Gambling: The Social-Economic Impact Of Sports Betting On Ugandan Youth; The Case Of Mbale Youth

Worldwide, there is a tremendous increase in the level of gambling activity for example approximatley 70% of Australians participated in some form of gambling in 2009" (Australian Productivity Commission Report on Gambling 2010) and that two out of every three Americans place a bet every year (Jones, 2004). According to Basham and White (2002) “heightened public awareness and participation in gambling has sparked considerable debate about its economic viability and its overall effect on society”. This may explain why some countries are now legalizing gambling with an objective of balancing budget deficits and creating a safe betting gambling environment

Determinants of high neonatal mortality rates in Migori County Referral Hospital in Kenya

The purpose of this study was to investigate the determinants of high neonatal mortality rates in Migori County, Kenya. The neonatal mortality cases were utilised as the target population to the study. A quantitative, descriptive, cross-sectional, non-experimental research design was used. A systematic sampling technique was employed to draw a sample of 201 archived neonatal cases out of 420 neonatal mortality medical records, which constituted the study population. Data were collected by means of a developed questionnaire. The Statistical Package for Social Sciences (SPSS) Version 21 was used to analyse data. The main findings revealed the leading determinants of neonatal mortality were early neonatal period, prematurity, poor 1st Apgar score, low birth weight and neonates with intrapartum complications. Obstetrical haemorrhage and HIV were the main maternal complications associated to neonatal mortalities, while the leading direct causes of death in this study were birth asphyxia and sepsis. Other determinants were gender, rural residence, lowly educated and informally employed mothers. To reduce mortalities, a multifaceted approach is needed to establish quality improvement in neonatal intensive care, reduce preterm birth incidences, and empower mothers socio-economically.Health StudiesM.A. (Nursing Science

Association of Vitamin B-12 Deficiency with use of metformin in diabetic patients.

Objective: To find out the frequency of vitamin B12 deficiency in patients with type II diabetes mellitus using metformin.  Methodology: Ninety two patients were involved after getting informed consent. This cross – sectional study was done at department of Medicine, Nishtar Hospital, Multan.  HbA1c, body mass index and blood pressure and deficiency for vitamin B12 was assessed by using electro-chem-iluminescence immunoassay method. B12 levels were categorized as normal (>220pg/ml), possibly deficient (150 to 220 pg/ml) and definitely deficient (<150pg/ml). Neuropathy was assessed and was classified by using Toronto clinical scoring system by the researcher himself. All the data was subjected to statistical analysis using computer software SPSS version 23. Continuous variables were analyzed by their mean and standard deviation while quantitative variables were analyzed by frequency and percentages. Chi square test was applied and P value less than or equal to 0.05 was taken as significant.  Results: Mean Serum B-12 levels were 378.42±161.27 pg/ml and 488.90±147.02 pg/ml in metformin and non-metformin groups, respectively. The difference was statistically significant (p=0.001). The patients who were possibly deficient and definitely deficient were 15 (28.30%) and 5 (9.43%) in metformin group and were significantly more (p=0.006) than non-metformin group i.e. 4 (10.26%) and 0. The mean Toronto Neuropathy Score was statistically different (p<0.001) between metformin group (6.03±1.73) and non-metformin group (4.13±1.75). The patients who had mild neuropathy and moderate neuropathy were 23 (43.39%) and 5 (9.43%) in metformin group, while 6 (15.38%) and 2 (5.13%) in non-metformin group. Statistically, both the groups were significantly different (p=0.005). Conclusion: At the end of this study conclusion can be made that metformin use for type II diabetes mellitus is strongly associated with vitamin B12 deficiency and worsening of already susceptible neuropathy. Keywords: vitamin B12, Type II diabetes mellitus, neuropathy. DOI: 10.7176/JMPB/68-06 Publication date:December 30th 202

Determinants of High Neonatal Mortality Rates in Migori County Referral Hospital in Kenya

Background: Neonatal mortality is a significant public health problem worldwide. In Kenya, neonatal mortality rates are unacceptably high within the sub-Saharan region. In 2017 the country had 20.9 deaths per 1000 live births above the WHO target of 12 deaths per 1000 live births. Purpose: The purpose of this study was to investigate the determinants of high neonatal mortality rates in Migori County, Kenya. The neonatal mortality cases were utilised as the target population to the study. Method: A quantitative, descriptive, cross-sectional, non-experimental research design was used. A systematic sampling technique was employed to draw a sample of 201 archived neonatal cases out of 420 neonatal mortality medical records, which constituted the study population. Data were collected by means of a developed questionnaire. The Statistical Package for Social Sciences (SPSS) Version 21 was used to analyse data. Results: The main findings revealed the leading determinants of neonatal mortality were early neonatal period, prematurity, low birth weight, neonates with intrapartum complications and poor 1st Apgar score. Obstetrical haemorrhage and HIV were the main maternal complications associated to neonatal mortalities, while the leading direct causes of death in this study were birth asphyxia and sepsis. Conclusions: To reduce mortalities, a multifaceted approach is needed to establish quality improvement in neonatal intensive care and reduce preterm birth incidences in Migori County.Health Studie

