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1.
OAlib ; 7(6)2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32661500

RESUMO

Sub-Saharan Africa has the worst global shortage of health professionals. The use of eLearning interventions, that lead to increased interactions according to the Interaction Equivalency theorem, is a potential means of addressing this shortage of health professionals. In this audit we set out to determine the effect of an eLearning general histology and general embryology intervention on student's summative examination scores. The audit compared the written and practical summative examination scores of three sets of student examinations one of which had a five-week eLearning intervention. Two of the examinations were for the same students in one year but different courses while the other two were for students doing the same subject but in different years. In each of the above pair of examinations there was one group from the course that had the eLearning intervention. A Bayesian multilevel regression modelling approach was used to analyse the student scores. The course with the online eLearning intervention had significantly better scores (p-value < 0.01), than the course on a different subject offered at the same time to the same students without the intervention and the same course with students from the previous academic year. On controlling for other factors, the eLearning intervention led to higher examination scores though this was not significant. Student's nationality, sponsorship and program significantly affected the examination scores, controlling for other factors. Overall the students in the course with the online eLearning intervention had significantly better examination scores. The student's nationality, sponsorship and program significantly affect their examination scores. Future, larger and or qualitative studies, are needed to further explore the effect of these factors on student's examination scores.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32454955

RESUMO

Background. Periodontitis and rheumatoid arthritis have similar epidemiology and pathophysiology. Understanding the interaction between these two diseases is vital in our settings. We set out to assess the effect of oral hygiene interventions on disease activity of rheumatoid arthritis patients with periodontitis in Kampala, Uganda. Methods. Fifty-eight patients attending an arthritis clinic with rheumatoid arthritis and periodontitis were randomly assigned to either an intervention group or a control group. Patients diagnosed with rheumatoid arthritis at least two years before, who were on the same medication, dose, or formulation for RA treatment during the preceding three months, were included. The patients were >18 years of age, would be available for all the study visits in the next six months, had at least six natural teeth, had periodontal disease classified as Dutch Periodontal Index (DPSI) >3 and provided written informed consent. Those who had a chronic disorder requiring chronic or intermittent use of antibiotics, were pregnant, were lactating, or had intent to become pregnant were excluded. The primary outcome measure was a change in Disease Activity Score of 28 Joints (DAS28 score) in two 3-month follow-up periods after the intervention. The secondary outcome measure was a change in periodontal status. Results. There was a statistically significant improvement in the DAS-28 score in both the intervention and control arms during the follow-up period (P<0.01). The participants carrying more than one bacterial species had worse DAS-28 scores. Conclusion. Oral hygiene interventions given to RA patients could drastically improve their RA treatment outcomes, especially in resource-limited settings.

3.
Forensic Med Anat Res ; 8(2): 18-37, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32337321

RESUMO

Human cadaver dissection remains a core and preferred method of anatomical instruction at most low- and middle-income health professional training institutions. Dissection, which is both traumatic and stressful, sets the tone of the students' responses to later and or similar stressful learning opportunities like the post-mortems or care for terminally ill patients. Partial least squares structural equation modelling was used to determine the effect of the students': personality, perception of the learning environment, learning approach, and effect of the environment on the student, on undergraduate health professional student's activity in the human cadaver dissection room. This was a secondary analysis of previously collected data from a cross sectional survey of undergraduate health professional students. We found that personality type and perception of the environment had a positive effect on dissection room activity. Approach to learning and being affected by the dissection room experience (impact), had a negative effect on dissection room activity. All the above effects on dissection room activity were not significant. This study showed that personality, perception of the learning environment, learning approach and effect of the environment on the student, had effects on undergraduate health professional student's activity in the human cadaver dissection room. The modelled effects are opportunities for educational interventions aimed at increasing student activity in the dissection room.

