Developing a Framework Strategy for Supporting Radiographers in the Clinical Supervision of Radiography Students in Zambia: A Mixed Methods Study

BACKGROUND፡ Clinical supervisors of radiography students play a key role in the facilitation of practice-based learning. However, there is a scarcity of evidence-based strategies to support clinical supervisors. This study aimed at exploring the level of support required by radiographers in order to develop a framework strategy for supporting clinical supervisors ofradiography students in Zambia.METHODS: This study used an exploratory sequential mixedmethods approach. The qualitative phase was conducted first, and the findings were used to develop the questionnaire for the quantitative phase. The study population was radiographers working in the Lusaka and Copperbelt provinces of Zambia. For the first phase, data were collected from a purposive sample of 10 clinical supervisors of radiography students. For the survey, data were collected from 120 radiographers using a questionnaire. In the third phase, a group of experts validated the proposed framework using an online questionnaire. Qualitative data were analysed thematically and quantitative data using statistics.RESULTS: Four support areas were identified: training and education in clinical supervision, clinical training resources, human resources and relationships, and quality assurance programmes related to clinical supervision. These findings informed the development of a support framework strategy for clinical supervisors.CONCLUSION: This study has revealed that clinical supervision of radiography students requires coordinated support from stakeholders: schools of radiography, professional body, and radiology and hospital management. It is anticipated that the developed framework, when implemented, will enhance the experiences of clinical supervisors and improve the quality of clinical education

How to Conduct a Qualitative Systematic Review to Guide Evidence-Based Practice in Radiography

In recent years, there has been emphasis on evidence-based practice. Traditionally, systematic reviews of quantitative evidence on randomized clinical trials (RCTs) and the effectiveness of technology in radiography provided the evidence on which to base decisions for patients and policies. However, there has been a recognition that to have in-depth understanding into human behaviour, opinions and experiences also requires evidence-based literature from systematic reviews of qualitative evidence. Unfortunately, there is limited educational literature on how to conduct systematic reviews of qualitative evidence. Therefore, this article provides this information to radiographers, radiography students and other healthcare professionals. This information is applicable in both clinical and educational settings

Knowledge, Attitude and Practices towards Corona Virus Disease 2019 among Allied Health Students: A Case Study at International Paramedical Institute-Maya, Wakiso District.

Background:  Coronavirus disease 2019 (Covid-19) is a disease caused by a new strain of coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 was first detected as a respiratory illness in December 2019 in Wuhan City, China, and in March 2020, the World Health Organization classified covid-19 as an international pandemic. This study was done to find out the Knowledge, Attitude, and Practices toward COVID-19 amongst Allied Health students of International Paramedical Institute- Maya using interviewer-administered questionnaires Methodology:  The study was cross-sectional and descriptive. The cross-sectional design utilized surveys to generate quantitative data at the time of data collection. It was cross-sectional because data were collected at one point in time without having to follow up with the study participants thus making the method cheap to execute. Qualitative data was collected using closed-ended researcher-administered questionnaires. It was of an advantage to the researcher because it was affordable and suitable for a short time frame. The survey was conducted in January 2022 and it included 384 participants. Results:  Results of the study revealed that the majority of the allied health students had good knowledge, attitude, and practice toward COVID-19. All the parameters considered to assess knowledge, attitude, and practices had a percentage greater than 50%. Conclusion:   Allied health students at International Paramedical Institute were found to have good knowledge, an optimistic attitude, and appropriate preventive practices toward COVID-19.  Recommendations:  The researcher recommends further studies on larger numbers, diverse responders, and at a community level which will allow us to know the KAP towards COVID-19 in a broad perspective and can be an important tool to plan preventive measures

Attitudes, Practices and Knowledge of Communities Towards Climate Change Around Lake Mburo National Park Uganda: A Gender Centered Analysis

