Multilingualism in Computer mediated communication. A study of language choice among youngsters in rural Tanzania.

Mastergradsoppgave i digital kommunikasjon og kultur, Høgskolen i Innlandet, 2019.African youth linguistic practices have merely been regarded as an urban phenomenon that has nothing to do with rural areas. They have sometimes been labelled as urban vernaculars, a label that excludes creative linguistic practices of rural youths. This thesis aims to study how linguistic practices of Tanzania’s multilingual rural based youngsters are reflected in Computer mediated communication by examining to what extent are their linguistic practices fixed in the sense that they orient to the monolingual system and standard varieties or fluid in the sense that their whole linguistic repertoire is involved in the meaning-making process. I also examine which languages these youngsters use. I introduce multilingualism by considering its historical background regarding its evolution during the last six decades as well as a brief explanation of Computer mediated communication in general and in Africa. I have chosen to briefly introduce and explain language situation in Tanzania because its awareness will ensure understanding of the aim of research topic and the analysis of the youngsters’ linguistic practices in Computer mediated communication. Throughout the theory chapter, there will be a discussion of multilingualism’s central concepts such are language choice and code-switching. However, data in this thesis will be analyzed in the light of fixity and fluidity, and theories that suppose fluid linguistic practices, such as metrolingualism and translanguaging are also introduced in the theory. This study is done through a qualitative research design. Data used in this thesis is based on individual interviews and observation collected from six rural based Tanzania’s youths. There is a total of 22 examples of both interviews and observation selected to represent the main tendencies in the data. Findings of this study shows how youths’ linguistic practices in computer mediated communication challenge the monolingual approach to language emphasized by once but no longer hegemony state that is Tanzania. Online youth linguistic practices appear in many different shapes characterized by both local and global practices witnessed in many various social networking sites. Such linguistic diversity in computer mediated communication is contributed by various motives

Effect of eWOM, Ease of Use, Trust on Purchase Decision (Case Study on Blibli.com)

The purpose of this study was to determine: 1) Whether eWOM has a positive effect on purchase decisions, 2) Does Ease of Use have a positive effect on purchase decisions, 3) Does trust have a positive effect on purchase decisions. Data collection in this study was carried out using a questionnaire distributed online to Blibli users. The number of respondents used in this study is 100 respondents. The sampling technique used in this study is non-probability sampling by relying on judgmental sampling. Partial least square-structural equation modeling (PLS-SEM) analysis was performed using the SmartPLS 3.0 program to analyze the data. The findings of this study are that eWOM, Ease of Use and Trust have a positive effect on purchase decisions. The contribution of this research can provide input to the Blibli company to better maintain and manage ease of use, trust and electronic word of mouth so that Blibli users can use Blibli more freely and comfortably so that transactions carried out in Blibli can run more smoothly and safely, which is then will give Blibli an advantage as a player in Internet-based transaction systems because it is a fast paced industries that can change in a matter of time

Effects of Agroforestry Practices on Soil Properties in the Drylands of Eastern Kenya

Drylands, which are home to about 2 billion people face a myriad of problems among them low land productivity. Agroforestry is one of the land use practices that is perceived to be sustainable with beneficial effects on soil properties. However, the effects of agroforestry practices on soils especially in the drylands have rarely been quantified and studied in details. The study determined the effects of selected agroforestry practices on soil properties in Makueni County of Kenya where agroforestry has been promoted by various organizations. Four soil samples were collected at 0-15cm, 15-30cm, 30-45cm and 45-60cm depths in a zigzag pattern at each 10 x 10m plots established along line transects laid in woodlots established in 2007, 2010 and 2013 and their adjacent parkland and grazing land. Seven randomly selected farms were sampled. The samples were analyzed using laboratory methods for soil nutrients and physical properties. Density of tree species in these established plots were also determined using quadrat technique. Tree density was higher in woodlots followed by grazing area and parkland .Soil samples showed that Soil Organic Carbon and Total Nitrogen were significantly higher in the woodlots than in the parkland and grazing lands ((p≤0.05). Soil Organic Carbon was significantly higher in woodlots established in 2007 than those established in 2013. Phosphorus was significantly higher in cropland compared to woodlots and grazing land. Phosphorus and Potassium were significantly higher at 0-15 cm depth compared to other soil depths. Bulky density was significantly higher with a corresponding lower total porosity in grazing lands than in the woodlots and parklands. The results suggest that different agroforestry practices contribute differently to soil properties. Mixed tree woodlots contributed significantly to improving soil properties and could be considered as a strategy to sustainably restore degraded and infertile soils in the drylands

