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A racial and urban-rural comparison of the nature of stroke in South AfricaConnor, Myles Dean 11 July 2008 (has links)
ABSTRACT
Sub-Saharan Africa is thought to be undergoing a health (or epidemiological) and
demographic transition, moving from a pattern of disease dominated by infection,
perinatal illness and other diseases of poverty, to one dominated by noncommunicable
disease, in particular vascular disease. If such a transition is occurring,
then the burden of vascular disease including stroke will increase. Stroke is a
heterogeneous condition and it is likely that the nature of stroke (pathological types,
subtypes, and causes) will change during this transition. However, little is known
about the burden and nature of stroke in Sub-Saharan Africa, as it is now. This
information is essential to inform health services to appropriately plan and deliver
health care for the future, to develop strategies for stroke prevention, and to test the theory of the health and demographic transition.
My overall aim was to assess and compare the burden and nature of stroke in rural
and urban South Africa, and to establish whether there is any evidence of a health
transition. Specifically I aimed to:
• review what is known about stroke in Sub-Saharan Africa;
• establish the prevalence and nature of prevalent stroke in rural South Africa;
• compare the nature of hospital-based stroke in urban and rural stroke patients;
• compare the nature of urban hospital-based stroke in different population
groups; and • validate two stroke scores in the urban stroke register to enable us to diagnose
pathological stroke type in rural stroke patients who do not have access to
brain imaging.
Methods: The following methods were used to achieve these aims:
• I systematically searched the literature for, and critically reviewed, studies of
stroke from Sub-Saharan Africa (literature review).
• The rural Agincourt Health and Population Unit demographic surveillance site
was screened for stroke using two questions during the annual census.
Anyone who screened positive for stroke was examined to decide whether
they had had a stroke (stroke prevalence study).
• The Tintswalo Hospital Stroke Register was established to ascertain and
assess rural stroke patients over 20 months (rural hospital-based stroke), and
• The Johannesburg Hospital Stroke Register similarly established to assess
urban stroke patients over 23 months (urban hospital-based stroke).
• The accuracy of the Siriraj and Guy’s Hospital stroke scores was compared to
the CT brain scan “gold-standard” in the Johannesburg Hospital Stroke Register. Results: Using these approaches I found that:
• Very little is currently known about the burden and nature of stroke in Sub-
Saharan Africa.
• The prevalence of rural stroke was about half that found in high-income
countries, and double that found in Tanzania. However, disabling stroke was at
least as prevalent as it is in high-income countries.
• Both rural and urban black South Africans are probably in early phases of the
health transition, and this is impacting on the nature of stroke, particularly the
cause of cardioembolic stroke.
• Neither the Siriraj nor Guy’s Hospital stroke score are sufficiently accurate for
use in epidemiological studies or clinical management of stroke in Sub-
Saharan Africa.
Conclusion: There is already a heavy burden of stroke in Sub-Saharan Africa, and
there is some evidence of a health transition in the black population. However, it is
not possible to accurately assess the burden and nature of stroke without communitybased
incidence studies using early brain imaging to distinguish ischaemic stroke
from cerebral haemorrhage. Until we have these studies, we will never know the
precise burden and nature of stroke, the effect of the health transition, or the optimal
approach to preventing a stroke epidemic in our population.
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An actor-orientated analysis of development failure : an application of interface analysis to development project evaluation in MadagascarAndriamandroso, Denis A. H. January 1996 (has links)
No description available.
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Receive your own mystery and become what you receive: the Eucharist as a source of reconciliation, justice and peace in conflicting Sub-Saharan AfricaPhiri, Felix Mabvuto January 2009 (has links)
Thesis advisor: John Baldovin / Twentieth century is an epoch that has known the ravages of war, violence, oppression, exploitation and conflict. In a century marked by great human brokenness which has escalated the alienation from God, from one another and from the whole of creation; what would be the proper mission of the Church in such a context? This breakdown of the whole human family which has led to great suffering stares us in the face. It has been an epoch with two world wars, genocides, nature‘s rebellion as the weather and atmospheric conditions have been unpredictable and above all that world development has taken place on the heads of billions of people who live in abject poverty. In a world torn apart by conflicts and division, reconciliation becomes a necessary theological theme for mission, if we are to work for a better future for "All have sinned and fall short of the glory of God" (Rom. 3:23). / Thesis (STL) — Boston College, 2009. / Submitted to: Boston College. School of Theology and Ministry. / Discipline: Sacred Theology.
