Dong; Zhao, Yuanli

2017-09-01

Aspirin has been implicated in the postoperative management of moyamoya disease (MMD) in order to avoid bypass failure and decrease the incidence of subsequent stroke. However, its effect has not been completely determined yet. In this study, we retrospectively reviewed data of 184 adult patients (197 hemispheres) presented with ischemic-onset MMD who had undergone direct or combined revascularization in our hospital, to clarify the effect of postoperative aspirin therapy in the management of moyamoya disease. Fifty-nine hemispheres that had been administered with aspirin (100 mg/day) after bypass surgery were defined as the "aspirin group," whereas 138 that hadn't been given aspirin postoperatively were defined as the "control group". Among 197 hemispheres, the mortality rate was 0. The incidence of postoperative newly developed infarction, transient ischemic attack, and hemorrhage were not significantly different between the aspirin and control groups. The patency rate of bypass graft was not significantly different between the groups, either. Notably, more patients experienced major stroke in the control group (9/138) than the aspirin group (1/59), but no statistical difference was found (P > 0.05). In the aspirin group, more patients had improved outcome than the control group (P = 0.04). Our findings showed that aspirin might not decrease the incidence of postoperative ischemic stroke or increase patency rate of bypass graft, but it does not increase the risk of hemorrhages, either. Also, postoperative aspirin therapy might improve outcome. More studies are needed to provide evidence for postoperative antiplatelet therapy in MMD management. Copyright © 2017 Elsevier Inc. All rights reserved.

The Determinants of the Compliance to Public Procurement Policy Requirements among Public Enterprises in Zimbabwe

Directory of Open Access Journals (Sweden)

Maxwell Sandada

2016-09-01

Full Text Available Many public entities in Zimbabwe are operating in a very volatile environment characterised by public procurement systems open to abuse. Zimbabwe is one of the first countries in Africa to have a Procurement Act however non-compliance issues are still a challenge. Public procurement scandals have been a hot topic with the media and also with the Report of the Auditor General for the financial year ended December 31, 2014 having picked on a lot of issues relating to non-compliance with procurement regulations in a number of public enterprises. The purpose of the study was to assess the influence selected factors (enforcement, professionalism, political interferences, familiarity with Procurement Act regulations and ethics on compliance to procurement regulations within the public entities. A quantitative survey research approach was used to collect data from 144 public procurement professionals in public entities in Harare, Zimbabwe. SPSS software version 21 was used to process the data that were later analysed through correlation and regression analyses. Familiarity with procurement regulations, enforcement and political interference were found to be statistically significant predictors of compliance. The managerial implications and direction for future research are provided.

Country watch: Zimbabwe.

Science.gov (United States)

Laver, S

1999-01-01

Tsungirirai is a counseling and information service developed during 1994 in response to the growing problem of HIV/AIDS in the small town of Norton, southwest of Harare, Zimbabwe. The objectives of the project include identification of key leaders in the area, determination of the setting in which HIV was spreading, and community consultation in program design and implementation. Tsungirirai's initial activities included a series of workshops on participatory techniques particularly the LADA (Listening-Appraisal-Dialogue-Action) method for key leaders, community men, women, and adolescents. Workshop participants demonstrated different views concerning HIV/AIDS problems. Key leaders viewed the HIV/AIDS problem within the context of existing laws that contradict traditional mores, while the youth linked the problem of HIV to the issue of unemployment and lack of recreation. Lessons learned include the following: 1) stop talking and listen; 2) start where people are at instead of telling them what they already know; 3) let the people decide; 4) turn a dream into reality; and 5) facilitate awareness process instead of leading it.

Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery

DEFF Research Database (Denmark)

Weibel, S; Jokinen, J; Pace, N L

2016-01-01

BACKGROUND: Improvement of postoperative pain and other perioperative outcomes remain a significant challenge and a matter of debate among perioperative clinicians. This systematic review aims to evaluate the effects of perioperative i.v. lidocaine infusion on postoperative pain and recovery in p...

Challenges of Communicating Nuclear and Radiation Information: The Case of Zimbabwe

International Nuclear Information System (INIS)

Mudota, B.

2015-01-01

Communication is paramount in all human activities and appears to be a very easy subject. But in actual fact it is a complicated process with a capacity to change perceptions from being negative to positive or vice versa. The issue of communication becomes even more challenging when it involves issues or topics which are generally perceived as complex in various societies. A case in point involves the communication challenges faced in communicating radiation/nuclear issues especially to third world country audiences where the concept is still in its infancy and therefore not well understood by the public. Increasing awareness to the public on issues to do with nuclear/radiation is critical especially in terms of developing and building future competencies which are currently skewed towards males in Zimbabwe. The ratio of female citizens engaged in nuclear/radiation fields is still very low in Zimbabwe. There is therefore need to start communicating nuclear/radiation issues from an early age with a focus on changing women’s perceptions over such issues. The Radiation Protection Authority of Zimbabwe’s Corporate Communications Department presents a study based on the experiences of the Corporate Communications Officer over a period of four years in that capacity. This study provides reasons why third world country publics, especially in Zimbabwe s are showing little interest in nuclear/radiation issues. Experiences are also shared on how the Corporate Communications Officer has managed to increase awareness of /nuclear issues from two percent to five percent over the last four years. The different methods of communication used are also detailed together with the accompanying challenges. (author)

Evaluating the Impact of the Medical Education Partnership Initiative at the University of Zimbabwe College of Health Sciences Using the Most Significant Change Technique.

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Connors, Susan C; Nyaude, Shemiah; Challender, Amelia; Aagaard, Eva; Velez, Christine; Hakim, James

2017-09-01

In medical education, evaluating outcomes from programs intended to transform attitudes or influence career trajectories using conventional methods of monitoring is often difficult. To address this problem, the authors adapted the most significant change (MSC) technique to gain a more comprehensive understanding of the impact of the Medical Education Partnership Initiative (MEPI) program at the University of Zimbabwe College of Health Sciences. In 2014-2015, the authors applied the MSC to systematically examine the personal significance and level of positive transformation that individuals attributed to their MEPI participation. Interviews were conducted with 28 participants nominated by program leaders. The authors coded results inductively for prevalent themes in participants' stories and prepared profiles with representative quotes to place the stories in context. Stakeholders selected 9 themes and 18 stories to illustrate the most significant changes. Six themes (or outcomes) were expected, as they aligned with MEPI goals-becoming a better teacher, becoming a better clinician, increased interest in teaching, increased interest in research, new career pathways (including commitment to practice in Zimbabwe), and improved research skills. Three themes were unexpected-increased confidence, expanded interprofessional networks, and improved interpersonal interactions. The authors found the MSC to be a useful and systematic evaluation approach for large, complex, and transformative initiatives like MEPI. The MSC seemed to encourage participant reflection, support values inquiry by program leaders, and provide insights into the personal and cultural impacts of MEPI. Additional trial applications of the MSC technique in academic medicine are warranted.

Outcome measures in stapes surgery: postoperative results are independent from preoperative parameters.

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Koopmann, Mario; Weiss, Daniel; Savvas, Eleftherios; Rudack, Claudia; Stenner, Markus

2015-09-01

The aim of this study was to compare audiometric results before and after stapes surgery and identify potential prognostic factors to appropriately select patients with otosclerosis who will most likely benefit from surgery. We enrolled 126 patients with otosclerosis (162 consecutive ears) in our study who underwent stapes surgery between 2007 and 2012 at our institution. Preoperative and postoperative data including pure-tone audiometry, speech audiometry, stapedial reflex audiometry and surgical data were analyzed. The average preoperative air-bone gap (ABG) was 28.9 ± 8.6 dB. Male patients and patients older than 45 years of age had greater preoperative ABGs in comparison to females and younger patients. Postoperative ABGs were 11.2 ± 7.4 dB. The average ABG gain was 17.7 ± 11.1 dB. Preoperative audiometric data, age, gender and type of surgery did not influence the postoperative results. Stapes surgery offers predictable results independent from disease progression or patient-related factors. While absolute values of hearing improvement are instrumental in reflecting audiometric results of a cohort, relative values better reflect individual's audiometric data resembling the patient's benefit.

Prospective randomized investigation for evaluation of postoperative changes in the microbial climate of paranasal mucosa by the use of different dissoluting techniques during postoperative care.

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Maune, S; Johannssen, V; Sahly, H; Werner, J A; Salhy, H

1999-09-01

Endonasal dissolution by the use of NaCl-solution is a common postoperative treatment of the nasal mucosa after endonasal surgery. These procedure involve for example endonasal shower and sterilized solutions. The contamination of nasal shower in case of unprofessional cleaning after treatment was an argument against this technique in earlier discussions. The danger of such an infection should be avoided by the use of sterilized solution. Therefore the dependence of nasal microbial climate on different nasal dissoluting techniques was investigated by the use of such named endonasal shower (Siemens und Co, Bad Ems, Germany) in comparison with sterilized solution (Rhinomer, Zyma SA, Nyon, France). Microbial cultures were investigated of 80 patients after endonasal surgery (53 m, 27 f; 31 +/- 21 age). Surgery was done for the treatment of chronic polypous sinusitis. Pre-, intra- and postoperative samples were taken in 640 cases to proceed microbial cultures. Material was transferred with the use of a Port-A-Cul-transport medium and preparation of the microbial cultures was done during the first four hours. As a result 895 bacterial clones were cultivated. These consisted of 87% aerob and 13% anaerob bacteria. Staphylococcus aureus (39%) and members of the family of Enterobactericae (30%) were the most common microbes. There was neither an evidence for postoperative microbes on the nasal mucosa nor a correlation between the dissoluting technique and the postoperative outcome. The use of sterilized solutions for the postoperative care of endonasal mucosa does not cause an additional worthful effect on neither the postoperative microbial climate nor the outcome in comparison to endonasal shower.

Migrant remittances and household wellbeing in urban Zimbabwe.

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Bracking, Sarah; Sachikonye, Lloyd

2010-01-01

Evidence from household surveying in December 2005 in Harare and Bulawayo, Zimbabwe, indicates that a wide network of international migrant remitters are ameliorating the economic crisis in Zimbabwe by sending monetary and in-kind transfers to over 50 per cent of urban households. The research combines quantitative measurement of scale and scope, with demographic and qualitative narrative to build a holistic picture of the typography of receiving and non-receiving households. A complex set of interrelated variables helps to explain why some households do and others do not receive income and goods from people who are away, and the economic and social extent of their subsequent benefit from them. Moreover, the mixed methods approach is designed to capture inter-household and likely macroeconomic effects of how households receive their goods and money; and of how they subsequently exchange (if applicable), store and spend it. Evidence emerges of a largely informal, international social welfare system, but one which is not without adverse inter-household effects for some. These include suffering exclusion from markets suffering from inflationary pressures, not least as a result of other people’s remittances. This paper explores the role of remittances, within this internationalised informal welfare system which we can map from our household survey, in reframing vulnerability and marginalization differentially among and between our subject households.

Inflammation-based prognostic score is a useful predictor of postoperative outcome in patients with extrahepatic cholangiocarcinoma.

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Oshiro, Yukio; Sasaki, Ryoko; Fukunaga, Kiyoshi; Kondo, Tadashi; Oda, Tatsuya; Takahashi, Hideto; Ohkohchi, Nobuhiro

2013-03-01

Recent studies have revealed that the Glasgow prognostic score (GPS), an inflammation-based prognostic score, is useful for predicting outcome in a variety of cancers. This study sought to investigate the significance of GPS for prognostication of patients who underwent surgery with extrahepatic cholangiocarcinoma. We retrospectively analyzed a total of 62 patients who underwent resection for extrahepatic cholangiocarcinoma. We calculated the GPS as follows: patients with both an elevated C-reactive protein (>10 mg/L) and hypoalbuminemia (L) were allocated a score of 2; patients with one or none of these abnormalities were allocated a s ore of 1 or 0, respectively. Prognostic significance was analyzed by the log-rank test and a Cox proportional hazards model. Overall survival rate was 25.5 % at 5 years for all 62 patients. Venous invasion (p = 0.01), pathological primary tumor category (p = 0.013), lymph node metastasis category (p GPS (p = 0.008) were significantly associated with survival by univariate analysis. A Cox model demonstrated that increased GPS was an independent predictive factor with poor prognosis. The preoperative GPS is a useful predictor of postoperative outcome in patients with extrahepatic cholangiocarcinoma.

Do Sublaminar Polyester Bands Affect the Outcomes of Postoperative Infections After Adolescent Idiopathic Scoliosis Surgery?

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Issa, Samir P; Angelliaume, Audrey; Vidal, Christophe; Mazda, Keyvan; Ilharreborde, Brice

2017-12-01

The incidence of surgical site infections (SSI) after adolescent idiopathic scoliosis (AIS) surgery ranges from 0.5% to 7%. There is currently a regain of interest in hybrid constructs, combining lumbar pedicle screws and thoracic sublaminar bands, but some authors have raised concerns about the risk of SSI and the difficulty of bacterial eradication. The goal of this study was therefore to assess the outcomes of SSI after AIS surgery using sublaminar bands. A total of 524 consecutive patients operated for AIS using sublaminar bands between June 2006 and June 2014 were included. SSI cases were identified and analyzed retrospectively. Radiologic and functional outcomes were evaluated at follow-up using EOS imaging and SRS 30 scores, and compared with a control group. The overall SSI rate was 5.3%, with a majority of monomicrobial (86%) infections occurring in the first 6 weeks postoperative (93%). The most frequent pathogens were skin germs (Staphylococcus aureus and Propionibacterium acnes) with a community profile. Patients were treated successfully with surgical debridement without implants removal, associated with 6 weeks of antibiotherapy. However, 25% of patients required >1 surgical debridement. Instrumentation removal was decided in the 2 cases with late SSI, and performed uneventfully. Radiologic and functional outcomes at follow-up were not affected by the occurrence of SSI. Sublaminar bands are not associated with a higher risk of infection. However, the SSI rate in the current study stands in the upper range of the literature, and other preventive strategies should be considered. In case of early infection, bands removal is not necessary to obtain pathogen eradication, but the sublaminar implants can be pulled out safely in case of late SSI. The occurrence of SSI does not alter the outcomes at follow-up. Level III.

Risk factors and outcomes of postoperative pancreatic fistula after pancreatico-duodenectomy: an audit of 532 consecutive cases.

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Fu, Shun-Jun; Shen, Shun-Li; Li, Shao-Qiang; Hu, Wen-Jie; Hua, Yun-Peng; Kuang, Ming; Liang, Li-Jian; Peng, Bao-Gang

2015-03-26

Pancreatic fistula (PF) remains the most challenging complication after pancreaticoduodenectomy (PD). The purpose of this study was to identify the risk factors of PF and delineate its impact on patient outcomes. We retrospectively reviewed clinical data of 532 patients who underwent PD and divided them into PF group and no PF group. Risk factors and outcomes of PF following PD were examined. PF was found in 65 (12.2%) cases, of whom 11 were classified into ISGPF grade A, 42 grade B, and 12 grade C. Clinically serious postoperative complications in the PF versus no PF group were mortality, abdominal bleeding, bile leak, intra-abdominal abscess and pneumonia. Univariate and multivariate analysis showed that blood loss ≥ 500 ml, pancreatic duct diameter ≤ 3 mm and pancreaticojejunostomy type were independent risk factors of PF after PD. Blood loss ≥ 500 ml, pancreatic duct diameter ≤ 3 mm and pancreatico-jejunostomy type were independent risk factors of PF after PD. PF was related with higher mortality rate, longer hospital stay, and other complications.

Postoperative Respiratory Function and Survival After Pneumonectomy in Dogs and Cats.

Science.gov (United States)

Majeski, Stephanie A; Steffey, Michele A; Mayhew, Philipp D; Hunt, Geraldine B; Holt, David E; Runge, Jeffrey J; Kass, Philip H; Mellema, Matthew

2016-08-01

To describe indications for, and outcomes after, pneumonectomy in dogs and cats, including assessment of immediate postoperative respiratory function in comparison to dogs undergoing single lung lobectomy. Retrospective case series. Dogs (n=16) and cats (n=7) with naturally occurring pulmonary disease. Medical records (1990-2014) of dogs and cats undergoing right or left pneumonectomy were reviewed. Data retrieved included signalment, history, preoperative diagnostics, operative descriptions, postoperative data including respiratory function, and postdischarge outcomes. For respiratory function comparisons, medical records of dogs having undergone a single lung lobectomy via median sternotomy (n=15) or intercostal thoracotomy (n=15) were reviewed. Twenty-three cases (16 dogs, 7 cats) were included. Pneumonectomy was performed for congenital (1 dog, 1 cat), neoplastic (8 dogs, 1 cat), and infectious (7 dogs, 5 cats) disease. Postoperative aspiration pneumonia occurred in 2 dogs; 15 of 16 dogs (94%) and 6/7 cats (86%) survived to hospital discharge. After pneumonectomy, dogs had a significantly higher postoperative PaO2 on 21% oxygen (P=.033) and lower postoperative A-a gradient (P=.004) compared to dogs undergoing single lung lobectomy. Survival times (right-censored at last follow-up) for dogs ranged from 2 days to 7 years (estimated median=1,868 days) and for cats from 1-585 days. Dogs and cats have acceptable respiratory function immediately postoperatively and most have protracted long-term survival after pneumonectomy for a variety of pulmonary diseases. © Copyright 2016 by The American College of Veterinary Surgeons.

Nurse practitioners in postoperative cardiac surgery: are they effective?

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Goldie, Catherine L; Prodan-Bhalla, Natasha; Mackay, Martha

2012-01-01

High demand for acute care nurse practitioners (ACNPs) in Canadian postoperative cardiac surgery settings has outpaced methodologically rigorous research to support the role. To compare the effectiveness of ACNP-led care to hospitalist-led care in a postoperative cardiac surgery unit in a Canadian, university-affiliated, tertiary care hospital. Patients scheduled for urgent or elective coronary artery bypass and/or valvular surgery were randomly assigned to either ACNP-led (n=22) or hospitalist-led (n=81) postoperative care. Both ACNPs and hospitalists worked in collaboration with a cardiac surgeon. Outcome variables included length of hospital stay, hospital readmission rate, postoperative complications, adherence to follow-up appointments, attendance at cardiac rehabilitation and both patient and health care team satisfaction. Baseline demographic characteristics were similar between groups except more patients in the ACNP-led group had had surgery on an urgent basis (p < or = 0.01), and had undergone more complicated surgical procedures (p < or =0.01). After discharge, more patients in the hospitalist-led group had visited their family doctor within a week (p < or =0.02) and measures of satisfaction relating to teaching, answering questions, listening and pain management were higher in the ACNP-led group. Although challenges in recruitment yielded a lower than anticipated sample size, this study contributes to our knowledge of the ACNP role in postoperative cardiac surgery. Our findings provide support for the ACNP role in this setting as patients who received care from an ACNP had similar outcomes to hospitalist-led care and reported greater satisfaction in some measures of care.