Bench to Bed Evidences for Pharmacokinetic and Pharmacodynamic Interactions Involving Oseltamivir and Chinese Medicine

Oseltamivir (OA), an ethyl ester prodrug of oseltamivir carboxylate (OC), is clinically used as a potent and selective inhibitor of neuraminidase. Chinese medicines have been advocated to combine with conventional drug for avian influenza. The current study aims to investigate the potential pharmacokinetic and pharmacodynamic interactions of a Chinese medicine formula, namely, Yin Qiao San and Sang Ju Yin (CMF1), commonly used for anti-influenza in combination with OA in both rat and human, and to reveal the underlined mechanisms. It was found that although Cmax, AUC and urinary recovery of OC, as well as metabolic ratio (AUCOC/AUCOA), were significantly decreased in a dose-dependent manner following combination use of CMF1 and OA in rat studies (P<0.01), such coadministration in 14 healthy volunteers only resulted in a trend of minor decrease in the related parameters. Further mechanistic studies found that although CMF1 could reduce absorption and metabolism of OA, it appears to enhance viral inhibition of OA (P<0.01). In summary, although there was potential interaction between OA and CMF1 found in rat studies, its clinical impact was expected to be minimal. The coadministration of OA and CMF1 at the clinical recommended dosages is, therefore, considered to be safe

Landslide resilience in Equatorial Africa: Moving beyond problem identification!

Landslides (LS) impacts are acute in Equatorial Africa, which is characterized by mountainous topography, intense rains, deep weathering profiles, high population density and high vulnerability. This study aims to move beyond the recognition of landslide occurrence and investigate effective risk reduction strategies. Based on 5 workshops with local stakeholders, we illustrate the widespread occurrence of LS on 4 representative study areas known for being severely affected by rainfall-triggered LS in Uganda (Mount Elgon, Mount Rwenzori) and Cameroon (Limbe and Bamenda urban regions). The findings highlight the good knowledge of local stakeholders on factors controlling the timing and spatial distribution of these events. Stakeholders identify a wide range of direct, but also far-reaching indirect and intangible cumulative impacts of LS. Finally, the project inventoried and categorized risk reduction strategies currently implemented in the targeted regions, as well as the factors identified by stakeholders as bottlenecks in the implementation of potential alternative strategies. The experience underlines the usefulness of involving stakeholders at an early stage in selecting study areas and defining specific research objectives.En Afrique Équatoriale les glissements de terrain ont des conséquences très lourdes en raison de la topographie montagneuse, des pluies intenses et d'épais profils d'altération, ainsi que d'une densité de population élevée et d'une grande vulnérabilité. Cette étude a pour objet de dépasser la simple identification des occurrences des glissements de terrain et de rechercher des stratégies efficaces de réduction des risques. En nous basant sur 5 workshops organisés avec des acteurs locaux, nous montrons la fréquence générale des glissements de terrain sur 4 zones d'étude sévèrement impactées par les précipitations en Ouganda (Mount Elgon, Mount Rwenzori) et au Cameroun (zones urbaines de Limbe et Bamenda). Il ressort de nos résultats que les acteurs locaux ont une bonne connaissance des facteurs qui déterminent la distribution de ces évènements dans le temps et l'espace. Ils identifient toute une série d'impacts directs mais aussi d'impacts indirects intangibles d'une grande portée.Enfin, le projet a inventorié et catégorisé les stratégies de réduction des risques habituellement mises en œuvre dans les régions touchées, ainsi que les facteurs identifiés par les acteurs comme des obstacles à la mise au point de stratégies alternatives. Cette expérience souligne l'utilité d'engager des acteurs locaux à un stade très précoce de la sélection des zones d'étude et de la définition d'objectifs de recherche spécifiques

Quantification of structural changes in the corpus callosumin children with profound hypoxic-ischaemic brain injury

Background Birth-related acute profound hypoxic–ischaemic brain injury has specific patterns of damage including the paracentral lobules. Objective To test the hypothesis that there is anatomically coherent regional volume loss of the corpus callosum as a result of this hemispheric abnormality. Materials and methods Study subjects included 13 children with proven acute profound hypoxic–ischaemic brain injury and 13 children with developmental delay but no brain abnormalities. A computerised system divided the corpus callosum into 100 segments, measuring each width. Principal component analysis grouped the widths into contiguous anatomical regions. We conducted analysis of variance of corpus callosum widths as well as support vector machine stratification into patient groups. Results There was statistically significant narrowing of the mid–posterior body and genu of the corpus callosum in children with hypoxic–ischaemic brain injury. Support vector machine analysis yielded over 95% accuracy in patient group stratification using the corpus callosum centile widths. Conclusion Focal volume loss is seen in the corpus callosum of children with hypoxic–ischaemic brain injury secondary to loss of commissural fibres arising in the paracentral lobules. Support vector machine stratification into the hypoxic–ischaemic brain injury group or the control group on the basis of corpus callosum width is highly accurate and points towards rapid clinical translation of this technique as a potential biomarker of hypoxic–ischaemic brain injur

Brief Report: Suboptimal Lopinavir Exposure in Infants on Rifampicin Treatment Receiving Double-dosed or Semisuperboosted Lopinavir/Ritonavir: Time for a Change.

