Experiences of caregivers of stroke patients in Lusaka, Zambia

INTRODUCTION: Stroke is a major cause of death and most survivors are left with residual disability and are dependent on others for essential care. OBJECTIVES: The objective of the present study was to determine the experiences of informal caregivers of stroke patients receiving out-patient physiotherapy treatment at the University Teaching hospital in Lusaka, Zambia. METHODS: Both quantitative and qualitative approaches were used to collect data in the present study. PARTICIPANTS: A convenient sample of 70 caregivers was selected for the quantitative part of the study while 10 caregivers were purposively selected for the in-depth qualitative interviews. Setting: Out-patients at the University Teaching Hospital (UTH) in Lusaka, Zambia INTERVENTION: The Caregiver Strain Index was used to collect quantitative data and in-depth interviews provided the qualitative data. RESULTS: The mean age of the participants was 37.6 years. The study sample consisted of more females (70%) than males (30%). Financial constraints, family adjustments and being overwhelmed by their care-giving role were the experiences mostly highlighted by the caregivers in this study CONCLUSION: Caregivers are important role players in the rehabilitation of stroke patients. It is therefore important that rehabilitation professionals are aware of the experiences of these caregivers so that their needs could also be addressed when managing the stroke patien

The rehabilitation of stroke patients at community health centres in the Western Cape

The structure and process of rehabilitation of stroke patients affects the outcomes of the patients. The aim of this study was to determine the structure and process of rehabilitation of stroke patients at Community Health Centres (CHCs) in the Western Cape, South Africa. A quantitative descriptive study was conducted. Questions and archived records were used to collect the data. The study sample used to collect information related to the structure consisted of therapists (16) employed at the centres; while the study sample used to collect information related to the process consisted of 100 first time stroke patients. Descriptive statistics were conducted using Excel and SPSS . The results of the study revealed that there is a lack of occupational and speech therapy services at the centres forming part of the study sample. At centres where these services are provided the frequency and intensity with which the services are received by the patients is extremely low. Further research is needed to determine if the decreased intensity is only as a result of decreased availability of services or if inability of stroke clients to access the services also plays a roleDepartment of HE and Training approved lis

Health-promotion needs of youth with a spinal cord injury in South Africa

Purpose. To determine the health promotion needs through an exploration of health-related behaviours and the factors that influence the behaviour of physically disabled youth with spinal cord injury. Methods. A descriptive and exploratory study that utilized a qualitative approach was carried out among ten participants aged between 15 and 29 years who were purposely selected. Information was obtained from individual face-to-face interviews and a focus-group discussion. Results. The participants were involved in risky health behaviours including sedentary lifestyles, use of alcohol, tobacco, and drugs. Various factors that influenced their participation in these behaviours were identified including personal struggles with identity and adjustment issues. Conclusions. The results emphasize that participants were involved in health-risk behaviours, which are associated with development of secondary conditions such as respiratory problems, heart diseases, and stroke. Health-promotion strategies employed for these individuals should address the psychological impact of spinal cord injury (SCI) on the individual as an influence to participation in health risk behaviours

Communities' views, attitudes and recommendations on community-based education of undergraduate Health Sciences students in South Africa: A qualitative study

Background: Medical and Health Sciences students in South Africa undertake community-based education (CBE). Health professionals based at host sites are jointly responsible for training of these students in conjunction with university staff. This study explored the communities’ views, attitudes and recommendations regarding CBE undertaken by these students, in order to improve the quality of community support for these programmes. Method: A qualitative descriptive study was conducted at CBE placement sites of students from the Faculties of Health Sciences of the University of Limpopo (UL), University of KwaZulu-Natal (UKZN) and University of the Western Cape (UWC) during 2010 and 2011. Focus group discussions were held with site facilitators, community leaders and patients, and interviews were audio recorded, transcribed and translated into English where necessary. Data were analysed using NVivo (version 9). Findings: CBE was seen to benefit communities, students and host institutions as there was perceived improvement of service delivery, better referral to hospitals and reduction of workloads on site staff. CBE was also seen as having potential for recruiting professionals who have better orientation to the area, and for motivating school pupils for a career in health sciences. Students acquired practical skills and gained confidence and experience. Challenges included poor communication between universities and host sites, burden of student teaching on site facilitators, cultural and religious sensitivity of students and language barriers. Conclusion: The study revealed that communities have an important role to play in the CBE of future health care professionals. CBE activities could be better organised and managed through formalised partnerships.Department of HE and Training approved lis

Targeted next generation sequencing approach identifies eighteen new candidate genes in normosmic hypogonadotropic hypogonadism and Kallmann Syndrome