4.
Open J Stomatol ; 9(10): 215-226, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31695961

RESUMO

Background: This review identified papers that described periodontitis and rheumatoid arthritis in sub-Saharan Africa. Only English language publications from January 2010 to December 2017 describing original research in sub-Saharan Africa on the association between periodontitis and rheumatoid arthritis were considered for this study. Methods: Published databases: PubMed, Science direct and Google scholar, were searched using terms "periodontitis", "rheumatoid arthritis" and "Sub-Saharan Africa" to generate a set of putative studies. Articles with data on both rheumatoid arthritis and periodontitis compared to controls were selected. Studies on the association of periodontitis with cardiovascular disease, arthritis or rheumatoid arthritis alone were excluded. Data were extracted, critically appraised, and analyzed using a random-effect Mantel-Haenszel meta-analysis on plaque index, gingival index, pocket depth and clinical attachment loss. Results: Three publications were selected for the systematic review and 2 for the meta-analysis. Two studies were from Sudan, and one was from Burina Faso. There was a significant increase in pocket depth (mean difference: 0.31; 95% CI: 0.21, 0.41; N= 274; (p ≤ 0.001) and clinical attachment loss (mean difference: 0.47; 95% CI: 0.22, 0.75; N= 274; (p ≤ 0.001) in participants with rheumatoid arthritis compared to normal controls. Conclusion: Findings from these combined studies show a significant relationship between periodontal disease and rheumatoid arthritis with increased periodontal pocket depth and clinical attachment loss. They also highlight the need for additional work especially in the area of associating rheumatoid arthritis with P. gingivalis, the oral microbiome and treating periodontal diseases to help in the management of rheumatoid arthritis.

5.
BMC Res Notes ; 12(1): 652, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31601254

RESUMO

OBJECTIVE: Dental development is a useful method for age estimation. Although third molar eruption is commonly used to estimate age in Uganda, it is reported to be unreliable because of external influences. The more reliable radiographic techniques have inter-ethnic differences but data from sub-Saharan Africa are limited regarding estimating age in young adults. This study, therefore, aimed at determining the accuracy of Demirjian's classification of the lower third molar, a common dental age estimation method, in estimating key ages in a Ugandan population using Ugandan references. Dental records of 1021 Ugandans aged 10-22 years were assigned to two groups; reference and test. The reference data was retrieved from a database of a previous bigger research project. RESULTS: The overall sample population comprised of 514/1021 (50.3%) males. The mean age was 15.8 (3.6) years. No significant sex differences in dental age were established in the reference sample (520 records). Accuracy values (area under the curve) at the 12-, 14-, 16- and 18-year cut-offs were between 0.83 and 0.90 using the test sample (501 records). The results suggest that Demirjian's classification of the lower third molars is a useful method for age estimation in the young urban Ugandan population in the 10-22-year age-group.


Assuntos
Determinação da Idade pelos Dentes/métodos , Dente Serotino/diagnóstico por imagem , Radiografia Panorâmica/métodos , Erupção Dentária , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Uganda , População Urbana/estatística & dados numéricos , Adulto Jovem
6.
Epilepsy Behav ; 85: 21-27, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29906697

RESUMO

OBJECTIVE: This systematic review identified papers that described epilepsy misconceptions or stigma in sub-Saharan Africa (SSA) and research interventions focused on reducing these misconceptions. MATERIALS AND METHODS: Publications in the English language from January 2000 to October 2017 that described original research conducted in SSA on misconceptions about epilepsy were utilized. RESULTS: Twenty-three publications were identified. Studies were from Nigeria (N = 4), Cameroon (N = 4), Uganda (N = 3), Zambia (N = 2), Ethiopia (N = 2), Tanzania (N = 2), Kenya (N = 2), Ghana, Zimbabwe, Benin, and Mali (N = 1 each). The studies included assessments of misconceptions among healthcare providers and medical students (N = 3), high school students (N = 2), teachers (N = 2), the general public (N = 10), people with epilepsy (N = 7), and traditional healers (N = 1). Only two studies had stigma-focused interventions. Majority of the studies reported limitations to socialization with people with epilepsy and various beliefs associated with epilepsy. CONCLUSIONS: Epilepsy misconceptions, stigmatizing cultural beliefs, and perceptions were widely prevalent in SSA, and there are a few studies targeting epilepsy stigma. Existing stigma-reduction educational approaches may be impractical for general population implementation. Scalable approaches to reduce stigma are urgently needed within SSA.


