Applicability of the doctrine of Res Ipsa Loquitur in medical negligence in Nigeria

Medical negligence or malpractice is a recurrent challenge in the field of medical practice. This occurs as a result of failure to exercise due diligence in the acts or omissions of medical practitioners while discharging their duties in the treatment and care of their patients. Before a patient can obtain damages from the medical practitioner/doctor or hospital (defendant) for injury suffered, he has to prove that the defendant’s negligence is the cause of the injury. However, majority of medical negligence/malpractice cases are difficult to prove by the plaintiff, hence, the latter relies on the doctrine of Res Ipsa Loquitur which shifts the onus of proof to the defendant. Thus, this paper examines the elements of negligence in tort; and medical negligence; the concepts of vicarious liability, occupier’s liability, contributory negligence; and the principle of Res Ipsa Loquitur and its elements. It further discusses the synergy between Res Ipsa Loquitur and medical negligence; and finally concludes by making few recommendations.Keywords: Medical Negligence/Malpractice, Duty of Care, Breach of Duty, Damages, Res Ipsa Loquitur, Nigeri

Transient flow modelling of carbon dioxide (CO2) injection into depleted gas fields

The internationally agreed global climate deal reached at the Paris Climate Conference in 2015 is intended to limit the increase in global average temperatures to ‘well below’ 2°C above pre-industrial levels. This comes in addition to the European Union ambition for 80% to 95% reduction in the 1990 greenhouse gas emissions by 2050 in order to avoid dangerous climate change. Most scenario studies indicate that Carbon Capture and Storage (CCS) is essential for achieving such ambitious reductions. In CCS operations, depleted gas fields represent prime targets for large-scale storage of the captured CO2. Considering the relatively low wellhead pressure of such fields, the uncontrolled injection of the high-pressure dense phase CO2 will result in its rapid, quasi-adiabatic Joule-Thomson expansion leading to significant temperature drops. This could pose several risks, including blockage due to hydrate and ice formation following contact of the cold sub-zero CO2 with the interstitial water around the wellbore and the formation water in the perforations at the near well zone, thermal stress shocking and fracture of the wellbore casing steel and over-pressurisation accompanied by CO2 backflow into the injection system due to the violent evaporation of the superheated liquid CO2 upon entry into the wellbore. In order to minimise the above risks and develop best-practice guidelines for the injection of CO2, the accurate prediction of the CO2 pressure and temperature along the well during the injection process is of paramount importance. This thesis deals with the development and verification of a Homogeneous Equilibrium Mixture (HEM) model and a Homogenous Equilibrium Relaxation Mixture (HERM) model for simulating the transient flow phenomena taking place during the injection of dense phase CO2 into depleted gas fields. The HEM model assumes instantaneous interface mass, momentum and energy exchange between the constituent CO2 liquid and vapour phases. As such they remain at the same pressure, temperature and velocity, whence the corresponding fluid-flow may be described using a single set of mass, momentum and energy conservation equations. The HERM on the other hand presents an additional equation which accounts for the thermodynamic non-equilibrium thorough the introduction of a relaxation time. It also accounts for phase and flow dependent fluid/wall friction and heat transfer, variable well cross sectional area as well as deviation of the well from the vertical. At the well inlet, the opening of the upstream flow regulator valve is modelled as an isenthalpic expansion process; whilst at the well outlet, a formation-specific pressure-mass flow rate correlation is adopted to characterise the storage site injectivity. The testing of the models is based on their application to CO2 injection into the depleted 2582 m deep Goldeneye Gas Reservoir at Hewett field in the North Sea for which the required design and operational data are publically available. Varying injection scenarios involving the rapid (5 mins), medium (30 mins) and slow (2 hrs) linear ramping up of the injected CO2 flow rate to the peak nominal value of 33.5 kg/s are simulated. In each case, the simulated pressure and temperature transients at the top and bottom of the well are used to ascertain the risks of well-bore thermal shocking or interstitial ice formation leading to well blockage due to the rapid cooling of the CO2. Detailed sensitivity analysis of the most important parameters affecting the CO2 in-well flow behaviour, including the wellbore diameter variations, well inclination, upstream temperature, pressure and time variant injection mass flow rate are conducted. The simulation results obtained for a slow (2 hrs) flowrate ramp-up case using the HEM model produce a minimum wellhead temperature of - 11 oC. The corresponding minimum temperature using the HERM model on the other hand is - 21 oC, demonstrating the importance of accounting for non-equilibrium effects and the model’s usefulness as a tool for the development of optimal injection strategies for minimising the risks associated with the injection of CO2 into depleted gas fields