Socio–economic benefits and pollution levels of water resources, Pece Wetland, Gulu Municipality - Uganda

Communities are dependent on wetlands resources for income generation. However, anthropogenic activities that result into pollution of water are one of the major public health problems. Assessment of socio–economic activities and pollution levels of domestic water sources in Gulu Municipality, Pece wetland was done. The technique for socio–economic data collection was an exploratory method using transect walk along the wetland. Questionnaires and interviews were used. Domestic water sources around the wetland were sampled and analyzed according to APHA (1992). The major activities in the wetland were edge gardening, waste disposal, petty business center called ‘Owino’ market, water collection for sale, livestock grazing, agro–forestry, brick laying, papyrus harvesting and vehicle washing. The climax of some of the activities was affected by seasons. Over all, the activities contributed to > 50% of the monthly income of the respondents. A section of the wetland seems to be sacrificed for socio–economic activities due to the prevailing insecurity as evidenced in the unclear coordination and monitoring plan for conservation of the wetland. Temperature was not significantly different (p = 0.672) and pH was significantly different (p = 0.000). The values ranged from 23.4 to 26.0°C and 5.37 to 5.83 for all the water sources respectively. There was significant difference (p = 0.00 and p = 0.03) in EC and TSS that ranged from 52 to 330 μScm-1 and 0.89 to 2.93 mgL-1 respectively. Spring water had higher EC and TSS than the boreholes. Faecal coliforms ranged from 14 to 50 CFU/100 ml and was significantly higher (p = 0.006) for the spring water than the boreholes. The chloride ion concentration was significantly different (p = 0.000) in the water sources and ranged from 89.2 to 331.1 mgL-1. The correlation for faecal coliforms and chloride ions was positive (r = 0.3577). The domestic water sources were contaminated, although the assumption in the community is that, boreholes are clean and safe. The communities should be sensitized to treat water before drinking. This could reduce the chances of infection by the pathogenic organisms.Key words: Benefits, pollution, water sources, wetlands, socio–economics

Neonatal Survival in Sub-Sahara: A Review of Kenya and South Africa

Introduction: The majority (99%) of the children who die during the first 4 weeks of life do so in the poorer parts of the world, especially in sub-Saharan Africa and South Asia. In 2018, sub-Saharan Africa had a neonatal mortality rate of 28 deaths per 1000 live births. The purpose of the review was to explore and describe the trends of neonatal mortality within the two sub-Saharan countries. Methods: We did a literature search in biomedical databases of data published, in English, between Jan 1, 1975, and November 30, 2019. The databases included Scopus, Web of Science, Science Direct, Cochrane Library, PUBMED, OVID and Google scholar. The keywords used in the search: “Neonatal Survival”, “Sub-Sahara”, “Kenya” and “South Africa”. Results: The search generated 2209 articles of which only 27 met the inclusion criteria. The present study qualitatively analysed data. Data were presented and organized under two thematic domains: 1) trends of national neonatal mortality rates in South Africa and Kenya and 2) causes of neonatal mortality. Conclusion: The current review results noted that in 2018, the neonatal mortality rate for Kenya was 19.6 deaths per 1000 live births. The neonatal mortality rate has fallen gradually from 35.4 deaths per 1000 live births in 1975. On the other hand, South Africa has had its neonatal mortality rate fall from 27.9 deaths per 1000 live births in 1975 to 10.7 deaths per 1000 live births in 2018. Most neonatal deaths resulted in preterm birth complications followed by intrapartum-related events for the two countries. Within the sub-Saharan region, disparities exist as neonates born in South Africa are more likely to survive during the neonatal period compared to Kenya.Health Studie

LA COMPLEXITE D’INTEGRATION DES ETATS AFRICAINS EN DROIT INTERNATIONAL PRIVE.

