Quality of life among vitiligo patients attending dermatology out-patient clinics in Johannesburg

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Medicine in the discipline of Dermatology Johannesburg, 2017Introduction: Vitiligo is a skin pigmentation disorder and has an estimated global prevalence of around one to two percent. Vitiligo can significantly affect patients’ Quality of life (QoL). It is cosmetically and psychologically devastating, and can affect anyone irrespective of race, skin type or ethnicity. There is a paucity of research evaluating the QoL amongst vitiligo patients in Africa and Sub-Saharan Africa in particular. The objectives of this study were to demonstrate how vitiligo has altered the QoL of vitiligo patients treated at the skin outpatients’ clinics in Johannesburg, South Africa. Methods: Our research was a prospective cross-sectional study of all individuals who were diagnosed with vitiligo at the three dermatology outpatients’ clinics in three academic public hospitals, and the phototherapy daycare centre in Johannesburg. All patients fulfilling the inclusion criteria were requested to take part in the study. Data was obtained from enrolled individuals using a data collection sheet and the Dermatology Life Quality index questionnaire. This information was analysed using statistical software (STATA version 12). Results: A total of ninety-five (n=95) respondents were included as per inclusion criteria in our study. Our cohort comprised of sixty-two females (n=62, 65.26%), thirty-three males (n=33, 34. 74%). DLQI scores were in the ranges of 0 to 28 and the mean was 10.06±6.52, which indicates a moderate Quality of life (QoL) impairment in our cohort. Conclusion: Our study has shown that vitiligo moderately affects the QOL life of adult South African vitiligo patients. Therefore, treatment measures should be directed towards medical and psychological aspects of our patients for better treatment outcomes and improved QoL. This would be an argument for establishment of psychodermatology clinics at our referral hospitals.MT201

The predictors of and experiences in the use of maternal healthcare services by unmarried youth in Uganda