Jet Fire Analysis of Highly Flammable Hydrocarbons Part I: High Pressure Natural Gas Transportation

This study is based on the analysis of predicted jet fire occurrence following the puncture or rupture of a high pressure natural gas pipeline. A case study of high pressure pipeline transporting natural gas at 8.9 MPa (89 bar) with pipeline diameter of 720 mm (0.72 m), and assumed puncture sizes of 0.1 m, 0.2 m and 0.3 m and a full bore rupture (FBR) are considered. The severity of a jet fire is dependent on the puncture size, flame length and its impingement on nearby equipment, accompanied heat fluxes and the distance between flame zone and target (humans/equipment). Research has shown that 6.3 kW/m2 is the maximum bearable heat flux recommended for humans, buildings and other facilities. As such it is recommended that a safe distance be maintained between the pipeline facility and humans/equipment based on this bearable heat flux. Applying a modified Chamberlin’s jet fire model, the results obtained from this analysis showed that for puncture sizes of 0.1 m, 0.2 m, 0.3 m and FBR, the minimum safe distances to receive 6.3 kW/m2 heat radiations are 38.5 m, 60 m, 79.5 m and 95.5 m respectively. However, a highly busy major road with residential houses is 10 m away from our case study pipeline. Therefore, calculating the heat fluxes based on that distance for puncture sizes of 0.1 m, 0.2 m, 0.3 m and FBR. The results were 104.05 kW/m2, 288.91 kW/m2, 395.39 kW/m2 and 593.09 kW/m2 respectively. Keywords: heat flux, jet fire, natural gas, pipeline, safe distanc

Traditional healers' perceptions of the integration of their practices. into the South African national health system.

Thesis (M.A.)-University of Natal, Pietermaritzburg, 2000.This study was aimed at identifying and exploring the perceptions of traditional healers particularly izangoma and izinyanga, on the integration of their practices into the South African National Health System. The main reason behind this research was to establish the position of traditional healers as well as to study their opinions on the issue of integration. The paucity of previous research studies on the 'perceptions of traditional healers on the integration of their practice-s into the national health care system, was the main motivation behind this study. Participants were drawn from the Pietermaritzburg area and selection was based on purposeful sampling. The data of the study was collected by means of semi-structured interviews, which employed open- ended questions. This study was conceptualized within the African world-view and cosmology. The interactive model design by Maxwell (1996) was employed in the design of this study. According to this model the purpose, conceptual context, research questions and methods as well as issues of validity and reliability, are all essential for the coherence of any qualitative study. The ethical considerations of this study were mainly around the issue of informed consent, and this was negotiated and discussed with the participants until they could understand the process of consent. The results of the study reflect the fact that traditional healers are positive about the process of integration. However, the participants were in favol of integration as a process of collaboration and co-operation as opposed to total integration, which was perceived as a process in which one system w0ll-Id dominate and oppress the other. The participants in this study perceive themselves as equal to their western counterparts because oftheir training and ability to treat "spiritual illnesses". Further, they view their role as that of providing alternative healing as well as acting as a medium between people and their ancestors. Education and negotiations were identified as the possible solutions to most problems in the process of integration. The findings of this study further reveal that there is mistrust and suspicion about western healers form traditional healers. As a result of this, improved collaboration between traditional and modem health care systems seems to be the only process, which could benefit all the people of the country

Prevalence and correlates of internalized stigma among adults with HIV and major depressive disorder in rural Malawi

Internalized stigma is common among individuals with sexually transmitted infections such as HIV and among those with mental health conditions such as major depressive disorder (MDD). As part of a cluster randomized trial, we investigated the prevalence and correlates of internalized stigma among adults living with comorbid HIV and MDD in rural Malawi (n = 339). We found heightened stigma toward HIV and mental illness among those in the cohort: more than half of respondents (54%) endorsed negative perceptions associated with each health condition. Internalized HIV-related stigma was higher among those with no education (p = 0.04), younger adults (p = 0.03), and those with less social support (p = 0.001). Mental illness-related stigma was elevated among those with no source of income (p = 0.001), and it was also strongly associated with HIV-related stigma (p < 0.001). Our findings highlight potential avenues for reducing internalized stigma associated with high-prevalence health conditions in Malawi.Trial registration: ClinicalTrials.gov identifier: NCT04777006