Increased incidence of tuberculosis in zimbabwe, in association with food insecurity, and economic collapse: an ecological analysis.

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Burke, Stephen J; Lass, Elliot; Thistle, Paul; Katumbe, Lovemore; Jetha, Arif; Schwarz, Dan; Bolotin, Shelly; Barker, R D; Simor, Andrew; Silverman, Michael

2014-01-01

Zimbabwe underwent a socioeconomic crisis and resultant increase in food insecurity in 2008-9. The impact of the crisis on Tuberculosis (TB) incidence is unknown. Prospective databases from two mission hospitals, which were geographically widely separated, and remained open during the crisis, were reviewed. At the Howard Hospital (HH) in northern Zimbabwe, TB incidence increased 35% in 2008 from baseline rates in 2003-2007 (pcrisis at HH showed a decrease of 33% in TB incidence between 2009 to 2010 (pcrisis years of 2008/2009 (pcrisis in this high HIV prevalence country.

Challenges of communicating integrated water resource management in Zimbabwe

Science.gov (United States)

Marimbe, Simbiso; Manzungu, Emmanuel

With the promulgation of the 1998 Water Act the Government of Zimbabwe took a decisive step to reform the country’s water sector, to bring it in line with contemporary socio-political realities obtaining in the country, and in tune with the philosophy of integrated water resources management. Researchers have reported a lack of awareness of the reforms, particularly among the black communities, who were considered not just as one of the target of the reforms, but the beneficiaries. This paper analyses why this has been the case. The paper makes a case for differentiating communication from information dissemination. Information refers to a set of data packaged for delivery to a receiver while communication involves a dialogue. This paper critiques communication strategies used to communicate water reforms in Zimbabwe, applying recent developments in communication theories. The argument in the paper is that there was a failure to communicate although there was some success in dissemination information about the reforms. If the situation is to be reversed then methods that involve audience analysis may have to be used. Such methods tend to be expensive and time consuming--however, there is no substitute to this if integrated water resources management is to be institutionalised among the various stakeholders.

Peace and Conflict in Zimbabwe – A Call for Peace Education (A ...

African Journals Online (AJOL)

Developments in peace studies and peace theory have resulted in two conceptualizations of peace, notably, 'negative / cold' peace and 'positive / hot / stable' peace, respectively. It can be surmised that situations and conditions in most countries internationally and Zimbabwe in particular, seem consistent with negative ...

Assessments of genetic diversity and anthracnose disease response among Zimbabwe sorghum germplasm.

Science.gov (United States)

The USDA-ARS National Plant Germplasm System maintains a Zimbabwe sorghum collection of 1,235 accessions from different provinces. This germplasm has not been extensively employed in U.S. breeding programs due to the lack of phenotypic and genetic characterization. Therefore, 68 accessions from th...

Challenges of Virtual and Open Distance Science Teacher Education in Zimbabwe

Science.gov (United States)

Mpofu, Vongai; Samukange, Tendai; Kusure, Lovemore M.; Zinyandu, Tinoidzwa M.; Denhere, Clever; Huggins, Nyakotyo; Wiseman, Chingombe; Ndlovu, Shakespear; Chiveya, Renias; Matavire, Monica; Mukavhi, Leckson; Gwizangwe, Isaac; Magombe, Elliot; Magomelo, Munyaradzi; Sithole, Fungai; Bindura University of Science Education (BUSE),

2012-01-01

This paper reports on a study of the implementation of science teacher education through virtual and open distance learning in the Mashonaland Central Province, Zimbabwe. The study provides insight into challenges faced by students and lecturers on inception of the program at four centres. Data was collected from completed evaluation survey forms…

Postoperative CT appearance in chronic subdural hematomas

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Kaneko, Takaaki; Nishikawa, Michio; Handa, Hajime; Iwaki, Kazuo; Sawai, Teruaki; Munaka, Masahiro

1988-05-01

Postoperative CT appearances in 65 cases of chronic subdural hematomas were evaluated in terms of patient's age, preoperative neurological symptoms and CT findings, final outcomes, and so on. All of the cases were treated with trepanation and irrigation. CT appearances were divided into four different types as follows; Type Ia: No abnormal findings in the subdural sapce, Type Ib: The same as above except for a linear high density suggestive of thickened outer membrane, Type II: Persistence subdural fluid collection and widened cortical sulci which indicate underlining brain atrophy, Type III: Remaining hematoma and/or density changes during follow-up period. Although the mean age of the patients in type Ib was higher than those in type Ia and reexpansion of the brain appear to delay in type Ib and preoperative CT in type Ib tended to show mixed density, final outcome in both groups were excellent. Characteristics in type II were that most of cases were in the eighth decade, preceding head injury was unclear, preoperative psychiatric symptoms and disturbance of consciousness were common and postoperative improvement of the symptoms was not satisfactory compared to other types. Aged patients as in type Ib and type II and thick hematomas of over 2 cm depth with mixed or high density tended to show type III postoperatively. All of the nine patients who required reoperation were included in this type. The present study indicates that thick hematomas with sizable mass effect and mixed or high density in the aged must be carefully treated, such as with placement of the subdural drainage or keeping the patient in the Trendelenburg position, to facilitate postoperative reexpansion of the brain.

Metastatic spine tumor surgery: does perioperative blood transfusion influence postoperative complications?

Science.gov (United States)

Zaw, Aye Sandar; Kantharajanna, Shashidhar B; Maharajan, Karthikeyan; Tan, Barry; Saparamadu, Amarasinghe A; Kumar, Naresh

2017-11-01

The question of independent association between allogeneic blood transfusion (ABT) and postoperative complications in cancer surgeries has been controversial and remains so. In metastatic spine tumor surgery (MSTS), previous studies investigated the influence of ABT on survival, but not on postoperative complications. We aimed to evaluate the influence of perioperative ABT on postoperative complications and infections in patients undergoing MSTS. This retrospective study included 247 patients who underwent MSTS at a single tertiary institution between 2005 and 2014. The outcome measures were postoperative complications and infections within 30 days after MSTS. Multivariate logistic regression analyses were performed to assess influence of blood transfusion on the outcomes after adjusting for potential confounders. Of 247 patients, 133 (54%) received ABT with overall median (range) of 2 (0-10) units. The adjusted odds of developing any postoperative complication was 2.27 times higher in patients with transfusion (95% confidence interval [CI], 1.17-4.38; p = 0.01) and 1.24 times higher odds per every unit increase in blood transfusion (95% CI, 1.05-1.46; p blood transfusion also increased the odds of having overall postoperative infections (odds ratio, 3.58; 95% CI, 1.15-11.11; p = 0.02) and there were 1.24 times higher odds per every unit increase in transfusion (95% CI, 1.01-1.54; p = 0.04). This study adds evidence to the literature implicating ABT to be influential on postoperative complications and infections in patients undergoing MSTS. Appropriate blood management measures should, therefore, be given a crucial place in the care of these patients so as to reduce any putative effect of blood transfusion. © 2017 AABB.

Prevention of Postoperative Bile Leak in Partial Cystectomy for Hydatid Liver Disease: Tricks of the Trade.

Science.gov (United States)

Peker, Kivanc Derya; Gumusoglu, Alpen Yahya; Seyit, Hakan; Kabuli, Hamit Ahmet; Salik, Aysun Erbahceci; Gonenc, Murat; Kapan, Selin; Alis, Halil

2015-12-01

The presence of postoperative bile leak is the major outcome measure for the assessment of operative success in partial cystectomy for hydatid liver disease. However, the optimal operative strategy to reduce the postoperative bile leak rate is yet to be defined. Medical records of patients who underwent partial cystectomy for hydatid liver disease between January 2013 and January 2015 were reviewed in this retrospective analysis. All patients were managed with a specific operative protocol. The primary outcome measure was the rate of persistent postoperative bile leak. The secondary outcome measures were the morbidity and mortality rate, and the length of hospital stay. Twenty-eight patients were included in the study. Only one patient (3.6 %) developed persistent postoperative bile leak. The overall morbidity and mortality rate was 17.8 and 0 %, respectively. The median length of hospital stay was 5 days. Aggressive preventative surgical measures have led to low persistent bile leak rates with low morbidity and mortality.

Characterization of some Brucella species from Zimbabwe by biochemical profiling and AMOS-PCR

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Skjerve Eystein

2009-12-01

Full Text Available Abstract Background Bovine brucellosis caused by Brucella abortus is endemic in most large commercial and smallholder cattle farms of Zimbabwe, while brucellosis in other domestic animals is rare. The diagnosis of brucellosis is mainly accomplished using serological tests. However, some Brucella spp. have been isolated from clinical cases in the field and kept in culture collection but their biochemical profiles were not documented. We report biochemical profiling and AMOS-PCR characterization of some of these field isolates of Brucella originating from both commercial and smallholder cattle farming sectors of Zimbabwe. Findings Fourteen isolates of Brucella from culture collection were typed using biochemical profiles, agglutination by monospecific antisera, susceptibility to Brucella-specific bacteriophages and by AMOS-PCR that amplifies species- specific IS711. The results of the biochemical profiles for B. abortus biovar 1 (11 isolates and biovar 2 (2 isolates were consistent with those of reference strains. A single isolate from a goat originating from a smallholder mixed animal farm was identified as B. melitensis biovar 1. The AMOS-PCR produced DNA products of sizes 498 bp and 731 bp for B. abortus (biovar 1 and 2 and B. melitensis biovar 1, respectively. Conclusion We concluded that the biochemical profiles and AMOS-PCR characterization were consistent with their respective species and biovars. B. abortus biovar 1 is likely to be the predominant cause of brucellosis in both commercial and smallholder cattle farms in Zimbabwe.

A prospective single-institute study of the impact of Daikenchuto on the early postoperative outcome after living donor liver transplantation.

Science.gov (United States)

Takatsuki, Mitsuhisa; Hidaka, Masaaki; Soyama, Akihiko; Hara, Takanobu; Okada, Satomi; Ono, Shinichiro; Adachi, Tomohiko; Eguchi, Susumu

2018-01-20

The aim of this study was to investigate the impact of Daikenchuto (DKT) on early postoperative outcomes after living donor liver transplantation (LDLT), focusing on the prevention of abdominal distension and bacterial translocation. Adult LDLT recipients were prospectively divided into 2 groups, who were administered DKT (n = 20, group A) or not (n = 20, group B). The area of bowel gas defined as gas volume score (GVS) 7 days after LDLT was calculated. Postoperative liver function tests, the development of bacterial, viral, and fungal infections, and GVS after LDLT were reviewed. There were no significant differences in liver function tests and ammonia level after LDLT. Also, the rates of infection and the result of culture study were not different between groups. The median GVS 7 days after LDLT was not significantly different between groups A (0.26 (range, 0.12-0.58)) and B (0.23 (range, 0.15-0.42)). No positive impact was observed for 14-day DKT administration after LDLT, in terms of preventing infection or abdominal distension. Copyright © 2018. Published by Elsevier Taiwan.

Delayed primary closure of bladder exstrophy: immediate postoperative management leading to successful outcomes.

Science.gov (United States)

Baradaran, Nima; Stec, Andrew A; Schaeffer, Anthony J; Gearhart, John P; Mathews, Ranjiv I

2012-02-01

To present the critical features of our postoperative plan for children undergoing delayed primary bladder closure because appropriate postoperative management is crucial to successful exstrophy repair. Using an institutionally approved database, patients with bladder exstrophy whose primary bladder closure was performed at least 1 month after birth were identified. All aspects of the postoperative management were reviewed. A total of 20 patients (18 boys) were identified: 19 with classic bladder extrosphy and 1 with an exstrophy variant. The patients underwent closure at a mean age of 9.9 months. All patients underwent pelvic osteotomy and immobilization for an average of 34.8 days. Analgesia was administered by way of a tunneled epidural catheter in 90% of patients for an average of 18.8 days, and 12 patients (60%) required adjunct intravenous analgesia. Bilateral ureteral catheters and suprapubic tubes were used in all patients. Total parenteral nutrition was administered to 10 (83%) of 12 patients who underwent closure after 2000. All patients received preoperative antibiotics and 2 weeks of postoperative intravenous antibiotics that was followed by oral prophylaxis. The mean hospital stay was 6.3 weeks. With an average follow-up of 7.4 years, delayed closure was 100% successful. Successful delayed primary closure of bladder exstrophy requires a multidisciplinary approach. The keys to success include osteotomy, pelvic immobilization, analgesia, nutritional support, maximal bladder drainage, and infection prophylaxis. Copyright © 2012. Published by Elsevier Inc.

Electricity access. Southern Africa sub-regional study: South Africa and Zimbabwe

Energy Technology Data Exchange (ETDEWEB)

Davidson, O.R.; Mwakasonda, S.A.

2004-07-01

This study focuses on the accessibility of electricity to the poor in South Africa and Zimbabwe as a means to improve understanding of the various factors that affect the provision of modern energy to the poor in these countries. The study examines the impact on the poor of power sector reforms. Specifically, it makes an assessment of the impact of the electrification programmes in the two countries. The situation in the two countries is discussed separately, followed by a comparative analysis. South Africa is the most industrialised country in Africa and it is endowed with a wide variety of natural resources. It is currently going through major changes in many spheres of its economy, including energy, following the democratic elections in 1994. An important consideration that is directing all aspects of government policy is the need to address the enormous disparities in income levels and living conditions betaveen the different racial groups, a result of apartheid. The rural areas are even more impoverished than urban ones. Alter the 1994 democratic elections, the South African Government launched the first phase of the National Electrification Programme (1994-99), aimed at increasing electrification from 36 per cent to about 66 per cent nationally by 2001 - 46 per cent rural and 80 per cent urban. By the end of 2001, 66.1 per cent of households were electrified, with more than 3.4 million connections made since 1994. Since then, several polities have been introduced in the electricity sector that are of direct relevance to this work. The most important of these concern the restructuring of the electricity supply industry and direct subsidies for the poor and disadvantaged. The South African Government established a National Electrification Fund to subsidise a portion of the capital costs of new electricity connections under the National Electrifcation Programme. The Fund derives its income not only from the electricity industry, but also from fiscal allocations

Fuelwood and stoves: lessons from Zimbabwe

Energy Technology Data Exchange (ETDEWEB)

Gill, J

1983-03-01

Laboratory tests on traditional open fires as methods of cooking give values of thermal efficiency varying from 12-30%. These are significantly higher than values which are widely quoted in the literature. The results of a research visit to Zimbabwe indicated that in three villages fuel efficiency did not appear to be the main determinant of choice of cooking method: villagers had changed from their traditional mode of cooking to stoves which they perceived to consume substantially more fuel. These stoves enable meals to be prepared more quickly which the women found useful during the busy months. The increased labour costs could be borne because the fuel was gathered during the slack season.

Learning outcomes of occupational therapy and physiotherapy students during their communitybased education attachment

Directory of Open Access Journals (Sweden)

T Ndlovu

2017-12-01

Full Text Available Background. Community-based education (CBE is a learning approach that enables students to acquire skills by means of applied learning in the community. The goals of CBE include creating adequate knowledge, skills and attitudes that facilitate service delivery in communities. These goals ensure the provision of efficient health services to marginalised communities with significant resource constraints. The Department of Rehabilitation at the University of Zimbabwe, Harare, has adopted CBE as one of the learning approaches that enables students to acquire comprehensive skills for future service provision in the community.Objectives. To determine the learning outcomes of rehabilitation students at the University of Zimbabwe and to identify factors affecting learning during the CBE attachments.Methods. A descriptive cross-sectional survey was conducted at the University of Zimbabwe. Thirty-five final-year occupational therapy and physiotherapy students responded to a self-administered questionnaire. Data were analysed using Microsoft Excel 2013 (USA and SPSS version 21 (IBM Corp., USA.Results. All the students reported that the CBE attachment improved their community-engagement skills, professional skills and personal growth. Barriers to effective learning included inadequate transport (100%, poor internet connectivity (82%, lack of research-related objectives (74% and inadequate resources for CBE activities (60%.Conclusion. The CBE attachment enabled students to gain skills in community engagement, professionalism and personal growth. However, more funding directed towards CBE activities and introducing objectives related to research, are some of the strategies that might improve the students’ learning outcomes during the attachments.

The Driving Forces for the Practice of Strategic Planning in SMEs: Evidence from Harare Metropolitan Province, Zimbabwe

Directory of Open Access Journals (Sweden)

Maxwell Sandada

2016-08-01

Full Text Available Despite Zimbabwe sharing with the rest of the world, the notion that SMEs are the impeccable engines to economic revival, growth and development, many of the nation`s SMEs are plagued with high failure rates. Previous studies carried out in most foreign countries suggested that the high failure rate of SMEs was attributable to lack of strategic planning among a host of other factors. Against this backdrop, the purpose of this study was to examine the driving forces for the practice of strategic planning in SMEs. A quantitative cross sectional study was conducted among active SMEs who are registered with the Ministry of Small and Medium Enterprises and Cooperative Development in Zimbabwe. The study revealed that globalisation, business ownership motivations, environmental dynamism and innovation & technological advancement have a positive and statistically significant influence on the adoption or practice of strategic planning among SMEs. The study has important implications for the practice and implementation of strategic planning among SMEs especially in the context of a developing country such as Zimbabwe.

The outcome of the postoperative radiotherapy of autonomic nerve preserving operation for lower rectal cancer

International Nuclear Information System (INIS)

Takahashi, Keiichi; Mori, Takeo; Yasuno, Masamichi

1997-01-01

It is unclear whether adjuvant radiotherapy before or after surgery is effective for locally advanced, resectable lower rectal cancer. This study consists of a prospective randomized trial of postoperative radiotherapy for locally advanced curatively resected lower rectal carcinoma. We divided patients into two groups, one with postoperative 50 Gy radiation therapy to pelvic wall (N=64), and the other with no radiation therapy (N=46). The 5 year disease-free rate was 61.8% in the radiation group and 70.6% in the no radiation group. There was statistically no significant difference between these two groups. The local recurrence rate was 2.7% (radiation therapy group: 1.6%, no radiation therapy group: 4.3%). This local recurrence rate was very low. These results made us suspect that postoperative radiation therapy was not always necessary to prevent local recurrence. Postoperative complications had a higher incidence in the radiation therapy group than in the no-radiation therapy group. In the radiation therapy group, 35.5% of the patients suffered from diarrhea or frequent defecation, and 10.8% from severe abdominal pain. We operated on 4 cases of radiation-induced ileal stenosis and ileus. Postoperative radiation therapy did not help prevent local recurrence even though many complications resulted. (author)

What was the population of Great Zimbabwe (CE1000 - 1800)?