Assuntos
Atitude do Pessoal de Saúde , Epilepsia/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Estigma Social , Estereotipagem , África ao Sul do Saara , Pessoal de Saúde , Humanos , Estudantes , Estudantes de Medicina
7.
Artigo em Inglês | MEDLINE | ID: mdl-28353306

RESUMO

BACKGROUND: Anatomical variations of the sternal angle and anomalies of the sternum are unique happenings of major clinical significance.It is known that misplaced sternal angles may lead to inaccurate counting of ribs and create challenges with intercostal nerve blocks and needle thoracostomies. Sternal foramina may pose a great hazard during sternal puncture, due to inadvertent cardiac or great vessel injury. These sternal variations and anomalies are rarely reported among Africans. The aim of this study was to determine the anatomical variations of the sternal angle and anomalies of the sternum among adult dry human sterna at the Galloway osteological collection, Makerere University, Uganda. METHODS: This was a descriptive cross sectional study in which quantitative and qualitative data were collected. The study examined 85 adult human sterna at the Department of Anatomy, Makerere University. Univariate and bivariate analyses were done using SPSS 21.0 for windows. RESULTS: Over 40% (36/85) of the specimens had variations in size, location and fusion of the sternal angle. There was no significant difference in the mean size of the sternal angle in males at 163.40 (SD 6.7) compared with 165.00 (SD 6.4) in females (p=0.481). Of the 85 specimens examined, only 21 (24.7%) had a xiphoid process. The most frequent sternal anomalies were bifid xiphoid process 42.9% (9/21) and sternal foramen 12.9% (11/85). CONCLUSIONS AND RECOMMENDATIONS: Sternal variations and anomalies are prevalent in the Galloway osteological collection and there is need for increased awareness of these findings as they may determine the accuracy of clinical and other procedures in the thoracic region.

8.
Pan Afr Med J ; 24: 74, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27642414

RESUMO

INTRODUCTION: In this study we used a model of adult learning to explore undergraduate students' views on how to improve the teaching of research methods and biostatistics. METHODS: This was a secondary analysis of survey data of 600 undergraduate students from three medical schools in Uganda. The analysis looked at student's responses to an open ended section of a questionnaire on their views on undergraduate teaching of research methods and biostatistics. Qualitative phenomenological data analysis was done with a bias towards principles of adult learning. RESULTS: Students appreciated the importance of learning research methods and biostatistics as a way of understanding research problems; appropriately interpreting statistical concepts during their training and post-qualification practice; and translating the knowledge acquired. Stressful teaching environment and inadequate educational resource materials were identified as impediments to effective learning. Suggestions for improved learning included: early and continuous exposure to the course; more active and practical approach to teaching; and a need for mentorship. CONCLUSION: The current methods of teaching research methods and biostatistics leave most of the students in the dissonance phase of learning resulting in none or poor student engagement that results in a failure to comprehend and/or appreciate the principles governing the use of different research methods.


Assuntos
Educação de Graduação em Medicina/métodos , Pesquisa/educação , Faculdades de Medicina , Estudantes de Medicina/psicologia , Adulto , Bioestatística , Feminino , Humanos , Aprendizagem , Masculino , Inquéritos e Questionários , Ensino/organização & administração , Uganda
9.
Int J Surg Case Rep ; 27: 41-43, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27541058

RESUMO

INTRODUCTION: Severe hollow organ injury following trivial blunt abdominal trauma is uncommon. If it occurs it can easily be missed during routine clinical evaluation. Though less than ten cases of jejunal transection following trivial trauma have been reported in literature, this is the first case of jejunal transection occurring in a patient who fell while walking. CASE PRESENTATION: We report a 32year old female Ugandan, who walked into the emergency room due to abdominal pain following a fall while walking. She was found to be hemodynamically stable and was initially hesitant to do further investigations but finally accepted to go for abdominal ultrasound scan and a chest x-ray. Abdominal ultrasound scan noted free peritoneal fluid and erect chest radiograph revealed a pneumoperitoneum. She was admitted for an exploratory laparotomy. At laparotomy we found a complete jejunal transection with mesenteric laceration. Primary anastomosis was done; the patient had an uneventful recovery and was discharged on the tenth postoperative day. DISCUSSION: Any trauma to the abdomen can potentially cause devastating injury to hollow viscera and should therefore be evaluated thoroughly. CONCLUSION: This case demonstrates that even in a resource limited setting, basic investigations like an abdominal ultrasound scan and erect chest radiographs are important when managing a patient with blunt abdominal trauma even though the injury seems trivial.

