Young adults’ experiences of dialysis and kidney transplant decision-making.

Background Young adults with end-stage kidney disease make decisions to select a renal replacement therapy choice with the support of healthcare professionals once their kidneys fail. However, little is known about how they experience dialysis and kidney transplant decision-making and the effects on their well-being. Aim The aim was to explore how young adults who are diagnosed with end-stage kidney disease experience dialysis and/or kidney transplant decision-making, understand the meaning of their lived experiences, and investigate the effects of decision-making andchoice on their well-being. Methodology Interpretive phenomenology, informed by Heidegger’s hermeneutic principles, was used to purposefully recruit young adults with end-stage kidney disease through social media. A qualitative design using semi-structured interviews were conducted and the data analysed using Braun and Clarke’s thematic analysis approach. Findings Eighteen participants aged 18-30 years old were interviewed. Five themes developed from the analysis include: (1) world turned upside down; (2) experience of information delivery about options; (3) the experience of making my voice heard; (4) experiencing the new normal; and (5) the impact of decision-making and choice on well-being. Conclusion and original contribution This study illuminates our understanding of how young adults experience kidney therapy decision-making and their unmet informational and decisional needs. The majority struggle to cope due to the lack of support during the decision-making process. Kidney therapy decision-making and experiencing choice about therapies affect young adults’whole world and significantly impact their physical, psychosocial, and mental well-being.This thesis proposes a four-talk model, adding a new phase (‘implement talk’) to the existing phases (team talk, option talk, decision talk), to address some of the young adults’ unmet decisional needs and better support their well-being during the decision-making process

The adequacy of corporate mandatory disclosure practices on emerging markets: a case study of the Zimbabwe stock exchange.

This research study is descriptive, normative and empirical in scope. The main purpose of the study, reported in this thesis, is to empirically investigate the "adequacy" of mandatory information disclosure practices of public companies listed on an anglophone African stock exchange classified as an emerging equity stock market by the International Finance Corporation (IFC), and to assess the "stringency" of the disclosure regulatory regime of that market. The study also investigates the characteristics of the relationship between some selected corporate attributes and mandatory disclosure. The corporate attributes examined are: company size, audit quality, ownership structure of equity shares, industry-type, company age, multinational corporation affiliation, profitability, and liquidity. A sample of 49 non-financial companies listed on the Zimbabwe Stock Exchange (ZSE) as of 31 December 1994 formed the basis of the conclusions reported in this thesis. To measure the "adequacy" of mandatory disclosure in the annual reports and accounts of these companies, a disclosure measuring instrument was constructed consisting of information items required by companies law, financial accounting standards, and listing rules of the ZSE. Applying the measuring instrument against the annual reports and accounts of the sampled companies, their mandatory disclosure scores were obtained, and were used with other data specific to each sample company to test the relational hypotheses. To investigate the adequacy of mandatory disclosure practices of the sample companies, a descriptive statistical analysis was undertaken. The results of this analysis suggest that the amount of mandated information disclosed in the annual reports and accounts of these companies is inadequate for the information needs of users of annual reports and accounts in Zimbabwe. There were several instances where none of the sample companies disclosed the required information items. In another respect, the stringency of the disclosure regulatory regime of the stock exchange was empirically assessed with both a Paired sample t test and Wilcoxon signed-rank test. The results of these tests indicate that the disclosure regulatory regime of the stock market is less stringent. Although it has an elaborate monitoring and enforcement mechanisms, it failed to secure full compliance with its disclosure requirements in practice as there were several instances of non-compliance. To ascertain the nature and the strength of the relationship between the corporate attributes and mandatory disclosure, both correlation and multivariate regression analyses were undertaken. The results of the correlation analysis showed that only company age has a significant positive relationship with the extent of mandatory disclosure. In contrast, a robust regression analysis indicated that company size, ownership structure, company age, multinational corporation affiliation, and profitability are positively significantly associated with the extent of mandatory disclosure in Zimbabwe. Thus, of the eight corporate attributes, only company size, ownership structure, company age, multinational corporation affiliation, and profitability "best" explained mandatory disclosure behaviour of the sample companies. On the whole, the results of this study provide support to the general view and prior studies that disclosure practices of emerging equity stock market listed companies are inadequate due to weak monitoring and enforcement of disclosure requirements. It is recommended in this study that the disclosure regulatory regime should be made stringent to minimise non-compliance with requirements by increasing the number of annual reports and accounts of public listed companies that is reviewed annually under the existing monitoring and enforcement mechanisms. This will ensure that each listed company is subject to the review process, at least, once in every three years

