Background: Racial disparities in surgical outcomes have been shown to lead to subpar results in various patients. Variability and contradictions in the current literature highlight the need for a crucial evaluation of the matter in studies focusing on plastic and reconstructive surgery. Investigating the matter is a pivotal step toward effective guidelines that mitigate factors contributing to racial disparities in outcomes and improve our perception of a patient-centered health-care system. The study aimed to identify whether racial disparities exist in plastic and reconstructive surgery procedures. Methods: Systematic review of the literature as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed to find relevant articles assessing the impact of race on surgical outcomes. PubMed, Embase, MEDLINE, and Cochrane library were screened by both authors, and relevant articles were identified. Prevalence of complications were extracted from included studies, and odds ratio (OR) with 95% confidence interval (CI) was calculated and grouped for a statistical analysis. Results: Meta-analysis of 13 studies, with a mean of 8059 patients per study, demonstrated a pooled OR of 1.21 (95% CI: 1.00–1.46), indicating an insignificant association between non-White race and postoperative complications. Subanalysis comparing African American patients to White patients (10 studies) showed an OR of 1.36 (95% CI: 1.06–1.74), signifying a statistically significant risk for African Americans. No publication bias was observed, but substantial heterogeneity (73% and 79%) suggested varied study factors influencing outcomes. Conclusions: Racial disparities exist in plastic and reconstructive outcomes. Physicians and medical staff should focus on patients’ sociodemographic background, accessibility to care, support cycles, and language proficiency, while determining the surgical plan and postoperative care.
The study analyzes the development of business incubation literature in South Africa. The VOSviewer software was used to perform the bibliometric analysis of 44 articles on business incubation in South Africa conducted between 1996 and 2023 that were obtained from the Scopus database. The study has also revealed literature on business incubation started to appear in 1996 in South Africa. The study’s keyword co-occurrence analysis also revealed that the following words had the most occurrences and were clustered into the following: entrepreneurship and business incubation, business incubators and effectiveness, entrepreneurial education and informal Business, SMEs and start-up, business and sustainability, and business development and competitiveness. The study sorts the articles based on the following indicators: number of documents published in a year, eminent authors and keyword co-occurrence, which identified six categories of the most prominent research themes being covered by articles reviewed. The study only used articles that were written in English language only. Therefore, future research should consider articles written in other languages and expand the study to other regions, continents, and even global scale.
This study discusses The Pedagogical Significance of Biblical Languages in African Theological Education, focusing on the declining proficiency in biblical languages such as Hebrew and Greek within African theological institutions, using the Baptist College of Theology, Obinze. The problem identified was the increasing marginalisation of these languages, often substituted by more practical or contemporary subjects, resulting in a weakening of biblical exegesis and diminished theological depth in academic and pastoral contexts. The study’s primary objective was to assess biblical languages’ role in enhancing theological education, particularly in African contexts. It investigated how mastery of Hebrew and Greek could significantly improve scriptural interpretation, homiletics, and doctrinal accuracy among African theologians and pastors. The research aimed to demonstrate that proficiency in these languages offers essential insights into the original meaning of biblical texts and a greater connection to their cultural and historical contexts. Methodologically, the study employed discourse analysis and case studies, examining curricula from various African theological institutions and surveying educators and students. It also reviewed theological literature to evaluate biblical languages’ historical and contemporary significance in Christian education. The findings revealed that institutions prioritising biblical language instruction produce graduates with more vital exegetical skills, better equipped for accurate scriptural interpretation and culturally sensitive theological reflection. Based on these findings, the study recommends that African theological institutions reinstate the teaching of biblical languages as a core part of their curricula. These recommendations include creating more accessible language courses, integrating digital learning tools, and emphasising biblical language proficiency’s long-term academic and pastoral benefits. The study advocates for a balanced approach to theological education incorporating biblical languages as a vital component of developing sound theological scholarship and effective ministry in Africa.
