Novel concepts for non-invasive telemonitoring in chronic heart failure

Background: The morbidity and mortality from chronic heart failure (HF) remains alarmingly high, in part due to failure to apply substantial disease modifying strategies to halt disease progression. Telemonitoring has been proposed as a potential disease management strategy to deal with the burden posed by HF. While treatment decisions guided by invasive telemonitoring data have shown early promise, it is unclear whether non-invasively derived surrogates of haemodynamics could be reliable enough to guide therapeutic interventions.Aims: The principal aim of this thesis is to investigate whether non-invasive “smart technologies” could accurately detect and track subtle changes in surrogates of cardiovascular haemodynamics in response to challenges posed by activities of daily living and non-adherence to therapy. Methodology: A series of prospective clinical studies were conducted in stable patients with chronic heart failure, on optimum tolerated guideline directed therapy for heart failure. Studies were performed under clinically adapted conditions to mimic the patient’s own habitat.Results: Significant systemic haemodynamic perturbations were detected non-invasively with variations in environmental temperature. Additionally, music, which modulates the sympathetic tone, led to modest changes in systemic blood pressure and heart rate, although the changes did not reach statistical significance. Non-adherence to cardiovascular therapy led to striking adverse changes in systemic haemodynamics. Smart technologies demonstrated a remarkable consistency in detecting haemodynamic perturbations.Conclusion: Non-invasive detection and tracking of changes in haemodynamics is feasible with smart technologies. The results need to be validated in larger multicenter clinical trials, with particular emphasis on using the data to guide therapeutic decisions

Compulsory licensure as a cost-containment measure for essential medicines: a comparative study of South Africa, the Russian Federation and the People's Republic of China

This minor dissertation investigates alternative compulsory licencing (CL) policy approaches for the South African context. The purpose is to support the country's aspirations to reform certain components of its intellectual property (IP) regime, ensuring alignment with the country's development prerogatives. Homing in on technical barriers with the operationalisation of the existing CL mechanism; this paper investigates remedial recommendations to support South Africa's reform efforts. The paper also hopes to gauge whether it is feasible to leverage compulsory licensure as a cost-containment tool to circumvent price dominance in the sale of essential pharmaceutical commodities. The South African Patents Law provides for CL under three grounds. These are dealt with in chapter 2. The abuse of patents rights as a result of excessive pricing is one of these grounds. Yet, attempting to use this provision abuse of patents rights is procedurally and administratively cumbersome. This is notwithstanding the litigation costs. The 2018 national IP Policy aspires to reform the CL policy to ensure that it is a 'workable mechanism'. A comparative analysis of the CL policy landscapes in the People's Republic of China (PRC) and the Russian Federation will be taken to inform South Africa's discourse. These two countries are strategic because they have either reformed and/ or in the process of renovating their intellectual property rights (IPR) landscapes and both have interesting approaches to the way in which they have reformed their CL mechanisms. The findings of this paper reveal that Russia and China have undertaken extensive IPR reforms over the last three decades. They have both taken different policy approaches in adapting their CL instruments. Russia's CL reform proposals are underway and aim to advance a CL mechanism that can effectively regulate the abuse of patents, especially for essential pharmaceutical commodities. China has installed specific Implementing Measures which offer policy guidance on the applicability CLs. In the case study of China, the Measures imposed are not necessarily advanced as cost-containment tools. Rather they support the country's pharmaceutical agenda. The recommendations in this paper offer interesting insights to the feasibility exercises that will be advanced in South Africa's IPR reform process

Atitudes face à homossexualidade entre os futuros professores de biologia para o Ensino Secundário Geral em Moçambique

