Chemical composition of three herbaceous tropical forage legumes grown successfully in Zimbabwe

A scientific study on animal- feed nutrition for better stock production in Zimbabwe.Desmodium uncinatum, Stylosanthes guianensis and Macroptilium atropurpureum, grown at the University of Zimbabwe Farm, were harvested serially in the early (December), mid (February) and late (April) growing season in 1992/93 and oven-dried. Field-cured hays were also made from the legumes in April 1993 and 1994. The legumes differed in phenological development which, in turn, influenced crude protein (CP) levels. The CP content of S. guianensis (132 to 167 g/kg dry matter) was the least and first rose and then fell, that of D. uncinatum (195 to 234 g/kg DM) decreased, while that of M. atropurpureum (189 to 229 g/kg DM) increased with the season. Neutral detergent fibre (NDF) was higher in the early (364 to 440 g/kg DM) than in the mid to late season (470 to 559 g/kg DM). S. guianensis was the most fibrous in April, while D. uncinatum contained the most lignin across the season (148 to 159 g/kg DM). The legumes, especially M. atropurpureum, were rich in calcium (9.8 to 20.4 g/kg DM) and phosphorus (1.8 to 3.3 g/kg DM). Hay making was associated with loss of quality (e.g., 14 to 31 percent less CP and 12 to 51 percent more NDF) that was attributable to leaf loss. D. uncinatum hay contained the most fibre, lignin and acid detergent insoluble nitrogen and the least minerals. It is concluded that, overall, M. atropurpureum was chemically the most nutritious legume

The Role of Innovation Intermediaries in Developing Healthcare Innovation Ecosystems: Value Co-Creation through Platforms

Thesis (PhD)--Stellenbosch University, 2021.ENGLISH ABSTRACT: Creating sustainable agile innovative environments is a persistent challenge, which has been exacerbated by the COVID-19 global pandemic. The disruption in services has highlighted the need to foster innovation, build resilient health systems, operationalise technology banks and build more domestic capacity whilst harnessing global cooperation. These are the mandates of the 3rd, 9th and 17th Sustainable Development Goals (SDGs). One organisation cannot maintain and develop these systemic dynamics alone, hence ecosystems of actors ranging in structure and size are formed. These are the foundational precepts of this dissertation as it explores how to manage innovation ecosystems. Though such concerns are across diverse industries, this study was in healthcare. The aim was to inform under-resourced countries on how to ensure sustainability on projects often funded by foreign funders, which is rampant in the Global South. This study contributed to the discourse of ecosystems research by developing an Ecosystem Evolution and Emergence Framework that assists in the management of the innovation ecosystem. Ecosystems research has mainly focussed on the structure of ecosystems and less attention has been devoted to the emergence of ecosystems. Thus,this study contributes to shedding some light on ecosystem emergence.The framework has two pillars for the innovation intermediary: outlining the key tasks to undertake at each ecosystem stage and the key aspects that are important to identify, monitor or cultivate in the ecosystem for the ecosystem actors. A constructivist perspective was used to better understand the relationship between innovation intermediation and innovation ecosystems. Conceptually, the framework development process was guided by Soft Systems Methodology with an emphasis on learning from the history of past projects addressing the same issues. These theoretical tools were deduced from established theories in innovation systems and complexity science embedded in a narrative explanation-Event Structure Analysis. This analysis was utilised through applying event colligation and displaying through Causal Loop Diagrams Empirically, a comparison of the emergence sequences from three healthcare innovation ecosystems was undertaken. These are the Maternal Alliance for Mobile Action (MAMA), Mom Connect and the District Health Information System (DHIS2). The activities and functions were mapped in the study across the innovation ecosystem development stages of birth, expansion and self-renewal using the framework. This resulted in the identification of 39 core ecosystem events deemed leverage points–each with a myriad of activities. The evaluated framework culminated in five distinct leverage categories of structural, technological, social, knowledge and political leverage. This is presented as an ecosystem management tool that enables: 1) building of innovation ecosystems; 2) facilitating improvement and sustainability of existing innovation ecosystems; and 3) providing the ecosystem manager with tools to address commonly experienced challenges. The tool’s main aim is to provide guidelines on how ecosystems emerge and are governed. The systematic approach followed in the study lends itself to future development and expansion with various other computerised tools.AFRIKAANSE OPSOMMING: Raadpleeg teks vir opsommingDoctorat