10.
BMC Res Notes ; 8: 765, 2015 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-26653100

RESUMO

BACKGROUND: Informed consent during medical practice is an essential component of comprehensive medical care and is a requirement that should be sought all the time the doctor interacts with the patients, though very challenging when it comes to implementation. Since the magnitude and frequency of surgery related risk are higher in a resource limited setting, informed consent for surgery in such settings should be more comprehensive. This study set out to evaluate patients' experiences and perspectives of informed consent for surgery. METHODS: This was a survey of post-operative patients at three university teaching hospitals in Uganda. The participants were interviewed using guided, semi-structured questionnaires. Patients from different surgical disciplines participated in the study. RESULTS: A total of 371 patients participated in the study. Eighty percent of the participants reported having been given explanations on the indication for their surgery, 56.1 % had all their questions answered before the operation, 17 % did not know the type of operation they had undergone and another 17 % did not give their consent for the operation. Additionally, more than 81 % of the participants reported giving their own permission for surgery, although only 23.7 % were able to identify the person who obtained consent from them and 22.4 % knew the names of the surgeons who conducted the surgical procedure on them. About 20 % of the participants were not satisfied with the information provided by both the doctor before and after the operation. However, there were varying responses on when doctors should explain to patients with the majority saying it should be done before treatment or surgery, while others thought it should be done on admission, others proposed that it be made immediately after the examination among other responses. On what should be done to improve communication between doctors and patients, a number of suggestions, including the need for a detailed explanation for the patient by the doctor about their disease conditions and treatment options were suggested. CONCLUSIONS: Patients' perceptions of what constitutes informed consent are diverse and many patients undergo surgery without knowledge of the identity of the surgeon or the reason for the surgery. There is a need to improve on patients' participation in informed decision making, and this can be achieved through continuing medical education for doctors.


Assuntos
Consentimento Livre e Esclarecido/estatística & dados numéricos , Relações Médico-Paciente , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ética Médica , Feminino , Hospitais de Ensino , Hospitais Universitários , Humanos , Consentimento Livre e Esclarecido/ética , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Operatórios/métodos , Uganda , Adulto Jovem
11.
BMC Res Notes ; 8: 428, 2015 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-26358318

RESUMO

BACKGROUND: Dental arch dimensions are useful in dental practice and in forensic odontology. Local data is essential because ethnic differences exist in dental arch dimensions. In the Ugandan population no studies had been done on dental arch dimensions. The objective of the current study was to determine the variations in dental arch dimensions with age and gender in a sample of dental casts from the Ugandan population. METHOD: This was a secondary analysis of dental casts previously prepared using mandibular and maxillary arch impressions of 220 children (85 boys and 135 girls) aged 12-17 years recruited from schools in Kampala, Uganda. Dental arch dimensions for the maxilla and mandibular casts were taken using a digital vernier calliper. The data was analysed using the means based independent samples t test to obtain the descriptive statistics with regression analysis being used to obtain the regression coefficients and constants using STATA 12. RESULTS: The overall maxillary dimensions were significantly smaller in females than males by 1.50 mm (95% CI -2.91 to -0.09, P = 0.04), controlling for age group. The overall dimensions of the mandible were also smaller in younger participants, though this was not statistically significant. CONCLUSION: From this study we observed significant differences in arch dimensions between males and females that are of forensic value for this population. There is need for more study of the differences in arch dimensions with age using a larger and more age diverse study population.