IntroductionUganda has a high maternal mortality rate combined with poor use of maternal health services among unmarried youth. Improved use of maternal health services by unmarried youth would help reduce maternal deaths in the country. A better understanding of the reasons for the poor use of maternal health services, and the needs and priorities of young women is necessary for designing appropriate policies to address the problem of maternal mortality in Uganda.The Andersen’s behavioural model of access to medical care provided a framework for this study. This thesis explores: predisposing and enabling factors associated with the use of maternal health services among unmarried (compared to married) youth aged 15- 24 years between 1995 and 2011; and the experiences of unmarried youth aged 15-19 years during the maternity period in Uganda. More specifically, it examines: i). predisposing and enabling factors associated with the timing and the number of antenatal care visits among unmarried (compared to married) youth aged 15-24 years; ii) the variation in enabling and predisposing factors associated with the use of health facilities at childbirth among unmarried (compared to married) youth, aged 15-24 years; iii). the experiences and support for unmarried youth aged 15-19 years at home and in the community during the maternity period; and iv). the health providers’ perspectives in the use of maternal health care services for unmarried youth aged 15-19 years in Uganda.MethodologyUsing a sequential explanatory mixed methods design, two-level binary logistic and linear regression models with district as a second level of analysis were conducted on pooled data of the 1995, 2000/01, 2006 and 2011 Uganda Demographic and Health Surveys. This analysis was among 581 unmarried, compared to 5,437 married youth, aged 15-24 years. Qualitative data collection that followed was conducted among purposively sampled unmarried youth who were pregnant or had had a birth within three years before fieldwork aged between 15-19 years (14 in-depth interviews & 8 focus group discussions). Seven in-depth interviews with youth parents and seven key informant interviews with health providers in Bushenyi and Kibale districts of western Uganda were also carried out. Lived experiences and support to unmarried youth at their homes, in the community, and health facilities were explored using interpretative phenomenological analysis.ResultsThe levels of using antenatal care in the first trimester were generally low among youth, and unmarried youth were less likely to start antenatal care early compared to married youth. Education was the only factor that was significantly associated with the use of antenatal care in the first trimester among unmarried youth. Education predicted use of antenatal care in the first trimester among both unmarried and married youth, but the association was in the opposite direction. Whereas high education was associated with higher chances of the use of antenatal care in the first trimester among married youth (OR=1.30, 95%CI=1.08-1.57), it was associated with late start among unmarried youth (OR=0.56, 95%CI=0.31-0.98). In addition, higher parity, protestant membership and residence in eastern region were associated with late start of antenatal care, while access to radio and television, and at least primary education level of the partner were associated with higher odds of the use of antenatal care in the first trimester among married youth.It was observed that overall, married youth were more likely to have more frequent antenatal care visits than unmarried youth during the study period. Among unmarried and married youth, higher educational attainment and greater access to radio were associated with frequent antenatal care use. Although high wealth index was associated with more antenatal care visits among unmarried youth (Estimate=0.889, SE=0.424), married youth in highest wealth quintile were associated with infrequent antenatal care (Estimate= -0.334, SE=0.131). Residing in western region was associated with fewer antenatal care visits among both married and unmarried youth. Additionally, married youth living in esstern Uganda had fewer antenatal care visits. Also, access to newspaper was associated with more antenatal care visits among married youth though not among unmarried youth.Overall, unmarried youth had higher chances of having a childbirth within the health facilities than married youth. Most individual level factors were consistent with patterns observed in the literature among youth, for instance higher educational attainment and access to mass media were asoociated with higher odds of the use of health facilities at childbirth while higher parity and rural residence were associated with a lower likelihood of the use of health facilities at childbirth. However, some unique patterns emerged. For instance, both unmarried and married youth engaged in agriculture activities had a lower likelihood of using health facilities at child birth compared to non- working youth (OR=0.47, 95%CI=0.25-0.89 for unmarried vs OR=0.70, 95%CI=0.57- 0.87 for unmarried). Among married youth, use of health facilities was lower among those residing in western region compared to those residing in central region (OR=0.55, 95%CI=0.34-0.88), yet not among unmarried youth. Membership of other religions, middle and highest wealth quintiles, more access to radio, high partner education, and residing in a district with a middle education level district were associated with increased chances of the use of health facilities at childbirth among married youth but not among unmarried youth.The qualitative results reveal that unmarried youth in Bushenyi and Kibale districts of western Uganda had mixed experiences through the maternity period. Most youth experienced psychological distress because of negative attitudes from family, partners and community, and health providers. They were abused by parents, partners denied responsibility for the pregnancies, and most had limited support for their needs during this difficult time. Some got support with information, hospital requirement, and basic needs from parents especially mothers. Few youths got support from their fathers, partners, and community members. Mothers were supportive of the youth mostly to discourage them from engaging in risky abortion.At the health facilities, sharing of information was not tailored to unmarried youth who were pregnant for the first time. Most young women were mistreated by health providers. They waited for long hours to receive the services in a non-private general waiting area, and some were denied services because they did not go with their partners as the implementation of a policy aimed at increasing male involvement in reproductive health gave priority to couples. A few were satisfied with the competence of the health providers, reported better treatment from the male providers, good maternal and child care information, and appreciated supplies like mama kits provided at the health facilities. All these experiences influenced the unmarried youth’ use of maternal health services. The qualitative data were also used to explain some of the observed trends and associations in the quantitative analysis.ConclusionAlthough predisposing and enabling factors are important predictors of the use of maternal health care services, the findings on environment, need, and health provider factors like provider attitudes and implementation of a policy on increasing male involvement in reproductive health services as well as the change in parents’ attitudes provide crucial areas for policy intervention. The study provides important findings where policies should be focused to overcome barriers to the use of maternal health care services and reduce maternal deaths among unmarried youth in Uganda

Adaptive Process Distribution at the Edge of IoT using the Integration of BPMS and Containerization

Täna levivad pilvepõhised värkvõrgu (asjade interneti) süsteemid tuginevad protsesside halduseks kaugel asuvatel andmekeskustel, mis toob endaga kaasa latentsusprobleeme. Vastusena sellele probleemile on varem välja pakutud servaarvutuse lähenemine, kus arvutused viiakse läbi asjade interneti süsteemi võrgule füüsiliselt lähemal. Mitmete servaarvutuse metoodikate seas on uduarvutus lähenemine, kus rõhk on arvutuste liigutamisel värkvõrgu seadmetele endile. Ehkki uduarvutusel põhinev arhitektuur on paljutõotav, tõstatab see küsimuse – kuidas värkvõrgu protsessihaldussüsteemid (BPMS4IoT-süsteemid) äriprotsesse heterogeensetele värkvõrgu seadmetele jaotama peaksid? Levinud on lähenemine, kus protsesside töövooülesannete käituseks tuginetakse ühisele platvormile. Näiteks, kui haldusserver defineerib teatud töövoo ülesandena Pythoni skripti ja määrab selle seadmele, siis peab seadme töövookäitusmootor toetama vastavat mehhanismi skriptide jooksutamiseks. Selline nõue ei ole paindlik, arvestades värkvõrgu seadmete heterogeensust. Käesolevas magistritöös pakub autor välja raamistiku, mis eraldab töövoo ülesannete käitusmeetodi käitusmootorist kasutades selleks konteinertehnoloogiat. Töö käigus arendati välja raamistiku prototüüp ning viidi läbi katseid mikroarvutitel põhinevail seadmetel. Lisaks võrreldi väljapakutud uduarvutuse raamistiku jõudlust pilvearvutusel põhineva süsteemiga.Emerging cloud-centric Internet of Things (IoT) system relies on distant data centers to manage the entire processes, which raises the issue of latency. To address the issue, researchers have introduced the Edge computing methodologies that carry out computation closer to the edge network of IoT system. Among the numerous Edge computing approaches, Mist computing paradigm emphasises the mechanism that moves the computation further to the front-end IoT devices. Although the architecture of Mist computing is promising, it raises a new challenge in how the Business Process Management System for IoT (BPMS4IoT) distributes the business process workflow to the heterogeneous IoT devices? In general, executing business process workflows relies on the common platform for executing customized tasks. For example, if the management server defines a Python script task in a workflow, which has been allocated to an IoT device, the workflow engine of the IoT device must have the compatible execution method. Such a requirement is less flexible when one considers the heterogeneity of the IoT devices. Therefore, in this thesis, the author proposes a framework to decouple the workflow task execution method from the workflow engines using the containerization technology. A proof-of-concept prototype has been developed and has been tested on several single-board computers-based IoT devices. Further, a case study has been performed to demonstrate the performance of the proposed framework comparing to the cloud-centric system