Science.gov (United States)

Chirikure, Shadreck; Moultrie, Thomas; Bandama, Foreman; Dandara, Collett; Manyanga, Munyaradzi

2017-01-01

The World Heritage Site of Great Zimbabwe is one of the most iconic and largest archaeological settlements in Africa. It was the hub of direct and indirect trade which internally connected various areas of southern Africa, and externally linked them with East Africa and the Near and Far East. Archaeologists believe that at its peak, Great Zimbabwe had a fully urban population of 20,000 people concentrated in approximately 2.9 square kilometres (40 percent of 720 ha). This translates to a population density of 6,897, which is comparable with that of some of the most populous regions of the world in the 21st century. Here, we combine archaeological, ethnographic and historical evidence with ecological and statistical modelling to demonstrate that the total population estimate for the site's nearly 800-year occupational duration (CE1000-1800), after factoring in generational succession, is unlikely to have exceeded 10,000 people. This conclusion is strongly firmed up by the absence of megamiddens at the site, the chronological differences between several key areas of the settlement traditionally assumed to be coeval, and the historically documented low populations recorded for the sub-continent between CE1600 and 1950.

Issues and prospects for coal utilization in Zimbabwe's rural households

International Nuclear Information System (INIS)

Maya, R.S.

1990-01-01

The increasing shortage of traditional fuels in Zimbabwe has prompted government to consider seriously the use of coal in rural households. In this regard, both government and the privately owned coal industry have begun pilot projects in selected rural areas to initiate the introduction of coal stoves and coal fuels. These efforts by government and the coal industry need to be informed by knowledge of the financial and economic dimensions of coal diffusion to rural economies, the environmental implications of widespread coal use in rural households, and the general acceptability of coal as a fuel to households with a long tradition of free fuels. This paper summarizes the results of a study undertaken to provide such background information. Conducted over six months during 1988, the study included field surveys of four districts in Zimbabwe: Murewa, Shurugwi, Mberengwa, and Mazoe Citrus Estates. All but the Mazoe district are rural settings with severe shortages of fuelwood. Mazoe Citrus Estates is a semi-urban plantation community which has had over twenty years' experience with coal use in households under a company-sponsored programme which supplies both fuels and stoves free of charge

What was the population of Great Zimbabwe (CE1000 - 1800?

Directory of Open Access Journals (Sweden)

Shadreck Chirikure

Full Text Available The World Heritage Site of Great Zimbabwe is one of the most iconic and largest archaeological settlements in Africa. It was the hub of direct and indirect trade which internally connected various areas of southern Africa, and externally linked them with East Africa and the Near and Far East. Archaeologists believe that at its peak, Great Zimbabwe had a fully urban population of 20,000 people concentrated in approximately 2.9 square kilometres (40 percent of 720 ha. This translates to a population density of 6,897, which is comparable with that of some of the most populous regions of the world in the 21st century. Here, we combine archaeological, ethnographic and historical evidence with ecological and statistical modelling to demonstrate that the total population estimate for the site's nearly 800-year occupational duration (CE1000-1800, after factoring in generational succession, is unlikely to have exceeded 10,000 people. This conclusion is strongly firmed up by the absence of megamiddens at the site, the chronological differences between several key areas of the settlement traditionally assumed to be coeval, and the historically documented low populations recorded for the sub-continent between CE1600 and 1950.

Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score

DEFF Research Database (Denmark)

Foss, Nicolai Bang; Kristensen, Morten Tange; Kehlet, Henrik

2006-01-01

fracture patients with an independent walking function admitted from their own home. Rehabilitation followed a well-defined multimodal rehabilitation regimen and discharge criteria. MAIN OUTCOME MEASURE: Admission tests with a new mobility score to assess prefracture functional mobility and a short mental......OBJECTIVE: To validate the cumulated ambulation score as an early postoperative predictor of short-term outcome in hip fracture patients. DESIGN: Prospective, descriptive study. SETTING: An orthopaedic hip fracture unit in a university hospital. PATIENTS: Four hundred and twenty-six consecutive hip...... of short-term postoperative outcome after hip fracture surgery....

Establishing strategic energy assessment indicators for Zimbabwe: A key to improving electrical energy efficiency

Science.gov (United States)

Goto, Felix

In Zimbabwe, there is still very little realization of the potential of demand side management (DSM) to increase industrial energy efficiency. Without clear guidelines that indicate the most economic energy efficiency strategies to implement, it is difficult for industry to easily evaluate the benefits of energy assessments. This research focused on establishing and evaluating indicators that guide correct implementation of energy assessments into Zimbabwean industry. This quantitative and qualitative study used a theoretic approach to develop indicators that identified industrial subsectors that should be targeted for DSM interventions. This may bring about reduction in energy demand in high power consuming Zimbabwean industrial companies, which were compared with energy utility performances of similar industrial companies in countries located in other parts of the world. This research used pattern-matching, categorical aggregation, and stochastic frontier regression analysis for data analysis. In maximizing electrical efficiency, the implications of this study may be used by individual companies in Zimbabwe to perform energy efficiency self-diagnoses, operational efficiency evaluations, and capital resource justifications. From a societal perspective, this study may benefit Zimbabwe because it provides opportunities for the alleviation of both shortages in power supply and the capital constraints of building new generating capacity. This study will also benefit ordinary Zimbabweans by lowering energy costs and providing reliable power. This promotes sustainable economic growth and lowers the need for foreign currency to import power.

Wildlife tourism in Gonarezhou National Park, southeast Zimbabwe: opportunities for wildlife viewing

NARCIS (Netherlands)

Gandiwa, E.

2011-01-01

The aim of this study was to (i) estimate wild animal abundances, distribution and species diversity and (ii) examine the opportunities for wildlife viewing in major tourist areas in the southern part of Gonarezhou National Park (GNP), southeast Zimbabwe. In this study, road strip counts were used.

An assessment of alien invasive plant species in Gonarezhou National Park, Zimbabwe

NARCIS (Netherlands)

Sithole, D.; Zisadza-Gandiwa, P.; Gandiwa, E.

2012-01-01

This study investigated the occurrence of alien plant species in Gonarezhou National Park (GNP), Zimbabwe. We focused on two main habitat types, namely riparian areas of the major rivers and dry land areas. Sampling was carried out from 42 sampling plots in both habitat types. Variables studied

Human – environment relations in Zimbabwe: the case of land – pre ...

African Journals Online (AJOL)

At the Lancaster House Constitutional Conference of 1979, Britain agreed to fund Zimbabwe's resettlement program on a 'willing-seller willing buyer' basis to ... 'fast track' program to speed land acquisition by making amendments to the Constitution to obligate Britain, to pay compensation to farmers with designated land.

Teaching with and Learning through ICTs in Zimbabwe's Teacher Education Colleges

Science.gov (United States)

Musarurwa, Charles

2011-01-01

The use of ICTs (information and communication technologies) in Zimbabwe's teacher education colleges is of paramount importance. The teacher trainees have a dual role to play: learning through ICTs and also learning how to teach through them. Interestingly, the rate at which schools have embraced the use of ICTs is unprecedented, but this has not…

Spatial and temporal variation in domestic biofuel consumption rates and patterns in Zimbabwe: implications for atmospheric trace gas emission

International Nuclear Information System (INIS)

Ludwig, J.; Andreae, M.O.; Helas, G.; Marufu, L.; University of Utrecht; Lelieveld, J.

1999-01-01

An ecologically nationwide and all-year-round domestic biofuel consumption study was conducted in Zimbabwe from January 1996 to March 1997. The study aimed at (a) establishing the determinants and magnitudes of spatial and temporal variations in biofuel consumption rates, (b) estimating the overall mean national rural and urban consumption rates, and (c) estimating the contribution of domestic biomass burning in Zimbabwe to the emission of atmospheric trace gases. The main source of spatial variation in biofuel consumption rates was found to be settlement type (rural or urban). Within a settlement type, per capita consumption rates varied in time and space with household size, ambient temperature, and physical availability. In rural areas wood and agricultural residues were consumed at national average rates of 1.3±0.2 and 0.07±0.01 tonnes capita -1 year -1 , respectively. In urban centres wood was consumed at an average rate of 0.4±0.26 tonnes capita -1 year -1 . These consumption rates translate into emission outputs from Zimbabwe of 4.6 Tg CO 2 -C year -1 , 0.4 Tg CO-C year -1 , 5.3 Gg NO-N year -1 , 14.5 Gg CH 4 -C year -1 , 24.2 Gg NMHC-C year -1 , 2.9 Gg organic acid-C year -1 (formic and acetic acids) and 48.4 Gg aerosol-C year -1 . For CO 2 , CO, and NO, these domestic biofuel emissions represent 41±6%, 67±6%, and 8±1%, respectively, of the total output of all sources evaluated and documented in Zimbabwe to date. This means that of the studied sources, domestic biomass burning is the major source of CO 2 and CO emission in Zimbabwe

Access and Quality in Education in Resettlement Schools: The Case Study of Zvivingwi Secondary School in Gutu District, Masvingo Province in Zimbabwe

Science.gov (United States)

Jenjekwa, Vincent

2013-01-01

In Zimbabwe, the discourse on access and quality in education has been a raging one since the colonial days of bottlenecks and outright discrimination against black Zimbabweans in education. The doors to education were declared open to all at independence in 1980 with the new Zimbabwe government's enunciated policy of education for all. It is an…

Electroacupuncture reduces duration of postoperative ileus after laparoscopic surgery for colorectal cancer.

Science.gov (United States)

Ng, Simon S M; Leung, Wing Wa; Mak, Tony W C; Hon, Sophie S F; Li, Jimmy C M; Wong, Cherry Y N; Tsoi, Kelvin K F; Lee, Janet F Y

2013-02-01

We investigated the efficacy of electroacupuncture in reducing the duration of postoperative ileus and hospital stay after laparoscopic surgery for colorectal cancer. We performed a prospective study of 165 patients undergoing elective laparoscopic surgery for colonic and upper rectal cancer, enrolled from October 2008 to October 2010. Patients were assigned randomly to groups that received electroacupuncture (n = 55) or sham acupuncture (n = 55), once daily from postoperative days 1-4, or no acupuncture (n = 55). The acupoints Zusanli, Sanyinjiao, Hegu, and Zhigou were used. The primary outcome was time to defecation. Secondary outcomes included postoperative analgesic requirement, time to ambulation, and length of hospital stay. Patients who received electroacupuncture had a shorter time to defecation than patients who received no acupuncture (85.9 ± 36.1 vs 122.1 ± 53.5 h; P electroacupuncture also had a shorter time to defecation than patients who received sham acupuncture (85.9 ± 36.1 vs 107.5 ± 46.2 h; P = .007). Electroacupuncture was more effective than no or sham acupuncture in reducing postoperative analgesic requirement and time to ambulation. In multiple linear regression analysis, an absence of complications and electroacupuncture were associated with a shorter duration of postoperative ileus and hospital stay after the surgery. In a clinical trial, electroacupuncture reduced the duration of postoperative ileus, time to ambulation, and postoperative analgesic requirement, compared with no or sham acupuncture, after laparoscopic surgery for colorectal cancer. ClinicalTrials.gov number, NCT00464425. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

Parents' experiences managing their child's complicated postoperative recovery.

Science.gov (United States)

Purcell, Mary; Longard, Julie; Chorney, Jill; Hong, Paul

2018-03-01

Tonsillectomy is commonly performed as same-day surgery and parents are heavily relied upon for management of children's postoperative recovery. The objective of this study was to provide an in-depth description of the experiences parents face when managing their child's complicated postoperative recoveries at home. An exploratory qualitative study at an academic pediatric hospital in Eastern Canada was performed. Participants included 12 parents of children aged 3-6 years who underwent adeno/tonsillectomy and experienced unexpected outcomes or complications during the postoperative recovery period. Parents participated in semi-structured interviews within 6 months of their child's surgery. Interviews were transcribed verbatim and thematic analysis was used to identify themes in the parents' experiences. Parents described struggling to make the decision to come back to hospital, that adequate information does not prevent emotional difficulties, and feeling somewhat responsible for the unexpected outcome or complicated course of recovery. Communication with healthcare providers was considered very important in helping with the recovery process. This research helps to inform healthcare professionals about how they might better support families during complicated recovery processes. Areas of action may include clear communication, setting expectations, and psychosocial support. Copyright © 2018 Elsevier B.V. All rights reserved.

Postoperative outcomes in bariatric surgical patients participating in an insurance-mandated preoperative weight management program.

Science.gov (United States)

Schneider, Andrew; Hutcheon, Deborah A; Hale, Allyson; Ewing, Joseph A; Miller, Megan; Scott, John D

2018-02-02

Many insurance companies require patient participation in a medically supervised weight management program (WMP) before offering approval for bariatric surgery. Clinical data surrounding benefits of participation are limited. To evaluate the relationship between preoperative insurance-mandated WMP participation and postoperative outcomes in bariatric surgery patients. Regional referral center and teaching hospital. A retrospective review of patients who underwent vertical sleeve gastrectomy or Roux-en-Y gastric bypass between January 2014 and January 2016 was performed. Patients (N = 354) were divided into 2 cohorts and analyzed according to presence (n = 266) or absence (n = 88) of an insurance-mandated WMP requirement. Primary endpoints included rate of follow-up and percent of excess weight loss (%EWL) at postoperative months 1, 3, 6, and 12. All patients, regardless of the insurance-mandated WMP requirement, followed a program-directed preoperative diet. The majority of patients with an insurance-mandated WMP requirement had private insurance (63.9%). Both patient groups experienced a similar proportion of readmissions and reoperations, rate of follow-up, and %EWL at 1, 3, 6, and 12 months (P = NS). Median operative duration and hospital length of stay were also similar between groups. Linear regression analysis revealed no significant improvement in %EWL at 12 months in the yes-WMP group. These data show that patients who participate in an insurance-mandated WMP in addition to completing a program-directed preoperative diet experience no significant benefit to rate of readmission, reoperation, follow-up, or %EWL up to 12 months postoperation. Our findings suggest that undergoing bariatric surgery without completing an insurance-mandated WMP is safe and effective. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

A retrospective analysis of endoscopic treatment outcomes in patients with postoperative bile leakage.

Science.gov (United States)

Sayar, Suleyman; Olmez, Sehmus; Avcioglu, Ufuk; Tenlik, Ilyas; Saritas, Bunyamin; Ozdil, Kamil; Altiparmak, Emin; Ozaslan, Ersan

2016-01-01

Bile leakage, while rare, can be a complication seen after cholecystectomy. It may also occur after hepatic or biliary surgical procedures. Etiology may be underlying pathology or surgical complication. Endoscopic retrograde cholangiopancreatography (ERCP) can play major role in diagnosis and treatment of bile leakage. Present study was a retrospective analysis of outcomes of ERCP procedure in patients with bile leakage. Patients who underwent ERCP for bile leakage after surgery between 2008 and 2012 were included in the study. Etiology, clinical and radiological characteristics, and endoscopic treatment outcomes were recorded and analyzed. Total of 31 patients (10 male, 21 female) were included in the study. ERCP was performed for bile leakage after cholecystectomy in 20 patients, after hydatid cyst operation in 10 patients, and after hepatic resection in 1 patient. Clinical signs and symptoms of bile leakage included abdominal pain, bile drainage from percutaneous drain, peritonitis, jaundice, and bilioma. Twelve (60%) patients were treated with endoscopic sphincterotomy (ES) and nasobiliary drainage (NBD) catheter, 7 patients (35%) were treated with ES and biliary stent (BS), and 1 patient (5%) was treated with ES alone. Treatment efficiency was 100% in bile leakage cases after cholecystectomy. Ten (32%) cases of hydatid cyst surgery had subsequent cystobiliary fistula. Of these patients, 7 were treated with ES and NBD, 2 were treated with ES and BS, and 1 patient (8%) with ES alone. Treatment was successful in 90% of these cases. ERCP is an effective method to diagnose and treat bile leakage. Endoscopic treatment of postoperative bile leakage should be individualized based on etiological and other factors, such as accompanying fistula.

Incision integrity and postoperative outcomes after microcoaxial phacoemulsification performed using 2 incision-dependent systems.

Science.gov (United States)

Vasavada, Vaishali; Vasavada, Abhay R; Vasavada, Viraj A; Srivastava, Samaresh; Gajjar, Devarshi U; Mehta, Siddharth

2013-04-01

To compare incision integrity and clinical outcomes of 2 microcoaxial phacoemulsification systems. Iladevi Cataract & IOL Research Centre, Ahmedabad, India. Prospective randomized clinical trial. Eyes were randomized to have phacoemulsification using a 1.8 mm clear corneal incision (CCI) system (Group 1, Stellaris system) or a 2.2 mm CCI system (Group 2, Intrepid Infiniti system). Incision enlargement at end of surgery was measured. At the conclusion of surgery, trypan blue was applied over the conjunctival surface, anterior chamber aspirate withdrawn, and ingress into anterior chamber measured. Postoperative observations included evaluation of the CCI using anterior segment optical coherence tomography (AS-OCT), change in central corneal thickness (CCT), and anterior segment inflammation at 1 day, 1 week, and 1 month and endothelial cell loss and surgically induced astigmatism (SIA) at 3 months. Incision enlargement (P.05). At the end of surgery, it is not the initial incision size alone but also the distortion of the incision during subsequent stages of surgery that determine the integrity of the CCI. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Nutritional status, nutrition practices and post-operative complications in patients with gastrointestinal cancer.

Science.gov (United States)

Garth, A K; Newsome, C M; Simmance, N; Crowe, T C

2010-08-01

Malnutrition and its associated complications are a considerable issue for surgical patients with upper gastrointestinal and colorectal cancer. The present study aimed to determine whether specific perioperative nutritional practices and protocols are associated with improved patient outcomes in this group. Patients admitted for elective upper gastrointestinal or colorectal cancer surgery (n = 95) over a 19-month period underwent a medical history audit assessing weight changes, nutritional intake, biochemistry, post-operative complications and length of stay. A subset of patients (n = 25) underwent nutritional assessment by subjective global assessment prior to surgery in addition to assessment of post-operative medical outcomes, nutritional intake and timing of dietetic intervention. Mean (SD) length of stay for patients was 14.0 (12.2) days, with complication rates at 35%. Length of stay was significantly longer in patients who experienced significant preoperative weight loss compared to those who did not [17.0 (15.8) days versus 10.0 (6.8) days, respectively; P nutritional assessment, 32% were classified as mild-moderately malnourished and 16% severely malnourished. Malnourished patients were hospitalised twice as long as well-nourished patients [15.8 (12.8) days versus 7.6 (3.5) days; P nutrition post surgery was a factor in post-operative outcomes, with a positive correlation with length of stay (r = 0.493; P cancer. Poor nutritional status coupled with delayed and inadequate post-operative nutrition practices are associated with worse clinical outcomes.

A prospective randomized clinical trial to evaluate methods of postoperative care of hypospadias.