Assuntos
Arco Dental/anatomia & histologia , Mandíbula/anatomia & histologia , Maxila/anatomia & histologia , Odontometria/métodos , Adolescente , Fatores Etários , Criança , Dente Canino/anatomia & histologia , Feminino , Humanos , Masculino , Dente Molar/anatomia & histologia , Tamanho do Órgão , Análise de Regressão , Fatores Sexuais , Uganda
12.
BMC Res Notes ; 8: 54, 2015 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-25890154

RESUMO

BACKGROUND: Effective utilization of computers and their applications in medical education and research is of paramount importance to students. The objective of this study was to determine the association between owning a computer and use of computers for research data analysis and the other factors influencing health professions students' computer use for data analysis. METHODS: We conducted a cross sectional study among undergraduate health professions students at three public universities in Uganda using a self-administered questionnaire. The questionnaire was composed of questions on participant demographics, students' participation in research, computer ownership, and use of computers for data analysis. Descriptive and inferential statistics (uni-variable and multi- level logistic regression analysis) were used to analyse data. The level of significance was set at 0.05. RESULTS: Six hundred (600) of 668 questionnaires were completed and returned (response rate 89.8%). A majority of respondents were male (68.8%) and 75.3% reported owning computers. Overall, 63.7% of respondents reported that they had ever done computer based data analysis. The following factors were significant predictors of having ever done computer based data analysis: ownership of a computer (adj. OR 1.80, p = 0.02), recently completed course in statistics (Adj. OR 1.48, p =0.04), and participation in research (Adj. OR 2.64, p <0.01). CONCLUSIONS: Owning a computer, participation in research and undertaking courses in research methods influence undergraduate students' use of computers for research data analysis. Students are increasingly participating in research, and thus need to have competencies for the successful conduct of research. Medical training institutions should encourage both curricular and extra-curricular efforts to enhance research capacity in line with the modern theories of adult learning.


Assuntos
Computadores/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Faculdades de Medicina/estatística & dados numéricos , Estatística como Assunto , Estudantes de Medicina/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Masculino , Uganda , Universidades
13.
BMC Res Notes ; 7: 793, 2014 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-25380673

RESUMO

BACKGROUND: Malaria still remains the leading cause of childhood morbidity and mortality in Uganda. Interventions like malaria vaccines which reduce the malaria burden are needed in malaria endemic communities. There is need to establish baseline characteristics in vaccine trial study sites. This study determined the following baseline malariometric indices: spleen rates, bed net use, malaria parasitaemia and malaria episodes in an inception cohort of children aged 12 - 60 months in Iganga district, Uganda. METHODS: In a longitudinal cohort study, 748 children were enrolled with 397 in an active follow up arm and 351 in a passive arm. The children in the two arms were followed for 6 months to determine the incidence of malaria episodes. RESULTS: The overall baseline spleen rate was 8.2% (61/748) among the study participants. Of the households surveyed, about 36% reported using bed nets and almost 30% of the users had insecticide-treated nets. 274 (36.6%) of the study participants had a history of fever in the past 24 hrs at the time of the baseline survey. All participants had a peripheral blood smear for malaria parasites done at enrollment with 76.8% having the asexual form of malaria parasites. The malaria episodes per child per year were 1.5 and 0.79 in the active and passive follow up arms respectively. CONCLUSIONS: There is a high prevalence of malaria asexual parasitaemia in children below five years. The bed net usage still remains low among this population. These baseline malariometric indices have important implication for malaria control interventions.


Assuntos
Vacinas Antimaláricas/imunologia , Malária/imunologia , Malária/prevenção & controle , Distribuição por Idade , Pré-Escolar , Seguimentos , Humanos , Incidência , Lactente , Mosquiteiros Tratados com Inseticida , Malária/epidemiologia , Fatores de Tempo , Uganda/epidemiologia
14.
Pan Afr Med J ; 17: 81, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25018829

