Covid – 19 and the orthopaedic surgeon

No Abstract

Literacy for Students with Low Vision in Special Schools: Perceptions of Teachers on Instructional Media in Kenya

This article presents an analysis of teachers’ perceptions on instruction of print and Braille literacy in special primary schools for learners with visual impairment in Kenya. It is a summary of findings of a Ph.D study that sought to address the problem of decline in Braille literacy as a result of teachers’ reluctance to learn and teach Braille in these schools. The study targeted five (5) primary schools which had learners with visual impairment in the country. The target population comprised 132 teachers, teaching in the five primary schools and five headteachers. The research adopted the descriptive survey research design and was based on Bruner’s perceptual model which explains the process of perceptual development. Multiple sampling techniques were applied to select the five schools and respondents. Out of fifty-eight (58) respondents, fifty-three (53) were teachers while five (5) were headteachers. A questionnaire focusing on the objectives of the study was used to collect data from the teachers. An interview schedule was used to collect data from the headteachers. Pilot testing of the research instrument yielded a reliability of 0.842. The questionnaire was reviewed by experts to enhance validity. Quantitative data was analyzed using descriptive statistics namely: frequencies and percentages. The statistics were generated by means of the Statistical Package for Social Sciences (SPSS) version 22.0, while qualitative data was analyzed through narrative analysis and thematic approach. The findings of this study established that teachers believed that teaching both Braille and print reading and writing has a positive advantage for some learners with low vision, with a mean response of 1.68. They strongly supported the statement that learners with low vision should be taught both Braille and print reading and writing (dual media), regardless of how good their vision is, with the mean response of 2.06. The study also established that teachers provided Braille as an alternative medium for children who are experiencing progressive loss of vision, with a mean of 2.08. Keywords: Literacy, Students with low vision, Perceptions, Print and Braill

Opinions of Primary School Teachers Towards Inclusive Education in Central Kenya

The primary purpose of this study was to determine the opinions of primary school teachers towards inclusive education in Central Kenya. The sample size (N=500) represented all the teachers in the study area pursuing a diploma course in special needs education at Kenya Institute of Special education (KISE) through distance learning, and therefore, inferential statistics was not necessary. Teachers’ opinions were reported by questionnaire designed specifically for this study while from this instrument answers to the six research questions were also sought. Data analysis in this study was conducted using the statistical analysis software (Statistical Package for Social Science, SPSS version 11.5 for windows). The specific analysis included the descriptive data and cross-tabulation yielding the chi-square statistics. All the data were reported in form of descriptive Statistics-percentages, frequencies and mode where applicable. The results of the study revealed that teachers’ perceptions towards inclusive education in Central Kenya were positive. In addition, respondents strongly agreed that in order to prepare teachers for inclusive education, in-service training programs were needed (M=4.64). Further, they expressed the view that students with special needs had the right to receive education in mainstream classes (M=4.49). However, the statement that the country was not ready for inclusive education was rated low (M=2.44) implying that respondents disagreed with the statement. Keywords: Opinions, Inclusion, Inclusive education, Special Needs Education, Teacher

The Prevalence of Intraventricular Haemorrhage and Associated Risk Factors in Preterm Neonates in the Neonatal Intensive Care Unit at the University Teaching Hospital, Lusaka, Zambia

Objectives: The study was undertaken with the aims of determining the prevalence and most frequent grade of IVH as well as associated risk factors in preterm neonates with birth weight 1.5kg or less admitted to the neonatal intensive care unit at the UTH in Lusaka, ZambiaDesign: This was a cross sectional study where 298 preterm neonates meeting the study's inclusion criteria had cranial ultrasound done in the first three days of life and on the seventh postnatal day. Data on the risk factors was obtained from the neonatal referral form, maternal records and direct interview with the neonate's mother.Main outcomes and Measures: The main outcomes were the prevalence of IVH and the most frequent grade of IVH. The variable any-IVH generated at the time of analysis was used in determining the prevalence of IVH and also as the dependent variable in multivariate logistic regression. Any-IVH was the highest grade of IVH obtained on either the first 3 days or day 7 on cranial ultrasound.Results: In this study, the prevalence of intraventricular haemorrhage in preterm infants with birth weight 1.5kg and less was 34.2% in the first seven days of postnatal life. Grade 1 (mild) IVH was the most frequent (54.9%) followed by severe IVH (grade 3 and 4) at 27.5%. The case fatality rate was 85.7% for those with grade 4 in the first three days of life. Grade 2 was the least prevalent at 17.7%. Risk factors significantly associated with IVH were birth weight [p=0.04, OR= 0.25(0.06-0.98) 95% C.I.] and gestational age [p=0.02, OR= 0.82 (0.69-0.97) 95%C.I.]Conclusions: The study found a similar or even lower overall prevalence to that reported in studies in Africa and globally, while the frequency of severe IVH was relatively very high with a high case fatality rate (85.7%) in the first seven days of postnatal life in respect of grade 4 IVH. Risk factors significantly associated with IVH were birth weight and gestational age while the former was also significantly associated with severe IVH as in otherstudies internationally