Nitrogen Retention and Microbial Protein Yield of \u3cem\u3e Desmodium uncunatum, Mucuna pruriens\u3c/em\u3e and \u3cem\u3eVigna unguiculata \u3c/em\u3e Forage Legumes in Goats

Forage legumes have high potential degradability, indicating that they might need to stay in the rumen for a longer time (MolinaAlcaide et al., 1996) to increase microbial protein yield. Microbial protein contributes about two thirds of the amino acids absorbed by ruminants (Pathak 2008). Protein supplements which have proper levels of rumen undegradable protein provide growth limiting amino acids like lysine and methionine (Rezai et al., 2012). Nyambati et al. (2003) showed that milk production can be increased by supplementing with velvet bean, highlighting the importance of integrating legumes into the low-input, mixed cropping systems in the tropics. The current study was to determine total microbial protein yield from Vigna unguiculata (cowpea), Desmodium uncinatum (silverleaf desmodium) and Mucuna pruriens (velvet bean) legume forages in goats

Milk Production in Goats on Veld Hay Supplemented with Selected Legume Forages

Alternative affordable sources of feed such as forage legumes that provide protein, vitamins and mineral elements, which are lacking in mature natural grassland pastures, especially during the dry season (Baloyi et al. 2008), can be an option. The high protein content of these legumes suggests that they have high potential for use as protein supplements in goat feeding. However, there is need for an in-depth study of the utilization of different legume forages for milk production in goats. Gusha et al. (2014) reported that supplementing with legume hays could improve poor quality roughage intake in goats. Snyman (2010) observed lower kid mortality in supplemented does compared to those not supplemented during lactation. Therefore, this research was designed to investigate the effects of supplementing Desmodium uncunatum, Mucuna pruriens and Vigna unguiculata forage legumes to low quality veld hay on milk production in indigenous goats

A patient-centric Six-Sigma decision support system framework for continuous quality improvement in clinics

CITATION: Hlongwane, S., Ngongoni, C. & Grobbelaar, S. S. 2019. A patient-centric Six-Sigma decision support system framework for continuous quality improvement in clinics. South African Journal of Industrial Engineering, 30(3):224-237, doi:10.7166/30-3-2241.The original publication is available at http://sajie.journals.ac.zaENGLISH ABSTRACT: Primary health care facilities are widely regarded as the backbone of the South African healthcare system. For this reason, formalised standards such as the ‘ideal clinic’ and ‘national core standards’ dictate expected service levels for clinics. Although this is a big step towards the improvement of service delivery at the facilities, the level of uptake of and adherence to these standards is concerning. Service quality plays a huge role in the level of patient satisfaction, and emphasis is placed on the features of quality that are of importance to the patient. To this end, the focus on the patient is an important dimension in healthcare quality management in order to improve the service quality in healthcare facilities. This article provides an overview of quality and how it is managed in the context of clinics in South Africa. It outlines the gaps, aligned with how well quality is managed, from a patient perspective. The paper proposes a decision support framework aimed at continuous improvement of quality in clinics. The tool was developed using the Six Sigma methodology, complemented by service quality assessment instruments. The structure of the tool provides an integrated systematic approach that can assist the healthcare decision-maker in tracking the continuous improvement of processes and activities in clinics. The tool also takes the first step towards digitising a typical paper-based system.AFRIKAANS OPSOMMING: Primêre gesondheidsorgfasiliteite word wyd beskou as die ruggraat van die Suid-Afrikaanse gesondheidsorgstelsel. Om hierdie rede word formele standaarde deur die ‘ideale kliniek’ en ‘Nasionale kernstandaarde’ bepaal. Alhoewel dit ʼn groot stap is vir die verbetering van dienslewering by die fasiliteite, is die vlak van opname en nakoming van hierdie standaarde kommerwekkend. Diensgehalte speel ʼn groot rol in die vlak van pasiëntbevrediging, en klem word geplaas op die eienskappe van kwaliteit wat van belang is vir die pasiënt. Vir hierdie doel is die fokus op die pasiënt ʼn belangrike dimensie in gesondheidsorgkwaliteitsbestuur ten einde die diensgehalte in gesondheidsorgfasiliteite te verbeter. Hierdie artikel bied ʼn oorsig oor kwaliteit en hoe dit in die konteks van klinieke in Suid-Afrika bestuur word. Dit beskryf die gapings van hoe goed kwaliteit bestuur word, uit ʼn pasiëntperspektief. Die artikel stel ʼn besluitsteunraamwerk voor wat op deurlopende verbetering van gehalte in klinieke gemik is. Die instrument is ontwikkel met behulp van die Ses-Sigma metodologie, aangevul deur dienskwaliteit assesseringsinstrumente. Die struktuur van die instrument bied ʼn geïntegreerde sistematiese benadering wat die gesondheidsorgbesluitnemer kan help om die deurlopende verbetering van prosesse en aktiwiteite in klinieke te monitor. Die instrument neem ook die eerste stap in die rigting van digitalisering van ʼn tipiese papiergebaseerde stelsel.http://sajie.journals.ac.za/pub/article/view/2241Publisher's versio