RESUMO

INTRODUCTION: Low and middle income countries have severe nursing staff shortages which is associated with risk of poor quality of patient care and increased patient exposure to adverse events. This is accompanied with increased risk of musculoskeletal disorders to the nursing staff. This paper sets out to identify and compare factors associated with musculoskeletal disorders among nursing staff in 5 different hospitals in Uganda. METHODS: This was a cross sectional study on nurses from 5 different hospitals in Uganda. The study used a 12 month recall of reported Musculoskeletal disorders (MSD) among nurses. Ethical approval was obtained. Logistic regression analysis and ANOVA were used. The level of significance was set at 0.05 for all statistical tests. RESULTS: There were 755 respondents of whom 433 (58.4%) were nurses. The prevalence of MSD at anybody site was 80.8%. There were significant differences in reported MSD among nursing staff across different hospital settings which were worse in the public hospitals as compared to the private and private not for profit hospitals (p <0.001). Age (adjusted OR 1.03, 95% CI 1.01-1.06), self reported poor general health status (adj OR 4.5, 95% CI 2.8-7.24) and stress as suggested by waking up tired in the morning (adj OR 3.4, 95% CI 2.17-5.32) were significant associated factors for MSD in this population. CONCLUSION: Reported MSD among nursing staff across 5 different hospitals is worse in public as compared to private hospitals. Age, self reported poor general health status and stress were important factors for MSD in this population.


Assuntos
Doenças Musculoesqueléticas/epidemiologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Recursos Humanos de Enfermagem/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Uganda/epidemiologia , Adulto Jovem
15.
BMC Med Ethics ; 15: 40, 2014 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-24885609

RESUMO

BACKGROUND: Informed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching Hospitals in a low resource setting. METHODS: A cross-sectional study conducted at three university teaching hospitals in Uganda. Self-guided questionnaires were left at a central location in each of the surgical departments after verbally communicating to the surgeons of the intention of the study. Filled questionnaires were returned at the same location by the respondents for collection by the research team. In addition, 20 in-depth interviews were held with surgeons and a review of 384 patients' record files for informed consent documentation was done. RESULTS: A total of 132 (62.1%) out of 214 questionnaires were completed and returned. Respondents were intern doctors, residents and specialists from General surgery, Orthopedic surgery, Ear, Nose and Throat, Ophthalmology, Dentistry, Obstetrics and Gynaecology departments. The average working experience of respondents was 4.8 years (SD 4.454, range 0-39 years). 48.8% of the respondents said they obtained consent all the time surgery is done while 51.2% did not obtain consent all the time. Many of the respondents indicated that informed consent was not obtained by the surgeon who operated the patient but was obtained either at admission or by nurses in the surgical units. The consent forms used in the hospitals were found to be inadequate and many times signed at admission before diagnosing the patient's disease. CONCLUSIONS: Informed consent administration and documentation for surgical health care is still inadequate at University teaching hospitals in Uganda.


Assuntos
Anestesiologia , Cirurgia Geral/ética , Hospitais Universitários , Consentimento Livre e Esclarecido , Padrões de Prática Médica , Procedimentos Cirúrgicos Operatórios , Adulto , Compreensão , Termos de Consentimento , Estudos Transversais , Feminino , Humanos , Consentimento Livre e Esclarecido/ética , Masculino , Relações Médico-Paciente , Inquéritos e Questionários , Uganda
16.
BMC Res Notes ; 7: 222, 2014 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-24713177

RESUMO

BACKGROUND: Though seen as a convenient method of carrying books and other scholastic materials including food items, schoolbags are believed to contribute to back and other musculoskeletal problems in school going children. This study set out to determine the prevalence of low back and other musculoskeletal pains and describe their relationship with schoolbag use in pupils. RESULTS: This was a cross-sectional descriptive study involving 532 pupils from six primary schools with a mean age of 13.6 years. Analyses included the chi- square test, independent t tests, regression analysis and test for trend across ordered groups. Backpacks were the most common type of schoolbag and younger children carried disproportionately heavier bags. Urban pupils were younger, carried significantly heavier bags, and less likely to complain about schoolbag weight than the rural pupils. About 30.8% of the pupils carried schoolbags which were more than 10% of their body weight. About 88.2% of pupils reported having body pain especially in the neck, shoulders and upper back. About 35.4% of the children reported that carrying the schoolbag was the cause of their musculoskeletal pain. The prevalence of lower back pain was 37.8%. There was significant association between low back pain and; method of bag carriage (p < 0.0001), long duration of walking (odds ratio 2.67, 95% CI 1.38- 5.16) and the time spent sitting after school (p = 0.02). Only 19% had lockers at school. CONCLUSION: Urban pupils were younger, carried significantly heavier bags, and less likely to complain about schoolbag weight than the rural pupils. The majority of pupils complained of musculoskeletal pain of which 35.4% was attributed to the schoolbags.The prevalence of lower back pain was 37.8%. Schools need to provide lockers and functional libraries in order to avoid excessive loading and repetitive strain injuries.