Short term micronutrient-antioxidant supplementation has no impact on a serological marker of gastric atrophy in Zambian adults: retrospective analysis of a randomised controlled trial

BACKGROUND: Gastric cancer is a major contributor to cancer deaths in Zambia but, as elsewhere, no preventive strategies have been identified. We set out to investigate the possibility of reducing gastric atrophy, a premalignant lesion, using micronutrient-antioxidant supplementation. METHODS: We analysed 215 archival samples from a randomised controlled trial of micronutrient-antioxidant supplementation carried out from 2003 to 2006. Participants were randomised to receive either the supplement or placebo and had been taking the allocated intervention for a mean of 18 (range 14–27) months when the samples used in this study were taken. We used low pepsinogen 1 to 2 (PEP1:2) ratio as a surrogate marker of gastric atrophy. A PEP 1:2 ratio of less than three was considered low. HIV serology, age, nutritional status, smoking, alcohol intake and gastric pH were also analysed. Ethical approval was obtained from the University of Zambia Biomedical Research Ethics Committee (011-04-12). The randomized trial was registered (ISRCTN31173864). RESULTS: The overall prevalence of low PEP 1:2 ratio was 15/215 (7%) and it did not differ between the placebo (8/103, 7.8%) and micronutrient groups (7/112, 6.3%; HR 1.24; 95% CI 0.47-3.3; P = 0.79). The presence of low PEP 1:2 ratio was not influenced by HIV infection (HR 1.07; 95% CI 0.37-3.2; P =0.89) or nutritional status but it inversely correlated with gastric pH (Spearman’s rho = -0.34; P = 0.0001). Age above 40 years was associated with atrophy, but neither alcohol nor smoking had any influence. CONCLUSION: Short term micronutrient supplementation does not have any impact on PEP 1:2 ratio, a serological marker of gastric atrophy. PEP 1:2 ratio inversely correlates with gastric pH

Essays on natural resources and local economies

Development economics studies the dynamics in various areas such as poverty, health outcomes, economic development, economic growth etc. This thesis brings together a set of chapters that summarises and synthesises varied areas of development microeconomics. The thesis is composed of three main empirical chapters contributing to varied aspects of development economics, mainly the areas of natural resource curse and local communities, divestiture and its effects on local economies and the health and welfare impact of mining in a developing country setting. While researchers and policy makers focus on governance and macro-fiscal risks to identify areas for improvement, very little attention is being paid to the benefits gained by local communities living close to mining centers. This thesis has thus helped fill a gap that has been identified in previous literature by for example Cust and Poelhekke (2015) who observed that scholars are increasingly turning to within-country evidence to deepen our understanding of the potential drivers, and outcomes, of resource wealth effects. This shifts attention away from cross-country studies, thereby offers new perspectives on the resource curse debate, and can help overcome concerns regarding endogeneity. Chapter 1 provides an outline and introduction of the thesis. Chapter 2 provides an extensive and analytical review of how the natural resource curse affects the living standards in developing countries that have a rich endowment of natural resources focussing on the sub-national level. It discusses the causal economic impact of Zambia’s copper mines, a country located in sub-Saharan Africa endowed with vast copper deposits on living standards. It gives a detailed empirical literature on the natural resource curse and its relationship to local economies. Further, this chapter empirically analysed constituency data from 1996 to 2010, exploiting an episode where global copper prices were rising. The results highlight a significant impact of copper production on living standards. After splitting the constituencies close to and far away from the nearest mine, the results document that constituencies close to the mines benefited significantly from the increase in copper production. Finally, the results are not consistent with the natural resource curse hypothesis; findings show a positive causal relationship between the presence of natural resources and socioeconomic outcomes in less developed countries, particularly for constituencies close to the mines in Zambia. Chapter 3 provides a detailed analysis of the effect that privatization has on local economies. It provides the main objectives of privatization. It also gives a detailed empirical literature of privatization, mining and how developing countries have been impacted by privatization. This chapter empirically analyses the impact of a resource boom and of the privatization of the copper mines in Zambia on living standards by using a unique constituency level dataset of 150 constituencies in Zambia over the period 1996-2010 following the Living Conditions and Monitoring Survey years. Using a 2sls fixed effects model approach and controlling for constituency characteristics the results show that the privatization of the copper mines benefited the local economies through improved living standards. Lastly, a causal relationship exists between natural resource extraction and living standards even when there have been changes to the structural relationship between the economy and the mining sector is run privately. Chapter 4 focusses on the effect of copper mining on health outcomes. Mining can be an engine and catalyst for economic growth, but often results in heavy metal releases, that could negatively impact human health. High levels of pollution may cause temporary illness, which in turn may cause lost work hours. Using regression analysis, this chapter analyzed the impact of copper mining on health in Zambia. It further explored changes in health outcomes for constituencies located within 200km to nearest mine as these are the ones to be greatly affected by pollution. Matching just over a decade of repeated cross-section survey data on living conditions in constituencies in Zambia in a 2SLS fixed effects approach, it was observed that an increase in copper mining which led to a copper boom from 2003 induced some changes in health outcomes for constituencies located close to the mining operations after the privatization of the mines. It also finds that the probability of suffering from general sicknesses becomes less likely if a constituency is located close to an open pit mine or in a rural area while it increases if a constituency is located close to an underground mine. The results illustrate that copper mining somehow reduces the prevalence of certain health conditions, for example, anaemia and chest infections. Finally, chapter 5 provides a conclusion for the thesis. Overall, the thesis endeavored to make a little empirical contribution to the literature on natural resources and local economies by establishing the causal effects of natural resource endowments on local economies in a single country at a subnational level using a novel panel dataset