BACKGROUND: Although super-boosted lopinavir/ritonavir (LPV/r; ratio 4:4 instead of 4:1) is recommended for infants living with HIV and receiving concomitant rifampicin, in clinical practice, many different LPV/r dosing strategies are applied due to poor availability of pediatric separate ritonavir formulations needed to superboost. We evaluated LPV pharmacokinetics in infants with HIV receiving LPV/r dosed according to local guidelines in various sub-Saharan African countries with or without rifampicin-based tuberculosis (TB) treatment. METHODS: This was a 2-arm pharmacokinetic substudy nested within the EMPIRICAL trial (#NCT03915366). Infants aged 1-12 months recruited into the main study were administered LPV/r according to local guidelines and drug availability either with or without rifampicin-based TB treatment; during rifampicin cotreatment, they received double-dosed (ratio 8:2) or semisuperboosted LPV/r (adding a ritonavir 100 mg crushed tablet to the evening LPV/r dose). Six blood samples were taken over 12 hours after intake of LPV/r. RESULTS: In total, 14/16 included infants had evaluable pharmacokinetic curves; 9/14 had rifampicin cotreatment (5 received double-dosed and 4 semisuperboosted LPV/r). The median (IQR) age was 6.4 months (5.4-9.8), weight 6.0 kg (5.2-6.8), and 10/14 were male. Of those receiving rifampicin, 6/9 infants (67%) had LPV Ctrough <1.0 mg/L compared with 1/5 (20%) in the control arm. LPV apparent oral clearance was 3.3-fold higher for infants receiving rifampicin. CONCLUSION: Double-dosed or semisuperboosted LPV/r for infants aged 1-12 months receiving rifampicin resulted in substantial proportions of subtherapeutic LPV levels. There is an urgent need for data on alternative antiretroviral regimens in infants with HIV/TB coinfection, including twice-daily dolutegravir

Uganda's experience in Ebola virus disease outbreak preparedness, 2018-2019.

BACKGROUND: Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda's experience in EVD preparedness. RESULTS: On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. CONCLUSION: As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a "fire-fighting" approach during public health emergencies

Dolutegravir twice-daily dosing in children with HIV-associated tuberculosis: a pharmacokinetic and safety study within the open-label, multicentre, randomised, non-inferiority ODYSSEY trial

Background: Children with HIV-associated tuberculosis (TB) have few antiretroviral therapy (ART) options. We aimed to evaluate the safety and pharmacokinetics of dolutegravir twice-daily dosing in children receiving rifampicin for HIV-associated TB. Methods: We nested a two-period, fixed-order pharmacokinetic substudy within the open-label, multicentre, randomised, controlled, non-inferiority ODYSSEY trial at research centres in South Africa, Uganda, and Zimbabwe. Children (aged 4 weeks to <18 years) with HIV-associated TB who were receiving rifampicin and twice-daily dolutegravir were eligible for inclusion. We did a 12-h pharmacokinetic profile on rifampicin and twice-daily dolutegravir and a 24-h profile on once-daily dolutegravir. Geometric mean ratios for trough plasma concentration (Ctrough), area under the plasma concentration time curve from 0 h to 24 h after dosing (AUC0–24 h), and maximum plasma concentration (Cmax) were used to compare dolutegravir concentrations between substudy days. We assessed rifampicin Cmax on the first substudy day. All children within ODYSSEY with HIV-associated TB who received rifampicin and twice-daily dolutegravir were included in the safety analysis. We described adverse events reported from starting twice-daily dolutegravir to 30 days after returning to once-daily dolutegravir. This trial is registered with ClinicalTrials.gov (NCT02259127), EudraCT (2014–002632-14), and the ISRCTN registry (ISRCTN91737921). Findings: Between Sept 20, 2016, and June 28, 2021, 37 children with HIV-associated TB (median age 11·9 years [range 0·4–17·6], 19 [51%] were female and 18 [49%] were male, 36 [97%] in Africa and one [3%] in Thailand) received rifampicin with twice-daily dolutegravir and were included in the safety analysis. 20 (54%) of 37 children enrolled in the pharmacokinetic substudy, 14 of whom contributed at least one evaluable pharmacokinetic curve for dolutegravir, including 12 who had within-participant comparisons. Geometric mean ratios for rifampicin and twice-daily dolutegravir versus once-daily dolutegravir were 1·51 (90% CI 1·08–2·11) for Ctrough, 1·23 (0·99–1·53) for AUC0–24 h, and 0·94 (0·76–1·16) for Cmax. Individual dolutegravir Ctrough concentrations were higher than the 90% effective concentration (ie, 0·32 mg/L) in all children receiving rifampicin and twice-daily dolutegravir. Of 18 children with evaluable rifampicin concentrations, 15 (83%) had a Cmax of less than the optimal target concentration of 8 mg/L. Rifampicin geometric mean Cmax was 5·1 mg/L (coefficient of variation 71%). During a median follow-up of 31 weeks (IQR 30–40), 15 grade 3 or higher adverse events occurred among 11 (30%) of 37 children, ten serious adverse events occurred among eight (22%) children, including two deaths (one tuberculosis-related death, one death due to traumatic injury); no adverse events, including deaths, were considered related to dolutegravir. Interpretation: Twice-daily dolutegravir was shown to be safe and sufficient to overcome the rifampicin enzyme-inducing effect in children, and could provide a practical ART option for children with HIV-associated TB