Young adults' experiences of dialysis or kidney transplant decision-making

Young adults with kidney failure experience disruptions in their education, growth development, building relationships and face employment problems during the journey of the disease (Murray et al., 2014). Once their kidneys fail, they need to make a choice about which dialysis treatment to have or whether they prefer the option of kidney transplant. So, they have to work with their health care professionals to make decisions to select their preferred dialysis or kidney transplant choice. This is known as shared decision-making. The three-talk model of shared decision making shown on the screen is used as a guide by health care professionals to encourage discussions of treatment options with patients during the shared decision-making process (Elwyn et al., 2018). A recent report by the renal registry highlighted that over 50% of young adults with kidney failure started haemodialysis as their first treatment option and less of them (14.1%) received a kidney transplant, although kidney transplantation is recommended as the best treatment (NICE, 2014). Evidence suggests that among adults with kidney failure, not all patients receive timely information on kidney failure treatment options to enable them share in the decision-making or make an informed choice, which falls short of the recommended guidelines. It matters because little is known about young adults with kidney failure experiences of dialysis or kidney transplant decision-making and how the decision to select a dialysis or kidney transplant choice may have impacted on their psychosocial and mental well-being. This is where my study plays an important role. Our involvement group who have dialysis and kidney transplant experiences as children and young adults, suggested that the study should focus on the impact of decision-making on the psychosocial and mental well-being of young adults as it was a neglected area and their views incorporated. My study will explore young adults’ experiences of decision-making to select a dialysis or kidney transplant choice. It will examine the impact of dialysis or kidney transplant decision-making on young adults psychosocial and mental well-being. Lastly it will seek to understand how young adults can be better supported during the decision-making process to enhance their coping abilities and participation in the decision-making process

Biomass yield and fodder quality of Napier grass (Pennisetum purpureum) as affected by Pigeon pea (Cajanus cajan) intercrop and planting distance

The study sought to investigate the effect of two planting distances and Pigeon Pea (Cajanus cajan) intercrop on the biomass yield, chemical composition and in vitro organic matter digestibility (IVOMD) of Napier grass (Pennisetum purpureum). The treatments were laid in a 2x2 factorial RCBD. The factors were two planting distances (0.5x0.5 and 0.5x1m) and two levels of intercrop (Pigeon Pea intercrop and sole Napier grass). At 90-days, the grasses were harvested and biomass yield measured. The fodder was separated into leaves and stems for chemical and digestibility analysis in 2x2x2 factorial in CRD. The interaction at all levels was not significant for all the parameters. There was a significant main effect of planting distance, intercrop and botanical fraction on biomass yield, plant height, tiller number and fodder quality. Whilst biomass yield was higher (P=0.02) in the 0.5x0.5m, no significant difference was recorded in the effect of the intercrop. Whilst intercrop affected (P<0.05) IVOMD and ME, botanical fraction significantly affected DM, CP and ME. The leaf fraction had more (P<0.05) DM, CP and ME than the stem fraction. The study revealed that close planting distance enhanced biomass yield whilst Pigeon Pea intercrop and botanical fraction affected fodder quality of Napier grass

Assessment of citrus diversity in Ghana

Citrus is among the plant germplasm conserved at the CSIR - Plant Genetic Resources Research Institute (CSIR - PGRRI), Bunso in Ghana; however, due to lack of information on the specific traits of this germplasm at the Institute, the potential diversity within the collection is not yet fully exploited. The objective of this study was to evaluate the morphological diversity among the citrus accessions under conservation at the field genebank of the CSIR - PGRRI, Bunso, Eastern region of Ghana. The various accessions were raised on rough lemon rootstocks, planted using the augmented design. The citrus accessions evaluated include different citrus types suitable for different purposes, such as Flying Dragon for rootstock, Sweet Lime for medicine and Mediterranean Sweet for fruit drink. Late Valencia and Mediterranean Sweet were used as checks. Planting was done at 8 m by 8 m. Apart from watering immediately after planting, the plants grew under natural condition without irrigation. Variability was revealed by all the traits studied, including scion trunk surface, tree shape, tree growth habit and branch angle, based on IPGRI descriptors for citrus. The resulting phylogenic tree clustered the citrus accessions mainly based on known genetic relationships, using the clustering away of citrons from mandarins as an example. Although the morphological traits used in the characterisation were not sophisticated, they were useful in discriminating among the accessions. Based on this study, the citrus genebank at CSIR - PGRRI, Bunso, Eastern region of Ghana contains 44 morphologically distinct accessions. The information generated in this study is important for guiding conservation and utilisation decisions geared towards the improvement of the citrus sub-sector in the country

Improved forage cultivation for increased in fodder availability and climate change mitigation in the Savanna agro-ecological zone of northern Ghana