Science.gov (United States)

McLorie, G; Joyner, B; Herz, D; McCallum, J; Bagli, D; Merguerian, P; Khoury, A

2001-05-01

Hypospadias repair is a common operation performed by pediatric urologists. Perhaps the greatest variable and source of controversy of postoperative care is the surgical dressing. We hypothesized that using no dressing would achieve surgically comparable results to those traditionally achieved by a postoperative dressing and it would also simplify postoperative parent delivered home care. Accordingly we designed a prospective randomized clinical trial to compare surgical outcome and postoperative care after hypospadias repair in boys with no dressing and those who received 1 of the 2 most common types of dressing. In a 12-month period 120 boys with an average age of 2.2 years underwent primary 1-stage hypospadias repair at a single center with 4 participating surgeons. Repair was performed in 60 boys with proximal and 60 with distal hypospadias on an outpatient basis. Ethics and Internal Review Board approval, and informed consent were obtained. Boys were then prospectively randomized to receive no dressing, an adhesive biomembrane dressing or a compressive wrap dressing. Comprehensive instructions on postoperative care were distributed to all families and a questionnaire was distributed to the parents at the initial followup. Surgical outcome was evaluated and questionnaire responses were analyzed. Fisher's exact test was done to test the significance of differences in surgical outcomes and questionnaire responses. A total of 117 boys completed the prospective randomized trial. Surgical staff withdrew 3 cases from randomized selection to place a dressing for postoperative hemostasis. We obtained 101 questionnaires for response analysis. The type or absence of the dressing did not correlate with the need for repeat procedures, urethrocutaneous fistula, or meatal stenosis or regression. Analysis revealed less narcotic use in the no dressing group and fewer telephone calls to the urology nurse, or on-call resident and/or fellow. These findings were statistically

[Risk factors of postoperative meningitis in patients with chiasm-sellar tumors].

Science.gov (United States)

Popugaev, K A; Savin, I A; Ershova, O N; Kurdyumova, N V; Tabasaransky, T F; Oshorov, A V; Kadashev, B A; Kalinin, P L; Kutin, M A

2014-01-01

Postoperative intracranial infectious complications are one of the most topical problems of neurosurgical intensive care due to theirs significant capability to impair outcomes of the main disease. To define the risk factors of postoperative meningitis in patients with chiasm-sellar tumors. 1. to define the effect of somatic and intracranial risk factors on occurrence of postoperative meningitis in patients after transsphenoidal and transcranial approaches to the tumor. 2. To define the effect of postoperative meningitis on outcomes of treatment in patients after transsphenoidal and transcranial approaches to the tumor. Somatic and intracranial risk factors of occurrence of postoperative meningitis (pneumonia, urinary tract infection, sepsis, intra-abdominal hypertension, the presence of external ventricular and lumbar drainage, monitoring of intracranial pressure, cerebrospinal fluid, and reoperation) were fixed every day. The study was conducted in the ICU of the Burdenko from October, 2010 to July, 2012. The 34 patients (19 males, 15 females) were included in the study (average age 47.5 years). The patients were divided into two groups; 17 patients each group. The group-1 included patients after transcranial approach to the tumor and the group-2 included patients after transsphenoidal approach. In the group-1 a meningitis occurred in 3 patients (17.6% +/- 9.2%, DI [-0.4 - 35.6]). In the group-2 a meningitis occurred in 7 patients (41.2% +/- 11.9) DI 95% [17.8 - 64.4]. Accumulation of cerebrospinal fluid under the skin flap authentically increased a risk of a meningitis occurrence in patients after transcranial approach to the tumor (p = 0.031). There was no defined statistical significance of other risk factors. But there was defined a trend of the increasing of meningitis occurrence in patients after transsphenoidal approach in case of lumbar drainage or reoperation. Duration of mechanical ventilation and ICU stay in patients with meningitis was authentically

Two-Way Social Media Messaging in Postoperative Cataract Surgical Patients: Prospective Interventional Study.

Science.gov (United States)

Sanguansak, Thuss; Morley, Katharine E; Morley, Michael G; Thinkhamrop, Kavin; Thuanman, Jaruwan; Agarwal, Isha

2017-12-19

Social media offers a new way to provide education, reminders, and support for patients with a variety of health conditions. Most of these interventions use one-way, provider-patient communication. Incorporating social media tools to improve postoperative (postop) education and follow-up care has only been used in limited situations. The aim of this study was to determine the feasibility and efficacy of two-way social media messaging to deliver reminders and educational information about postop care to cataract patients. A total of 98 patients undergoing their first eye cataract surgery were divided into two groups: a no message group receiving usual pre- and postop care and a message group receiving usual care plus messages in a mobile social media format with standardized content and timing. Each patient in the message group received nine messages about hand and face hygiene, medication and postop visit adherence, and links to patient education videos about postop care. Patients could respond to messages as desired. Main outcome measures included medication adherence, postop visit adherence, clinical outcomes, and patients' subjective assessments of two-way messaging. The number, types, content, and timing of responses by patients to messages were recorded. Medication adherence was better in the message group at postop day 7, with high adherence in 47 patients (96%, 47/49) versus 36 patients (73%, 36/49) in the no message group (P=.004), but no statistically significant differences in medication adherence between the groups were noted at preop and postop day 30. Visit adherence was higher at postop day 30 in the message group (100%, 49/49) versus the no message group (88%, 43/49; P=.03) but was 100% (49/49) in both groups at postop day 1 and 7. Final visual outcomes were similar between groups. A total of 441 standardized messages were sent to the message group. Out of 270 responses generated, 188 (70%) were simple acknowledgments or "thank you," and 82 (30

Prediction of base flows from catchment characteristics: a case study from Zimbabwe

NARCIS (Netherlands)

Mazvimavi, D.; Meijerink, A.M.J.; Stein, A.

2004-01-01

Base flows make up the flows of most rivers in Zimbabwe during the dry season. Prediction of base flows from basin characteristics is necessary for water resources planning of ungauged basins. Linear regression and artificial neural networks were used to predict the base flow index (BFI) from basin

Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery

OpenAIRE

Ogawa, Masato; Izawa, Kazuhiro P.; Satomi-Kobayashi, Seimi; Tsuboi, Yasunori; Komaki, Kodai; Gotake, Yasuko; Sakai, Yoshitada; Tanaka, Hiroshi; Okita, Yutaka

2017-01-01

Background Postoperative delirium (POD) is a common and critical complication after cardiac surgery. However, the relationship between POD and postoperative physical frailty and the effect of both on long-term clinical outcomes have not been fully explored. Objective We aimed to examine the associations among POD, postoperative frailty, and major adverse cardiac events (MACE). Design This was a prospective cohort study. Methods We studied 329 consecutive patients undergoing elective cardiac s...

SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION: EARLY POSTOPERATIVE COMPLICATIONS

Directory of Open Access Journals (Sweden)

M.Sh. Khubutia

2014-01-01

Full Text Available Aim: evaluation of the incidence of early postoperative complications after simultaneous pancreas-kidney transplantation.Materials and methods. The analysis of early postoperative complications after simultaneous pancreas-kidney transplantation is presented in the paper, the most rational diagnostic algorithms, non-surgical and surgical complications’ treatment; the outcomes of the SPKT are reported.Results. 15,6% of patients experienced surgical complications, 12,5% – immunological complications, 12,5% – infectious complications, 6,25% – complications of the immunosuppressive therapy. 1-year patient survival after SPKT was 91,4%; pancreas graft survival – 85,7%; kidney graft survival – 88,6%.Conclusion. The incidence of early postoperative complications after simultaneous pancreas-kidney transplantation remains signifi cant in spite of progressive improvement of simultaneous pancreas-kidney transplantation due to surgical technique improvement, introduction of new antibacterial and immunosuppressive agents. Data, we recovered, fully correspond to the data obtained from the global medical community.

Post-operative serious adverse events in a mixed surgical population

DEFF Research Database (Denmark)

Hansen, M S; Petersen, E E; Dahl, J B

2016-01-01

BACKGROUND: The number of surgical procedures is increasing, and knowledge of surgical risk factors, post-operative mortality and serious adverse events (SAE) is essential. The aim with our study was to determine the risk of a composite outcome of post-operative: death; myocardial infarction...... or gynaecological surgery was conducted retrieving data from The Danish Civil Registration System and the National Patient Register. Total observation time was from January 1, 2012 to June 6, 2013. RESULTS: A total7449 adult patients were included in the final analysis. The risk of the composite outcome during...... of 8.3% (7.8-9.0). The results are applicable in estimations of adequate sample sizes in future clinical trials investigating effects of interventions on SAEs....

Individual resilience as a strategy to counter employment barriers for people with epilepsy in Zimbabwe.

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Mugumbate, Jacob; Gray, Mel

2017-09-01

Understanding individual resilience helps to improve employment opportunities of people with epilepsy. This is significant because, in Zimbabwe, as in many other countries in the Global South, people with epilepsy encounter several barriers in a context of less-than-ideal public services. Despite this disadvantage, some people with epilepsy have better employment outcomes for reasons including level of seizure control, social background, employment support services, and individual resilience. This article reports on data from participants (n=8), who were part of a larger study (n=30) on employment experiences of people with epilepsy in Harare. The study used in-depth interviews with the participants, who were all service users and members of the Epilepsy Support Foundation (ESF) in Harare. The eight resilient participants comprised four males and four females aged between 26-48years, who were selected because, unlike the remaining 22 participants, they had overcome chronic unemployment. Seven of the eight participants were employed, while one had recently become unemployed. Views of service providers (n=7) were sought on the experiences of people with epilepsy through a focus group discussion. The service providers included two health workers, three social service workers, and two disability advocacy workers. Data were analysed using NVivo, a computer-assisted qualitative data analysis package. The study found that participants experienced barriers, such as a lack of medical treatment, yet this was important for education and training, lack of finances for training, and negative attitudes at workplaces. Despite these barriers, participants had overcome chronic unemployment due to their individual resilience characterised by: (i) a 'fighting spirit', (ii) being their own advocates, and (iii) having a mastery over, and acceptance of, their epilepsy. The research concluded that, where people with epilepsy faced barriers, as in Zimbabwe, individual resilience acted as

Impact of Postoperative Antibiotic Prophylaxis Duration on Surgical Site Infections in Autologous Breast Reconstruction.

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Drury, Kerry E; Lanier, Steven T; Khavanin, Nima; Hume, Keith M; Gutowski, Karol A; Thornton, Brian P; Hansen, Nora M; Murphy, Robert X; Fine, Neil A; Kim, John Y S

2016-02-01

Although some surgeons prescribe prolonged postoperative antibiotics after autologous breast reconstruction, evidence is lacking to support this practice. We used the Tracking Operations and Outcomes for Plastic Surgeons database to evaluate the association between postoperative antibiotic duration and the rate of surgical site infection (SSI) in autologous breast reconstruction. The intervention of interest for this study was postoperative duration of antibiotic prophylaxis: either discontinued 24 hours after surgery or continued beyond 24 hours. The primary outcome variable of interest for this study was the presence of SSI within 30 days of autologous breast reconstruction. Cohort characteristics and 30-day outcomes were compared using χ² and Fischer exact tests for categorical variables and Student t tests for continuous variables. Multivariate logistic regression was used to control for confounders. A total of 1036 patients met inclusion criteria for our study. Six hundred fifty-nine patients (63.6%) received antibiotics for 24 hours postoperatively, and 377 patients (36.4%) received antibiotics for greater than 24 hours. The rate of SSI did not differ significantly between patients given antibiotics for only 24 hours and those continued on antibiotics beyond the 24-hour postoperative time period (5.01% vs 2.92%, P = 0.109). Furthermore, antibiotic duration was not predictive of SSI in multivariate regression modeling. We did not find a statistically significant difference in the rate of SSI in patients who received 24 hours of postoperative antibiotics compared to those that received antibiotics for greater than 24 hours. These findings held for both purely autologous reconstruction as well as latissimus dorsi reconstruction in conjunction with an implant. Thus, our study does not support continuation of postoperative antibiotics beyond 24 hours after autologous breast reconstruction.

Renal Resistance Trend During Hypothermic Machine Perfusion Is More Predictive of Postoperative Outcome Than Biopsy Score: Preliminary Experience in 35 Consecutive Kidney Transplantations.

Science.gov (United States)

Bissolati, Massimiliano; Gazzetta, Paolo Giovanni; Caldara, Rossana; Guarneri, Giovanni; Adamenko, Olga; Giannone, Fabio; Mazza, Michele; Maggi, Giulia; Tomanin, Deborah; Rosati, Riccardo; Secchi, Antonio; Socci, Carlo

2018-03-30

Hypothermic machine perfusion (HPM) grants a better postoperative outcome in transplantation of organs procured from extended criteria donors (ECDs) and donors after cardiac death (DCD). So far, the only available parameter for outcome prediction concerning those organs is pretransplant biopsy score. The aim of this study is to evaluate whether renal resistance (RR) trend during HPM may be used as a predictive marker for post-transplantation outcome. From December 2015 to present, HMP has been systematically applied to all organs from ECDs and DCD. All grafts underwent pretransplantation biopsy evaluation using Karpinski's histological score. Only organs that reached RR value ≤1.0 within 3 hours of perfusion were transplanted. Single kidney transplantation (SKT) or double kidney transplantation (DKT) were performed according to biopsy score results. Sixty-five HMPs were performed (58 from ECDs and 7 from DCD/ECMO donors). Fifteen kidneys were insufficiently reconditioned (RR > 1) and were therefore discarded. Forty-nine kidneys were transplanted, divided between 21 SKT and 14 DKT. Overall primary nonfunction (PNF) and delayed graft function (DGF) rate were 2.9 and 17.1%, respectively. DGF were more common in kidneys from DCD (67 vs. 7%; P = 0.004). Biopsy score did not correlate with PNF/DGF rate (P = 0.870) and postoperative creatinine trend (P = 0.796). Recipients of kidneys that reached RR ≤ 1.0 within 1 hour of HMP had a lower PNF/DGF rate (11 vs. 44%; P = 0.033) and faster serum creatinine decrease (POD10 creatinine: 1.79 mg/dL vs. 4.33 mg/dL; P = 0.019). RR trend is more predictive of post-transplantation outcome than biopsy score. Hence, RR trend should be taken into account in the pretransplantation evaluation of the organs. © 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Panorámica de la geología médica en Zimbabwe y áreas aledañas

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Tendai Njila

2014-05-01

Full Text Available Geochemical anomalies of fluorine, arsenic, mercury, cadmium and other chemical elements in soils, sediments and water, as well as exposure to asbestiform materials in mining areas may adversely affect human and animal health. Rural and peri-urban communities in Zimbabwe living within the vicinity of mining and mineralized areas are most prone to the impacts of their environment because of they often rely on artisanal, small-scale mining, and subsistence agriculture. Cases of dental and skeletal fluorosis, mercury and arsenic poisoning and the more deadly mesothelioma have been reported in Zimbabwe dating back to the last millennium and mitigation measures have been proposed in a number of publications, though their implementation is still relatively poor. We intend to summarize the work done up to date on the effects of geological elements on human and ecosystems in and around Zimbabwe, their impacts and the need to further research and implementation of mitigation measures

ECONOMIC PERFORMANCE OF COMMUNITY GARDEN IN ZIMBABWE

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Zivenge E.

2013-09-01

Full Text Available Zimbabwe has experienced an unprecedented decline of nearly all human development indicators for the past ten years. Despite the introduction of community gardens in drought-prone areas of Zimbabwe, poverty persists amongst the vulnerable groups. The potential to improve household, community and national food and nutrition security through garden activities is high if issues of water availability cost and availability of inputs, marketing and farmer empowerment can be addressed. This paper seeks to assess the community garden's cost structure to sales volume and profitability and the land use efficiency. Primary data were collected through structured questionnaire. A two stage sampling techniques was used to select respondents. The study was conducted in Zaka district. Three major crops namely tomatoes, covo and onion were chosen for the study basing on size of land under that particular crop. Cost-Volume-Profit analysis employed for analysis of cost structure to sales volume and profitability. Land use efficiency was also employed to measure the ratio yield per acre of farm to average yield of locality. The results showed that although the farmers are able to break even the margin of safety is small especially for cove and onion. The study recommends farmers to increase the size of acreage under onion production whilst reduce acreage under production of covo. Farmers should adopt technology that would improve land use efficiency of onion. There is a need for the intervention by the Government and other stakeholders to improve the profitability and efficiency of the community gardeners. Stakeholders' collaboration especially, in terms of farmer training which can improve garden activities as participants lack knowhow.

Near real time water quality monitoring of Chivero and Manyame lakes of Zimbabwe

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R. Muchini

2018-05-01

Full Text Available Zimbabwe's water resources are under pressure from both point and non-point sources of pollution hence the need for regular and synoptic assessment. In-situ and laboratory based methods of water quality monitoring are point based and do not provide a synoptic coverage of the lakes. This paper presents novel methods for retrieving water quality parameters in Chivero and Manyame lakes, Zimbabwe, from remotely sensed imagery. Remotely sensed derived water quality parameters are further validated using in-situ data. It also presents an application for automated retrieval of those parameters developed in VB6, as well as a web portal for disseminating the water quality information to relevant stakeholders. The web portal is developed, using Geoserver, open layers and HTML. Results show the spatial variation of water quality and an automated remote sensing and GIS system with a web front end to disseminate water quality information.

Determinants of infant and child mortality in Zimbabwe: Results of multivariate hazard analysis

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Joshua Kembo

2009-10-01

Full Text Available This study addresses important issues in infant and child mortality in Zimbabwe. The objective of the paper is to determine the impact of maternal, socioeconomic and sanitation variables on infant and child mortality. Results show that births of order 6+ with a short preceding interval had the highest risk of infant mortality. The infant mortality risk associated with multiple births was 2.08 times higher relative to singleton births (p<0.001. Socioeconomic variables did not have a distinct impact on infant mortality. Determinants of child mortality were different in relative importance from those of infant mortality. This study supports health policy initiatives to stimulate use of family planning methods to increase birth spacing. These and other results are expected to assist policy makers and programme managers in the child health sector to formulate appropriate strategies to improve the situation of children under 5 in Zimbabwe.

The interrelationship between preoperative anemia and N-terminal pro-B-type natriuretic peptide: the effect on predicting postoperative cardiac outcome in vascular surgery patients.