COVID-19-Related Testing, Knowledge and Behaviors among Severe and Chronic Non-Communicable Disease Patients in Neno District, Malawi: A Prospective Cohort Study

COVID-19-related knowledge and behaviors remain essential for controlling the spread of disease, especially among vulnerable patients with advanced, chronic diseases. We prospectively assessed changes over 11 months in COVID-19-related testing, knowledge, and behaviors among patients with non-communicable diseases in rural Malawi using four rounds of telephone interviews between November 2020 to October 2021. The most commonly reported COVID-19-related risks among patients included visiting health facilities (35–49%), attending mass gatherings (33–36%), and travelling outside the district (14–19%). Patients reporting having experienced COVID-like symptoms increased from 30% in December 2020 to 41% in October 2021. However, only 13% of patients had ever received a COVID-19 test by the end of the study period. Respondents answered 67–70% of the COVID-19 knowledge questions correctly, with no significant changes over time. Hand washing, wearing face masks and maintaining a safe distance were the most frequently reported strategies to prevent the spreading of COVID-19. Wearing face masks significantly improved over time (p < 0.001). Although the majority reported accurate knowledge about COVID-19 and enhanced adherence to infection prevention measures over time, patients commonly visited locations where they could be exposed to COVID-19. Government and other stakeholders should increase COVID-19 testing accessibility to primary and secondary facilities

كلمة التحرير

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; يقول الله تعالى : &nbsp; التوبة [122] ويقول النبي ÷( من يرد الله به خيراً يفقهه في الدين ) متفق عليه . &nbsp; بحمد الله وتوفيقه صدر العدد الثاني من مجلة الجزيرة لعلوم الوحي التي يصدرها معهد البحوث والدراسات الإسلامية تحت مظلة عمادة البحث العلمي والابتكار بالجامعة، وتجدون طي هذا العدد مجموعة من الأوراق العلمية، &nbsp;ففي ملف الدراسات القرآنية – قدم الدكتور/ موسى تيه كودي عبد الله ورقة بحثية بعنوان : (السكت في عُرف القراء:&nbsp; حقيقته وأنواعه)، حيث هدفت الدراسة إلى التعريف بالسكت وبيان أنواعه وبيان المواضع التي ورد فيها إجمالاً وتفصيلاً. &nbsp; وفى ملف دراسات السنة النبوية قدم الدكتور/ نبيل العامري ورقة بحثية بعنوان: ( شبهات الحداثيين حول أحاديث المرأة : دراسة تحليلية نقدية)، وقد هدفت الدراسة إلى بيان خطورة الحداثيين على السنة وإيراد شبهاتهم، وتفنيدها، &nbsp;وفي نفس الملف شارك الدكتور/ محمد الفاتح المأمون إبراهيم بورقة بحثية &nbsp;بعنوان: (أثر الرحلة في رواية الحديث)، فكانت من أهدافها: معرفة أثر الرحلة في رواية الحديث، تطّورها، ونشأتها، وأسباب الرحلة، ودوافعها وفوائدها وعيوبها. وفي ملف دراسات الفقه وأصوله، قدم الأستاذ الدكتور/طارق عثمان علي ورقة بعنوان: (الاجتهاد في تحقيق المناط عند الأصوليين وما يتخرج عليه دراسة&nbsp; أصوليه فقهية)، إذ هدفت الدراسة إلى بيان مفهوم الاجتهاد ومجالاته وتوضيح معنى تحقيق المناط وأقسامه، وإبراز أهمية تحقيق المناط في الواقع العملي. كما قدمت الأستاذة / مناهل أبو القاسم محمد أحمد برفقة الأستاذين: الدكتورة/ غالية بوهيدة والأستاذ الدكتور /عارف علي عارف، ورقة بحثية بعنوان (التحكيم ودوره في حل النزاعات الأسرية)، حيث هدفت الدراسة إلى التعريف بالتحكيم في اصطلاح الفقهاء والقانونيين، وبيان أهمية التحكيم في الشريعة الإسلامية ودوره في الإصلاح بين المتخاصمين عموماً والأزواج خصوصاً