Neuropsychiatric manifestations and sleep disturbances with dolutegravir-based antiretroviral therapy versus standard of care in children and adolescents: a secondary analysis of the ODYSSEY trial

BACKGROUND: Cohort studies in adults with HIV showed that dolutegravir was associated with neuropsychiatric adverse events and sleep problems, yet data are scarce in children and adolescents. We aimed to evaluate neuropsychiatric manifestations in children and adolescents treated with dolutegravir-based treatment versus alternative antiretroviral therapy. METHODS: This is a secondary analysis of ODYSSEY, an open-label, multicentre, randomised, non-inferiority trial, in which adolescents and children initiating first-line or second-line antiretroviral therapy were randomly assigned 1:1 to dolutegravir-based treatment or standard-of-care treatment. We assessed neuropsychiatric adverse events (reported by clinicians) and responses to the mood and sleep questionnaires (reported by the participant or their carer) in both groups. We compared the proportions of patients with neuropsychiatric adverse events (neurological, psychiatric, and total), time to first neuropsychiatric adverse event, and participant-reported responses to questionnaires capturing issues with mood, suicidal thoughts, and sleep problems. FINDINGS: Between Sept 20, 2016, and June 22, 2018, 707 participants were enrolled, of whom 345 (49%) were female and 362 (51%) were male, and 623 (88%) were Black-African. Of 707 participants, 350 (50%) were randomly assigned to dolutegravir-based antiretroviral therapy and 357 (50%) to non-dolutegravir-based standard-of-care. 311 (44%) of 707 participants started first-line antiretroviral therapy (ODYSSEY-A; 145 [92%] of 157 participants had efavirenz-based therapy in the standard-of-care group), and 396 (56%) of 707 started second-line therapy (ODYSSEY-B; 195 [98%] of 200 had protease inhibitor-based therapy in the standard-of-care group). During follow-up (median 142 weeks, IQR 124–159), 23 participants had 31 neuropsychiatric adverse events (15 in the dolutegravir group and eight in the standard-of-care group; difference in proportion of participants with ≥1 event p=0·13). 11 participants had one or more neurological events (six and five; p=0·74) and 14 participants had one or more psychiatric events (ten and four; p=0·097). Among 14 participants with psychiatric events, eight participants in the dolutegravir group and four in standard-of-care group had suicidal ideation or behaviour. More participants in the dolutegravir group than the standard-of-care group reported symptoms of self-harm (eight vs one; p=0·025), life not worth living (17 vs five; p=0·0091), or suicidal thoughts (13 vs none; p=0·0006) at one or more follow-up visits. Most reports were transient. There were no differences by treatment group in low mood or feeling sad, problems concentrating, feeling worried or feeling angry or aggressive, sleep problems, or sleep quality. INTERPRETATION: The numbers of neuropsychiatric adverse events and reported neuropsychiatric symptoms were low. However, numerically more participants had psychiatric events and reported suicidality ideation in the dolutegravir group than the standard-of-care group. These differences should be interpreted with caution in an open-label trial. Clinicians and policy makers should consider including suicidality screening of children or adolescents receiving dolutegravir