A hostilidade em relação às pessoas não-heterossexuais, comummente chamada de discriminação sexual, homofobia ou homo-negatividade, é um fenômeno evidente em várias sociedades e culturas, quer ocidental quer africana, visível nas escolas moçambicanas. A profissão docente é uma ocasião não só para reproduzir os padrões sociais e normativos sexuais, mas também para questionar, discutir e desconstruir todas as "verdades" acabadas e recebidas muitas vezes de forma acrítica pelos estudantes e a sociedade em geral. Neste contexto, esta investigação tem como objetivo analisar quais são as atitudes de alunos do Curso de Licenciatura em Educação em Biologia de Moçambique em relação a gays e lésbicas. Foi selecionada uma amostra (N=127) composta por estudantes universitários matriculados, do primeiro ao último ano em curso de Licenciatura em Ensino de Biologia na Faculdade de Ciências Naturais e Matemática da Universidade Pedagógica de Maputo. Uma escala de atitude para gays e lésbicas, que incluiu quatro fatores (condenação do comportamento homossexual, moralidade, contato com os homossexuais e estereótipos) foi utilizada como instrumento de coleta de dados. Os resultados mostraram que os estudantes tinham atitudes moderadamente negativas em relação aos homossexuais, as quais foram influenciadas pela experiência docente, idade, estado civil, religiosidade e conhecimento de pessoas homossexuais, enquanto que as variáveis como género, área e local de residência, não tiveram efeitos estatisticamente significativos sobre as atitudes em relação aos homossexuais. Os resultados deste estudo mostram como é urgente trabalhar a diversidade sexual e, mais especificamente, a homo-negatividade, na formação inicial de professores

The curricula of Sexuality Education in Mozambican and Portuguese schools : what are the challenges for teachers and international partnerships?

Publicado em "Proceedings of the 37th Annual Conference of ATEE", ISBN 9789081563949The Ministry of Education and Culture of Mozambique has integrated in the curriculum of primary and secondary education, contents of Sexuality Education as cross-curricular themes. In Portugal, the Ministry of Education has already established from the 1st to 12th grades, similar cross-curricular contents of sexuality education with a different approach to integrate sexuality education in the school curriculum, including subject and non-subject curricular and extracurricular areas. In this context, a comparative analysis between curricular integration of Sexuality Education and the challenges for teachers and schools and other professionals and organizations which collaborate with schools in sexuality education will be discussed with the aim of emphasising the potentials of international collaboration among students from different countries, especially those speaking the Portuguese language, and among researchers and other professionals regarding this particular area of teaching