Complejo polideportivo paisajístico en el distrito de La Victoria – Chiclayo 2022

Se presenta una propuesta de Proyecto Arquitectónico de un Complejo Polideportivo Paisajístico en el área del Parque Zonal para la promoción y desarrollo del deporte en el distrito de La Victoria, que satisfaga las necesidades recreativas de la población y dé solución al déficit de cultura deportiva presente en la comunidad, así como también a las repercusiones directas o indirectas que ésta desencadena tanto en el ámbito social como urbano. Para ello, el presente trabajo realiza un análisis del territorio desde una escala macro hasta acercarse a la escala barrial, con la finalidad de realizar un diagnóstico urbano que determine con exactitud las carencias existentes, y valorar a través de una síntesis, la situación del deporte en la zona de estudio. Así mismo, la delimitación de las condicionantes del lugar permitirá establecer los criterios de diseño a utilizar en el proyecto planteado, y a su vez, definir las actividades albergadas en el programa del edificio y los usuarios que lo ocuparán. Finalmente, la realización del Proyecto Arquitectónico de un Complejo Polideportivo Paisajístico en el área del Parque Zonal generará un nuevo nodo que permita la revitalización del sector y brindará espacios de convergencia que fomenten la integración y cohesión social de la comunidad mediante el deporte para la formación de hábitos saludables y bienestar colectivo

Salud oral en adultos mayores que acuden a los establecimientos de salud en la Micro Red Trujillo – La Libertad, 2015

El presente estudio tuvo como objetivo determinar la salud oral en adultos mayores que acudieron a los Establecimientos de Salud en la Micro Red Trujillo – La Libertad en el periodo abril - junio 2015. El estudio fue prospectivo, transversal, descriptivo y observacional e incluyó un total de 244 adultos mayores que acudieron a los Establecimientos de Salud en la Micro Red Trujillo. Se utilizó una ficha estomatológica como instrumento de evaluación, en la cual se recopiló la información del examen bucal. Los resultados obtenidos de la población examinada según el Índice Gingival de Silness y Löe, fue de 57.4% siendo frecuentemente moderado; el Índice de Higiene Oral de Silness y Löe simplificado, fue de 70.5% el cual fue frecuentemente moderado y finalmente el Índice CPOD fue de 18.225 siendo severo; donde sólo no se presenta diferencia significativa para el Índice Gingival en género. (p<0.05). Se concluyó que la salud oral en adultos mayores que acudieron a los establecimientos de Salud en la Micro Red Trujillo – La Libertad fue regular, mientras que el Indice CPOD fue malo, se recomienda planificar alternativas de tratamiento en mejora de la salud oral de esta población.This study aimed to determine the oral health in older adults who came to the health facilities in the Micro Red Trujillo - La Libertad in the period April to June 2015. The study was prospective, transversal, descriptive and observational and included a total of 244 older adults who came to the health facilities in the Micro Red Trujillo. One dental record as an assessment tool, in which the information was collected oral exam was used. The results he obtained from the population examined under the gingival index and Löe Silness was 57.4% often being moderate; Oral Hygiene Index Silness and simplified Löe was 70.5% which was often moderate and finally the CPOD index was 18,225 where not only significant difference is presented for gender Gingival Index. (p <0.05). It was concluded that oral health in health facilities in the Micro Red Trujillo - La Libertad is in a range of moderate, which determined an Oral Health: Regular in the Gingival Index and Oral Hygiene Silness and Löe while CPOD Index is in a severe range, which determined an Oral Health: Bad; we recommend taking this information for planning an effective treatment in improving the health of the older population.Tesi