The study was conducted to investigate the biomass yield and quality of two forage species Brachiaria ruziziensis (B. ruziziensis) and Sorghum almum (S. almum) in a Randomized Complete Block Design (RCBD) in two different locations (Bihinayili in the Savelugu District and Zanlerigu in the Nabdam District) in the Savanna agro-ecological zone of Ghana. Agronomic data were collected and representative samples of forage biomass taken at 60 days after planting to estimate dry matter yield and nutritive quality. The two-way interaction effect of forage species and experimental site was not significant for both agronomic and chemical parameters except for tiller number. The average leaf size was broader (P=0.006) in S. almum (299.0 cm2) than B. ruziziensis (85.0 cm2). Number of leaves per plant was higher (P=0.016) in B. ruziziensis (10.75). Number of tillers per plant in B. ruziziensis (9.62) was higher (P=0.001) than S. almum (2.88). Plant height was however, higher in S. almum (183.1 cm) than B. ruziziensis (90.1 cm). Dry matter yield of forages at 60 days after planting was higher (P<0.001) at Bihinayili (8.49 tons/ha) than that at Zanlerigu (2.23 tons/ha). The CP content of the forages at Bihinayili (89.7 g/kg DM) was also higher (P=0.018) than that at Zanlerigu (68.6 g/kg DM). Dry matter yield of B. ruziziensis (4.84 tons/ha) did not differ significantly from that of S. almum (5.88 tons/ha). In conclusion, B. ruziziensis and S. almum performed well within the Savanna agroecological zone and could enhance fodder supply and carbon sequestration

Packaging Research Outputs into Extension and Training Materials: Experiences and Lessons Learned in Development of Grains in Ghana

La recherche engendre beaucoup de technologies qui restent sous-dissemineés. Donc l'objectif principal de propager les résultats de la recherche aux utilisateurs n'est jamais achevé. Le papier décritles expériences et les leçons apprises lors du conditionnement des résultats de la recherche en matériau de la formation et la vulgarisation pour l'utilisation des paysans et des vulgarisations sous le prójet du dévéloppement des grains au Ghana. Basé sur les expériences et les leçons apprises, une série de récommendations sont proposées pour améliorer le processus de la production du matériau de la formation et la vulgarisation. Ce sont:i) déterminer le type du matériau à produire et pourquoi,ii) appliquer un plan efficace d'écriture et de rédaction,iii) employer les dessins appropriés,iv) évaluer les matériaux pendant et après la production.Research generates numerous technologies that remain under-disseminated. As a result one primary objective of research to develop improved production systems and get the research results out to the user is not achieved. This paper describes the experiences and lessonslearned in packaging research outputs into extension and training materials for use by extension workers and farmers under the Ghana Grains Development Project. Based on the experiences and lessons learned, a series of recommendations are made for improving theproduction process of extension and training materials. These emphasize (i) determining the type of material to be produced and why, (ii) applying effective writing and editing guidelines, (iii) using appropriate designs and (iv) to evaluate materials during and after production

Review of critical success factors for the implementation of total quality management in the construction industry

Abstract: Total Quality Management (TQM) is a philosophy that involves every organization in the industry in the effort to improve performance. The concept is an integrative management principle for continuously improving the quality of products and processes to achieve customer satisfaction. To achieve this concept required a clear establishment of Critical Success Factors (CSFs). However, lack of clear establishment of CSFs for the implementation of TQM in the construction industry has led to failure of the system. In the pursuit of performance excellence in the construction industry and with an increasing awareness of construction quality, construction firms have no option than to implement TQM with clear CSFs

The use of free autogenous rib grafts in maxillofacial reconstruction

Background: Hard tissue defects in the maxillofacial region due to trauma or ablative surgery result in functional and cosmetic problems. State-of-theart methods for reconstruction include the use of vascularised tissue. Objective: To review our results with the use of non-vascularised rib grafts for maxillofacial reconstruction. Method: Patients who underwent maxillofacial reconstruction using rib at the Komfo Anokye Teaching Hospital during 1996-2004 were studied. The technique for rib harvest and implantation of the graft was standardized. Clindamycin was administered peri-operatively and the harvested rib was temporarily stored in clindamycin/saline before implantation. The graft was successful if it survived beyond 6 months after placement. Follow- up was for at least 12months postoperatively. Results: A total of 29 patients were studied. The indications for grafting included ameloblastoma, malignant disease, cyst, ankylosis, and trauma. Either rib bone only or with cartilage were used. In 90% of patients (26/29) the graft healed uneventfully. Two patients had dehiscence of the wound with exposure of the graft intraorally within two weeks of surgery and were successfully managed with antibiotics. Conclusion: Free autogenous rib was successfully used to reconstruct defects in the maxillofacial region. Further stabilization of the graft by intermaxillary fixation and the prophylactic use of clindamycin may have helped to minimize complications