Passado, presente e reflexão prospetiva do futuro

A Força Aérea de Moçambique (FAM) tem vinte anos de existência fruto da unifi-cação das forças governamentais da FRELIMO e da resistência nacional moçambicana RENAMO. Ao longo destas duas décadas de vida, pouco, ou quase nada, tem sido feito para levantamento das suas capacidades aéreas, principalmente no que tange aos aspetos relativos a dispositivo, equipamentos e formação. Esta situação é caracterizada pelo desinvestimento resultante das prioridades que o governo atribuiu a outros setores sociais tais como a educação, saúde, agricultura e meio ambiente, aliado aos escassos recursos materiais e financeiros de que o país dispõe. Com vista a dar a minha contribuição e recomendação para o desenvolvimento da FAM, neste Trabalho de Investigação Individual vou falar do tema “Força Aérea de Moçambique. pas-sado, presente e reflexão prospetiva do futuro”. O país opta por uma política pacífica dissuasora, resolve os seus problemas políti-cos internos de forma satisfatória, não se mete em problemas alheios dos vizinhos e não pretende transformar-se numa potência militar regional. Contudo, não põe de lado a neces-sidade e a indispensável criação e desenvolvimento de uma FAM capaz de garantir a defe-sa, o controlo e vigilância do espaço aéreo nacional, que possa garantir o transporte de mi-litares e material dentro do país e, quando necessário, fora do território nacional, em apoio às operações de manutenção da paz, no âmbito da Comunidade de Desenvolvimento da África Austral, da União Africana e da Organização das Nações Unidas. Devemos ter uma FAM com capacidade para realizar ações de busca e salvamento, uma vez que o nosso país é ciclicamente assolado pelas inundações devido aos cursos dos rios que nascem no interior dos países vizinhos e que vão desaguar no Oceano Indico, per-correndo o nosso território, aliado às fracas infraestruturas (barragens), que o país possui. Moçambique precisa de uma Força Aérea com capacidade para efetuar operações de eva-cuação sanitária, fazer transporte em apoio das populações em caso de catástrofe, calami-dade ou acidente e apoiar a atividade de fiscalização marítima. Para se alcançarem estes objetivos a FAM deve adotar um dispositivo adequado, ser dotada de equipamentos que lhe permitam cumprir a sua missão e aperfeiçoar o modelo de formação de modo a garantir a contínua formação dos seus recursos humanos. Abstract: The last twenty years of existence of the Air Force of Mozambique (FAM) are the result of the unification of the government forces of FRELIMO and the Mozambican Na-tional Resistance, RENAMO. Throughout these two decades of existence little or nothing has been done to survey its air capabilities, especially in regard to matters affecting the territorial display, equipment and trainings. This situation is characterized by disinvestment resulting from the allocation that the government has been giving to other priorities in social sectors such as education, health, agriculture and environment, coupled with scarce material and financial re-sources. In order to give my contribution and recommendation to the development of FAM, this Individual Research Work will address to the subject "Air Force Mozambique. Past, Present and Prospective Reflection of the Future." Given that Mozambique acts by legitimate and appropriate means for its defense and for the defense of national interests of the exclusive economic zone, adjacent seabed and the airspace under national responsibility within or outside its territory as the situa-tion requires, the country opts for a dissuasive peaceful policy, solves its internal political problems satisfactorily, does not involve itself in conjunctions created by problems of his neighbor countries and does not intend to become a regional military power. However, one cannot be put aside the need of creating and developing a FAM able to secure protection, control and monitoring the national airspace, which can ensure transportation of troops and equipment within the country and , when necessary outside Nationwide , in support of peacekeeping operations under the Community Development Southern Africa , the African Union and the United Nations. Mozambique should have a suitable Air Force to conduct search and rescue ac-tions, considering the country is cyclically damaged by floods due to the courses of the rivers originating within the neighboring countries which empty into the Indian Ocean crossing the territory, destroying the already weak infrastructure (dams) in exist-ence. There is also the need of a Mozambican Air Force with capacity to provide medical evacuation operations, perform transportation in support of populations in the event of disaster, calamity or accident and support the activity of maritime surveillance. To achieve these objectives the Mozambique Air Force should adopt a suitable ter-ritorial display and be provided with capabilities in equipment and continuous training of its human resources

O discurso opinativo de indignação: Estudo do editorial do jornal Notícias de Moçambique

Utilizando os estudos de Análise Crítica do Discurso, especialmente a partir de Norman Fairclough e Teun Van Djik, analisa-se o editorial do Jornal Notícias (principal jornal impresso de Moçambique) quanto aos argumentos e reconstruções de factos, que mostram a indignação do locutor (empresa jornalística), que solicitam, exortam a indignação do co-lucutor (leitor). Trabalha-se a partir do conceito de abordagem cognitiva de Van Djik e suas categorizações para produzir análises críticas, dos discursos em tela, identificam-se as conotações de convencimento (levar a crer) e de persuasão (levar a fazer) no texto do editorial, avaliando o seu potencial de produzir indignação no público leitor a partir da análise de macroproposições discursivas identificadas e analisadas. Para essa análise do discurso do editorial do Jornal Notícias também são levados em conta aspectos como o contexto em que a locução se dá, os sujeitos envolvidos, a identidade, a interdiscursividade, a intertextualidade e a crítica de uma maneira geral. Sendo a linguagem uma forma de intervenção na ordem social, é necessário buscar compreensões sobre os seus níveis constitutivos (o semântico, o lexicogramatical e o fonológico/grafológico) nas mais diversas manifestações discursivas, aqui enfoca-se o texto opinativo de jornais periódicos

Mechanisms conditioning the implementation of an integrated quality assurance and enhancement approach at a South African University of Technology