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Goei, Dustin; Flu, Willem-Jan; Hoeks, Sanne E; Galal, Wael; Dunkelgrun, Martin; Boersma, Eric; Kuijper, Ruud; van Kuijk, Jan-Peter; Winkel, Tamara A; Schouten, Olaf; Bax, Jeroen J; Poldermans, Don

2009-11-01

N-terminal pro-B-type natriuretic peptide (NT-proBNP) predicts adverse cardiac outcome in patients undergoing vascular surgery. However, several conditions might influence this prognostic value, including anemia. In this study, we evaluated whether anemia confounds the prognostic value of NT-proBNP for predicting cardiac events in patients undergoing vascular surgery. A detailed cardiac history, resting echocardiography, and hemoglobin and NT-proBNP levels were obtained in 666 patients before vascular surgery. Anemia was defined as serum hemoglobin value of NT-proBNP for the prediction of the composite end point. Multivariable regression analysis was used to assess the additional value of NT-proBNP for the prediction of postoperative cardiac events in nonanemic and anemic patients. Anemia was present in 206 patients (31%) before surgery. Hemoglobin level was inversely related with the NT-proBNP levels (beta coefficient = -2.242; P = 0.025). The optimal predictive cutoff value of NT-proBNP for predicting the composite cardiovascular outcome was 350 pg/mL. After adjustment for clinical cardiac risk factors, both anemia (odds ratio [OR] 1.53; 95% confidence interval [CI]: 1.07-2.99) and increased levels of NT-proBNP (OR 4.09; 95% CI: 2.19-7.64) remained independent predictors for postoperative cardiac events. However, increased levels of NT-proBNP were not predictive for the risk of adverse cardiac events in the subgroup of anemic patients (OR 2.16; 95% CI: 0.90-5.21). Both anemia and NT-proBNP are independently associated with an increased risk for postoperative cardiac events in patients undergoing vascular surgery. NT-proBNP has less predictive value in anemic patients.

Potential clinical predictors of outcome after postoperative radiotherapy of non-small cell lung cancer

Energy Technology Data Exchange (ETDEWEB)

Buetof, R. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Department of Radiation Oncology, Dresden (Germany); Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, OncoRay National Center for Radiation Research in Oncology, Dresden (Germany); Kirchner, K.; Appold, S. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Department of Radiation Oncology, Dresden (Germany); Loeck, S. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, OncoRay National Center for Radiation Research in Oncology, Dresden (Germany); Rolle, A. [Lungenfachklinik Coswig, Department of Thoracic and Vascular Surgery, Coswig (Germany); Hoeffken, G. [Lungenfachklinik Coswig, Department of Pneumology, Coswig (Germany); Krause, M.; Baumann, M. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Department of Radiation Oncology, Dresden (Germany); Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, OncoRay National Center for Radiation Research in Oncology, Dresden (Germany); German Cancer Consortium (DKTK), Dresden (Germany); German Cancer Research Center (DKFZ), Heidelberg (Germany); Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany)

2014-03-15

The aim of this analysis was to investigate the impact of tumour-, treatment- and patient-related cofactors on local control and survival after postoperative adjuvant radiotherapy in patients with non-small cell lung cancer (NSCLC), with special focus on waiting and overall treatment times. For 100 NSCLC patients who had received postoperative radiotherapy, overall, relapse-free and metastases-free survival was retrospectively analysed using Kaplan-Meier methods. The impact of tumour-, treatment- and patient-related cofactors on treatment outcome was evaluated in uni- and multivariate Cox regression analysis. No statistically significant difference between the survival curves of the groups with a short versus a long time interval between surgery and radiotherapy could be shown in uni- or multivariate analysis. Multivariate analysis revealed a significant decrease in overall survival times for patients with prolonged overall radiotherapy treatment times exceeding 42 days (16 vs. 36 months) and for patients with radiation-induced pneumonitis (8 vs. 29 months). Radiation-induced pneumonitis and prolonged radiation treatment times significantly reduced overall survival after adjuvant radiotherapy in NSCLC patients. The negative impact of a longer radiotherapy treatment time could be shown for the first time in an adjuvant setting. The hypothesis of a negative impact of longer waiting times prior to commencement of adjuvant radiotherapy could not be confirmed. (orig.) [German] Das Ziel der vorliegenden Analyse war, den Einfluss von tumor-, patienten- und therapieabhaengigen Kofaktoren auf die lokoregionale Tumorkontrolle und das Ueberleben nach postoperativer adjuvanter Strahlentherapie bei Patienten mit einem nicht-kleinzelligen Bronchialkarzinom (NSCLC) zu untersuchen. Ein spezieller Fokus lag dabei auf der Wartezeit zwischen Operation und Beginn der Strahlentherapie sowie der Gesamtbehandlungszeit der Strahlentherapie. Fuer 100 Patienten, die eine postoperative

Barriers to Surgical Care and Health Outcomes: A Prospective Study on the Relation Between Wealth, Sex, and Postoperative Complications in the Republic of Congo.

Science.gov (United States)

Lin, Brian M; White, Michelle; Glover, Ana; Wamah, Greta Peterson; Trotti, Davi L; Randall, Kirstie; Alkire, Blake C; Cheney, Mack L; Parker, Gary; Shrime, Mark G

2017-01-01

Approximately thirty percent of the global burden of disease is comprised of surgical conditions. However, five billion people lack access to surgery, with complex factors acting as barriers. We examined whether patient demographics predict barriers to care, and the relation between these factors and postoperative complications in a prospective cohort. Participants included people presenting to a global charity in Republic of Congo with a surgical condition between August 2013 and May 2014. The outcomes were self-reported barrier to care and postoperative complications documented by medical record. Logistic regression was used to adjust for covariates. Of 1237 patients in our study, 1190 (96.2 %) experienced a barrier to care and 126 (10.2 %) experienced a postoperative complication. The most frequently reported barrier was cost (73 %), followed by lack of provider (8.2 %). Greater wealth was associated with decreased odds of cost as a barrier (OR 0.72 [0.57, 0.90]). Greater wealth (OR 1.52 [1.03, 2.25]) and rural home location (OR 3.35 [1.16, 9.62]) were associated with increased odds of no surgeon being available. Cost as a barrier (OR 2.82 [1.02, 7.77]), female sex (OR 3.45 [1.62, 7.33]), and lack of surgeon (OR 5.62 [1.68, 18.77]) were associated with increased odds of postoperative complication. Patient wealth was not associated with odds of postoperative complication. Barriers to surgery were common in Republic of Congo. Patient wealth and home location may predict barriers to surgery. Addressing gender disparities, access to providers, and patient perception of barriers in addition to removal of barriers may help maximize patient health benefits.

Barriers and Coping Mechanisms Relating to Agroforestry Adoption by Smallholder Farmers in Zimbabwe

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Chitakira, Munyaradzi; Torquebiau, Emmanuel

2010-01-01

Purpose: The purpose of the present study was to investigate agroforestry adoption by smallholder farmers in Gutu District, Zimbabwe. Design/Methodology/Approach: The methodology was based on field data collected through household questionnaires, key informant interviews and direct observations. Findings: Major findings reveal that traditional…

78 FR 41192 - Publication of General License Related to the Zimbabwe Sanctions Program

Science.gov (United States)

2013-07-09

... DEPARTMENT OF THE TREASURY Office of Foreign Assets Control Publication of General License Related to the Zimbabwe Sanctions Program AGENCY: Office of Foreign Assets Control, Treasury. ACTION: Notice, publication of general license. SUMMARY: The U.S. Department of the Treasury's Office of Foreign Assets...

A comparison between tourniquet application and epinephrine injection for hemostasis during hypospadias surgery: The effect on bleeding and postoperative outcome.

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Alizadeh, F; Fakoor, A; Haghdani, S

2016-06-01

To compare tourniquet application and epinephrine injection for hemostasis during hypospadias surgery in terms of bleeding and complications. Between April 2013 and September 2014, patients who were admitted for hypospadias repair were divided by random allocation into either a diluted epinephrine injection (DE) group or tourniquet application (T) group for hemostasis during the procedure. In the T group, a rubber band was applied at the base of the penis after skin dissection, and in the DE group, epinephrine 1/100,000 was injected along the incision lines. The patients' ages, urethral defect lengths, pre-operative, intraoperative and postoperative variables were compared between the two groups. A total of 70 patients (35 in each group) were enrolled into the study. The mean ages and preoperative variables were not significantly different. Average blood loss was 23.51 ± 15.36 cc in the tourniquet group and 15.99 ± 10.00 cc in the epinephrine group, and was significantly higher in tourniquet group (P = 0.022); however, the mean operative time was not significantly different. Postoperative complications, described as Clavian classification, were reported in eight patients (23%) in the T group and 10 patients (30%) in the DE group, which was not significantly different. Epinephrine injections minimize operative bleeding without significant harmful effects on postoperative outcomes; therefore, it could be considered to be a safe and effective method for preparation of a bloodless field during hypospadias surgery. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Indications and postoperative treatment for Ex-PRESS® insertion in Japanese patients with glaucoma: comparison with standard trabeculectomy

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Kato N

2015-08-01

Full Text Available Noriko Kato,1,2 Genichiro Takahashi,1,2 Koichi Kumegawa,1,2 Yoshiaki Kabata,1,2 Hiroshi Tsuneoka1 1Department of Ophthalmology, Jikei University, School of Medicine, 2Katsushika Medical Center, Tokyo, Japan Background: We investigated indications and early postoperative treatment for Ex-PRESS® insertion for glaucoma by comparing postoperative outcomes with those for standard trabeculectomy. Methods: Ex-PRESS insertion was performed in 21 eyes and standard trabeculectomy (TLE in 22 eyes. Mean intraocular pressure (IOP in the 6 months after surgery, success rate for postoperative IOP decline, postoperative complications, postoperative treatment, filtering blebs, and indications were then retrospectively investigated. Results: Mean postoperative IOP did not differ significantly between the groups at any observation time for 6 months after surgery. Further, it did not differ between either the groups of patients with primary open-angle glaucoma (POAG and neovascular glaucoma (NTG, or the patients with primary open-angle glaucoma and NTG in the Ex-PRESS group. Comparison of success rates in reduction of postoperative IOP between the groups under the following four survival conditions showed no significant differences: postoperative IOP <30% of the preoperative IOP, complete success (no additional ophthalmic solution, and qualified success (ophthalmic solution required; 5 mmHg ≤ postoperative IOP ≤21 mmHg, complete success (no additional ophthalmic solution, and qualified success (ophthalmic solution required. With regard to postoperative complications and postoperative treatment, the incidence of hyphema was significantly lower in the Ex-PRESS group, but no other significant intergroup differences were seen. The height of the filtering bleb was lower in the Ex-PRESS group. Conclusion: Postoperative outcomes in the Ex-PRESS and TLE groups were comparable. The incidence of hyphema was significantly lower in the Ex-PRESS group. Ex-PRESS insertion

Role of ketamine in acute postoperative pain management: a narrative review.

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Radvansky, Brian M; Shah, Khushbu; Parikh, Anant; Sifonios, Anthony N; Le, Vanny; Eloy, Jean D

2015-01-01

The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. A literature search was performed using the phrases "ketamine" and "postoperative pain." The authors analyzed the studies that involved testing ketamine's effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain scores, and persistent postoperative pain at long-term follow-up. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. More randomized controlled trials are necessary to determine the surgical procedures and administrations (i.e., intravenous, epidural) that ketamine is best suited for.

Cholera in Zimbabwe: Developing an Educational Response to a Health Crisis

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Mandikonza, Caleb; Musindo, Beatrice; Taylor, Jim

2011-01-01

In February 2009, the World Health Organization (WHO) reported that the cholera epidemic in Zimbabwe had claimed 3,300 lives and infected 66,000 people--greater than the toll of that disease in the whole of Africa in most years. How is it possible that a disease such as cholera can have such a devastating effect in modern times? How should one…

Postoperative Pain in Children After Dentistry Under General Anesthesia.

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Wong, Michelle; Copp, Peter E; Haas, Daniel A

2015-01-01

The objective of this study was to determine the prevalence, severity, and duration of postoperative pain in children undergoing general anesthesia for dentistry. This prospective cross-sectional study included 33 American Society of Anesthesiology (ASA) Class I and II children 4-6 years old requiring multiple dental procedures, including at least 1 extraction, and/or pulpectomy, and/or pulpotomy of the primary dentition. Exclusion criteria were children who were developmentally delayed, cognitively impaired, born prematurely, taking psychotropic medications, or recorded baseline pain or analgesic use. The primary outcome of pain was measured by parents using the validated Faces Pain Scale-Revised (FPS-R) and Parents' Postoperative Pain Measure (PPPM) during the first 72 hours at home. The results showed that moderate-to-severe postoperative pain, defined as FPS-R ≥ 6, was reported in 48.5% of children. The prevalence of moderate-to-severe pain was 29.0% by FPS-R and 40.0% by PPPM at 2 hours after discharge. Pain subsided over 3 days. Postoperative pain scores increased significantly from baseline (P children do experience moderate-to-severe pain postoperatively. Although parents successfully used pain scales, they infrequently administered analgesics.

Cervical cancer screening: Safety, acceptability, and feasibility of a single-visit approach in Bulawayo, Zimbabwe.

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Fallala, Muriel S; Mash, Robert

2015-05-05

Cervical cancer is the commonest cancer amongst African women, and yet preventative services are often inadequate. The purpose of the study was to assess the safety, acceptability and feasibility of visual inspection with acetic acid and cervicography (VIAC) followed by cryotherapy or a loop electrical excision procedure (LEEP) at a single visit for prevention of cancer of the cervix. The United Bulawayo Hospital, Zimbabwe. The study was descriptive, using retrospective data extracted from electronic medical records of women attending the VIAC clinic. Over 24 months 4641 women visited the clinic and were screened for cervical cancer using VIAC. Cryotherapy or LEEP was offered immediately to those that screened positive. Treated women were followed up at three months and one year. The rate of positive results on VIAC testing was 10.8%. Of those who were eligible, 17.0% received immediate cryotherapy, 44.1% received immediate LEEP, 1.9% delayed treatment, and 37.0% were referred to a gynaecologist. No major complications were recorded after cryotherapy or LEEP. Amongst those treated 99.5% expressed satisfaction with their experience. Only 3.2% of those treated at the clinic had a positive result on VIAC one year later. The service was shown to be feasible to sustain over time with the necessary consumables. There were no service-related treatment postponements and the clinic staff and facility were able to meet the demand for the service. A single-visit approach using VIAC, followed by cryotherapy or LEEP, proved to be safe, acceptable and feasible in an urban African setting in Bulawayo, Zimbabwe. Outcomes a year later suggested that treatment had been effective.

The role of the adult literacy organization of Zimbabwe (ALOZ) in the ...

African Journals Online (AJOL)

This study was carried out between October and December 1999. It looks at the nature of the literacy activities, successes and problems faced by the Adult Literacy Organization of Zimbabwe (ALOZ) in its efforts to spread literacy activities in the country. Data was collected by means of interviews and consultation of literature ...

Economic Analysis of Urban Fuelwood Demand - The case of Harare in Zimbabwe

NARCIS (Netherlands)

Chambwera, M.

2004-01-01

This study carries out an economic analysis of the demand for fuelwood in urban areas using Harare, the capital city of Zimbabwe, as a case study. The demand for fuelwood in urban areas is one of the causes of several environmental and health problems in Africa, where the up to 90% of energy

Post-operative morbidity of the obese patient undergoing posterior ...

African Journals Online (AJOL)

Outcome measures: Post-operative morbidity measures – infection, seroma, pulmonary embolism, urinary tract infection, neurological injury and dural tears. Methods: One hundred consecutive patients undergoing posterior lumbar spine surgery were enrolled in the study. Three fellowship trained attending orthopaedic ...

Data on introduced plants in Zimbabwe: Floristic changes and patterns of collection based on historical herbarium records

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Alfred Maroyi

2017-12-01

Full Text Available National herbaria with significant historical plant collections are critical to tracking floristic changes and patterns, which include the introduction and spread of non-native plant species. To explore the importance of herbarium specimen data in understanding floristic changes in Zimbabwe, the plant collections housed by the National Herbarium (SRGH in Harare, Zimbabwe were utilized with historical specimens dating back to 1870. A list of naturalised plant taxa and collection data were compiled. A total of 2916 plant specimens were recorded, comprising of 401 taxa, 237 genera and 76 plant families. Twenty eight specimens (1.0% were collected between 1870 and 1908, prior to the establishment of the National Herbarium in 1909 and 123 specimens (4.2% were collected in the first 25 years of the establishment of the institute (1909–1934. Intensive collection of herbarium specimens of casual, naturalised and invasive alien plant species occurred between 1950 and 1970. This data demonstrates the utility of plant species data housed in the National Herbaria and how such data can be used to map floristic changes and patterns. Keywords: Casual, Floristic changes, Invasive, Naturalised, National herbarium, Zimbabwe

IMPACT OF AGRICULTURAL DEVELOPMENT ON YOUTH EMPLOYMENT IN ZIMBABWE: THE CASE OF MASVINGO PROVINCE

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Clainos Chidoko

2012-11-01

Full Text Available Zimbabwe is basically endowed in agricultural resources. As a result agricultural activities have a large bearing on developmental issues in the country. Employment is one such economic issue that hinges much on agricultural development. Over the past decade employment levels have reduced as a result of low investment in the country. Masvingo Province has not been spared. This scenario has seen many youths being out of employment as the sector employed less labour. The study found out that economic woes that Zimbabwe experienced over the past half decade have contributed significantly to youth unemployment in agriculture in Masvingo Province as a result of low investment in the sector. The study recommends that heavy investment be put in agriculture and agriculture related projects to enhance employment levels of the Zimbabwean youths in Masvingo province.

Minimally traumatic stapes surgery for otosclerosis: Risk reduction of post-operative vertigo

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An-Suey Shiao

2018-06-01

Full Text Available Background: The author (Dr. Shiao modified traditional stapes surgery (TSS specifically for patients with otosclerosis. The proposed technique, referred to as minimally traumatic stapes surgery (MTSS, reduces the risk of subjective discomfort (i.e. vertigo and tinnitus following surgery. This paper compares the effectiveness of MTSS with that of TSS. Methods: The medical records of patients with otosclerosis after stapes surgery (TSS or MTSS were analyzed. Outcome variables included post-operative vertigo, tinnitus, and hearing success. Multivariate logistic regression analysis was used to determine the correlation between surgical technique and outcome variables. Results: TSS was performed in 23 otosclerosis ears and MTSS was performed in 33 otosclerosis ears. The risk of post-operative vertigo was significantly lower among patients that underwent MTSS (27% than among those that underwent TSS (83%, p < 0.001. No differences in the incidence of tinnitus were observed between the two groups. Post-operative audiometric outcomes were also equivalent between the two groups. However, multivariate logistic regression analysis revealed a correlation between post-operative vertigo and surgical technique (p < 0.001. Conclusion: MTSS involves a lower risk of vertigo than does TSS. MTSS helps to prevent damage to the footplate, thereby reducing the risk of footplate floating. Therefore, MTSS provides a means to overcome some of the limitations associated with the narrow surgical field in Asian patients. Keywords: Footplate floating, Minimally traumatic, Otosclerosis, Stapes surgery, Vertigo

Effect of anaesthesia type on postoperative mortality and morbidities: a matched analysis of the NSQIP database.

