An introduction to the New Online Journal Club - 'Surgery in Africa', and the first summary of a module - Compartment syndrome and diagnostic tests

No Abstrac

Challenges and opportunities related to postgraduate evidence-based practice module using blended learning

The use of information and communications technology (ICT) has become integral to health professions education worldwide. The incorporation of online facilities and maintaining of the face-to-face element make blended learning the ‘best of both worlds’. Blogs can be used to create a relatively learner-centred environment that allows students to learn at their own pace. Though blended learning has been proved to be appropriate in higher learning institutions, it comes with challenges and opportunities. Our study intended to highlight the challenges and identify opportunities encountered by an evidencebased practice (EBP) postgraduate class who used the blended learning model of learning. An action-based research methodology was utilised in this study. This involved data gathering, action planning, action taking and action evaluation. Data were gathered through the use of a blog that was accessed by all participants. They made comments which were reflecting their perceptions on the model that was used for the course. The students gave consent to participate while permission from the physiotherapy head of department was also acquired. Deductive analysis was used for data analysis. The information from the blog was extracted and converted into text files. Coding and analysis into opportunities and challenges as expressed by the participants was performed. Theoretical saturation through every reviewer’s agreement and satisfaction about the information was included. The data consisted of 94 postings made of primary postings (22) and responses (72). All the authors acted as reviewers. Certainty was achieved by discussing any ambiguity in coding. Any necessary amendments were made. The participants reported to have experienced some challenges pertaining to blended learning. The blog that was used as a media between students and the facilitator was inefficient in some way. Some students could not access it when required and some resources in the blog were inaccessible. The wireless internet connection mainly used in this model was not reliable. However, there were opportunities experienced by the learners. These included easy interaction between the learners and the facilitator at any time. The model also reduced instructor dependence and made the learners more responsible of their work. The blog appeared as a resource base for skills development. Timely feedback involving solving the problems students encountered during the course improved the communication skills between the students and the facilitator. However, technology constraints involving the blog and the internet connection were overwhelming among the students while writing up the tasks allocated to them. Despite the fact that students faced some challenges, facilitators of blended learning such as the interaction between the students and the facilitator of the course were motivating to keep the course interesting. While students experienced some opportunities about blended learning, its future rests on averting the challenges associated with it more, especially in developing countries. If the challenges reported would be addressed in developing countries, blended learning can be effective in building students’ engagement and relieving of overcrowded classrooms in higher learning institutions

Eliciting experts’ tacit models for the interpretation of soil information, an example from the evaluation of potential benefits from conservation agriculture

© 2020 The Authors We examined a procedure to elicit the tacit models underlying expert opinions on environmental factors that affect the absolute yield benefits expected from the adoption of conservation agriculture (CA) practices in southern Africa. The procedure is based on expert evaluation of the expected improvement in crop yield on adoption of CA in a particular scenario or ‘state’, a state being a specified set of soil conditions captured by a standard soil profile description from a specified agroecological zone (AEZ) of Zambia. Mixed groups of scientists including soil scientists, agronomists, agricultural economists and other environmental scientists, facilitated by experienced senior researchers, were presented with multiple subsets each of three states, and asked to rank the states in each subset with respect to expected yield improvement under CA. The groups of scientists could be divided into two sets. Each set comprised two groups, and the agreement on ranking between groups within each set was larger than would be expected if the ranking were done at random. For both sets of groups the ranking could be modelled with respect to properties of the soil, and the contrast between AEZ. The models revealed two contrasting groups of conceptual assumptions. One group broadly expected larger absolute yield improvements from conservation agriculture in settings where water is most likely to be limiting and the carbon status of the soil is poor. By contrast, the other group expected larger improvements where water was less likely to be limiting. These contrasting views are relevant to current discussions as to whether conservation agriculture, which is promoted as a ‘climate smart’ strategy for cropping, is sufficiently attractive for smallholder producers in conditions where crop production is already challenging, and whether the potential benefits in areas where water availability is not of itself a common limitation should be considered. The elicited models could be translated directly into competing hypotheses to be tested, perhaps in on-farm trials of conservation agriculture practices over contrasting soils in the different AEZ. The method, based on modelling the ranking process, could be of more general interest for the elicitation of expert opinion about complex soil, crop and environmental systems

Reconnaissance sampling and determination of hexavalent chromium in potentially-contaminated agricultural soils in Copperbelt Province, Zambia

