Ageing and its effect on the functional capacity of the thymus

Background: Thymus gland is the only primary lymphoid organ in mammals, the first organ to become lymphoid and influences the development of other lymphoid organs in the body. It develops from the 3rd pharyngeal pouch in 5th week of intra uterine life and is located in the anterior and superior mediastinum of the thorax. Survival of an organism is influenced by an adequate immune system, and the thymus is a dependable lymphoid organ responsible for cell mediated immunity via T-cell training and maturation. It also produces hormones that play a role in immune mediation. However, the gland is said to increase in size from birth onwards but undergo involution after puberty and may disappear by middle age as reported in other parts of the world. Hence the need to establish what happens in Ugandans, with an aim to determine the functional capacity of the gland as one grows or if T-cell production does continue. The objective of this study was to determine the structural changes and functional ability of the thymus gland with age among Ugandans.Methods: This was a descriptive cross-sectional study. The study was carried out at Makerere University and the associated Mulago teaching hospital. Autopsy cases at Mulago hospital and Kampala city mortuaries were used for the study.Results: A total of 41 cases were dissected comprising of 71% male and 29% female specimens. Of them, 34% were pre-puberty and 66% were post- pubertal individuals. The age range was six months to seventy years with a mean age of 22.3, median 34.75 and mode 25. Seventy five percent of all cases were 30years and below, only 5% were more than 45years. It should be noted that only The thymus tissue was found in 39 cases and absent in two aged 40 and 43 years respectively.Conclusions/Recommendation: The relative size of the cortex and proportion of lymphoblasts decreased with age while the medulla and lymphocytes increased. The fat content of the gland increased with age. The study showed a positive correlation of weight of the glands with age from birth to puberty, later the correlation becomes negative. There is a decrease in the activity of the gland as shown by the reduced ratio of lymphoblasts to lymphocytes

Knowledge about the research and ethics committee at Makerere University, Kampala

Background: All research involving human participants should be reviewed by a competent and independent institutional research and ethics committee. Research conducted at Makerere University College of Health Sciences should be subjected to a rigorous review process by the ethics committee in order to protect human participants’ interests, rights and welfare.Objective: To evaluate researchers’ knowledge about the functions and ethical review process of the College of Health Sciences research and ethics committee.Methods: A cross sectional study. 135 researchers consented to participate in the study, but 70 questionnaires were answered giving a 52% response.Results: Age ranged between 30 to 61 years, majority of participants 30-39 years. Most of the respondents do agree that the REC functions include Protocol review 86%, protection of research participants 84.3%, and monitoring of ongoing research. During ethical review, the RECpays special attention to scientific design [79.7%] and ethical issues [75.3%], but less to the budget and literature review. More than 97% of the respondents believe that the REC is either average or very good, while 2.8% rank it below average.Conclusion: Respondents knew the major functions of the committee including protection of the rights and welfare of research participants, protocol review and monitoring of on going research, and the elements of protocol review that are given more attention include ;scientific design and ethical issues. Overall performance of the REC was ranked as average by respondents. The committee should limit delays in approval and effectively handle all functions of the committee.African Health Sciences 2013; 13(4): 1041 - 104

Perception, understanding and practice of ethics during research on humans.

Background: Scandals have occurred over time involving conduct of research in different parts of the world. This study was aimed at exploring researchers’ perception, understanding, appreciation and practice of research ethics during research on human subjects.Methods: A qualitative approach using the exploratory and descriptive designs was used. Participants in the study academic staff and graduate students in the Faculties of Medicine and Social Sciences.Results: Of the 37 respondents 68% were faculty while 32% were graduate students in the fields of social sciences, clinical and basic sciences. Research experience ranged from one to thirty four years. 27% had had formal training in research ethics; the remaining 73% had a vague idea about research ethics. All respondents appreciated the importance of confidentiality although data management procedures were lacking in many. A total of 22% of the participants appreciated the need for research subjects to understand the informed consent, 38% think it is not always the case and in many cases their subjects do not have to understand, while the remaining 40% believe that research subjects’ understanding of the informed consent process may not be necessary. Sixty five percent of participants have no knowledge and usually give no feed back to research communities unless the funding organization request so.Conclusion: Most researchers appreciate the importance of confidentiality, but have limited understanding of the process of informed consent, information handling and the importance of feedback

Course of the Sciatic Nerve: a review of cases seen at Mulago Hospital, Kampala - Uganda

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Linking Farmers to Markets through Modern Information and Communication Technologies in Kenya

