Physical public infrastructure and private sector output/productivity in Uganda: a firm level analysis

physical infrastructure; public works; private sector; productivity; enterprises; Uganda;

Emotional And Behavioural Disorders In HIV Seropositive Adolescents In Urban Uganda

Objective: To investigate the emotional and behavioral problems of HIV sero-positive adolescents.Design: A cross-sectional descriptive study.Setting: A specialised HIV/ AIDS Health Care Centre, the Mildmay Centre, in Kampala, Uganda.Subjects: Eighty two HIV sero-positive adolescents were consecutively enrolled for the study.Results: Over half (55.6%) of the subjects were females. They were mostly (88.9%) under the age of 15 years, orphans (97.6%) and stayed with non-parental relatives (68.3%). Almost two thirds (60.9%) of them were in the HIV/ AIDS clinical disease stage III or IV and were not on ARVs drugs. Forty two (51.2%) of the subjects had significant psychological distress (SRQ-25 scores > 6) and 14 (17.1 %) had attempted suicide within the last 12 months. Their specific psychiatric disorders, made usingICD-10 criteria, were: Anxiety 45.6%, depression 40.8%, somatisation 18.0%, seizures 8.4%, mania 1.2% and HIV-associated progressive encephalopathy 4.8%.Conclusion: HIV/AIDS infection in adolescence was associated with considerable psychological problems and the presence of major psychiatric disorders. With the current increasing availability of effective antiretroviral therapy, many of these children are surviving into adolescence, thus calling for the development of adolescent friendly HIV medical and psychological support and treatment services in developing countries such as Uganda

Association between attachment and mental health symptoms among school-going adolescents in Northern Uganda: the moderating role of war-related trauma

Background: The association between attachment and mental health symptoms in adolescents in a post-conflict low resource setting has not been documented. Methods: We investigated the relationship between parent and peer attachment and posttraumatic stress, depression and anxiety symptoms in a sample of 551 adolescents aged 13-21 years old. Attachment quality was assessed using the Inventory of Parent and Peer Attachment (IPPA). Post-traumatic stress, depression and anxiety symptoms were assessed using the Impact of Events Scale Revised (IESR) and Hopkins Symptom Checklist for Adolescents (HSCL-37A) respectively. Gender differences in attachment relationships were determined using independent t-tests. Multivariate logistic regression was used to assess whether attachment relationships were independently associated with posttraumatic stress, depression and anxiety symptoms. Hierarchical linear regression analyses were conducted to explore the moderating role of war-related trauma. Results: Our analyses revealed gender differences in attachment to parents, with males reporting stronger attachment than females. Parental attachment was protective against depression and anxiety symptoms but not posttraumatic stress symptoms after adjusting for potential confounders. Alienation by parents was independently associated with an increase in these mental health symptoms while peer attachment was not associated with any of these symptoms. However, in situations of severe trauma, our analyses showed that peer attachment was significantly protective against post-traumatic stress symptoms. Conclusions: Secure parental attachment is associated with better psychosocial adjustment in adolescents affected by war. Further, adolescents with secure peer attachment relationships in situations of severe war trauma may be less likely to develop posttraumatic stress symptoms. Interventions to enhance peer support in this post conflict setting would benefit this vulnerable population

A comparison of the clinical features of depression in HIV-positive and HIV-negative patients in Uganda

Objective: Depressive illness is the most common psychiatric disorder in HIV/AIDS with prevalence 2 to 3 times higher than the general population. It’s still questionable whether HIV related depression is clinically different from depression in HIV-negative populations, a fact that could have treatment implications.This study compared the clinical features of major depression between HIV-Positive and HIV-negative patients with a view to intervention strategies. Method: A comparative, descriptive, cross-sectionalstudy was carried out on 64 HIV-Positive depressed patients and 66 HIV-negative depressed patients in Butabika and Mulago hospitals. They were compared along the parameters of clinical features of depression, physical examination and laboratory findings. Pair wise comparisons, logistic regression and Multivariate analysis were done for the two groups on a number of variables. Results: Compared to HIV-Negative patients, HIV-Positive patients were more likely to be widowed ; older (≥ 30years), less likely to have a family member with a mental illness; a later onset of depressive illness (≥30years); more likely to have a medical illness and taking medication before onset of depressive, symptomatically compared to HIV-Negative patients, HIV-Positive patients were more critical of themselves ; had significantly more problems making decisions ; had poorer sleep; felt more easily tired; more appetite changes; more cognitive impairment. Low CD4 counts were not significantly associated with depression, but HIV related depression was more likely to occur in stages II and III illness. Conclusion: These findings show that the clinical and associated features of depression differ between HIV-Positive and HIV-Negative patients, thus requiring different management approaches and further studies related to HIV-related depression.Key words: Clinical features; Depression; HIV/AIDS; Ugand

A historical analysis of the impact of the 1966 Ugandan constitutional crisis on Buganda’s monarchy