The genetic basis is unknown for ∼60% of normosmic hypogonadotropic hypogonadism (nHH)/Kallmann syndrome (KS). DNAs from (17 male and 31 female) nHH/KS patients were analyzed by targeted next generation sequencing (NGS) of 261 genes involved in hypothalamic, pituitary, and/or olfactory pathways, or suggested by chromosome rearrangements. Selected variants were subjected to Sanger DNA sequencing, the gold standard. The frequency of Sanger-confirmed variants was determined using the ExAC database. Variants were classified as likely pathogenic (frameshift, nonsense, and splice site) or predicted pathogenic (nonsynonymous missense). Two novel FGFR1 mutations were identified, as were 18 new candidate genes including: AMN1, CCKBR, CRY1, CXCR4, FGF13, GAP43, GLI3, JAG1, NOS1, MASTL, NOTCH1, NRP2, PALM2, PDE3A, PLEKHA5, RD3, and TRAPPC9, and TSPAN11. Digenic and trigenic variants were found in 8/48 (16.7%) and 1/48 (2.1%) patients, respectively. NGS with confirmation by Sanger sequencing resulted in the identification of new causative FGFR1 gene mutations and suggested 18 new candidate genes in nHH/KS

Towards long-term standardised carbon and greenhouse gas observations for monitoring Europe's terrestrial ecosystems : a review

Research infrastructures play a key role in launching a new generation of integrated long-term, geographically distributed observation programmes designed to monitor climate change, better understand its impacts on global ecosystems, and evaluate possible mitigation and adaptation strategies. The pan-European Integrated Carbon Observation System combines carbon and greenhouse gas (GHG; CO2, CH4, N2O, H2O) observations within the atmosphere, terrestrial ecosystems and oceans. High-precision measurements are obtained using standardised methodologies, are centrally processed and openly available in a traceable and verifiable fashion in combination with detailed metadata. The Integrated Carbon Observation System ecosystem station network aims to sample climate and land-cover variability across Europe. In addition to GHG flux measurements, a large set of complementary data (including management practices, vegetation and soil characteristics) is collected to support the interpretation, spatial upscaling and modelling of observed ecosystem carbon and GHG dynamics. The applied sampling design was developed and formulated in protocols by the scientific community, representing a trade-off between an ideal dataset and practical feasibility. The use of open-access, high-quality and multi-level data products by different user communities is crucial for the Integrated Carbon Observation System in order to achieve its scientific potential and societal value.Peer reviewe

Trouble de déficit de l'attention avec hyperactivité chez l'enfant (intérêt du méthylphénidate)

AIX-MARSEILLE2-BU Pharmacie (130552105) / SudocSudocFranceF

Le Soi et l'Autre (identité, différence et altérité dans la philosophie de la Pratyabhijñā)

Cette étude offre une analyse des concepts d'identité, de différence et d'altérité dans les Īśvarapratyabhijñākārikā du cachemirien Utpaladeva (Xe siècle) et dans leurs commentaires par Utpaladeva lui-même et par son compatriote Abhinavagupta (Xe-XIe siècles). Selon les Ecritures (āgama) sívaïtes non dualistes, les divers sujets et objets ne sont que des aspects limités d'une conscience infinie et omnipotente, et se libérer consiste à recouvrer la pleine conscience de cette identité. Utpaladeva et Abhinavagupta, en s'engageant dans un dialogue rationnel avec des philosophes tant bouddhistes que brahmaniques, transforment ce dogme en un système philosophique. les chapitres 1 à 4 examinent la manière dont les deux sìvaïtes démontrent la permanence du sujet conscient contre les bouddhistes - selon que l'identité personnelle est la projection d'une unité factice sur une multiplicité de cognitions instantanées - tout en exploitant la critique bouddhique des définitions brahmaniques du Soi(ātman) afin d'asseoir leur propre conception du sujet. Les chapitres 5 à 8 présentent une analyse de la stratégie complexe par laquelle ils établissent leur idéalisme tout en se démarquant de l'idéalisme bouddhique des Vijñānavādin, notamment par l'affirmation selon laquelle contrairement au Vijñānavāda, leur idéalisme fait place à l'altérité et à l'intersubjectivité. Enfin, le chapitre 9 examine le statut ontologique qu'ils accordent à la différence par le biais d'une analyse critique de l'ontologie moniste de l'Advaita Vedānta, et explore leur propre définition de l'identité comme dynamisme conscient capable d'inclure à la fois différence (bheda) et non-différence (abheda).PARIS-EPHE-Sciences religieuses (751052336) / SudocSudocFranceF