Il sied de préciser que cette réflexion a eu pour mérite, le plaidoyer pour l’intégration des Etats africains qui passerait forcement par les règles de droit international privé au travers le moyen de l’harmonisation des celles-ci. Cela permettrait de retenir un rattachement simple pour chaque règle de conflit notamment les cas des statuts personnel et réel dont la complexité n’est pas à démontrer, celui-ci (le rattachement) doit répondre d’une localisation scientifique du rapport de droit c’est-à-dire neutre et objective. Le rattachement doit nécessairement se traduire sous la forme des liens les plus étroits pour répondre du principe de proximité qui dirige toute idée de localisation spatiale. En sus, sa détermination sera nécessairement concrète afin de répondre du réalisme de chaque situation internationale.  Afin de bannir tout risque d’arbitraire et d’insécurité juridique, chaque catégorie de rattachement devra être dotée d’un faisceau d’indices propres à la nature du rapport de droit en cause et sur la base duquel le juge pourra déterminer quantitativement la loi compétente. Ainsi, l’intégration des Etats sera possible et il sera envisageable d’aspirer à un système universel ou continental à l’avenir.Il sied préciser cette réflexion a eu pour mérite, le plaidoyer pour l’intégration des Etats africainsqui passerait forcement par les règles de droit international privé au travers le moyendel’harmonisation des celles-ci. Cela permettrait de retenir un rattachement simple pour chaquerèglede conflit notamment les cas des statuts personnel et réel dont la complexité n’est pas à démontrer,celui-ci (le rattachement) doit répondre d’une localisation scientifique du rapport de droit c’est-à-dire neutre et objective. Le rattachement doit nécessairement se traduire sous la forme des liens les plus étroitspourrépondre du principe de proximité qui dirige toute idée de localisation spatiale. Ensus, sadétermination sera nécessairement concrète afin de répondre du réalisme de chaquesituationinternationale. Afin de bannir tout risque d’arbitraire et d’insécurité juridique, chaque catégorie de rattachementdevra être dotée d’un faisceau d’indices propres à la nature du rapport de droit en causeet surlabase duquel le juge pourra déterminer quantitativement la loi compétente. Ainsi, l’intégrationdesEtats sera possible et il sera envisageable d’aspirer à un système universel ou continentalàl’avenir

A strategy for reducing maternal mortality in Migori, Kenya

The aim of the study was to investigate the determinants of maternal mortality and develop a strategy for reducing the maternal mortality ratio (MMR) in Migori, Kenya. The objectives of the study were to describe the causes and the socio-economic determinants of maternal mortality, analyse the existing strategies that aim at reducing MMR, and develop a strategy to reduce MMR in Migori, Kenya. A sequential explanatory mixed methods study design was used to conduct the study. A checklist and in-depth interview guides were employed to collect the data. The quantitative data was analysed using the Statistical Package for Social Science (SPSS) version 23 and simple descriptive statistics. Thematic analysis was employed to analyse the qualitative data. The study revealed that the leading causes of maternal mortalities are haemorrhage (34.7%), eclampsia (20.8%) and sepsis (15.8%). Moreover, social and system factors which largely determined the deaths of mothers were found to be timely provision of and lack of drugs and blood, rural residence, and maternal ignorance of danger signs. The above-mentioned factors were exacerbated by the delays in accessing appropriate healthcare that could have saved the lives of mothers. Identified delays were theatre delays, resuscitation delays, competent care delays, referral delays, and the delays in decision-making by the mothers themselves. The study further established that the existing maternal improvement interventions such as the free maternal service policy, the haemorrhage prevention programmes, and family planning were poorly implemented with low coverage. The findings informed development of an alternative strategy that would reduce MMR in Migori, Kenya. The proposed strategy targets maternal care delays, which the study found to contribute to the persisting high levels of maternal deaths in Migori, Kenya. Increased focus on the identified determinants of maternal deaths by policy makers is recommended. The study further alerts stakeholders that hospital systems as well as community empowerment programmes are in dire need of quality improvement initiatives. The Kenyan government and non-profit organisations should be involved in the implementation of the proposed strategy

Impact of Commercial Car Washing Bay on Water Quality of River Nakiyanja in Central Uganda

Car washing bays discharge a wide range of pollutants into water bodies which degrade water quality and affect aquatic ecosystem functions. The study examined the influence of the motor vehicle-washing bay on water quality of River Nakiyanja wetland system. Physicochemical water quality was measured by both in-situ and x-situ following standard protocols. Data was analyzed using one-way ANOVA. The study revealed higher concentrations of contaminants such as oil and grease, biochemical oxygen demand, chemical oxygen demand, total suspended solids, and turbidity at impact sites associated with vehicle washing compared to the pre-washing bay sites, and these differed significantly. This affects  aquatic  ecosystem  functions  and  probably posing  health  impacts  to  the  direct  users  of  water  resources. The study recommended enforcement of water and environmental legislations and constructions of wastewater treatment facilities at each of the car washing bays to protect aquatic ecosystems