Abstract The study was done to assess gender dimensions in relation to climate change attitudes and adaptation strategies among small holder crop farmers, pastoralists and ago-pastoralists of Isingiro and Kiruhura districts, among communities surrounding Lake Mburo National Park in Uganda. The study contributes to the theoretical and conceptual discourse on climate change and varied gender responses. Through the lenses of gender socialization, the study reviewed men and women’s attitudinal responses to climate change: a pragmatic research paradigm was used based on a thematic review model. Participatory methods and a questionnaire were used to collect data. Both sexes (99.5%) observed signs of climate change. The major causes of climate change were cutting of trees (39%, p\u3c0.001), drainage of swamps (21.9%, p\u3c0.01), use of solar panels (16.7%) and a curse from God (14.3%). More men (46.9%) than women (31.2%) (p\u3c0.001) said that cutting of trees was the cause of climate change. A highly significant (p=0.003) more women (19.4%) said the curse from God was a cause. The other causes mentioned had no gender differences. The major observed ecological effect of climate change was drought (39%, p\u3c0.001), followed by shifts of crop growing seasons (21.9%, p=0.01), increase in crop diseases and pests (13.5%) and soil erosion (11.3%). Significantly (p=0.0001) more men (18.4%) said soil erosion was the ecological effect of climate change than women (4.4%). There were no significant differences in gender responses identifying coping mechanisms to deal with the effects of climate change. The findings indicate that there were no salient climate change coping strategies adopted. On a low scale, communities, migrated to the neighboring districts and around LMNP in search of pasture and water; found alternative sources of income, sold cattle at salvage prices and reduced daily meals taken. In conclusion, the communities were aware that there was climate change but had no sustainable coping strategies adopted; hence the study recommends communal education on how to cope with climate change effects using a gender approach

Rapid tests for multidrug resistant tuberculosis in low income settings

Tuberculosis (TB) is at epidemic levels in the resource-limited settings (RLSs) due to HIV/AIDS, poverty and insufficient TB control programmes. These factors are also contributing to TB drug resistance. Patients with multidrug drug resistant tuberculosis (MDR-TB) do not respond to first line drugs. These patients require unique drug regimens, making it necessary to routinely screen for MDR-TB. Screening for MDR-TB with the Lowenstein-Jensen proportion method (LJPM), which is common in the RLSs is a very slow process taking 2-3 months. More rapid tests suitable for RLSs are urgently needed. In this thesis, a comparison of the technical and operational performance of several rapid tests for MDR-TB was done, and the most optimal tests for RLSs are proposed. In paper I, a meta-analysis of rapid tests for direct detection of MDR-TB was conducted. The direct nitrate reductase assay (NRA), microscopic observation drug susceptibility (MODS) and Genotype® MTBDRplus (GT-DRplus) were highly sensitive and specific, and far more rapid than the conventional indirect drug susceptibility testing (DST). In paper II, the NRA, MODS, Mycobacterium Growth Indicator Tube (MGIT 960), GT-DRplus, Alamar blue, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and resazurin assays were compared head-to-head for indirect detection of MDR-TB at the National Tuberculosis Reference Laboratory (NTRL) Kampala. The NRA, MGIT 960, GT-DRplus and MODS were the most sensitive and specific tests, with significantly shorter time to results compared to the LJPM. In paper III, the direct NRA and MODS assays were compared at the NTRL on sputum specimens from consecutive re-treatment TB patients. Interpretable results were obtained in over 90% of the samples with both assays. The median days to results were 10 with the NRA and 7 with MODS. The direct NRA was more sensitive and specific, and was cheaper. In paper IV, the sensitivity, specificity, time to results (TTR) and reproducibility of the direct GTDRplus against the MGIT 960 was assessed. Sensitivity and specificity were 100% and 96% for detection of rifampicin resistance; 81%, and 100% for isoniazid resistance; and 92%, and 96%, for MDR-TB, respectively. The TTR was 1-3 days, and concordance of results between the Molecular Laboratory at Makerere University and the FIND Diagnostics Laboratory was 98%. In paper V, we applied spoligotyping to study the clustering rate and predominant genotypic strains of 99 MDR-TB strains isolated from patients in Kampala. Eighty-three percent of the strains occurred in clusters, and the T2 lineage was the largest single cluster. Conclusion. The direct NRA and the GT-DRplus appear to be the most appropriate tests for MDR-TB in RLSs. The NRA being the cheapest test can be applied where resources are extremely limited, while the ultra rapid but commercially available GT-DRplus can be used where resources permit

Effective dose of radiation on the eye, thyroid and pelvic region resulting from exposures to the Galileos comfort cone beam computerized tomographic scanner

Degree of Master of Science in Dentistry by coursework and dissertation A research report submitted to the Faculty of Health Sciences, University of the Health Sciences. University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Dentistry Johannesburg, 2014Introduction: Dental Cone beam CT has encountered great success in diagnostics and treatment planning in dentistry. However, it makes use of ionizing radiation. Lots of concern on the effects of x-rays on vital organs of the head and neck region has been raised. Clarity on the amount of radiation received on these specific organs will be a contribution to a better use of the emergent technology. Aim: The aim of this study is to determine the potential dose of radiation received on the eye and thyroid and to quantify the amount of potential scatter on the gonads during CBCT examinations. Material and Methods: Calibrated Lithium- Fluoride thermoluminescent dosimeters were inserted inside an anthropomorphic phantom, on sites of the eye, thyroid and the gonads. After its submission to a CBCT examination, using the high and standard resolution for a similar scanning protocol, the dose of radiation received on each organ was calculated according to the ICRP guidelines. Results: An equivalent dose of 0.059 mGy was calculated for the eye. Compared to the threshold dose of 0.5 Gy fixed by the ICRP 2007, this can be considered as relatively low. The thyroid with an effective dose of 23.5 μSv represented 20% of the full body effective dose existing in literature. The gonads absorbed an effective dose of 0.05 μSv, which was considered as negligible. Conclusion: The doses calculated were considered as relatively low. However, dentists must be aware of risks of cumulative exposure. Therefore adherence to the ALARA principle and consideration of clinical indication for CBCT remain a priority