System design of the MeerKAT L - band 3D radar for monitoring near earth objects

This thesis investigates the current knowledge of small space debris (diameter less than 10 cm) and potentially hazardous asteroids (PHA) by the use of radar systems. It clearly identifies the challenges involved in detecting and tracking of small space debris and PHAs. The most significant challenges include: difficulty in tracking small space debris due to orbital instability and reduced radar cross-section (RCS), errors in some existing data sets, the lack of dedicated or contributing instruments in the Southern Hemisphere, and the large cost involved in building a high-performance radar for this purpose. This thesis investigates the cooperative use of the KAT-7 (7 antennas) and MeerKAT (64 antennas) radio telescope receivers in a radar system to improve monitoring of small debris and PHAs was investigated using theory and simulations, as a cost-effective solution. Parameters for a low cost and high-performance radar were chosen, based on the receiver digital back-end. Data from such radars will be used to add to existing catalogues thereby creating a constantly updated database of near Earth objects and bridging the data gap that is currently being filled by mathematical models. Based on literature and system requirements, quasi-monostatic, bistatic, multistatic, single input multiple output (SIMO) radar configurations were proposed for radio telescope arrays in detecting, tracking and imaging small space debris in the low Earth orbit (LEO) and PHAs. The maximum dwell time possible for the radar geometry was found to be 30 seconds, with coherent integration limitations of 2 ms and 121 ms for accelerating and non-accelerating targets, respectively. The multistatic and SIMO radar configurations showed sufficient detection (SNR 13 dB) for small debris and quasi-monostatic configuration for PHAs. Radar detection, tracking and imaging (ISAR) simulations were compared to theory and ambiguities in range and Doppler were compensated for. The main contribution made by this work is a system design for a high performance, cost effective 3D radar that uses the KAT-7 and MeerKAT radio telescope receivers in a commensal manner. Comparing theory and simulations, the SNR improvement, dwell time increase, tracking and imaging capabilities, for small debris and PHAs compared to existing assets, was illustrated. Since the MeerKAT radio telescope is a precursor for the SKA Africa, extrapolating the capabilities of the MeerKAT radar to the SKA radar implies that it would be the most sensitive and high performing contributor to space situational awareness, upon its completion. From this feasibility study, the MeerKAT 3D distributed radar will be able to detect debris of diameter less than 10 cm at altitudes between 700 km to 900 km, and PHAs, with a range resolution of 15 m, a minimum SNR of 14 dB for 152 pulses for a coherent integration time of 2.02 ms. The target range (derived from the two way delay), velocity (from Doppler frequency) and direction will be measured within an accuracy of: 2.116 m, 15.519 m/s, 0.083° (single antenna), respectively. The range, velocity accuracies and SNR affect orbit prediction accuracy by 0.021 minutes for orbit period and 0.0057° for orbit inclination. The multistatic radar was found to be the most suitable and computationally efficient configuration compared to the bistatic and SIMO configurations, and beamforming should be implemented as required by specific target geometry