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Saied, N N; Helwani, M A; Weavind, L M; Shi, Y; Shotwell, M S; Pandharipande, P P

2017-01-01

The anaesthetic technique may influence clinical outcomes, but inherent confounding and small effect sizes makes this challenging to study. We hypothesized that regional anaesthesia (RA) is associated with higher survival and fewer postoperative organ dysfunctions when compared with general anaesthesia (GA). We matched surgical procedures and type of anaesthesia using the US National Surgical Quality Improvement database, in which 264,421 received GA and 64,119 received RA. Procedures were matched according to Current Procedural Terminology (CPT) and ASA physical status classification. Our primary outcome was 30-day postoperative mortality and secondary outcomes were hospital length of stay, and postoperative organ system dysfunction. After matching, multiple regression analysis was used to examine associations between anaesthetic type and outcomes, adjusting for covariates. After matching and adjusting for covariates, type of anaesthesia did not significantly impact 30-day mortality. RA was significantly associated with increased likelihood of early discharge (HR 1.09; Ppatient characteristic confounders, RA was associated with significantly lower odds of several postoperative complications, decreased hospital length of stay, but not mortality when compared with GA. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Option A improved HIV-free infant survival and mother to child HIV transmission at 9-18 months in Zimbabwe.

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Buzdugan, Raluca; Kang Dufour, Mi-Suk; McCoy, Sandra I; Watadzaushe, Constancia; Dirawo, Jeffrey; Mushavi, Angela; Mujuru, Hilda Angela; Mahomva, Agnes; Kangwende, Rugare Abigail; Hakobyan, Anna; Mugurungi, Owen; Cowan, Frances M; Padian, Nancy S

2016-06-19

We evaluated the impact of Option A on HIV-free infant survival and mother-to-child transmission (MTCT) in Zimbabwe. Serial cross-sectional community-based serosurveys. We analyzed serosurvey data collected in 2012 and 2014 among mother-infant pairs from catchment areas of 132 health facilities from five of 10 provinces in Zimbabwe. Eligible infants (alive or deceased) were born 9-18 months before each survey to mothers at least 16 years old. We randomly selected mother-infant pairs and conducted questionnaires, verbal autopsies, and collected blood samples. We estimated the HIV-free infant survival and MTCT rate within each catchment area and compared the 2012 and 2014 estimates using a paired t test and number of HIV infections averted because of the intervention. We analyzed 7249 mother-infant pairs with viable maternal specimens collected in 2012 and 8551 in 2014. The mean difference in the catchment area level MTCT between 2014 and 2012 was -5.2 percentage points (95% confidence interval = -8.1, -2.3, P Option A regimen. The association between HIV-free infant survival and duration of Option A implementation was NS at the multivariate level (P = 0.093). We found a substantial and statistically significant increase in HIV-free survival and decrease in MTCT among infants aged 9-18 months following Option A rollout in Zimbabwe. This is the only evaluation of Option A and shows the effectiveness of Option A and Zimbabwe's remarkable progress toward eMTCT.

Surgical efficiencies and quality in the performance of voluntary medical male circumcision (VMMC procedures in Kenya, South Africa, Tanzania, and Zimbabwe.

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Dino Rech

Full Text Available This analysis explores the association between elements of surgical efficiency in voluntary medical male circumcision (VMMC, quality of surgical technique, and the amount of time required to conduct VMMC procedures in actual field settings. Efficiency outcomes are defined in terms of the primary provider's time with the client (PPTC and total elapsed operating time (TEOT.Two serial cross-sectional surveys of VMMC sites were conducted in Kenya, Republic of South Africa, Tanzania and Zimbabwe in 2011 and 2012. Trained clinicians observed quality of surgical technique and timed 9 steps in the VMMC procedure. Four elements of efficiency (task-shifting, task-sharing [of suturing], rotation among multiple surgical beds, and use of electrocautery and quality of surgical technique were assessed as explanatory variables. Mann Whitney and Kruskal Wallis tests were used in the bivariate analysis and linear regression models for the multivariate analyses to test the relationship between these five explanatory variables and two outcomes: PPTC and TEOT. The VMMC procedure TEOT and PPTC averaged 23-25 minutes and 6-15 minutes, respectively, across the four countries and two years. The data showed time savings from task-sharing in suturing and use of electrocautery in South Africa and Zimbabwe (where task-shifting is not authorized. After adjusting for confounders, results demonstrated that having a secondary provider complete suturing and use of electrocautery reduced PPTC. Factors related to TEOT varied by country and year, but task-sharing of suturing and/or electrocautery were significant in two countries. Quality of surgical technique was not significantly related to PPTC or TEOT, except for South Africa in 2012 where higher quality was associated with lower TEOT.SYMMACS data confirm the efficiency benefits of task-sharing of suturing and use of electrocautery for decreasing TEOT. Reduced TEOT and PPTC in high volume setting did not result in decreased

Challenges faced by franchise entrepreneurs operating in a volatile business environment: a case of the fast food industry in Harare, Zimbabwe

OpenAIRE

Knowledge Shumba; Stanislous Zindiye; Gift Donga

2017-01-01

Franchising plays a pivotal role in sustainable economic development through employment creation, improving the standards of living and increasing the growth of entrepreneurship worldwide. However, the volatile business environment in Zimbabwe has a negative impact on the growth of franchising in the fast food industry. The aim of the study was to uncover the challenges of franchising in a volatile business environment in Zimbabwe. The study focused on an under studied area of franchising in ...

Postoperative morbidity after fast-track laparoscopic resection of rectal cancer

DEFF Research Database (Denmark)

Stottmeier, S; Harling, H; Wille-Jørgensen, Peer Anders

2012-01-01

Aim: Analysis was carried out of the nature and chronological order of early complications after fast-track laparoscopic rectal surgery with a view to optimize the short-time outcome of rectal cancer surgery. Method: 102 consecutive patients who underwent elective fast-track laparoscopic rectal......: Postoperative morbidity remains a significant problem even in the fast-track era, even in experienced surgical hands. Our results suggest that besides improvement of surgical technique further improvement of outcome lies in early recognition and proper treatment of complications and the perioperative...... cancer surgery were analysed prospectively from the Danish Colorectal Cancer Database supplemented by data from the medical records. We studied in detail the nature and chronological order of postoperative morbidity and reason for prolonged stay (>5 days). Results: Twenty-five patients (25 per cent) had...

The Extent of Teacher Participation in Decision-Making in Secondary Schools in Zimbabwe

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Wadesango, Newman

2010-01-01

In Zimbabwe, there have been some debates on democratisation and decentralisation, which led to the development of policies meant to increase teacher participation in decision-making in schools. However, despite these developments, teacher participation in decision-making in Zimbabwean schools is regarded as insignificant. Teachers work closely…

Transversus abdominis plane block using a short-acting local anesthetic for postoperative pain after laparoscopic colorectal surgery: a systematic review and meta-analysis.

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Oh, Tak Kyu; Lee, Se-Jun; Do, Sang-Hwan; Song, In-Ae

2018-02-01

Transversus abdominis plane (TAP) block using a short-acting local anesthetic as part of multimodal analgesia is efficient in various abdominal surgeries, including laparoscopic surgery. However, information regarding its use in laparoscopic colorectal surgery is still limited and sometimes controversial. Therefore, we conducted a systematic review and meta-analysis to determine whether TAP block using a short-acting anesthetic has a positive postoperative analgesic outcome in patients who have undergone laparoscopic colorectal surgery. We searched for studies comparing the postoperative pain outcome after laparoscopic colorectal surgery between patients who received TAP block and a control group (placebo or no treatment). Outcome measures were early pain at rest (numeric rating scale [NRS] score at 0-2 h postoperatively), late pain at movement (NRS score at 24 h postoperatively), late pain at rest (NRS score at 24 h postoperatively), and postoperative opioid consumption (up to 24 h postoperatively). We used a random-effects model for the meta-analysis and Egger's regression test to detect publication bias. We included six studies involving 452 patients (224 in the TAP block group, 228 in the control group). Early and late pain scores at movement were significantly different between the TAP block and control groups (standardized mean difference: - 0.695, P consumption (P = 0.257). The TAP block using a short-acting anesthetic had a significant effect on the postoperative pain outcome in the early (0-2 h) and late (24 h) period at movement. However, it did not have a significant effect on the postoperative pain outcome in the early (0-2 h) and late (24 h) periods at rest after laparoscopic surgery.

The Rise of Mobile Technology on the Financial Sector in Zimbabwe

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Paul Mupfiga

2017-07-01

Full Text Available The emergence of technology has revolted the way that the financial industry operates and the increasing use of mobile gadgets has changed the banking system from the traditional brick and mortar building to a virtual system. The sudden rise in use and innovation of smart mobile phones, mobile personal computers, tablets and various other mobile electronic gadgets has resulted in the rise of mobile financial products. Rapid quickening innovative headways are making completely new business suggestions, for example, crowd financing, shared loaning, advanced monetary forms, versatile managing an account, online speculation and new instalment frameworks. Zimbabwe's mobile technology use is currently on the rise too as mobile service providers like Econet are enabling the connection between consumers and financial related products. Despite the fact that innovation without a doubt brings benefits, prominent specialized disappointments in the money related part lately are disturbing and several negative factors are to some extent affecting production. Drawbacks like cybercrime, resistance to change, and compatibility of mobile gadgets are affecting the information technology environment. This paper highlights the rise of mobile technology in the financial sector in Zimbabwe.

Investigating the Impact of Dollarization on Economic Growth: A Case of Zimbabwe

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Ruby NGAMANYA MUNHUPEDZI

2017-03-01

Full Text Available This study examined the effects of dollarization on business in Zimbabwe focusing on economic indicators such as inflation rate, GDP, employment and ease of doing business during the period 2009-2015. Zimbabwe experienced a very difficult economic phase characterised by hyperinflation, negative economic growth, unavailability of basic commodities and negative economic growth rates during the period 1998-2008. In 2009 the country adopted a multi-currency system whereby the Zimbabwean dollar was in circulation alongside various other currencies, with the United States Dollar and the South African Rand being the dominant ones. There has been general speculation that Zimbabwe’s economic problems are due to dollarization. Through analysing data from interviews and secondary sources, the research established that dollarization brought about stability in the economy, arrested inflation, and caused a marginal increase in GDP. However, the response of the employment rate was independent of the dollarization and may be attributed to other factors such as Economic Structural Adjustment Programme (ESAP in 1992, the global economic crisis in 2008 and the absence of reliable data.

Importation of canid rabies in a horse relocated from Zimbabwe to South Africa : research communication

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C.T. Sabeta

2005-09-01

Full Text Available In July 2003 a 2-year-old Thoroughbred colt was imported from Harare, Zimbabwe to the Ashburton Training Centre, Pietermaritzburg, South Africa. Five months after importation, the colt presented with clinical signs suggestive of rabies: it was uncoordinated, showed muscle tremors and was biting at itself. Brain tissue was submitted for analysis and the clinical diagnosis was confirmed by the fluorescent antibody test and reverse-transcription polymerase chain reaction (RT-PCR. Phylogenetic analysis of the nucleotide sequence of the cytoplasmic domain of the glycoprotein and the G-L intergenic region of the rabies virus confirmed it to be an infection with a canid rabies virus, originating from an area in Zimbabwe endemic for the domestic dog (Canis familiaris and side-striped jackal (Canis adustus rabies.

Strengthening Locus Standi in Human Rights Litigation in Zimbabwe: An analysis of the Provisions in the New Zimbabwean Constitution

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Lovemore Chiduza

2016-05-01

Full Text Available Zimbabweans have been both victims of and witnesses to serious human rights violations over the years. Though there is wide agreement and speculation that the state and its agencies are the perpetrators of these atrocities, they have largely remained unprosecuted and unpunished. Such impunity is inter alia the result of ineffective law enforcement mechanisms and institutions as well as the lack of capacity and legal knowledge of victims to approach the courts and seek redress. These factors negatively affected the protection of human rights and access to justice in Zimbabwe. Although the Lancaster House Constitution contained a Declaration of Rights, its enforcement mechanisms, particularly those relating to locus standi (legal standing, posed a great challenge to human rights litigation in Zimbabwe. This is so because the Lancaster House Constitution adopted the traditional common law approach to standing. Under this approach it was required that an individual must have a "personal, direct or substantial interest" in a matter in order to have standing. The Lancaster House Constitution failed to recognise the importance of broader rules of standing, which would accommodate public interest litigation, specifically for protecting human rights. Contrary to this, the new Constitution of Zimbabwe (2013 broadens the rules of standing in order to enhance access to the courts. This paper analyses the new approach to standing under the new constitutional dispensation in Zimbabwe. To this end, the discussion commences with an elucidation of the concept of locus standi and its link to access to justice. This is followed by an analysis of locus standi under the Lancaster House Constitution. Since the new approach in Zimbabwe is greatly informed by the South African approach to locus standi, a brief analysis of standing in South Africa is made. The paper concludes with a discussion of the approach to locus standi under the new constitution with a view to

Population-level impact of Zimbabwe's National Behavioural Change Programme.

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Buzdugan, Raluca; Benedikt, Clemens; Langhaug, Lisa; Copas, Andrew; Mundida, Oscar; Mugurungi, Owen; Watadzaushe, Constancia; Dirawo, Jeffrey; Tambashe, Basile O; Chidiya, Samson; Woelk, Godfrey; Cowan, Frances M

2014-12-15

To assess the impact of Zimbabwe's National Behavioural Change Programme (NBCP) on biological and behavioral outcomes. Representative household biobehavioral surveys of 18- to 44-year-olds were conducted in randomly selected enumeration areas in 2007 and 2011 to 2012. We examined program impact on HIV prevalence among young women, nonregular partnerships, condom use with nonregular partners, and HIV testing, distinguishing between highly exposed and low-exposed communities and individuals. We conducted (1) difference-in-differences analyses with communities as unit of analysis and (2) analyses of key outcomes by individual-level program exposure. Four thousand seven hundred seventy-six people were recruited in 2007 and 10,059 in 2011 to 2012. We found high exposure to NBCP in 2011. Prevalence of HIV and reported risky behaviors declined between 2007 and 2011. Community-level analyses showed a smaller decline in HIV prevalence among young women in highly exposed areas (11.0%-10.1%) than low-exposed areas (16.9%-10.3%, P = 0.078). Among young men, uptake of nonregular partners declined more in highly exposed areas (25%-16.8%) than low-exposed areas (21.9%-20.7%, P = 0.055) and HIV testing increased (27.2%-46.1% vs. 31.0%-34.4%, P = 0.004). Individual-level analyses showed higher reported condom use with nonregular partners among highly exposed young women (53% vs. 21% of unexposed counterparts, P = 0.037). We conducted the first impact evaluation of a NBCP and found positive effects of program exposure on key behaviors among certain gender and age groups. HIV prevalence among young women declined but could not be attributed to program exposure. These findings suggest substantial program effects regarding demand creation and justify program expansion.

Operative Start Time Does Not Affect Post-Operative Infection Risk.

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Guidry, Christopher A; Davies, Stephen W; Willis, Rhett N; Dietch, Zachary C; Shah, Puja M; Sawyer, Robert G

2016-10-01

Surgical care is delivered 24 h a day at most institutions. Alarmingly, some authors have found that certain operative start times are associated with greater morbidity and mortality rates. This effect has been noted in both the public and private sector. Although some of these differences may be related to process, they may also be caused by the human circadian rhythm and corresponding changes in host defenses. We hypothesized that the time of day of an operation would impact the frequency of certain post-operative outcomes significantly. Cases at a single tertiary-care center reported to the American College of Surgeons National Surgical Quality Improvement Program over a 10-year period were identified. Operative start times were divided into six-hour blocks, with 6 am to noon serving as the reference. Standard univariable techniques were applied. Multivariable logistic regression with mixed effects modeling then was used to determine the relation between operative start times and infectious outcomes, controlling for surgeon clustering. Statistical significance was set at p operative infectious complication. Seventy percent of these infections (n = 1,506) were surgical site infections. On univariable analysis considering all cases, nighttime and evening operations had higher rates of post-operative infections than those in performed during the day (9.1% from 6 am to noon; 9.7% from noon to 6 pm; 14.8% from 6 pm to midnight; and 14.4% from midnight to 6 am; p operative start time was not associated with the risk of post-operative infection, even when emergency cases were considered independently. Our data suggest that operative start times have no correlation with post-operative infectious complications. Further work is required to identify the source of the time-dependent outcome variability observed in previous studies.

Artistic activities and cultural activism as responses to HIV/AIDS in Harare, Zimbabwe.

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Pietrzyk, Susan

2009-12-01

Over the last two decades both the number and types of civil-society-led organisations involved in addressing HIV and AIDS have increased dramatically. In many cases, the work undertaken is thoughtfully researched, appropriately focused, and as a result produces positive outcomes. Yet questions can be raised about what civil society engagements involve, particularly at a micro level. An important element concerns the role of the arts in efforts to understand and address HIV and AIDS. This article examines ways that insight, analysis, and action around HIV and AIDS have unfolded through the purview of artistic activities undertaken by cultural activists in Harare, Zimbabwe-that is, arts-oriented engagements occurring beyond the boundaries of formally structured organisations. Artistic expressions, which often concern lived experiences, make clear the complex circumstances surrounding HIV and AIDS, and at the same time seek to act upon those circumstances. Understanding and addressing HIV and AIDS requires more than one form of knowledge. Drawing on data from 21 months of ethnographic research in Harare, I examine artistic expressions as legitimate forms of knowledge and as strategies for intervention.

Decentralized domestic wastewater systems in developing countries: the case study of Harare (Zimbabwe)

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Chirisa, Innocent; Bandauko, Elmond; Matamanda, Abraham; Mandisvika, Gladys

2017-06-01

Until recently there has been little, if any, concern over revamping let alone improving wastewater management system in Zimbabwe's urban areas given the dominance and institutionalised water-borne system. Yet, the current constraints in this system and the immensity of urbanisation in the country begs and compels planners, engineers and systems thinkers to rethink what best can work as a sustainable wastewater system. With particular reference to the ever-expanding Harare metropolitan region, this article provides an evaluative analysis on the potentiality, risks and strategies that can be adopted by Harare and its satellites in addressing the problems of the conventional wastewater management system. The suggested framework of operation is a decentralised domestic wastewater collection and treatment system which however has its own multifarious risks. Using systems dynamics conceptualisation of the potentiality, opportunities, risks and strategies, the paper seeks to model the path and outcomes of this decentralised domestic wastewater collection and treatment system and also suggests a number of policy measures and strategies that the city of Harare and its satellites can adopt.

Predictive Power of the NSQIP Risk Calculator for Early Post-Operative Outcomes After Whipple: Experience from a Regional Center in Northern Ontario.