Assuntos
Dor Musculoesquelética/epidemiologia , Estudantes , Adolescente , Dorso/fisiopatologia , Peso Corporal , Criança , Feminino , Humanos , Masculino , Dor Musculoesquelética/fisiopatologia , Prevalência , População Rural , Instituições Acadêmicas , Ombro/fisiopatologia , Inquéritos e Questionários , Uganda/epidemiologia , População Urbana , Suporte de Carga , Adulto Jovem
17.
BMC Nurs ; 13(1): 7, 2014 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-24565421

RESUMO

BACKGROUND: Musculoskeletal disorders (MSD) constitute one of the main occupational hazards among health care workers. However, few epidemiological studies on work related MSD among nursing professionals have been carried out in Africa. The purpose of this study was to assess the work related musculoskeletal disorders and associated risk factors among nursing professionals in Uganda. METHODS: This was a cross-sectional study of MSD among 880 nursing professionals from five selected hospitals in Uganda. Data was collected using a questionnaire adapted from the Dutch Musculoskeletal and Nordic Musculoskeletal questionnaires. Descriptive (mean, standard deviation and percentages) and inferential (Chi square test and logistic regression analysis) statistics were used to analyse data. Alpha level was set at p < 0.05. RESULTS: A total of 741 completed questionnaires were analysed (response rate 85.4%). The average age of the respondents was 35.4 (SD 10.7) years and a majority were female (85.7%). The average working hours per week was 43.7 (SD 18.9 hours). The 12-month period-prevalence of MSD at anybody site was 80.8%. The most common site of MSD was the lower back (61.9%). Significant risk factors for reported MSD included often working in a slightly bent posture (adjOR 2.25, 95% CI 1.20-4.26), often working in a slightly twisted posture for long (adjOR 1.97, 95% CI 1.03-3.77), mental exhaustion (adjOR 2.05, 95% CI 1.17-3.5), being absent from the work station for more than 6 months due to illness or an accident (adjO|R, 4.35, 95% CI 1.44-13.08) and feeling rested after a break (adjOR 2.09, 95% CI 1.16-3.76). CONCLUSIONS: Musculoskeletal disorders affect more than 80% of nursing professionals in Uganda with the most commonly, affected site being the lower back. Significant risk factors for MSD include; being absent from the work station for more than 6 months due to illness or an accident, working in awkward postures, pushing/pulling of heavy loads and mental exhaustion. There is a need for greater advocacy, better working conditions and adoption of strategies to reduce occupational injuries.

18.
Hum Resour Health ; 12 Suppl 1: S5, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25859744

RESUMO

BACKGROUND: The ever increasing demand for surgical services in sub-Saharan Africa is creating a need to increase the number of health workers able to provide surgical care. This calls for the optimisation of all available human resources to provide universal access to essential and emergency surgical services. One way of optimising already scarce human resources for health is by clarifying job descriptions to guide the scope of practice, measuring rewards/benefits for the health workers providing surgical care, and informing education and training for health professionals. This study set out to determine the scope of the mandate to perform surgical procedures in current job descriptions of surgical care health professionals in Uganda. METHODS: A document review was conducted of job descriptions for the health professionals responsible for surgical service delivery in the Ugandan Health care system. The job descriptions were extracted and subjected to a qualitative content data analysis approach using a text based RQDA package of the open source R statistical computing software. RESULTS: It was observed that there was no explicit mention of assignment of delivery of surgical services to a particular cadre. Instead the bulk of direct patient related care, including surgical attention, was assigned to the lower cadres, in particular the medical officer. Senior cadres were assigned to perform predominantly advisory and managerial roles in the health care system. In addition, a no cost opportunity to task shift surgical service delivery to the senior clinical officers was identified. CONCLUSIONS: There is a need to specifically assign the mandate to provide surgical care tasks, according to degree of complexity, to adequately trained cadres of health workers. Health professionals' current job descriptions are not explicit, and therefore do not adequately support proper training, deployment, defined scope of practice, and remuneration for equitable surgical service delivery in Uganda. Such deliberate assignment of mandates will provide a means of increasing surgical service delivery through further optimisation of the available human resources for health.


