Development of a strategy and interpretation of the NIR spectra for application in automated sorting

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordThe Near Infrared (NIR) spectroscopy is a novel technique that can be used for early identification and separation of minerals from unwanted gangue during ore sorting. In this research, the potential of near infrared sensors for application in automated sorting was investigated on a copper-gold ore sample. The ore contains a substantial amount of carbonaceous material which results in excessive acid consumption in the subsequent leaching process during copper extraction. To classify this unwanted gangue material (carbonate) from the valuable metal (copper), a strategy to identify and distinguish the ore according to copper and carbonate content was developed. The near infrared spectra were measured on the surface of ore particles and characteristic absorption features were observed at a longer wavelength ranging from 2000 nm to 2405 nm. The results were then correlated with the chemical and mineralogical composition of the ore determined using X-Ray fluorescence and X-Ray diffraction equipments respectively. The near infrared spectra showed distinct characteristic absorption features for carbonate rich particles that distinguished these from copper bearing particles, which are fairly featureless at longer wavelengths. Combined interpretation of spectral features and chemical and mineralogical data indicates that near infrared-based sorting has potential for this type of ore.The authors wish to thank the Zambian government and the Copperbelt University management for the financial support towards this research

Acute confusion and ataxia in the emergency department with an unexpected underlying diagnosis

No Abstrac

Survival strategies employed by state university libraries in Zimbabwe in the face of limited funding

The study examined the survival strategies employed by state university libraries in Zimbabwe in the face of limited funding in 2014-2018. Financial and other challenges have had adverse effects on the provision of effective library services in most academic libraries world over. This study explored the funding models used by state university libraries in Zimbabwe and established fund raising strategies employed by such libraries. The research was qualitative in nature and used a multiple case-study methodology focusing on eight university libraries which were purposively selected. The data was collected using face to face and telephone interviews, and document analysis. The data was analysed using the Taguette Software and graphs and tables were used to present the findings. The study findings acknowledged state university libraries efforts and initiatives in resource mobilization though limited. Most of these libraries expected much more funding from the mother institutions through annual budget allocations and grants, and very minimal fundraising activities were done. The study recommends that state university libraries work together with other libraries and push for the revision and revamp of the National Library and Documentation Services Act of 1985. The revision of this Act and its revamp to suit the current 21st century information needs could aid in the financing and development of academic libraries and other libraries in Zimbabwe at large. State university libraries should also put more effort into seeking unrestricted fundraising activities. The authors proposed a Three Layer Library Survival Strategies (TLLSS) Model for adoption by libraries facing funding challenges

Community-linked maternal death review (CLMDR) to measure and prevent maternal mortality: a pilot study in rural Malawi.

In Malawi, maternal mortality remains high. Existing maternal death reviews fail to adequately review most deaths, or capture those that occur outside the health system. We assessed the value of community involvement to improve capture and response to community maternal deaths

Development of a public audiology service in Southern Malawi: profile of patients across two years

Objective To describe the profile of patients attending the Queen Elizabeth Central Hospital (QECH) audiology clinic in Malawi, over a two-year period (2016–2017). Design A retrospective patient record review. Study sample There were 2299 patients assessed at the QECH audiology department between January 2016 and December 2017. Adult patients’ ages ranged from 18 to 94 years (M = 45.8, SD = 19.22). The mean age of children included in this study was 7.7 years (SD= 5.21). Overall, 45.4% of patients were female. Results Of the 61.6% of adults and 41.7% of children found to have some degree of hearing loss, 28.3% and 15.4% were fitted with hearing aids, respectively. The number of patients seen in 2017 (n = 1385) was 34% higher than that of 2016 (n = 914). Conclusion This study found that demand for hearing services is increasing in this public sector Malawian audiology department but uptake of hearing aids for those in need is low. Future evaluation of service provision and treatment outcomes is needed. Results from this study can be used to inform the development of future audiology clinics in low resource settings

Prevalence and Determinants of Unintended Pregnancy in Mchinji District, Malawi; Using a Conceptual Hierarchy to Inform Analysis