This paper investigates the forms and functions of imperative constructions and other non-imperative command strategies in the western variety of Oromo. It describes the morphological realizations of the second person and third person imperative main and dependent verbs, both in affirmative and negative paradigms. It also examines the structure of other non-imperative constructions used for directive speech acts, based on data collected from a web text corpus, native speakers and secondary sources. The analysis shows that the second person imperative is the simplest of all verb forms in Western Oromo. Unlike the third person imperative and other verb forms, it does not occur with any of the aspect markers. The anterior converb marker, third person direct and indirect object markers, and the first person pronominal subject clitic are grammatical morphemes that are compatible with both second person and third person imperative constructions. Imperative constructions are mainly used for commands and warnings, but can also be used for other speech acts, such as blessings, curses, farewells, and suggestions. Commands and warnings can alternatively be expressed through negative interrogatives and insubordinate clauses. Animal-directed commands are expressed by interjections.
Background Disasters are increasing worldwide, with Sub-Saharan Africa (SSA) being one of the most prone regions. Hospitals play a key role in disasters. This study provides a systematic review of the evidence on disaster preparedness by hospitals in SSA countries based on English literature. Methods A systematic literature review was conducted of articles published between January 2012 and July 2022. We searched PubMed, Elsevier, Science Direct, Google Scholar, the WHO depository library and CDC sites for English language publications. The key inclusion criteria were: publications should have been published in the above period, deal with hospital disaster preparedness in SSA, the full paper should have been available, and studies should have presented a comparison between hospitals and/or a single hospital. Results Results indicate improvements in disaster preparedness over time. However, health systems in SSA are generally considered vulnerable, and they find it difficult to adapt to changing health conditions. Inadequately skilled healthcare professionals, underfunding, poor knowledge, the absence of governance and leadership, lack of transparency and bureaucracy are the main preparedness barriers. Some countries are in an infancy stage of their health system development, while others are among the least developed health system in the world. Finally, a major barrier to disaster preparedness in SSA countries is the inability to collaborate in disaster response. Conclusions Hospital disaster preparedness is vulnerable in SSA countries. Thus, improvement of hospital disaster preparedness is highly needed.
Background Non-tuberculous mycobacteria (NTM) have been reported to cause pulmonary and extrapulmonary infections. These NTMs are often misdiagnosed as MTB due to their similar clinical presentations to tuberculosis, leading to inappropriate treatment and increased morbidity and mortality rates. This literature review aims to provide an overview of the prevalence, clinical manifestations, diagnosis, and management of NTM infections in Africa. Methods A systematic search was performed using various electronic databases including PubMed, Scopus, and Web of Science. The search was limited to studies published in the English language from 2000 to 2021. The following keywords were used: “non-tuberculous mycobacteria”, “NTM”, “Africa”, and “prevalence”. Studies that focused solely on the Mycobacterium tuberculosis complex or those that did not report prevalence rates were excluded. Data extraction was performed on eligible studies. Overall, a total of 32 studies met the inclusion criteria and were included in this review. Results In our literature review, we identified a total of 32 studies that reported non-tuberculosis mycobacteria (NTM) in Africa. The majority of these studies were conducted in South Africa, followed by Ethiopia and Nigeria. The most commonly isolated NTM species were Mycobacterium avium complex (MAC), Mycobacterium fortuitum, and Mycobacterium abscessus. Many of the studies reported a high prevalence of NTM infections among HIV-positive individuals. Other risk factors for NTM infection included advanced age, chronic lung disease, and previous tuberculosis infection. Conclusion In conclusion, this literature review highlights the significant burden of non-tuberculosis mycobacteria infections in Africa. The prevalence of these infections is high, and they are often misdiagnosed due to their similarity to tuberculosis. The lack of awareness and diagnostic tools for non-tuberculosis mycobacteria infections in Africa is a major concern that needs to be addressed urgently. It is crucial to improve laboratory capacity and develop appropriate diagnostic algorithms for these infections.