How I improvised an external fixator to manage open fractures

No Abstrac

Calibration of a SuperDARN Radar Antenna by means of a Satellite Beacon

This dissertation reports on the investigation to determine which orbits, ionospheric conditions and seasons of the year that will facilitate the reception of the high frequency (HF) beacon signal from the 1 U CubeSat ZACUBE 1 by the SuperDARN HF radar in Antarctica, and by the HF direction-finding (DF) systems in both Pretoria and Hermanus. The primary objective of the HF beacon on ZACUBE 1 is to provide a continuous radio signal to calibrate and verify the elevation-resolving algorithm of the SuperDARN HF Radar antenna at SANAE IV in Antarctica. The signal will also be used to characterise the beam pattern of this and other HF radar antennas in the SuperDARN network, and to characterise the ionosphere over the Earth’s polar region. A secondary objective of the HF beacon on the satellite is to measure the ionospheric total electron content (TEC) by using either measurements of the carrier phase delays or of the Faraday rotation of the signal. An orbit analysis was done for the CubeSat using parameters for an orbit at an altitude of 600 km and inclination angles of 97.8° and 65°. To account for the propagation effects of the radio wave at 14.099 MHz, the IRI-2007 model and the Chapman layer model were used to define the ionosphere. A ray tracing algorithm written in MATLAB was used to simulate the ray paths. To evaluate the results, a documented ray tracing algorithm known as Haselgrove ray tracing was used. The results obtained show that for an orbit at an inclination above 70° and altitude of 600 km, a number of rays actually traverse the ionosphere and reach the receivers during most of the year for a sufficient period of time during every pass. The least refraction is experienced during winter, therefore it is the best time for the calibration of the radar antenna. The results indicate that the objectives of the CubeSat mission should be achieved

Incorporating Exponential Functions into an Optimal Control Model for a Chronic Wound

A chronic wound is a wound that does not heal in an orderly manner and on time. In this project, we simulate different ways of minimizing the time of therapy using exponential functions. The analysis in this research project focuses on treating chronic wounds using both mathematical and biological models. These models primarily focus on the amount of oxygen supplied to the wound using both hyperbaric and topical oxygen therapies. This amount should be optimal since too much oxygen is toxic to the body, and can potentially lead to death. The goal is to minimize the time spent in therapies since longer periods make treatments costlier. In this project, we incorporate exponential functions into several existing models of wound healing

Modelling the Spread of COVID-19 with Impact of Awareness and Medical Assistance

Coronavirus disease 2019 originated from Wuhan, China and spread rapidly across the globe. The virus was first identified in Nigeria on 27th February, 2020 and announced by the Minister of Health on 28th February, 2020 through a press briefing. As at 4th May, 2020, the Nigeria Centre for Disease Control recorded a total of 2,802 confirmed cases of COVID-19 individuals with 93 fatalities. Available data from inception to 4th May, 2020 were extracted from Nigeria Centre for Disease Control (NCDC) situation reports and used to trace the epidemic curves of COVID-19 in Nigeria. Furthermore, the disease transmission rate and the basic reproduction number were estimated by using an SEIHR epidemic model with the influence of awareness and medical assistance through MATLAB application. The results of the numerical evaluation of the model indicated that awareness dissemination aid in reducing the spread of COVID-19 and medical assistance has significant impact. The disease transmission rate and the basic reproduction number were estimated as  and  respectively. While the analysis predicted that the epidemic peak of COVID-19 in Nigeria will occur approximately 216 days from the inception of NCDC situation report. The overall outcome of the analysis advocates for more awareness campaign, accessible medical assistance and proper enforcement of adherence to strict measures for the control and possibly elimination of COVID-19. Keywords: COVID-19, Nigeria, Model, Basic reproduction number, Epidemic pea

Modelling the impact of insecurity on human existence and agricultural activities

Food constitutes one of the basic necessities of life and the availability of food supply to all and sundry provides the pedestals upon which human security is defined. In addition, the general quest for global development and advancement are often crippled in a society governed by food scarcity or insecurity. The cases of food and nutritional insecurity seems to be a worldwide challenge calling for urgent interventions, especially in this advent of banditry and herdsmen-farmers conflicts, a devastating state with enormous negative impacts on both human lives and the environs. This paper uses the concept of dynamical systems to derive a mathematical model that evaluates the impact of herdsmen/bandits attacks on the lives of farmers and their agricultural activities. The analytical outcome of the model is supplemented with numerical simulations using MATLAB mathematical applications. The results show that there exist significance influence of the exposure rate of the susceptible and the sponsoring of herdsmen attacks by some elites on the lives of farmers and the low engagement in agricultural activities. In addition, the number of migrants (including those that escape the nest of herdsmen with or without injury) increases in search for treatment and/or safety in nearby communities.  The analysis of some of the model parameters also provided useful information about the system dynamics leading to possible measures in curtailing insecurity for harmonious living among herdsmen and farmers. Keywords: Modelling, Agriculture, Herdsmen, Insecurity, Dynamical systems, Analysi