Scaling up delivery of HIV services in Africa through harnessing trends across global emerging innovations

Globally, innovations for HIV response present exciting opportunities to enhance the impact and cost-effectiveness of any HIV program. However, countries especially in the African region are not on equal footing to effectively harness some of the existing innovations to accelerate impact on HIV services delivery. This paper aims to add to the discourse on innovative solutions to support countries to make informed decisions related to technologies that can be adapted in different contexts to strengthen HIV programs. A scoping review which involved a search of innovations that can be used in response to the HIV epidemic was carried out between June 2021 and December 2022. The results showed that a high level of technological advancement occurred in the area of digital technologies and devices. Out of the 202 innovations, 90% were digital technologies, of which 34% were data collection and analytics, 45% were mobile based applications, and 12% were social media interventions. Only 10% fell into the category of devices, of which 67% were rapid diagnostic tools (RDTs) and 19% were drone-based technologies among other innovative tools. The study noted that most of the innovations that scaled relied on a strong ICT infrastructure backbone. The scoping review presents an opportunity to assess trends, offer evidence, and outline gaps to drive the adoption and adaptation of such technologies in Africa

Neural cross-correlation for radio astronomy

Includes abstract.Includes bibliographical references (leaves 56-62).Correlation engines are essential elements of most signal processing systems. Areas of applicability include image processing, speech synthesis and analysis, high energy physics, wireless and mobile communication systems, spread spectrum communication systems and even prosthetics. Finding cost effective and computationally less intensive engines is the thrust of most research. Neural networks have also been used as aids in making complex tasks relatively easy to process

Building together: Value Co-Creation for Entrepreneurial Firms

The purpose of this thesis is to examine how entrepreneurial firms use external actors to create value in their companies in an entrepreneurial ecosystem. Of particular importance is how an intermediary organisation can foster value co-creation. This is done by looking at a case study of the Oslo Cancer Cluster incubator in Norway. The incubator is situated in the middle of an oncology cluster which offers an intriguing arrangement. The thesis will examine the arrangement of the cluster, incubator and its actors

Prescribing And Dispensing Of Medicines Used To Treat Non-Communicable Diseases In Uganda