Although several studies have been conducted to summarize the progress of open educational resources (OER) in specific regions, only a limited number of studies summarize OER in Africa. Therefore, this paper presents a systematic literature review to explore trends, themes, and patterns in this emerging area of study, using content and bibliometric analysis. Findings indicated three major strands of OER research in Africa: (1) OER adoption is only limited to specific African countries, calling for more research and collaboration between African countries in this field to ensure educational equity; (2) most of the OER initiatives in Africa have focused on the creation process and neglected other important perspectives, such as dissemination and open educational practices (OEP) using OER; and (3) on top of the typical challenges for OER adoption (e.g., infrastructure), other personal challenges were identified within the African context, including culture, language, and personality. The findings of this study suggest that more initiatives and cross-collaborations with African and non-African countries in the field of OER are needed to facilitate OER adoption in the region. Additionally, it is suggested that researchers and practitioners should consider individual differences, such as language, personality and culture, when promoting and designing OER for different African countries. Finally, the findings can promote social justice by providing insights and future research paths that different stakeholders (e.g., policy makers, educators, practitioners, etc.) should focus on to promote OER in Africa.
Aim: The aim of the study was to explore the challenges facing African International Students (AIS) at research universities in the U.S. and the support systems used to overcome the challenges. Methods: Methods used to gather information included discussions, conceptual framework modeling, and a thorough literature review, employing a hand-searching journal and books approach. Results: The findings of the study revealed that a significant number of AIS encounter different challenges upon entering research universities in the United States. These obstacles include language barriers, cultural shock, discrimination, stereotypes, accommodation and transportation issues, financial difficulties, as well as stress and anxiety. However, even before setting foot in the U.S., these students face a range of challenges, including problems with school applications and associated fees, technical difficulties, issues with English language tests, stress and anxiety, visa acquisition, and the search for suitable accommodation. Conclusion: The study provides insight into the challenges facing AIS and provides coping strategies that can be used to mitigate the challenges. Recommendations: A newly developed framework was constructed. suggesting that AIS should develop the habit of seeking help and asking questions. Additionally, it emphasizes the importance of fostering self-motivation and practicing self-care.
This paper deals with the associated motion (AM) system in Nuasúɛ (A62A), a Bantu language spoken in Cameroon. It aims at determining the coding means and the grammatical properties of AM categories (motion and direction), their grammatical characteristics and their interactions with non-spatial verbal categories. Nuasúɛ has a complex AM system where prior motion and (mono-/bi-)directional motion are marked in a single verb word by two distinct satellites, of which the first is a high tone melody and the second is one of four polysemous directionals: the ventive àsɪ= and three itives kà-, à‑, ɲa=. The distribution and reading of these directionals correlate with the grammatical categories of (im)perfectivity, (non-)finiteness and the (ir)realis, when associated with the events described by the various verb words. Furthermore, in the case of a combination of spatial and non-spatial categories, there are two possible. When both are marked by tonal morphemes in a single verb word a tonal redistribution occurs. However, when both are marked by segmental morphemes, four types of motion echo constructions can be distinguished, each reflecting a different degree of separability/integration between the motion and the non-motion events.
Jennifer Cunningham-Erves, Sheila V. Kusnoor, V. Villalta-Gil
et al.
Background Previous studies support cultural tailoring of recruitment materials as a strategy to promote the enrollment of minoritized groups in clinical trials. However, there is a lack of guidance for research teams to create culturally tailored materials, potentially contributing to low recruitment rates of minoritized groups. We describe the development and pilot testing of recruitment material guidelines used to culturally tailor clinical trial recruitment materials targeting African Americans and Latinos. Methods The guideline development team consisted of investigators, research staff, and community leaders and members experienced in the recruitment and community engagement of minoritized groups. The recruitment material guidelines were developed using the literature, focus groups with African Americans and Latinos, the teams’ research experience, and guidance from a community advisory board. To assess the effectiveness of the guidelines, a pilot study was conducted comparing advertisement click-through rates and enrollment outcomes between two institutions differing in use of culturally tailored versus non-tailored Facebook banner ads for the “Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-Term Effectiveness” (ADAPTABLE) study. Results Five themes emerged from focus groups: (1) employ diversity and inclusion in recruitment efforts; (2) access multiple recruitment channels to increase reach and possible participation; (3) increase your “footwork”; (4) personalize outreach and recruitment to specific groups’ beliefs and values; (5) align recruitment messaging with language preferences and motivations for study participation; and (6) specify incentives for participation. Guidelines were: 1) be inclusive; 2) use all forms of media; 3) take a personalized approach; 4) align recruitment messaging with motivations for study participation; 5) specify incentives; and 6) get out into the community. Additional guidelines were developed addressing specific considerations for images and language when targeting African American and Latino populations. Pilot study results demonstrated that clicks per impression ratio (0.47 clicks per impression vs. 0.03 clicks per impression) and the percentage of African American enrollment were significantly higher when using tailored compared to non-tailored ads (12.8% vs. 8.3%, respectively). Conclusion The recruitment material guidelines offer practical recommendations to reach diverse populations for clinical trial participation more effectively. Our preliminary data supports use of these guidelines as a strategy to enhance recruitment of minoritized groups into clinical research studies.