Background: In 2012 there were around 85 million unintended pregnancies globally. Unintended pregnancies unnecessarily expose women to the risks associated with pregnancy, unsafe abortion and childbirth, thereby contributing to maternal mortality and morbidity. Studies have identified a range of potential determinants of unplanned pregnancy but have used varying methodologies, measures of pregnancy intention and analysis techniques. Consequently there are many contradictions in their findings. Identifying women at risk of unplanned pregnancy is important as this information can be used to help with designing and targeting interventions and developing preventative policies. Methods: 4,244 pregnant women from Mchinji District, Malawi were interviewed at home between March and December 2013. They were asked about their pregnancy intention using the validated Chichewa version of the London Measure of Unplanned Pregnancy, as well as their socio-demographics and obstetric and psychiatric history. A conceptual hierarchical model of the determinants of pregnancy intention was developed and used to inform the analysis. Multiple random effects linear regression was used to explore the ways in which factors determine pregnancy intention leading to the identification of women at risk of unplanned pregnancies. Results: 44.4% of pregnancies were planned. On univariate analyses pregnancy intention was associated with mother and father’s age and education, marital status, number of live children, birth interval, socio-economic status, intimate partner violence and previous depression all at p<0.001. Multiple linear regression analysis found that increasing socio-economic status is associated with increasing pregnancy intention but its effect is mediated through other factors in the model. Socio-demographic factors of importance were marital status, which was the factor in the model that had the largest effect on pregnancy intention, partner’s age and mother’s education level. The effect of mother’s education level was mediated by maternal reproductive characteristics. Previous depression, abuse in the last year or sexual abuse, younger age, increasing number of children and short birth intervals were all associated with lower pregnancy intention having controlled for all other factors in the model. This suggests that women in Mchinji District who are either young, unmarried women having their first pregnancy, or older, married women who have completed their desired family size or recently given birth, or women who have experienced depression, abuse in the last year or sexual abuse are at higher risk of unintended pregnancies. Conclusion: A simple measure of pregnancy intention with well-established psychometric properties was used to show the distribution of pregnancy planning among women from a poor rural population and to identify those women at higher risk of unintended pregnancy. An analysis informed by a conceptual hierarchical model shed light on the pathways that lead from socio-demographic determinants to pregnancy intention. This information can be used to target family planning services to those most at risk of unplanned pregnancies, particularly women with a history of depression or who are experiencing intimate partner violence

Assessment of non-standard HIV antiretroviral therapy regimens at Lighthouse Trust in Lilongwe, Malawi

Aim: Lighthouse Trust in Lilongwe, Malawi serves approximately 25,000 patients with HIV antiretroviral therapy (ART) regimens standardized according to national treatment guidelines. However, as a referral centre for complex cases, Lighthouse Trust occasionally treats patients with non-standard ART regimens (NS-ART) that deviate from the treatment guidelines. We evaluated factors contributing to the use of NS-ART and whether patients could transition to standard regimens.Methods: This was a cross-sectional study of all adult patients at Lighthouse Trust being treated with NS-ART as of February 2012. Patients were identified using the electronic data system. Medical charts were reviewed and descriptive statistics were obtained.Results: One hundred six patients were initially found being treated with NS-ART, and 92 adult patients were confirmed to be on NS-ART after review. Mean patient age was 42.4 ± 10.3 years, and 52 (57%) were female. Mean duration of treatment with the NS-ART being used at the time of data collection was 2.1 ± 1.5 years. Eight patients (9%) were on modified first-line NS-ART and 84 (91%) were on modified second-line NS-ART, with 90 patients (98%) having multiple factors contributing to NS-ART use. Severe toxicity from one medication contributed in 28 cases (30%) and toxicity from multiple medications contributed in 46 cases (50%), while 22 patients (24%) were transitioned to NS-ART following a stockout of their original medication. Following clinical review, 84 patients (91%) were transitioned to standard regimens, and eight (9%) were maintained on NS-ART because of incompatibility of their clinical features with the latest national guidelines.Conclusions: Primary factors contributing to NS-ART use were medication toxicities and medication stockouts. Most patients were transitioned to standard regimens, although the need for NS-ART remains