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Jiang, Henry Y; Kohtakangas, Erica L; Asai, Kengo; Shum, Jeffrey B

2017-05-02

NSQIP Risk Calculator was developed to allow surgeons to inform their patients about their individual risks for surgery. Its ability to predict complication rates and length of stay (LOS) has made it an appealing tool for both patients and surgeons. However, the NSQIP Risk Calculator has been criticized for its generality and lack of detail towards surgical subspecialties, including the hepatopancreaticobiliary (HPB) surgery. We wish to determine whether the NSQIP Risk Calculator is predictive of post-operative complications and LOS with respect to Whipple's resections for our patient population. As well, we wish to identify strategies to optimize early surgical outcomes in patients with pancreatic cancer. We conducted a retrospective review of patients who underwent elective Whipple's procedure for benign or malignant pancreatic head lesions at Health Sciences North (Sudbury, Ontario), a tertiary care center, from February 2014 to August 2016. Comparisons of LOS and post-operative complications between NSQIP-predicted and actual ones were carried out. NSQIP-predicted complications rates were obtained using the NSQIP Risk Calculator through pre-defined preoperative risk factors. Clinical outcomes examined, at 30 days post-operation, included pneumonia, cardiac events, surgical site infection (SSI), urinary tract infection (UTI), venous thromboembolism (VTE), renal failure, readmission, and reoperation for procedural complications. As well, mortality, disposition to nursing or rehabilitation facilities, and LOS were assessed. A total of 40 patients underwent Whipple's procedure at our center from February 2014 to August 2016. The average age was 68 (50-85), and there were 22 males and 18 females. The majority of patients had independent baseline functional status (39/40) with minimal pre-operative comorbidities. The overall post-operative morbidity was 47.5% (19/40). The rate of serious complication was 17.5% with four Clavien grade II, two grade III, and one grade

Precursor conditions related to Zimbabwe's summer droughts

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Nangombe, Shingirai; Madyiwa, Simon; Wang, Jianhong

2018-01-01

Despite the increasing severity of droughts and their effects on Zimbabwe's agriculture, there are few tools available for predicting these droughts in advance. Consequently, communities and farmers are more exposed, and policy makers are always ill prepared for such. This study sought to investigate possible cycles and precursor meteorological conditions prior to drought seasons that could be used to predict impending droughts in Zimbabwe. The Single Z-Index was used to identify and grade drought years between 1951 and 2010 according to rainfall severity. Spectral analysis was used to reveal the cycles of droughts for possible use of these cycles for drought prediction. Composite analysis was used to investigate circulation and temperature anomalies associated with severe and extreme drought years. Results indicate that severe droughts are more highly correlated with circulation patterns and embedded weather systems in the Indian Ocean and equatorial Pacific Ocean than any other area. This study identified sea surface temperatures in the average period June to August, geopotential height and wind vector in July to September period, and air temperature in September to November period as precursors that can be used to predict a drought occurrence several months in advance. Therefore, in addition to sea surface temperature, which was identified through previous research for predicting Zimbabwean droughts, the other parameters identified in this study can aid in drought prediction. Drought cycles were established at 20-, 12.5-, 3.2-, and 2.7-year cycles. The spectral peaks, 12.5, 3.2, and 2.7, had a similar timescale with the luni-solar tide, El Niño Southern Oscillation and Quasi Biennial Oscillation, respectively, and hence, occurrence of these phenomena have a possibility of indicating when the next drought might be.

Risky behaviour and HIV/AIDS-related stigma in Zimbabwe

OpenAIRE

Soares, Marisa Amarante

2010-01-01

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and Economics HIV/AIDS-related stigma and discrimination have been getting more and more attention by researchers and policy-makers. Since stigma has direct impact on the way-of-living of PLHA1 and their decision-making process, it can be an important key in the spread of HIV. Zimbabwe is one of the countries with the highest HIV prevalence rates ...

An ethnography of knowledge : the production of knowledge in Mupfurudzi resettlement scheme, Zimbabwe

NARCIS (Netherlands)

Mudege, N.N.

2007-01-01

This study is an extension of an earlier interdisciplinary study on the impact of the adoption of high-yielding varieties of maize on poverty reduction in Mupfurudzi resettlement area in Shamva, Zimbabwe, carried out in 2001. The present study focuses on how farmers in resettlement areas produce and

Living with wildlife and associated conflicts in northern Gonarezhou National Park, southeast Zimbabwe

NARCIS (Netherlands)

Gandiwa, E.; Gandiwa, P.; Muboko, N.

2012-01-01

Human-wildlife conflicts (HWC) are a common phenomenon world-wide, particularly in areas where humans and wild animal’s requirements overlap. In this study we focused on the nature of HWC in an area occurring within the northern Gonarezhou National Park (GNP), Zimbabwe. We collected data using focus

New imaging characteristics for predicting postoperative neurologic status in patients with metastatic epidural spinal cord compression. A retrospective analysis of 81 cases.

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Lei, Mingxing; Liu, Shubin; Yang, Shaoxing; Liu, Yaosheng; Wang, Cheng; Gao, Hongjun

2017-06-01

Several clinical features have been proposed for the prediction of postoperative functional outcome in patients with metastatic epidural spinal cord compression (MESCC). However, few articles address the relationship between preoperative imaging characteristics and the postoperative neurologic status. This study aims to analyze the postoperative functional outcome and to identify new imaging parameters for predicting postoperative neurologic status in patients with MESCC. This study is a retrospective consecutive case series of patients with MESCC who were treated surgically. We assessed 81 consecutive patients who were treated with decompressive surgery for MESCC between 2013 and 2015. Eight imaging characteristics were analyzed for postoperative motor status by logistic regression models. Neurologic function was assessed using the Frankel grade preoperatively and postoperatively. The following imaging characteristics were assessed for postoperative motor status: location of lesions in the spine, lamina involvement, retropulsion of the posterior wall, number of vertebrae involved, pedicle involvement, fracture of any involved vertebrae, T2 signal of the spinal cord at the compression site, and circumferential angle of spinal cord compression (CASCC). The postoperative neurologic outcome was better than the preoperative neurologic status (p<.01). In the entire group, 40.7% of the patients were non-ambulatory before the surgical procedure, whereas 77.8% of the patients could walk after surgery (p=.01). In the multivariate analysis, the location of the lesions (odds ratio [OR]: 3.89, 95% confidence interval [CI]: 1.19-12.77, p=.02) and CASCC (OR: 2.31, 95% CI: 1.44-3.71, p<.01) were significantly associated with postoperative neurologic outcome. A CASCC of more than 180° was associated with an increased OR that approached significance, and the larger the CASCC, the higher the risk of poor postoperative neurologic status. The postoperative neurologic status was

Postoperative spinal column; Postoperative Wirbelsaeule

Energy Technology Data Exchange (ETDEWEB)

Kaefer, W. [Westpfalzklinikum GmbH, Standort II, Abteilung fuer Wirbelsaeulenchirurgie, Kusel (Germany); Heumueller, I. [Westpfalzklinikum GmbH, Standort II, Institut fuer Radiologie II, Kusel (Germany); Harsch, N.; Kraus, C.; Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

2016-08-15

As a rule, postoperative imaging is carried out after spinal interventions to document the exact position of the implant material. Imaging is absolutely necessary when new clinical symptoms occur postoperatively. In this case a rebleeding or an incorrect implant position abutting a root or the spinal cord must be proven. In addition to these immediately occurring postoperative clinical symptoms, there are a number of complications that can occur several days, weeks or even months later. These include the failed back surgery syndrome, implant loosening or breakage of the material and relapse of a disc herniation and spondylodiscitis. In addition to knowledge of the original clinical symptoms, it is also important to know the operation details, such as the access route and the material used. In almost all postoperative cases, imaging with contrast medium administration and corresponding correction of artefacts by the implant material, such as the dual energy technique, correction algorithms and the use of special magnetic resonance (MR) sequences are necessary. In order to correctly assess the postoperative imaging, knowledge of the surgical procedure and the previous clinical symptoms are mandatory besides special computed tomography (CT) techniques and MR sequences. (orig.) [German] In der Regel erfolgt bei spinalen Eingriffen eine postoperative Bildgebung, um die exakte Lage des Implantatmaterials zu dokumentieren. Unbedingt notwendig ist die Bildgebung, wenn postoperativ neue klinische Symptome aufgetreten sind. Hier muessen eine Nachblutung bzw. inkorrekte, eine Wurzel oder das Myelon tangierende Implantatlage nachgewiesen werden. Neben diesen direkt postoperativ auftretenden klinischen Symptomen gibt es eine Reihe von Komplikationen, die erst nach mehreren Tagen, Wochen oder sogar nach Monaten auftreten koennen. Hierzu zaehlen das Failed-back-surgery-Syndrom, die Implantatlockerung oder -bruch, aber auch ein Rezidivvorfall und die Spondylodiszitis. Neben der

Biodiversity conservation versus artisanal gold mining: a case study of Chimanimani National Park, Zimbabwe

NARCIS (Netherlands)

Gandiwa, E.; Gandiwa, P.

2012-01-01

Artisanal gold mining plays an important role in sustainable development of rural communities. The objectives of this study were to: i) assess the environmental impacts of recent artisanal gold mining activities in Chimanimani National Park (CNP), eastern Zimbabwe, and ii) discuss the associated

Pre- and postoperative photographs and surgical outcomes in patients with Lenke type 1 adolescent idiopathic scoliosis.

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Albayrak, Akif; Buyuk, Abdul Fettah; Ucpunar, Hanifi; Balioglu, Mehmet Bulent; Kargin, Deniz; Kaygusuz, Mehmet Akif

2015-04-01

Clinical study with pre- and postoperative back photographs and postoperative Scoliosis Research Society-22 survey in patients who had undergone surgery for idiopathic scoliosis. To determine the effect of showing patients their photographs before and after surgery for idiopathic scoliosis on postoperative patient satisfaction. After scoliosis surgery, patient satisfaction may be limited because the patients cannot directly see their back and may forget the preoperative appearance. In 60 patients who had undergone surgery for correction of idiopathic scoliosis (Lenke type 1), pre- and postoperative photographs were taken from the anterior, posterior, and right and left lateral views. After surgery, patients in group 1 (30 patients) were shown the preoperative and most recent follow-up photographs, and patients in group 2 (30 patients) had routine evaluation but were not shown their photographs. All patients completed the Scoliosis Research Society-22 survey. Patients in both groups had similar age, sex, distribution of Lenke type and Risser sign, follow-up, and pre- and postoperative Cobb angles and balance (coronal and sagittal). A significant difference was observed between the groups for survey question 10 (which was about self-image), question 18 (which was about function and activity), and question 21 (which was about satisfaction) (P ≤ 0.05). There were no differences between patients in groups 1 and 2 in Scoliosis Research Society-22 domain or total scores. By showing patients the pre- and postoperative clinical photographs, patient satisfaction may be greater, as measured with some SRS-22 scores. This method may enable clinicians to positively change the patients' self-image perception after surgery for correction of scoliosis. 4.

Opioid exit plan: A pharmacist's role in managing acute postoperative pain.

Science.gov (United States)

Genord, Cheryl; Frost, Timothy; Eid, Deeb

The benefits of a pharmacist's involvement in medication reconciliation and discharge counseling are well documented in the literature as improving patient outcomes. In contrast, no studies have focused on the initiation of a pharmacist-led opioid exit plan (OEP) for acute postoperative pain management. This paper summarizes a pharmacist-led OEP practice model and the potential role that pharmacists and student pharmacists can have at the point of admission, during postoperative recovery, and on discharge in acute pain management patients. The pain management team at St. Joseph Mercy Hospital in Ann Arbor, MI, has developed and implemented a pharmacist-led OEP to better manage acute postoperative pain in neurosurgery and orthopedic and colorectal surgery in an effort to ensure appropriate patient and provider education and understanding of pain management. OEP is a tool with the potential to expand the role of pharmacists in managing acute pain in postoperative patients at the point of admission, during the postoperative inpatient stay, and on discharge. Its benefits include medication reconciliation review and prescription drug-monitoring program search before admission, interdisciplinary rounds with the medical team to provide optimal inpatient postoperative pain management, clinical assessment of outpatient prescriptions with opioid discharge counseling, and medication evaluation of prescribed pain regimen and opioid discontinuation status at the post-discharge follow-up appointment. A hospital pain management team operating a pharmacist-led OEP can be key to guiding the appropriate prescribing practice of opioids and assisting with transitions of care on discharge. Further outcomes-based evaluations of the practice model are planned and encouraged to validate and improve the pharmacist-led OEP practice. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Effect of postoperative brachytherapy and external beam radiotherapy on functional outcomes of immediate facial nerve repair after radical parotidectomy.

Science.gov (United States)

Hontanilla, Bernardo; Qiu, Shan-Shan; Marré, Diego

2014-01-01

There is much controversy regarding the effect of radiotherapy on facial nerve regeneration. However, the effect of brachytherapy has not been studied. Fifty-three patients underwent total parotidectomy of which 13 were radical with immediate facial nerve repair with sural nerve grafts. Six patients (group 1) did not receive adjuvant treatment whereas 7 patients (group 2) received postoperative brachytherapy plus radiotherapy. Functional outcomes were compared using Facial Clima. Mean percentage of blink recovery was 92.6 ± 4.2 for group 1 and 90.7 ± 5.2 for group 2 (p = .37). Mean percentage of commissural excursion restoration was 78.1 ± 3.5 for group 1 and 74.9 ± 5.9 for group 2 (p = .17). Mean time from surgery to first movement was 5.7 ± 0.9 months for group 1 and 6.3 ± 0.5 months for group 2 (p = .15). Brachytherapy plus radiotherapy does not affect the functional outcomes of immediate facial nerve repair with nerve grafts. Copyright © 2013 Wiley Periodicals, Inc.

Visual acuity outcomes in eyes with flat corneas after PRK.

Science.gov (United States)

Varssano, David; Waisbourd, Michael; Minkev, Liza; Sela, Tzahi; Neudorfer, Meira; Binder, Perry S

2013-06-01

To evaluate the impact of corneal curvatures less than 35 diopters (D) after photorefractive keratectomy (PRK) on visual acuity outcomes. Visual acuity outcomes of 5,410 eyes that underwent PRK from January 2006 to November 2010 were retrospectively analyzed for the impact of postoperative corneal curvatures on visual outcomes. All procedures were performed on a single platform (Allegretto 200Hz excimer laser; Alcon Laboratories, Inc., Irvine, CA). Main outcome measures were postoperative corrected distance visual acuity (CDVA) and loss of CDVA. Corneas with a measured or a calculated postoperative flat meridian less than 35 D and those with a measured postoperative steep meridian less than 35 D had worse postoperative CDVA than corneas with meridians of either 35 D or more (P ≤ .021). However, the preoperative CDVA was worse in the flatter curvatures in all comparisons performed (P ≤ .024). Consequently, the measured or calculated meridian curvature had no effect on CDVA loss (P ≥ .074). Postoperative corneal keratometry values (flat and steep meridians) less than 35 D did not have a predictive effect on the risk of losing visual acuity following myopic PRK performed on the Allegretto 200Hz excimer laser. Copyright 2013, SLACK Incorporated.

Economic assessment of postoperative pain control strategies for treatment of adult patients with cancer

Directory of Open Access Journals (Sweden)

Rafael Freitas dos Santos

Full Text Available Summary Objective: The authors performed an economic assessment of opioids currently being used for control of postoperative pain relating to the surgical treatment of cancer (fentanyl and sufentanil within the Brazilian Unified Health System (SUS, in the Portuguese acronym. Method: The assessment was based on the perspective of the government, in order to collaborate with the promotion of effectiveness in public policies of health, and to optimize the allocation of public resources into health. A cost-effectiveness analysis was performed using data collected from the Brazilian Unified Health System and information from literature review, in order to build a decision tree on the alternatives for control of postoperative pain related to cancer treatment among adult patients. The outcomes considered were: effectiveness of postoperative analgesia and occurrence of nausea and vomit in the 48 hour period after surgery, and additional 24-hour cycles in patient follow-up. A univariate sensitivity analysis was conducted in order to verify robustness of the model estimated. Results: Literature review showed a limited number of studies directly comparing fentanyl and sufentanil for control of postoperative pain. The adoption of sufentanil (cost = U$ 25.72 / outcome = 1.6 VAS points was dominant in relation to the use of fentanyl (cost = U$ 32.58 / outcome = 2.6 VAS points. The estimated model showed robustness in relation to changes in the parameters analyzed. Conclusion: Sufentanil presented higher cost-effectiveness ratio in relation to fentanyl for control of postoperative pain in surgeries related to cancer treatment among adult patients in the Brazilian Unified Health System.

Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review

Science.gov (United States)

Radvansky, Brian M.; Shah, Khushbu; Parikh, Anant; Sifonios, Anthony N.; Eloy, Jean D.

2015-01-01

Objectives. The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involved testing ketamine's effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain scores, and persistent postoperative pain at long-term follow-up. Results. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. Conclusions. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. More randomized controlled trials are necessary to determine the surgical procedures and administrations (i.e., intravenous, epidural) that ketamine is best suited for. PMID:26495312

Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review

Directory of Open Access Journals (Sweden)

Brian M. Radvansky

2015-01-01

Full Text Available Objectives. The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involved testing ketamine’s effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS pain scores, and persistent postoperative pain at long-term follow-up. Results. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. Conclusions. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. More randomized controlled trials are necessary to determine the surgical procedures and administrations (i.e., intravenous, epidural that ketamine is best suited for.

Encounters of Newly Qualified Teachers with Micro-Politics in Primary Schools in Zimbabwe

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Magudu, Snodia; Gumbo, Mishack

2017-01-01

This article demonstrates, through the example of Zimbabwe, the complexities of micro-political learning during induction. It reports on the experiences of ten newly qualified teachers with micro-politics or power relations in their schools during induction and locates these experiences within the broader context of their professional development.…

Beliefs and practices in using misoprostol for induction of labour among obstetricians in Zimbabwe

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M Madziyire

2017-05-01

Full Text Available Background. Misoprostol is commonly used for induction of labour in term pregnancy. There are different routes and dosing schedules for administering the drug.Objectives. To describe the prescribing pattern (dose, route, duration, beliefs and factors affecting use of misoprostol for inducing term pregnancy among practising obstetricians in Zimbabwe.Methods. A cross-sectional descriptive survey was undertaken among practising obstetricians in Zimbabwe. A questionnaire was sent as an email, WhatsApp or short message service (SMS, or text web link to all practising obstetricians in Zimbabwe using the SurveyMonkey online tool. All consenting practitioners were requested to respond online. The responses were analysed using the SurveyMonkey software.Results. There were 52 responses from the 63 questionnaires, a response rate of 82.5%. Seventy-six percent preferred oral misoprostol for induction of labour. The most common indication for induction was prolonged pregnancy accounting for 58% of respondents. The largest group of the practitioners who responded (36% learnt their misoprostol dosing regimen from WHO/FIGO/NICE guidelines. A composite of highly variable dose regimens referred to as ‘other regimens’ was the dosing regimen preferred by 34% of respondents. Fiftyeight percent of practitioners used two cycles of misoprostol dosing before concluding that induction had failed and 52% would resort to caesarean section immediately if induction failed.Conclusion. The results show marked heterogeneity in the dosing schedules employed by obstetricians for induction of labour with the majority not following standard misoprostol guidelines for labour induction.