Background Studies reporting factors associated with exclusive breastfeeding are mostly quantitative. No study has performed a systematic qualitative summary to document the recurring constraints and facilitators to exclusive breastfeeding in sub-Saharan African countries from breastfeeding mothers’ perspective. This study systematically reviews the literature reporting barriers and facilitators to exclusive breastfeeding from the breastfeeding mothers’ perspective in sub-Saharan Africa to develop an educational intervention to optimize exclusive breastfeeding. Methods A systematic literature review of qualitative studies such as phenomenological studies, followed by a risk of bias and methodological assessment of the included studies’ quality using the Critical Appraisal Skills Programme (CASP) tool was conducted. MEDLINE and Google Scholar were searched from January 1990 to October 2019 to retrieve studies of breastfeeding mothers who had infants aged between 0 and 12 months. Two authors independently carried out the review process and resolved disagreements through consensus. We analyzed the data thematically. Results After reviewing 92 studies, 20 studies involving 836 participants from 11 countries were eligible. Of the 72 studies excluded, 39 were not conducted in sub-Saharan Africa, and 33 included other participants such as fathers. Three themes emerged as barriers to exclusive breastfeeding (EBF) and five additional themes were identified with facilitators of maternal-infant factors being the most significant in both cases. Maternal employment and knowledge of the benefits of EBF were the most common maternal-infant factors that served as a barrier and a facilitator, respectively. The study’s limitations were that the review involved only primary research among breastfeeding mothers living in sub-Saharan Africa and excluded studies not available in the English language. The information synthesized from this review could be used to develop communication strategies employed during individual and group patient education in the hospitals to improve breastfeeding mothers’ understanding, acceptance, and practice of exclusive breastfeeding. This review was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42020133761. Conclusions This review found that maternal-infant factors have the most significant influence over the practice of exclusive breastfeeding. Therefore, interventions targeted towards maternal-infant factors will improve and optimize exclusive breastfeeding significantly and, ultimately, improve maternal-child health outcomes.
Tais de Moura Ariza Alpino, Maíra Lopes Mazoto, Denise Cavalcante de Barros
et al.
The interface between Climate Changes and Food and Nutrition Security (FNS) has been standing out in the sustainable development agenda since the early 1990's. Since then, studies show that climate changes have negative effects on the FNS, aggravated by poverty and social inequality. The purpose of this paper is to perform a review evidencing the relationships between climate changes and FNS. The research was carried out in PubMed using the descriptors "climate change and food security" on the headline, selecting only papers in Portuguese, Spanish, and English languages, and with a direct relation to the themes. The main impacts of climate changes on the FNS were related to the access, production, nutritional quality, and volatility of food prices. The studies also indicated mitigation/adaptation strategies to the effects of climate changes on the FNS, as well as a geographic panorama of the publications with fields of study in Africa and Asia, continents marked by social inequality and poverty. Climate changes affect the dimensions of FNS, especially in poorer populations in situation of social inequality. The relevance of the themes raises concern on the urgency of higher investments in public policies, studies, and research on the subject around the world.
Jamie A. Murkey, B. Watkins, Dorice L. Vieira
et al.