This paper highlights a market information and linkage system (MILS) developed and tested by the Kenya Agricultural Commodity Exchange Limited (KACE) that increases the efficiency of agricultural markets to work better for smallholder farmers and other small and medium sized agro-enterprises (SMEs). The MILS involves harnessing modern information and communication technologies (ICTs) to empower farmers with low-cost reliable and timely market information to enhance the bargaining power of the farmer for a better price in the market place, and to link the farmer to markets more efficiently and profitably. The components of the KACE MILS are (www.kacekenya.com): Rural based Market Information Points (MIPs) which are information kiosks located in rural markets, District-level Market Information Centres (MICs), Mobile Phone Short Messaging Service (SMS), Interactive Voice Response (IVR), Internet based database system, rural FM radio and the Central Coordinating Hub in Nairobi. KACE has adopted a business approach to the provision of its services: users pay for the services. For instance it charges: placement fees per initial offer or bid (US$1.5-15), commissions on concluded deals (0.5$ 65 for 6 months or US$125 for 12 months), fees to visiting foreign groups (US$ 2,000-5,000/visit) and revenue sharing agreements with SMS and IVR service providers. When the KACE MILS services are scaled out and widely used by many farmers and SMEs across Kenya, the system will generate sufficient revenue to sustain its services without reliance on development partner funding. To enhance the financial sustainability of the MILS services further, KACE has recently initiated two innovations: franchising MIPs and MICs to local entrepreneurs, and establishing a virtual trading floor to improve the matching of offers and bids through a rural-based FM Radio program. A recent study of the impact of the KACE MILS concluded that the proportion of farmers and traders that say their incomes has increased and their bargaining positions have improved is very high (75% farmers and 60% commodity traders). Furthermore, the study concluded that it was clear that during the years in which the KACE MILS has been operational, market integration improved for two commodities studied (i.e. maize and beans). This study also highlights the challenges faced by the KACE MILS, including poor infrastructure that imposes high transport costs to markets, high costs of mobile phone calls and SMS and small quantities of produce of varying quality offered. Keywords: Information and communication technology, innovations, Kenya,Agribusiness, Agricultural and Food Policy, Consumer/Household Economics, Environmental Economics and Policy, Farm Management, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, Institutional and Behavioral Economics, International Relations/Trade, Land Economics/Use, Marketing, Productivity Analysis, Research and Development/Tech Change/Emerging Technologies, Research Methods/ Statistical Methods,

Sternal Anomalies with Supernumerary and Subnumerary Vertebrae and Ribs – Case Reports

Background: Variations in the number of ribs and vertebrae have been noted in other wise normal looking people with some having supernumerary while others subnumerary. Sternal variations and anomalies though have not been as widely documented. These are two cases with one having a combination of sternal anomalies, supernumerary thoracic vertebrae and ribs and subnumerary lumbar vertebrae while the other had subnumerary thoracic vertebrae and ribs.Findings: Case 1: A 38year old female who had eleven thoracic vertebrae and corresponding pairs of ribs, nine pairs attached and two floating. The other skeletal components were normal. Case 2: Adult male had 13 thoracic vertebrae and thirteen corresponding pairs of ribs. Ten pairs of ribs attached to the cage and three floating. There were four lumber vertebrae. The manubrium of the sternum was much longer, ended at the third coastal cartilage attachment and there was an oval defect in the body of the sternum at the level of 5th costal cartilage. The rest of the skeleton was normal.Conclusions: Osteological variations in the rib cage and vertebrae are clinically important because they can mislead an unsuspecting clinician during diagnostic and therapeutic lumbar punctures, counting of ribs during heart examinations, drainage of the thorax and the 12th rib is important in citing of the incision for nephrectomy and other medical procedures. Radiological diagnosis, Forensic and medical legal pathological identifications need to put into consideration such variations

Practices of Makerere University students during anatomy dissection

Background: The knowledge, skills and practices medical students acquire during grossanatomy dissection are fundamental to the learning of human anatomy and eventual practice of medicine. The changes in the curriculum and the global concerns about how students acquire their anatomical skills and knowledge, made it important to find out what students in our low resource settings do in the anatomy dissection room.Methods : This was a cross-sectional descriptive survey with a qualitative component on two cohorts of 305-second year health professional students on what they do during anatomy dissection practical.Results:The overall response rate was 26.9%. Of the 82 respondents, 35 (42.7%) reported that they only observed the dissection, 25 (31.7%) read the manuals, 20 (24.4%) had actual hands on dissection and one (1.2%) had never dissected. Significantly less male students read the manuals as opposed to doing the hands on dissection (0.18, P=0.0007). The interviews highlighted some of the reasons behind the students preferred roles.Conclusion: The students’ responses highlight differences between institutional expectations of dissection and the actual student practices. Specific roles like reading the manual and dissecting show significant sexual bias. There is a need to examine of the institutional definition of dissection in relation to its low resource settings