Cryotherapy on postoperative rehabilitation of joint arthroplasty.

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Ni, Sheng-Hui; Jiang, Wen-Tong; Guo, Lei; Jin, Yu-Heng; Jiang, Tian-Long; Zhao, Yuyan; Zhao, Jie

2015-11-01

The effectiveness of cryotherapy on joint arthroplasty recovery remains controversial. This systematic review was conducted to assess the effectiveness of cryotherapy in patients after joint arthroplasty. Comprehensive literature searches of several databases including Cochrane Library (2013), MEDLINE (1950-2013), and Embase (1980-2013) were performed. We sought randomised controlled trials that compared the experimental group received any form of cryotherapy with any control group after joint arthroplasty. The main outcomes were postoperative blood loss, adverse events, and pain. Analyses were performed with Revman 5.0. Results were shown as mean differences (MD) and standard deviations or as risk difference and 95 % confidence intervals (CIs). Ten trials comprised 660 total knee arthroplastys and three trials comprised 122 total hip arthroplastys (THAs) met the inclusion criteria. Blood loss was significantly decreased by cryotherapy (MD = -109.68; 95 % CI -210.92 to -8.44; P = 0.03). Cryotherapy did not increase the risk of adverse effect (n.s.). Cryotherapy decreased pain at the second day of postoperative (MD = -1.32; 95 % CI -2.37 to -0.27; P = 0.0003), but did not decreased pain at the first and third day of postoperative (n.s.). Cryotherapy appears effective in these selected patients after joint arthroplasty. The benefits of cryotherapy on blood loss after joint arthroplasty were obvious. However, the subgroup analysis indicated that cryotherapy did not decreased blood loss after THA. Cryotherapy did not increase the risk of adverse effect. Cryotherapy decreased pain at the second day of postoperative, but did not decreased pain at the first and third day of postoperative. II.

Management of pediatric postoperative chylothorax.

Science.gov (United States)

Bond, S J; Guzzetta, P C; Snyder, M L; Randolph, J G

1993-09-01

Questions persist about the management of postoperative chylothorax in infants and children. Our experience with postoperative chylothorax over the most recent decade (1980 to 1990) has been reviewed. The type and amount of drainage, data from cardiac catheterization and echocardiography, operative decisions and details, and eventual outcomes have been cataloged. All patients were initially treated with total gut rest, with operation reserved for unabated drainage. Chylothorax developed postoperatively in 15 infants and 11 children (18 with a cardiac procedure and 8 with a noncardiac procedure). The average age was 3.1 years. Spontaneous cessation and cure occurred in 19 (73.1%) of these 26 patients, with an average drainage duration of 11.9 days (range, 4 to 30 days). Those for whom operation was chosen drained preoperatively for an average of 29.2 days (range, 25 to 40 days). There were no deaths in either group. Complications were lymphopenia (2 patients) and fungal sepsis (1 patient). The amount of drainage per day was not significantly different between patients treated operatively and those treated nonoperatively. Failure of nonoperative management was associated with venous hypertension from increased right-sided cardiac pressures or central venous thrombosis (p < 0.05, Fisher's exact test). Presumably this increased pressure is transmitted to the lymphatic system. These patients should be identified early and considered for thoracic duct suture or pleuroperitoneal shunting.

Kalanchoe lanceolata poisoning in Brahman cattle in Zimbabwe : the first field outbreak : case report

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C. Masvingwe

1997-07-01

Full Text Available Field outbreaks of Kalanchoe lanceolata poisoning in cattle on a commercial farm in Zimbabwe are reported. The clinical signs and pathological lesions observed in field cases resembled those reproduced in an experimental cow and were consistent with acute cardiac glycoside poisoning.

Factors influencing the demand of the service of community based animal health care in Zimbabwe.

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Mutambara, J; Dube, I; Matangi, E; Majeke, F

2013-11-01

This study was done to find out about animal health service providers and factors that determined demand for community based veterinary service delivery in smallholder sector of Zimbabwe. Focus group discussions and a questionnaire was used to collect data on veterinary services providers and socio-economic factors related to animal health from a sample (N=333) smallholder livestock farmers from Gutu district of Masvingo province in Zimbabwe. Analytical techniques used were descriptive statistics, K-mean cluster analysis and Tobit regression model. Results showed that the majority of farmers (45%) obtained services from both Community Based Animal Health Workers (CBAHWs) and Department of Veterinary Service (DVS), 25% DVS only, 20% used CBAHWs while 10% did not seek any services. Further analysis showed that distance to CBAHW, distance to AHMC and employment status were significantly related to demand for CBAHWs with coefficients of -1.5, 0.7 and -10.3, respectively. The study thus concluded that CBAHW is an alternative animal health service delivery approach already practiced in smallholder farming sectors of Zimbabwe. Socio-economic factors significantly influenced the demand for CBAHW services. Given limited resources by state sponsored veterinary services, it is recommended that the CBAHWs approach should be encouraged as supplementary service provider especially in areas further DVS. These community organizations can be empowered by the state to deliver more improved services based on hygiene and modern science at a relatively low cost to farmers. Copyright © 2013 Elsevier B.V. All rights reserved.

Potential water supply of a small reservoir and alluvial aquifer system in southern Zimbabwe

NARCIS (Netherlands)

de Hamer, W.; Love, D.; Owen, R.; Booij, Martijn J.; Hoekstra, Arjen Ysbert

2008-01-01

Groundwater use by accessing alluvial aquifers of non-perennial rivers can be an important additional water resource in the semi-arid region of southern Zimbabwe. The research objective of the study was to calculate the potential water supply for the upper-Mnyabezi catchment under current conditions

Potential water supply of a small reservoir and alluvial aquifer system in southern Zimbabwe

NARCIS (Netherlands)

de Hamer, W.; Love, D.; Owen, R.; Booij, Martijn J.; Hoekstra, Arjen Ysbert

2007-01-01

Groundwater use by accessing alluvial aquifers of non‐perennial rivers can be an important additional water resource in the semi‐arid region of southern Zimbabwe. The research objective of the study was to calculate the potential water supply for the upper‐Mnyabezi catchment under current conditions

Structure and composition of woody vegetation in two important bird areas in southern Zimbabwe

NARCIS (Netherlands)

Gandiwa, P.; Chinoitezvi, E.; Gandiwa, E.

2013-01-01

This study assessed the status of woody vegetation structure and composition in two Important Bird Areas (IBA) i.e. Manjinji Pan and Save-Runde Junction located in southeastern Zimbabwe. The objectives of this study were to: (i) determine the woody vegetation structure and composition of the study

Predictive images of postoperative levator resection outcome using image processing software

OpenAIRE

Mawatari, Yuki; Fukushima, Mikiko

2016-01-01

Yuki Mawatari,1 Mikiko Fukushima2 1Igo Ophthalmic Clinic, Kagoshima, 2Department of Ophthalmology, Faculty of Life Science, Kumamoto University, Chuo-ku, Kumamoto, Japan Purpose: This study aims to evaluate the efficacy of processed images to predict postoperative appearance following levator resection.Methods: Analysis involved 109 eyes from 65 patients with blepharoptosis who underwent advancement of levator aponeurosis and Müller’s muscle complex (levator resection). P...

Infiltration and planting pits for improved water management and maize yield in semi-arid Zimbabwe

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Nyakudya, I.W.; Stroosnijder, L.; Nyagumbo, I.

2014-01-01

Realising that rainwater harvesting (RWH) improves crop productivity, smallholder farmers in semi-arid Zimbabwe modified contour ridges traditionally used for rainwater management by digging infiltration pits inside contour ridge channels in order to retain more water in crop fields. However,

Trans-Vaginal Mesh Revision: A Comprehensive Review on Etiologies and Management Strategies with Emphasis on Postoperative Pain Outcomes.

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Mock, Stephen; Reynolds, William S; Dmochowski, Roger R

2014-05-01

The use of polypropylene mesh to augment surgery aimed to correct pelvic organ prolapse and stress urinary incontinence stems largely from the high recurrence rates of native tissue repairs. While objective outcomes were improved, mesh related complications began to emerge that included mesh exposures, extrusions, dyspareunia and other pain issues. However, the indication for and benefit of surgical intervention(s) to address these complications are lacking. We aim to review to current literature regarding postoperative pain outcomes following vaginal mesh revision. Evidence based literature indicates that mesh complications are not rare and surgery that aims to address them generally have an overall benefit. However, studies available are generally small case series of a retrospective nature with short follow up. Some themes are evident: there is a long lag period from mesh insertion to removal; there is a lack of a true denominator of total mesh insertions making it hard to gauge the real scope of the problem; mesh material found not along the expected trocar path or coursing close to neurovascular structures thus raises the possibility of technical errors during insertion. Transvaginal mesh revision(s) for mesh complications generally have a positive effect on pain outcomes, but better controlled studies are needed. Additionally, since technical issues may be a factor in the development of mesh complications, rigorous training and sufficient surgical case volume should be emphasized. © 2014 Wiley Publishing Asia Pty Ltd.

HIV and schistosomiasis in rural Zimbabwe

DEFF Research Database (Denmark)

Kotzé, Sebastian Ranzi; Zinyama-Gutsire, Rutendo; Kallestrup, Per

2015-01-01

BACKGROUND: Vitamin A has widespread effects on immune function and is therefore interesting in HIV-infection. Retinol-binding protein (RBP or RBP4) is a negative acute-phase protein and a marker of vitamin A status. Our aim was to investigate the association of RBP with HIV progression, infection...... with schistosomiasis, inflammatory cytokines, and mortality. METHODS: The study included 192 HIV-infected and 177 HIV-uninfected individuals from Mupfure in rural Zimbabwe. Of these, 208 were infected with Schistosoma haematobium, 27 with S. mansoni and 48 with both. Plasma RBP, HIV-RNA, CD4 cell count, haemoglobin......, cytokines, clinical staging (CDC category), self-reported level of function (Karnoffsky Performance Score, KPS) and schistosomiasis status were assessed at baseline. Participants were followed up for survival 3-4 years post-enrolment. RESULTS: RBP levels were lower in HIV-infected individuals(p

CNS tumors: postoperative evaluation

International Nuclear Information System (INIS)

Dayanir, Y.

2012-01-01

Full text: Imaging assessment of brain tumors following surgery is complex and depends upon several factors, including the location of the tumor, the surgical procedure and the disease process for which it was performed. Depending upon these factors, one or a combination of complementary imaging modalities may be required to demonstrate any clinically relevant situation, to assist the surgeon in deciding if repeat surgery is necessary. Conventional magnetic resonance imaging (MRI) can show the shape, size, signal intensity, and enhancement of a brain tumor. It has been widely used to diagnose and differentiate brain tumors and to assess the surgery outcomes. Longitudinal MRI scans have also been applied for the assessment of treatment and response to surgery. The newly developed MRI techniques, including diffusion weighted imaging (DWI), perfusion weighted imaging (PWI) and magnetic resonance spectroscopy (MRS), have the potential to provide the molecular, functional and metabolic information of preoperative and postoperative brain tumors. Postoperative diffusion and perfusion magnetic resonance imaging are especially useful in predicting early functional recovery from new deficits after brain tumor surgery.This lecture will stress the principles, applications, and pitfalls of conventional as well as newly developing functional imaging techniques following operation of brain tumors

Preoperative body size and composition, habitual diet, and post-operative complications in elective colorectal cancer patients in Norway.

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Berstad, P; Haugum, B; Helgeland, M; Bukholm, I; Almendingen, K

2013-08-01

Both malnutrition and obesity are related to worsened post-operative outcomes after colorectal surgery. Obese cancer patients may be malnourished as a result of short-term weight loss. The present study aimed to evaluate preoperative nutritional status, body composition and dietary intake related to post-operative complications (POC) and post-operative hospital days (POHD) in elective colorectal cancer (CRC) patients. Anthropometry, body composition measured by bioelectric spectroscopy and dietary habits assessed by a validated food-frequency questionnaire were examined in 100 newly-diagnosed CRC patients. Data from 30-day POC and POHD were collected from medical records. Nonparametric and chi-squared tests and logistic regression were used to analyse associations between body and dietary variables and post-operative outcome. Twenty-nine patients had at least one POC. The median POHD was six. Body size and composition measures and short-term weight loss were no different between patients with and without POC, or between patients with POHD body size, body composition and short-term weight loss were not related to 30-day post-operative outcomes in CRC patients. A high content of marine n-3 PUFA in preoperative habitual diets may protect against POC after CRC surgery. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Postoperative respiratory outcomes in laparoscopic bariatric surgery: comparison of a prospective group of patients whose neuromuscular blockade was reverted with sugammadex and a historical one reverted with neostigmine.

Science.gov (United States)

Llauradó, S; Sabaté, A; Ferreres, E; Camprubí, I; Cabrera, A

2014-12-01

Bariatric surgery patients are at high risk of perioperative respiratory adverse events. We hypothesized that the use of sugammadex to reverse neuromuscular blockade could improve postoperative respiratory outcomes. Prospective observational series of consecutive patients scheduled for laparoscopic bariatric surgery in whom neuromuscular blockade was reverted with sugammadex were compared with a historical matched cohort of patients reverted with neostigmines. The necessity of postoperative mechanical ventilation or pathological changes in postoperative chest X-ray were two of the comparisons done. We enrolled 160 patients in each group (Sugammadex - SG and Historical - HG). Two patients (mean, CI 95%), (1.25, 0.34-4.4) in the SG and five patients in the HG (mean, CI 95%), (3.13, 1.34-7.11) required mechanical ventilation immediately after surgery (p=0.38, chi-square test). Significantly less chest X-ray postoperative changes were observed in the SG: 11 patients (6.9%) versus 26 patients (16.3%) in the HG (Odds ratio OR, CI 95%) (0.36, 0.18-0.8). Requirement of mechanical ventilation is not associated to the reversal agent employed. Less pathological postoperative chest X-ray changes were found in the group of patients whose neuromuscular blockade was reverted with sugammadex. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

What was the population of Great Zimbabwe (CE1000 – 1800)?

Science.gov (United States)

Moultrie, Thomas; Bandama, Foreman; Dandara, Collett; Manyanga, Munyaradzi

2017-01-01

The World Heritage Site of Great Zimbabwe is one of the most iconic and largest archaeological settlements in Africa. It was the hub of direct and indirect trade which internally connected various areas of southern Africa, and externally linked them with East Africa and the Near and Far East. Archaeologists believe that at its peak, Great Zimbabwe had a fully urban population of 20,000 people concentrated in approximately 2.9 square kilometres (40 percent of 720 ha). This translates to a population density of 6,897, which is comparable with that of some of the most populous regions of the world in the 21st century. Here, we combine archaeological, ethnographic and historical evidence with ecological and statistical modelling to demonstrate that the total population estimate for the site’s nearly 800-year occupational duration (CE1000–1800), after factoring in generational succession, is unlikely to have exceeded 10,000 people. This conclusion is strongly firmed up by the absence of megamiddens at the site, the chronological differences between several key areas of the settlement traditionally assumed to be coeval, and the historically documented low populations recorded for the sub-continent between CE1600 and 1950. PMID:28614397

Assessment of environmental flow requirements for river basin planning in Zimbabwe

Science.gov (United States)

Mazvimavi, D.; Madamombe, E.; Makurira, H.

There is a growing awareness and understanding of the need to allocate water along a river to maintain ecological processes that provide goods and services. Legislation in Zimbabwe requires water resources management plans to include the amount of water to be reserved for environmental purposes in each river basin. This paper aims to estimate the amount of water that should be reserved for environmental purposes in each of the 151 sub-basins or water management units of Zimbabwe. A desktop hydrological method is used to estimate the environmental flow requirement (EFR). The estimated EFRs decrease with increasing flow variability, and increase with the increasing contribution of base flows to total flows. The study has established that in order to maintain slightly modified to natural habitats along rivers, the EFR should be 30-60% of mean annual runoff (MAR) in regions with perennial rivers, while this is 20-30% in the dry parts of the country with rivers, which only flow during the wet season. The inclusion of EFRs in water resources management plans will not drastically change the proportion of the available water allocated to water permits, since the amount of water allocated to water permit holders is less than 50% of the MAR on 77% of the sub-basins in the country.

The Challenges of Using the Communicative Approach (CA) in the Teaching of English as a Second Language (ESL) in Zimbabwe: Implications for ESL Teacher Education

Science.gov (United States)

Mutekwa, Anias

2013-01-01

This article examines studies done on the use of the CA locally, in addition to insights from studies done abroad, as well as critically examining the nature of the CA and the language situation in Zimbabwe, to identify and discuss the main challenges associated with the use of this approach to the teaching of ESL in Zimbabwe and its implications…

No difference in postoperative outcome after acute surgery whether the patients presented for first time or are known with Crohn's disease

DEFF Research Database (Denmark)

El-Hussuna, Alaa; Hadi, Sabah; Iesalnieks, Igors

2017-01-01

.611–2.024]. No difference in intra-abdominal septic complications rate was found between the two groups: odds ratio 0.932, CI [0.369–2.355]. Re-admission was seen in six patients (9.8%) in group 1 vs. 23 (13.8%) in Group 2: odds ratio 1.464, CI [0.566–3.788]. Conclusion Patients undergoing acute surgery for the first CD......AbstractPurposes Acute operations (within 48 h) or urgent (within 2–7 days) carry the risk of unfavorable outcome as the patient is not optimized, the operation is performed by trainees and the disease is severe necessitating acute/urgent intervention. However, Crohn's disease (CD) patients who...... Retrospective multi-center study. Rate of complications, duration of hospitalization and rate of re-admission were used as a measure of postoperative outcome. Univariate and multi-variate analyses were used. Results Sixty-one patients in whom acute CD was first presentation (group 1) did not have more favorable...

Curriculum Issues: Teaching and Learning for Sustainable Development in Developing Countries--Zimbabwe Case Study

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Dambudzo, Ignatius Isaac

2015-01-01

The study sought to investigate curriculum issues, teaching and learning for sustainable development in secondary schools in Zimbabwe. Education for sustainable development (ESD) aims at changing the approach to education by integrating principles, values, practices and needs in all forms of learning. Literature has documented the importance of…

The Teaching of African Traditional Religion in Primary Schools in Zimbabwe: Challenges and Opportunities

Science.gov (United States)

Marashe, Joel; Ndamba, Gamuchirai Tsitsiozashe; Chireshe, Excellent

2009-01-01

Zimbabwe's Education Ministry recommended the teaching of African Traditional Religion in recognition of its multi-religious society. This study sought to establish the extent to which African Traditional Religion is taught in primary schools, the challenges faced by teachers, and opportunities for promoting its teaching. A descriptive survey…