Exploring psychosocial well-being in a group of marginalised African youth

PhD (Psychology)--North-West University, Vaal Triangle Campus, 2015This research using quantitative and qualitative methods studied the psychosocial well-being of marginalised youth of African descent in South Africa. The study of well-being amongst the youth has been the focus of many research studies in the past two decades (Bach, 2011; Koen, 2010; Ungar, 2005); hence the continuing intellectual debate on the best possible ways to promote youth well-being (Koen, 2010; Shah, Graidage, & Valencia, 2005; Van Schalkwyk, 2010). The major shift within the psychological sphere, i.e. from the illness model to positive psychology focusing on the enhancement of human capabilities as well as well-being (Seligman, 2004), has resulted in a greater need for studies exploring well-being, especially amongst the youth of South Africa. This study of psychosocial well-being was conducted in line with, amongst other theories, the Keyes and Lopez (2002) theory of complete mental health, viewing mental health as not only the absence of mental illness, but as high levels of functioning in the psychological, emotional and social dimensions of human behaviour. Of particular interest to the current author was the degree to which marginalised African youth could experience psychosocial well-being, considered against Jahoda‟s (1958) view of positive mental health, Ryff‟s psychological well-being model (Ryff, 1989, Ryff & Singer, 1995), Keyes‟ mental health continuum (1998, 2002, 2007), Wissing and Van Eeden‟s (2002) general psychological well-being factor, as well as Seligman‟s PERMA model (2011). Although some youth experience well-being and are flourishing, the urgent need for the development of wellness in youth was indicated by the findings of Keyes (2006) on adolescent mental health. In various studies, it was found that approximately 20% of youth experience mental illness, but Keyes (2006) questioned the quality of mental health of the remaining 80%, since he found that only moderate mental health was experienced in youth aged between 15-18 years. Although there have been a number of studies focusing on young people and their psychosocial well being, there is a lot that still needs to be done in terms of research and intervention. Van Schalkwyk (2009) indicated that although there is a dearth of validated data on the psychosocial well-being of the youth within the South African context; there is a need for more in-depth research on this subject. This study hopes to make a contribution in this regard. A mixed method research design was employed and the first quantitative phase (Article 1) used validated self-report questionnaires to measure the prevalence of psychosocial well-being amongst a group of marginalised African youth (N=794). These instruments measured psychological, emotional and social well-being (Mental Health Continuum-Short Form), coping self-efficacy (Coping Self Efficacy Scale) and symptoms of distress (Depression, Anxiety and Stress Scale). A structural equation model was identified explaining the relationships between the three constructs used in the research. The second phase of the research (Article 2) was qualitative in nature and it explored, through the use of semi-structured interviews and focus group discussions (N=30), the personal narratives of the participants who (during the quantitative phase) were identified as high, moderate or low in their well-being. Themes and subthemes were identified that gave a qualitative picture of the well-being or lack thereof of the participants. In the third and final phase of the study, the data obtained from the two preceding phases as well as the literature review was used to formulate guidelines with specific strategies. These can be used by professionals working with the youth to help them harness their strengths in order to enhance their psychosocial well-being as well as lessen their symptoms of depression, anxiety and stress. Results from the quantitative component of this study was mainly that coping self-efficacy proved to positively explain the variance of mental health and well-being and negatively the symptoms of depression, anxiety and stress. Mental health and well-being also proved to be salutary antecedents of symptoms of distress. Themes were analysed from the qualitative data and the following wellness-enhancing themes emerged from the data analysis: altruism, emotional resilience, social strengths, empathy for others, a positive outlook towards life, goals and aspirations, a strong support system, such as a loving and caring mother, and a supportive community. Religion, Christian faith and values further emerged as a common theme across all three groups of participants. The thematic similar findings on wellness-hindering attributes among the participants included loss of family well-being, painful past life experiences, an absent father, emotional turmoil, and poor self-esteem. The results provided by both the empirical components of the study were used in the formulation of guidelines with specific strategies for a strength-based intervention programme aimed at the enhancement of coping self-efficacy and psychosocial well-being amongst the youth. The study was finally evaluated and conclusions were drawn, limitations exposed and recommendations made.Doctora