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Babungo : a study of iron production, trade and power in a nineteenth century Ndop plain chiefdom (Cameroons)Fowler, Ian January 1990 (has links)
A survey of smelting debris undertaken in BABUNGO brought to light what is to date the largest single recorded centre of iron production in sub-Saharan Africa. High output in the 19th century was facilitated by innovation in furnace structure that enhanced capacity and brought in economies of scale along with changing fuel usage that enabled the intensification of production by a sedentary industry set within a grasslands environment. Elsewhere in the region separate smithing and smelting using older, smaller furnaces exploiting traditional fuels and ores collapsed and in its place arose a devolved technology centring on recycling of slag in simple open hearth furnaces. The enormous output of the BABUNGO industry was linked to a mode of labour recruitment and division of rewards that overrode the boundaries of the kin group. At the point of establishment of the foundry and throughout its operation non-kin freely offered their labour in return for access to the foundry. A pervading ethos of cooperation and stress on the sharing of the product in terms of a familial paradigm provided for the social validation of the accumulation of wealth by individual descent group heads. The distribution of products was characterised by periodic markets, organised trading groups, use of convertible currencies, credit and commissions. The heavy costs of transporting ironware to regional markets was largely taken over by specialist trading chiefdoms that clustered around BABUNGO. Unencumbered by these costs output rose to even higher levels. The great material wealth generated by iron production was further enhanced by the highly profitable conveyances to be made between continental and coastal spheres of trading activity that abutted on the Grassfields. The political organisation of BABUNGO offered only limited opportunity for conversion of wealth into political authority. The integrity of the chiefdom barely withstood the internal pressures generated by the enormous wealth derived from iron production but was bolstered by an external alliance undertaken by an astute FON with the vanguard of German colonisation.
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Variations in general circulation and climate over the tropical Atlantic and Africa weather anomalies in the Subsaharan region /Lamb, Peter J. January 1976 (has links)
Thesis (Ph. D.)--University of Wisconsin--Madison, 1976. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 102-113).
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Regional integration and conflict resolution in southern AfricaArtsy, Avishay January 2002 (has links)
Boston University. University Professors Program Senior theses. / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-02
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Determinants of Fire Intensity in a Mesic West Africa Savanna| A Statistical Analysis of Fire CharacteristicsJacobs, Rebecca L. 20 March 2018 (has links)
<p> A fundamental premise of savanna fire ecology is that late dry season fires burn more intensely than early dry season fires. Late dry season fires are considered a major determinant of savanna woody vegetation as they are thought to be more damaging to trees, thus shaping the grass/tree dynamic of savannas. Most savanna fire experiments have adopted the early/late fire convention in their experimental design, based on the pioneering work of Aubréville. Recent research suggests that numerous factors determine fire intensity, and that the widely accepted dichotomous view of fire intensity as driven by early/late seasonal timing greatly oversimplifies a complex phenomenon. In particular, wind direction may be a significant factor in determining fire intensity. </p><p> To determine the factors that influence fire intensity, experimental fires were conducted in the mesic savanna of Mali. Data were collected for fire season, biomass consumed, grass type, scorch height, speed of fire front, fire type, and ambient air conditions for each burn. Multiple regression analyses were used to determine the key factors affecting the fire intensity and severity. Results suggest there are fundamental differences in fire behavior and intensity depending on wind direction relative to the fire. Intensity is not explained by any tested variables in head fires. Intensity of back fires is determined primarily by seasonal timing and, to a lesser extent, grass characteristics. </p><p>
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The poverty debate with application to the Republic of GuineaShaffer, Paul January 1999 (has links)