Essential Medicines (EM) for non-communicable diseases (NCD) are often unavailable to patients in Uganda. We sought to determine the gap between prescribed and dispensed medicines for the treatment of NCD - specifically, diabetes mellitus (DM) and cardiovascular disease (CVD) - in Ugandan public healthcare facilities. We conducted a cross-sectional study in which systematic sampling was used to collect data from patients attending outpatient NCD clinics at 20 national, regional and general higher level public healthcare facilities throughout the country. Convenience sampling was used to obtain data from prescribers and dispensers of NCD medicines at the same facilities. Data were collected using structured questionnaires. The primary outcome was the percentage of prescribed doses that were not dispensed. We analyzed data from 637 patient participants, 24 prescribers and 28 dispensers. 454 (71.3%) patient participants were female, 107 (16.8%) had no formal education, 259 (40.7%) were unemployed and 391 (62.3%) earned below the poverty line. The mean number of prescribed medicines per encounter was 2.3 (SD 1.1), of which only 1.4 (SD 0.9) were dispensed. The most commonly prescribed medicines for DM were metformin 291 (48.6%) and glibenclamide 161 (26.9%) while for CVD they were nifedipine 188 (21.7%), bendroflumethiazide 134 (15.4%). Of the 1467 prescriptions analyzed, 1157 (78.9%) were generic names and 1412 (96.3%) were on the Essential Medicines List (EML), which is less than the World Health Organization (WHO) standard of 100% for prescription of generic names and medicines on the EML. 1151 (78.5%) prescriptions were adequately written by prescribers, and 802 (89.6%) dispensed medicines were adequately labelled. Overall, there were 82,591 total prescribed doses and 35,290.5 dispensed doses, meaning that 57.3% of prescribed doses were not dispensed. The percentage of non-dispensed doses varied significantly by participant travel time (p=0.04), facility (p\u3c0.001) and facility type (p=0.001). Additionally, the proportion of non-dispensed doses varied with the disease (CVD 67.5% v. DM 46.2%, p\u3c0.001). 535 (84.0%) patient participants did not receive all their prescribed doses. Of the 442 patient participants who reported not receiving all of their medicines, 317 (71.7%) reported this being due to low pharmacy stock. Upon follow-up, 90 (35.6%) of 253 patients contacted had not obtained their non-dispensed doses elsewhere. There is a marked discrepancy between prescribed and dispensed doses for medicines that treat NCD at public healthcare facilities in Uganda. The discrepancy differs by disease and appears to be driven by availability of medicines. Most patients do not close this gap by purchasing medicines at private pharmacies, suggesting that under-treatment of these chronic conditions is widespread among patients already linked to care. As noted above, this study found a number of indicators of irrational drug use including prescription of brand name medicines, prescription of medicines not included on the EML and inadequately labeling of prescriptions and dispensed medicines. Unavailability of medicines in facilities has been previously documented but this study describes the unavailability of medicines to patients. This offers a different statistical target for policy makers when determining policy to increase availability of NCD medicines to patients

Surgery, Liver Directed Therapy and Peptide Receptor Radionuclide Therapy for Pancreatic Neuroendocrine Tumor Liver Metastases

Pancreatic neuroendocrine tumors (PNETs) are described by the World Health Organization (WHO) classification by grade (1–3) and degree of differentiation. Grade 1 and 2; well differentiated PNETs are often characterized as relatively “indolent” tumors for which locoregional therapies have been shown to be effective for palliation of symptom control and prolongation of survival even in the setting of advanced disease. The treatment of liver metastases includes surgical and non-surgical modalities with varying degrees of invasiveness; efficacy; and risk. Most of these modalities have not been prospectively compared. This paper reviews literature that has been published on treatment of pancreatic neuroendocrine liver metastases using surgery; liver directed embolization and peptide receptor radionuclide therapy (PRRT). Surgery is associated with the longest survival in patients with resectable disease burden. Liver-directed (hepatic artery) therapies can sometimes convert patients with borderline disease into candidates for surgery. Among the three embolization modalities; the preponderance of data suggests chemoembolization offers superior radiographic response compared to bland embolization and radioembolization; but all have similar survival. PRRT was initially approved as salvage therapy in patients with advanced disease that was not amenable to resection or embolization; though the role of PRRT is evolving rapidl