The distribution of elemental species of chromium (Cr) in potentially-contaminated soil samples warrants investigation due to the differing mobilities and toxicities of trivalent [Cr(III)] and hexavalent chromium [(Cr(VI)]. In addition, the possibility of species interconversions requires the implementation of robust methods that can correct for changes at the point of sampling, extraction and analysis. This work presents the application of speciated isotope dilution mass spectrometry (SIDMS) to accurately quantify Cr(VI) in agricultural soils within close proximity to a mine tailings dam in the Copperbelt Province of Zambia. Interpolated plots of total Cr, produced from data collected through a nested sampling design, were used to optimise the sampling across the spatial domain. Extraction of Cr(VI) was undertaken using a microwave assisted reaction system (80 °C for 5 min) with 50 mM EDTA, to complex Cr(III) and reduce the likelihood of oxidation during the extraction. Isotopically-enriched 53Cr(VI) was added to each sample prior to extraction to account for species interconversions. The accuracy of the method was confirmed using NIST SRM 2700 and 2701. Cr(VI) concentrations in the soil samples ranged between 0.03 and 0.29 mg kg−1, significantly lower than the residential UK screening value for Cr(VI) of 21 mg kg−1. The data indicate that this site poses a low environmental/human health risk with respect to Cr(VI) exposure

Library Support Services at the University of Zambia amid the Covid-19 Pandemic: A SWOT Matrix

When the Coronavirus disease (COVID-19) forced learning institutions in Zambia to abruptly transition to virtual instruction, library services adapted quickly to provide research services, instruction, and access to collections. This paper details how the University of Zambia Library used a SWOT (Strengths, Weaknesses, Opportunities and Threats) Analysis framework to evaluate academic support services of the Library in the wake of the Covid-19 pandemic. Key variables included the library collections, staffing, services and technology. The analysis revealed that strengths comprised qualified staff, technology support and a rich collection of information resources. Weaknesses are in the areas of poor funding and low staffing at paraprofessional and non-professional levels. Opportunities comprised emerging technology and consortia opportunities. Poor funding, competition from other providers and Covid-19 restrictions are threats. It is hoped that this analysis will help define strategic directions important to the library in an emergency or disaster. The study recommends that the library should leverage digital platforms to enhance service delivery

Nutrient and aflatoxin contents of traditional complementary foods consumed by children of 6–24 months

Open Access Journal; Published online: 14 March 2018The nutrient composition and safety of complementary foods have recently become areas of concern, especially with regard to aflatoxin contamination which has been found to adversely affect health outcomes. This study presents the nutrient and aflatoxin contents of complementary foods consumed by children (6–24 months) and infants and young child feeding practices of mothers from two districts in eastern and southern Zambia. A total of 400 mother–child pairs were recruited from Monze and Chipata districts, and data on breastfeeding and complementary feeding practices were collected twice at 3‐month interval using a structured questionnaire. Samples of two traditional complementary foods (Maize Nshima and Maize porridge) were collected from the mothers and analyzed for nutrient contents and aflatoxin contamination. The results showed that there is a high level of awareness on exclusive breastfeeding among mothers. Fat, protein, carbohydrate, and ash contents of Maize nshima from Chipata were significantly lower (p < .05) compared to those from Monze district except for starch and sugar. Monze mothers preferred to prepare a thicker Maize nshima and Maize porridge compared to their Chipata counterparts. The aflatoxin contamination showed that the Maize porridge samples from Chipata were the most contaminated with mean aflatoxin content of 5.8 ± 15.93 mg/100 g, while Maize nshima was the most contaminated of the two complementary foods from Monze districts with mean aflatoxin level of 3.8 ± 6.41 mg/100 g. There were significant (p < .05) positive correlations between fat and aflatoxin contents for Chipata samples (r = .12409) and for Monze samples (r = .13666). The traditional complementary foods studied were found to be low in fat and protein and high in aflatoxin contamination. Thus, it is imperative that best practices and interventions are designed and introduced to reduce the possible lethal health implications of consumption of such complementary foods by children under 5 years

An Ethnographic Study of the Social Context of Migrant Health in the United States

BACKGROUND: Migrant workers in the United States have extremely poor health. This paper aims to identify ways in which the social context of migrant farm workers affects their health and health care. METHODS AND FINDINGS: This qualitative study employs participant observation and interviews on farms and in clinics throughout 15 months of migration with a group of indigenous Triqui Mexicans in the western US and Mexico. Study participants include more than 130 farm workers and 30 clinicians. Data are analyzed utilizing grounded theory, accompanied by theories of structural violence, symbolic violence, and the clinical gaze. The study reveals that farm working and housing conditions are organized according to ethnicity and citizenship. This hierarchy determines health disparities, with undocumented indigenous Mexicans having the worst health. Yet, each group is understood to deserve its place in the hierarchy, migrant farm workers often being blamed for their own sicknesses. CONCLUSIONS: Structural racism and anti-immigrant practices determine the poor working conditions, living conditions, and health of migrant workers. Subtle racism serves to reduce awareness of this social context for all involved, including clinicians. The paper concludes with strategies toward improving migrant health in four areas: health disparities research, clinical interactions with migrant laborers, medical education, and policy making