BACKGROUND The chronic disease burden among African Americans has continued to rise. Although racial disparities in chronic disease risk are well documented, the role of chronic stress in risk disparities among racial and ethnic minorities is not well understood. This systematic review of studies reporting on the relationship between chronic stress, education, and/or income, and biomarkers of chronic stress (allostatic load and telomere length) longitudinally among African Americans, seeks to contribute to this knowledge gap. OBJECTIVE To use the existing literature to both examine the strength of two objective biomarkers--telomere length and allostatic load--as measures of the overactivation of physiological stress processes in African American adults; and determine if existing studies used these two biomarkers to assess the relationship between chronic stress, income and level of educational attainment among African Americans longitudinally. METHODS In order to identify English-language articles published prior to October 11, 2021, a comprehensive search strategy was developed using five databases: PubMed/Medline, EMBASE, Web of Science Plus, Global Health (Ovid), and PsycINFO. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to record progress on the comprehensive search for studies reporting on allostatic load and/or telomere length biomarkers longitudinally within all bodily fluids and chronic stress among African American adults. RESULTS In total, 7 studies met the search criteria; 902 were excluded. Thus, less than 1% of all studies reporting on biomarkers of chronic stress longitudinally included African Americans. Each of the 7 studies described the relationship between telomere length and/or allostatic load among African Americans and chronic stress, education, and/or income. Higher chronic stress levels and experiences of racial discrimination were associated with telomere shortening while lower income and higher chronic stress levels were associated with an increase in allostatic load among African Americans. DISCUSSION Given the limited number of studies reporting on the association between allostatic load, telomere length, and/or the relationship between both in assessing chronic stress severity longitudinally among African American populations, it is impossible to determine whether one biomarker has greater predictive value than the other. However, based on the literature included in this review, higher chronic stress levels and experiences of racial discrimination were associated with shorter telomere length, while lower income and higher chronic stress levels are associated with an increase in allostatic load among African Americans. CONCLUSION These data illustrate a gap in the literature on the relationship between the biomarkers of telomere length and allostatic load combined as a potential measure for chronic stress among African Americans. To our knowledge, none the current literature describes the relationship between telomere length and allostatic load longitudinally among African American adults. As the field strives to develop a "gold standard" for measuring chronic stress, the combination of these biomarkers needs to be the subject of scientific inquiry and thus, fully examined. Future longitudinal studies among African Americans are needed to better understand which biomarker, or combination of biomarkers will provide the most accurate measure of physiological stress processes.
Chineme Enyioha, M. Hall, Christiane Voisin
et al.
Background Mobile health (mHealth) and web-based technological advances allow for new approaches to deliver behavioral interventions for chronic diseases such as obesity and diabetes. African American and Hispanic adults experience a disproportionate burden of major chronic diseases. Objective This paper reviews the evidence for mHealth and web-based interventions for diabetes and obesity in African American and Hispanic adults. Methods Literature searches of PubMed/Medline, The Cochrane Library, EMBASE, CINAHL Plus, Global Health, Scopus, and Library & Information Science Source were conducted for relevant English-language articles. Articles identified through searches were reviewed by 2 investigators and, if they met the inclusion criteria, were extracted and assessed for risk of bias. Findings were summarized in tabular and narrative format. The overall strength of the evidence was assessed as high, moderate, low, or insufficient on the basis of risk of bias, consistency of findings, directness, precision, and other limitations. Results Searches yielded 2358 electronic publications, 196 reports were found to be eligible for inclusion, and 7 studies met the eligibility criteria. All 7 included studies were randomized control trials. Five studies evaluated the effectiveness of an mHealth intervention for weight loss, including one that evaluated the effectiveness for diabetes and two studies focused on diabetes. Of all the studies that focused on weight loss, 3 reported significant differences in weight loss in participants in the intervention group compared with those in the usual care group. Although all studies on diabetes control showed greater improvement in glycemic control for the intervention group compared to that in the control group, only one study showed a significant difference between the 2 groups. Conclusions This analysis indicates that there are few published studies that assessed mHealth interventions among minority populations and focused on weight or diabetes. Although the overall strength of evidence was low for diabetes control, it was moderate for weight loss, and our findings suggest that mHealth and web-based interventions may provide a promising approach for interventions among African American and Hispanic adults who have obesity or diabetes.