1966 was a particularly tumultuous year in the East African country of Uganda. After an era of relative peace and stability, the country was plagued by a range of tragedies that resulted in a constitutional crisis after the 24 May attack on the palace of the King of Buganda. This was the first time in Uganda's short history that the state had deliberately and systematically turned its guns on its own people. As a point of departure the study advances that existing historical analyses on the crisis lack detail. Consequently, the core of the study was to provide a more focused detailed and multi-faceted historical account of the 1966 crisis on the Buganda’s monarchy. The study yielded insights into the political and socio-economic impacts of the 1966 political turmoil on the people of Buganda. Using the historical method to inform the research design; the study employed an archival history methodology to examine how both the colonial legacy and the internal dynamics of the Ugandan society combined to lead to a serious and dramatic conflict between the kingdom of Buganda and State of Uganda. Furthermore, the study demonstrates that the political turmoil left an indelible scar on the Kingdom of Buganda. The study offers clarity on why and how the crisis occurred and contributes a better understanding of the ‘grey area’ of knowledge and insights into what the abolition of the Kingdom meant to the Baganda

Prevalence and types of cognitive impairment among patients with stroke attending a referral hospital in Uganda

Background Cognitive impairment is associated with short and long term adverse outcomes in stroke patients that may impair functional recovery during their rehabilitative process.Aims This study determined the prevalence, grades and demographic factors associated with cognitive impairment among patients with stroke attending Mulago National Referral Hospital in Uganda, a teaching hospital for Makerere University College of Health Sciences.Methods This was a cross-sectional descriptive study conducted from Mulago National Referral Hospital between June 2006 and March 2007. Eighty five patients with stroke confirmed by brain computed tomography scan, consenting either by themselves or by their guardians, were consecutively recruited from the Medical wards, Neurology clinic and the Physiotherapy department. A standardized questionnaire was interviewer administered, to obtain demographic and clinical data, and the Mini-Mental State Examination instrument was used to screen and grade cognitive impairment.Results Of the 85 patients evaluated, 70 (82.4%) had infarct and 15 (17.6%) hemorrhagic stroke. Fifty-four (63%, 95% confidence interval (CI): 53 - 73) had cognitive impairment; of which 23 (27%) and 14 (16%) had mild and moderate cognitive impairment respectively accounting for 43% of the cognitively impaired but with no dementia, and 17 (20%) had severe cognitive impairment (dementia). The only socio-demographic factor associated with cognitive impairment was age . 40 years (odds ratio (OR) 4, 95% CI 1.2 - 13.4, P = 0.024). Conclusions The prevalence of cognitive impairment among patients with stroke is high. Increasing age is significantly associated with cognitive impairment. There is need for neurocognitive assessment programs among stroke patients and the introduction of rehabilitation services should target to maximize their functional recovery

The core competencies for mental, neurological, and substance use disorder care in sub-Saharan Africa.

The 2010 Global Burden of Disease Study points to a changing landscape in which non-communicable diseases, such as mental, neurological, and substance use (MNS) disorders, account for an increasing proportion of premature mortality and disability globally. Despite evidence of the need for care, a remarkable deficit of providers for MNS disorder service delivery persists in sub-Saharan Africa. This critical workforce can be developed from a range of non-specialist and specialist health workers who have access to evidence-based interventions, whose roles, and the associated tasks, are articulated and clearly delineated, and who are equipped to master and maintain the competencies associated with providing MNS disorder care. In 2012, the Neuroscience Forum of the Institute of Medicine convened a meeting of key stakeholders in Kampala, Uganda, to discuss a set of candidate core competencies for the delivery of mental health and neurological care, focusing specifically on depression, psychosis, epilepsy, and alcohol use disorders. This article discusses the candidate core competencies for non-specialist health workers and the complexities of implementing core competencies in low- and middle-income country settings. Sub-Saharan Africa, however, has the potential to implement novel training initiatives through university networks and through structured processes that engage ministries of health. Finally, we outline challenges associated with implementing competencies in order to sustain a workforce capable of delivering quality services for people with MNS disorders

The consumer decision process and determinants of choice for retail consumer lubricants in Gauteng South Africa

South Africa has an open lubricants market where new marketers and brands are welcome to join the competitive landscape. As a result, there are a vast number of players in the lubricants market including small local blenders. There are five major players in this market, namely: Engen, Chevron (marketed as Caltex), Shell, BP and Total as well as smaller marketers like ENI and Indy Oil (Kline and Company , 2018). Castrol is the leading lubricant brand consumed in the country, followed by Shell, Engen, and Chevron, respectively (Mordor Intelligence, 2021). The South African lubricants market is segmented between three main segments: industrial, commercial automotive, and consumer automotive. Industrial lubricants are sold to large producers of goods for their manufacturing equipment.Thesis (MA) -- Faculty of Business and Economic science, 202

The consumer decision process and determinants of choice for retail consumer lubricants in Gauteng South Africa

South Africa has an open lubricants market where new marketers and brands are welcome to join the competitive landscape. As a result, there are a vast number of players in the lubricants market including small local blenders. There are five major players in this market, namely: Engen, Chevron (marketed as Caltex), Shell, BP and Total as well as smaller marketers like ENI and Indy Oil (Kline and Company , 2018). Castrol is the leading lubricant brand consumed in the country, followed by Shell, Engen, and Chevron, respectively (Mordor Intelligence, 2021). The South African lubricants market is segmented between three main segments: industrial, commercial automotive, and consumer automotive. Industrial lubricants are sold to large producers of goods for their manufacturing equipment.Thesis (MA) -- Faculty of Business and Economic science, 202