Usawiri wa Mama wa Kambo Ndani ya Ngano za Kiswahili za Zanzibar katika Kipengele cha Malezi

Kuna dhana iliyozoweleka katika ngano na katika maisha yetu ya kila siku, sio tu ndani ya jamii ya Zanzibar bali katika sehemu nyingi duniani, kuwa Mama wa Kambo ni wakatili, waovu, watesaji na hata wauaji wa watoto wanaowalea. Ni dhana hiyo ndiyo iliyotushawishi kutafuta ukweli. Jee!, katika uhalisia ni kweli Mama wa Kambo ni waovu kama walivyo katika ngano? Ili kupata ukweli huo, tulikusanya Ngano kutoka sehemu mbalimbali za Visiwa vya Unguja na Pemba. Baada ya kuzisoma zote, hakuna hata moja iliyomuonesha Mama wa Kambo kuwa ni mtu mwema. Ndipo tulipoamua kwenda katika jamii ili kuihoji inamuonaje Mama wa Kambo. Katika jamii, tulifanya majadiliano na wanafunzi 90, wakiwemo wana wa kambo na wanaolelewa na wazazi wao au wengine. Ni wanafunzi 11 tu walimtetea Mama wa Kambo, lakini 79 walimwelelezea kama ni muovu. Baadaye tuliyahoji makundi manne: Watoto wanaolelewa na Mama wa Kambo, Watu wazima waliowahi kulelewa na Mama wa Kambo, Mama wa Kambo wenyewe na Majirani waliokuwa wanawaelewa watoto wa kambo. Kwenye kundi la kwanza, hakuna hata mmoja aliyesema moja kwa moja kuwa Mama wa Kambo ni wazuri bali walikiri kuwa wapo Wazuri na Wabaya. Hii ni tafauti na kundi la pili ambapo wote walikiri kuwa walipata malezi mazuri kutoka kwa mama zao wa kambo. Ama Mama wa Kambo wenyewe, hakuna hata mmoja aliyekiri kuwa yeye ni muovu, ingawaje walidai kuwajua walio waovu. Na kundi la mwisho, lilidai kuwa wapo Mama wa Kambo wabaya, lakini na wazuri wapo. Kwa hivyo, kutokana na data na maelezo tuliyokusanya, utafiti umegundua kuwa katika ngano, Mama wa Kambo wote ni wabaya lakini katika uhalisa wapo Mama wa Kambo wabaya na wazuri

Quantitative Risk Assessment of Developing Salmonellosis through Consumption of Beef in Lusaka Province, Zambia

Based on the Codex Alimentarious framework, this study quantitatively assessed the risk of developing salmonellosis through consumption of beef in Lusaka Province of Zambia. Data used to achieve this objective were obtained from reviews of scientific literature, Government reports, and survey results from a questionnaire that was administered to consumers to address information gaps from secondary data. The Swift Quantitative Microbiological Risk Assessment (sQMRA) model was used to analyse the data. The study was driven by a lack of empircally-based risk estimation despite a number of reported cases of salmonellosis in humans. A typology of consumers including all age groups was developed based on their beef consumption habits, distinguishing between those with low home consumption, those with medium levels of home consumption, and those with high levels through restaurant consumption. This study shows that the risk of developing salmonellosis in this population, from consuming beef, was generally low. At ID50 of 9.61 × 103 cfu/g and a retail contamination concentration of 12 cfu/g, the risk of developing salmonellosis through the consumption of beef prepared by consumers with low and medium levels of beef consumption was estimated at 0.06% and 0.08%, respectively, while the risk associated with restaurant consumption was estimated at 0.16% per year. The study concludes that the risk of developing salmonellosis among residents in Lusaka province, as a result of beef consumption, was generally low, mainly due to the methods used for food preparation. Further work is required to broaden the scope of the study and also undertake microbiological evaluation of ready-to-eat beef from both the household and restaurant risk exposure pathways