The thesis argues for one proposition: 'philosophical assumptions matter'. It uses a contemporary debate about poverty to show how philosophical assumptions matter. The poverty debate pits the Income/Consumption (IIC) approach to poverty against the Participatory (PA) approach to poverty. The philosophical assumptions are epistemological, with implications for methodology, and normative, with implications for conceptions/aspects of well-beinglill-being. It is argued that philosophical assumptions matter in three ways: I) they affect research orientation; 2) they affect conceptual categories in use; 3) they may affect research outcomes (with potential policy implications). The first issue is addressed in Chapter 2 which examines epistemological/methodological links between two different traditions of inquiry in the social sciences, Empiricism and critical hermeneutics, and the IIC and PA approaches to poverty, respectively. It examines both historical and analytical links. The latter establish connections between conflicting epistemological positions concerning knowledge and truth/validity and methodological aspects of the two poverty approaches concerning: determination of well-beinglill-being, measurement of ill-beinglwell-being, stance toward individual preferences, sources of data and prescriptive aims. The second issue is addressed in Chapter 3 which examines links between two different approaches to normative theory, Naturalist Normative Theory (NNT) and Discursive Normative Theory (DNT), and the conceptions/aspects of ill-being used in the IIC and PA approaches to poverty, respectively. As above, it examines both historical and analytical links. The latter establish connections between different modes of normative theory construction and the constituents/aspects of ill-being in the two poverty approaches. The third issue is addressed in Chapters 4 and 5 which compare findings of the IIC and PA poverty approaches undertaken in the Republic of Guinea with a view to determine if they identify different groups as 'poor' or 'worse-off' because they are using different conceptions/aspects of ill-being. Chapter 4 examines the poverty condition of female-headed and male-headed households, the distribution of girls and women in poor households, and the intrahousehold, gender distribution of food and health, to determine if women or girls face greater consumption poverty than men or boys. Chapter 5 presents the results of a Participatory Poverty Assessment which used a variety of techniques to determine if villagers considered women as a group to be 'worse-off than men. Chapter 6 concludes and offers a number of reasons why the central argument matters.
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Understanding State Responses to the HIV/AIDS Crisis in Sub-Saharan AfricaCoopamah, Padmini Devi January 2009 (has links)
This dissertation seeks to understand the factors that influence government responses to HIV/AIDS among sub-Saharan African countries. Specifically, I hypothesize that 1) under certain circumstances, countries with democratic institutions are more likely to fight the epidemic aggressively and 2) there are multiple pathways to strong government action. By examining government performance in 29 sub-Saharan African countries, I find strong support for both hypotheses. A case study of Botswana shows that various aspects of a democratic society, from the competitiveness of the political arena to an active civil society, shape government responses to HIV/AIDS.This research has both theoretical and practical implications. It contributes to the existing knowledge about the effects of democracy on public well-being by highlighting that, even in regions where democratic institutions may not be well-established, their dynamics are still powerful enough to encourage governments to adopt policies that benefit their populations. Additionally, it expands our understanding of HIV/AIDS policy-making in sub-Saharan Africa and in other areas of the world by specifying the different environments which lead governments to be aggressive in addressing the epidemic, a finding of interest to those involved in the field of development.
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Vzdělání a HIV: Studie subsaharské Afriky / Education and HIV: Evidence from Sub-Saharan AfricaKopecký, Tadeáš January 2017 (has links)
The HIV/AIDS epidemic remains a large threat for developing countries, es- pecially for Sub-Saharan Africa. To be able to fight the epidemic, we need to understand the socio-economic drivers of it to distinguish the groups of people at the highest risk of the HIV. We performed an econometric analysis using logistic regression dealing with the relationship between education and several HIV connected factors - HIV status, HIV knowledge and sexual behavior - based on a large sample from 21 Sub-Saharan African countries from Demographic and Health Survey data collection from years 2008-2014. The education ap- pears to be non-lineary correlated with the HIV status as people with primary and secondary education are at the highest risk of being HIV positive. These results can be nevertheless influenced by e.g. survivorship bias as the education appears to have a positive effect on both HIV knowledge and protective sexual behavior. It is thus advised to promote education in the Sub-Saharan Africa. At the same time, it is needed to target the help primary to the groups at the highest risk of being HIV positive to prevent further spread of HIV and to help families of the HIV positive individuals. Moreover, we found that there is no significant difference in the correlation between education and HIV status between...
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