Background Choroidal sarcoid granulomas are often diagnosed in patients without a prior history of sarcoidosis. They are often mistaken for choroidal metastasis, choroidal nevi, amelanotic choroidal melanomas, and uveal lymphomas; however, are easily treatable when accurately identified. Observations We searched PubMed, Medline, and Scopus for English-Language case reports published before September 2021. Additionally, we presented a case of a 45-year-old woman with a right-sided amelanotic choroidal mass whose diagnosis was delayed by a COVID-19 infection. Of the 26 cases reported in the literature, 46% were female, 38% were African American, and 19% had bilateral involvement. There was a mean age of 42.15 years and a mean follow-up period of 27 months. The most common complaint was of a progressive, painless blurring of vision, and only five patients had been previously diagnosed with sarcoidosis. The choroidal granulomas were typically described as yellow lesions, single or multiple, found temporal to or at the macula. Most patients were administered steroids, with 69% receiving them systemically, 5% topically, and 8% locally with a triamcinolone injection. All patients reported symptomatic improvement at their final follow-up with resolution of the mass in 65% of patients and improved visual acuity in 76%. Conclusion Primary testing including fundoscopy, fluorescein angiography, fundus autofluorescence, A/B-scan, and OCT are useful for diagnosis, differentiation from other choroidal lesions, and monitoring treatment response. Steroids are a mainstay of treatment for sarcoidosis and are effective at treating choroidal granulomas. Therefore, early recognition and diagnosis of choroidal granulomas is imperative as treatment can be curative and sight-sparing.
Ismaila Ouedraogo, B. M. Somé, Kiemute Oyibo
et al.
The African gaming industry is beginning to flourish as a result of a rise in the availability of inexpensive phones and the number of mobile phone subscribers. It has enabled the development and implementation of mobile serious games to promote healthy behavior change in rural communities. This paper examines the use of mobile serious games in healthcare education, with a particular focus on those designed to increase health literacy in rural Africa. Identifying and addressing the design challenges and issues faced by people living in rural African communities through the use of persuasive mobile games can promote behavior change among these underserved communities. We used PubMed, Scopus, Google Scholar and manual search to identify relevant studies published from 2011 to July 2021. The literature review highlights how the identified challenges affect the implementation of persuasive strategies, suggests design solutions for overcoming them, and discusses how persuasive games can be tailored to suit the target rural African populations. Some of the identified challenges are technical in nature (e.g., access to electricity and internet connectivity), while others are not (e.g., language diversity and low literacy). As the number of serious games for healthcare education and awareness continues to increase, it is essential for the successful implementation of inclusive mobile health technologies in rural Africa to identify and address the specific challenges faced by underserved populations such as rural African communities.
Cally Ardington, Gabrielle Wills, E. Pretorius
et al.
Abstract To prevent children from falling behind in the developmental sequence of reading, a shared vision of what reading success looks like is required. This paper provides the first benchmarks for early grade oral reading fluency that are necessary (albeit not sufficient) to read for meaning in three Nguni languages – isiZulu, isiXhosa and Siswati - belonging to the Southern Bantu family of African languages. In contrast with previous benchmarking methodologies, our approach is informed by a non-parametric analysis of longitudinal early grade reading assessment (EGRA) data, guided by reading development theory. The EGRA-type data used for this analysis is the largest compilation of data on early grade fluency in these languages, with comparative assessments for nearly 14,200 children. Analysing empirical regularities and reading trajectories, we identify a lower fluency threshold of 20 correct words per minute (cwpm) and an upper fluency benchmark of 35 cwpm for the early grades. These benchmarks contribute to guiding curriculum policy, provide specificity to improve tracking of literacy progress and address gaps in the literature on reading in African languages.
This article aims to respond to Vuyani Vellem’s challenge to black theology of liberation (BTL) to ‘think beyond rethinking and repeating its tried and tested ways of responding to black pain caused by racism and colonialism’. Vellem argued that ‘BTL needs to unthink the west by focusing on and retaining African spirituality as a cognitive spirituality’ for the liberation of black people in South Africa. This article argues that Ubuntu is the spirituality of liberation that BTL needs to advance as one of its interlocutors. This research work will consult the literature emerging from African philosophy, ethics, spirituality and BTL arguing that Ubuntu is an indigenous philosophy, spirituality that continues to exist in the languages and culture of the Abantu (Bantu) speaking people. This article is dedicated to the memory of Vellem as a BTL scholar and a faithful believer of the liberative paradigms of BTL.
Contribution: The scholarly contribution of this article is its focus on the systematic and practical reflection, within a paradigm in which the intersection of religious studies, social sciences and humanities generate an interdisciplinary contested discourse.