Assuntos
Pessoal de Saúde , Descrição de Cargo , Centros Cirúrgicos , Bases de Dados Factuais , Humanos , Pesquisa Qualitativa , Uganda , Recursos Humanos
19.
BMC Med Educ ; 13: 73, 2013 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-23706079

RESUMO

INTRODUCTION: Of more than the 2,323 recognized and operating medical schools in 177 countries (world wide) not all are subjected to external evaluation and accreditation procedures. Quality Assurance in medical education is part of a medical school's ethical responsibility and social accountability. Pushing this agenda in the midst of resource limitation, numerous competing interests and an already overwhelmed workforce were some of the challenges faced but it is a critical element of our medical profession's social contract. This analysis paper highlights the process of standard defining for Medical Education in a typically low resourced sub Saharan medial school environment. METHODS: The World Federation for Medical Education template was used as an operating point to define standards. A wide range of stakeholders participated and meaningfully contributed in several consensus meetings. Effective participatory techniques were used for the information gathering process and analysis. RESULTS: Standards with a clear intent to enhance education were set through consensus. A cyclic process of continually measuring, judging and improving all standards was agreed and defined. Examples of the domains tackled are stated. CONCLUSION: Our efforts are good for our patients, our communities and for the future of health care in Uganda and the East African region.


Assuntos
Acreditação , Faculdades de Medicina/normas , Acreditação/métodos , Acreditação/normas , Educação Médica/normas , Humanos , Uganda
20.
BMC Oral Health ; 13: 15, 2013 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-23497340

RESUMO

BACKGROUND: Tooth eruption is a continuous biological process by which developing teeth emerge through the jaws and the overlying mucosa to enter into the oral cavity. Tooth eruption time and sequence are important factors in dental treatment planning, particularly in orthodontics, but also in forensic dentistry to estimate age of a child. Tooth eruption time is influenced by many factors. In this study we set out to determine the timing of eruption of permanent teeth and assess its association with the height and weight of school children aged 4-15 years in Kampala, Uganda. METHODS: This was a cross sectional study comprising of 1041 healthy Ugandan children: boys/girls (520/521) who were consecutively selected from two primary schools in Kampala. The children were clinically assessed for tooth emergency through the oral mucosa as well as measuring their weight and height. The mean and standard deviation of tooth eruption time was estimated for boys and girls. Bivariate analysis was used to assess any significant association between tooth eruption time and demographic variables. Pearson and partial correlation analyses were used to assess any significant association between the tooth eruption time and anthropometric measurements of the children. RESULTS: Generally, the mean eruption times for girls were lower compared to boys except for three teeth (#25, #32 and #42) which erupted earlier in boys. The average difference in mean eruption times of all teeth between boys and girls was found to be 0.8 (range, 0-1.5) years. In partial correlation analysis, mean tooth eruption times were positively, but not significantly associated with height while controlling for weight except for the mandibular left central incisor (#31). On the other hand, in partial correlation analysis, mean tooth eruption times were positively associated with weight while controlling for height except for tooth #11, #16, #26 and #41. The weight of the child was significantly correlated with mean eruption times in 50% of the teeth. CONCLUSION: In the present study, the mean tooth eruption times for girls were lower compared to boys except for three teeth (#25, #32 and #42). The height of the child did not show any significant influence on the tooth eruption times while the influence of weight on tooth eruption times was non-conclusive.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Dentição Permanente , Erupção Dentária/fisiologia , Adolescente , Análise de Variância , Estatura , Peso Corporal , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Valores de Referência , Fatores Sexuais , Estatísticas não Paramétricas , Uganda , População Urbana
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