Literature related to quality in higher education argues that achieving an integrated approach which balances improvement and accountability in a single quality assurance (QA) system, is not easy. In response to the literature, I decided to conduct a realist study to identify mechanisms that can enable or constrain the implementation of an integrated approach in a single quality assurance system at the Tshwane University of Technology (TUT). The scope of my study was limited to teaching and learning as one of the University’s core functions. An integrated approach encouraged a deliberate focus and attention on transformative learning and teaching. The main research question, “what mechanisms enable or constrain the implementation of an integrated approach to quality assurance and enhancement at the Tshwane University of Technology,” underpinned this study. I used Bhaskar’s critical realist philosophy as an underlabourer for the study and Archer’s social realism as an analytical framework to enable me to seek answers to the research questions. The study took the form of a case study at TUT. Data was generated through document analysis and thirty-five semi-structured interviews with agents from across the various levels and campuses of TUT. In keeping with a social realist study, I used Archer’s concept of analytical dualism to analyse structure, culture, and agency separately, and their interplay. My findings indicated that compliance and accountability are related cultural mechanisms and were dominant in the University’s cultural system. This signalled a strong emphasis on quality assurance (QA) rather than quality enhancement (QE). In addition, the findings showed that the University has established sufficient structural and agential enablements to assure the quality of learning and teaching. However, there is a need to integrate transformative cultural mechanisms into the University’s QA system. Furthermore, there were limited structural, cultural, and agential enablements to encourage enhancement. In this regard, I recommended mechanisms that should be in place for an integrated QA and QE approach to be successful at TUT. My main argument is that an institutional context that encourages structural, cultural, and agential QA and QE mechanisms to work in tandem can enable an integrated QA and QE approach.Thesis (PhD) -- Faculty of Education, Centre for Higher Education Research, Teaching and Learning, 202

Sedimentological and geochemical evidence for late quaternary environmental changes in southern Africa : a case study of the mudbelt deposits off Namaqualand

Bibliography: leaves 105-121.This thesis is comprised of sedimentological and geochemical studies of seven 7m core sediments retrieved from the Namaqualand Mudbelt, South Africa. The purpose of this research is to contribute to the evidence for environmental change during the late Quaternary in the southern Africa from the analyses of continental shelf sediments and more specifically, to examine feasibility of using Namaqualand mudbelts as a key to understanding late environmental dynamics of both terrestrial and marine environment. Namaqualand mudbelts seem to have been deposited during the last 10 000 years. Chrono- and lithostratigraphy, coarse-fraction and geochemical analyses suggest the following sedimentary development on the Namaqualand offshore. An early period of deposition dominated by marine conditions off the coast, but with significant input in the north (Orange Delta) and south (off KIeinsee). There is a fining upcore sequence from the Orange Prodelta southward to the inner shelf (off Kleinsee). This fining-upward sequence is generally indicative of shoreward transgression of the sea (rising sea-level). As sea-level rises (shoreward transgression), finer-grained deeper water deposits migrate landward and are deposited over shallower water deposits. While the Orange River might be a major source of sediments on the Orange River Delta, marine contribution is increasingly important far south of the Orange Delta (off KIeinsee). ln addition, berg winds and local ephemeral Namaqualand rivers are also increasingly important

Trans-programming the student, the university and the community: an architectural response to changing social structures and systems in universities through negotiating boundaries

Issues such as diversity and inclusion are highlighted in the developing world due to their post colonization. Education is deemed to be the key to attaining equal citizenship in a global economy. Architecture has to function in a political, physical and social landscape that is hybrid and diverse, a space in which multiple publics exist and compete for resources and opportunities(Murray-Blank). This paper investigates how spatial and programmatic organizations promote internal knowledge transfer and social interaction, while simultaneously integrating with surrounding urban environments. The thesis focuses on University students in developing countries through understanding their diverse backgrounds which include a rural urban divide. It focuses its investigation at the University of the Western Cape. History shows the power of the University as an institution in society, its architecture should adapt rapidly to its environment. Given the situation of a new genre of economically challenged people coming into Universities in developing countries, trans-programming in the University is a necessity. The concept is explored through a review of current literature on the postcolonial theory of hybridity, the impact of globalization on the local identity, creating an inclusive built environment for diverse cultures and constructing a learning environment that addresses the immediate needs of students. Interviews and literature reinforce the need for architecture to function in a political, physical and social landscape that is hybrid and diverse. Our environment effects our development and this thesis suggests a trans-programming of facilities that will assist in the development of students, the communities they come from and those they reside in. This new spatial order will also evoke awareness, security, participation, a sense of inclusion and therefore bring about a possibility of narrowing the rural/township urban divide