Exploring the Impacts of Lead Farmer Selection on Community Social Learning: The case of Farmer-to-Farmer Model: A Review of Literature

Agricultural extension has shifted towards community-centric, farmer-centered, and participatory approaches that enhance rural change through a social learning lens, resulting in the emergence of the farmer-to-farmer extension model. The purpose of the study was to understand lead farmer selection criteria within the farmer-to-farmer model and their impacts on community social learning. We applied Torraco’s (2005) integrative literature review method to guide our discussion around lead farmer selection processes, types of lead farmers selected and their impacts on social learning. The study indicated farmer-to-farmer extension model has the potential of re-invigorating the provision of agriculture extension services owing to its low cost, reliability, and the potential to be sustainable. However, farmer-to-farmer faces numerous challenges such as a lack of funding, limited community adoption, and acceptance of the system. This study’s findings suggest the farmer-to-farmer approach can be more effective when stakeholders, especially the community is actively involved in designing, implementing, and evaluating the model. The study recommends that practitioners work closely with the community to develop long-term relationships based on trust through intentionality and inviting attitude that respects and values community knowledge

Lean Six Sigma implementation in East Africa: findings from a pilot study

Purpose – This paper reports the results of a pilot study on the implementation of Lean Six Sigma (LSS) in East African service and manufacturing organizations. The purpose of this paper is to determine the critical success factors for implementation of such a strategy as well as any barriers. A further aim was to determine the knowledge, usage and usefulness of LSS tools and techniques within those organizations. Design/methodology/approach – A quantitative approach was taken utilizing a survey questionnaire which was sent to a sample of organization employees who had attended Yellow, Green or Black Belt LSS training courses organized by the Kenya Institute of Management in Nairobi. Employees attending such courses came from Kenya, Uganda, Tanzania and Rwanda. Findings – Results indicate that the most useful tools are most of the original seven tools of quality improvement proposed by Ishikawa over 50 years ago and the most important factor for successful implementation of LSS is management involvement and participation. Research limitations/implications – The main limitation is that this is a pilot study so to confirm the findings a full survey of East African organization needs to be undertaken. Practical implications – The findings have implications for trainers, consultants and practitioners with regards to the implementation of LSS within organizations as well as the focus of the content of LSS training courses. Originality/value – This paper reports the first study on the implementation of LSS in East Africa and will be of value to practitioners, trainers, consultants and researchers of LSS in East Africa and beyond

Strengthening agricultural education and training in Sub-Saharan Africa from an innovation systems perspective: Case studies of Ethiopia and Mozambique

"This paper examines the role of postsecondary agricultural education and training (AET) in Sub-Saharan Africa in the context of the region's agricultural innovation systems. Specifically, the paper looks at how AET in Sub-Saharan Africa can contribute to agricultural development by strengthening innovative capabilities, or the ability to introduce new products and processes that are socially or economically relevant to smallholder farmers and other agents in the agricultural sector. Using AET in Ethiopia and Mozambique as case studies, the paper argues that while AET is conventionally viewed in terms of its role in building human and scientific capital, it also has a vital role to play in building the capacity of organizations and individuals to transmit and adapt new applications of existing information, new products and processes, and new organizational cultures and behaviors. The paper emphasizes the importance of improving AET systems by strengthening the innovative capabilities of AET organizations and professionals; changing organizational cultures, behaviors, and incentives; and building innovation networks and linkages. The paper draws on two main sources of information: the emerging literature on innovation systems in developing-country agriculture, and data gathered from secondary sources and semi-structured key informant interviews conducted in Ethiopia and Mozambique in late 2006. The paper offers several recommendations that can contribute to enhancing the effectiveness of AET's contribution to agricultural innovation and development. Key reforms include aligning the mandates of AET organizations with national development aspirations by promoting new educational programs that are more strategically attuned to the different needs of society; inducing change in the cultures of AET organizations through the introduction of educational programs and linkages beyond the formal AET system; and strengthening individual and organizational capacity by improving incentives to forge stronger linkages between AET and diverse user communities, knowledge sources, and private industry." - from authors' abstract.Agricultural education and training, Innovation systems, Sub-Saharan Africa, case studies, Small farmers, agricultural sector,