Digital Commons Network^™

Qualitative Approach To Understanding Barriers To Delivering Difficult News In Sub Saharan Africa, Karishma Sharma, Jasmit Shah, Sayed Karar

Internal Medicine, East Africa

Communication, especially delivery of difficult news (DDN), remains a key part of clinical practice. Despite its importance, many medical providers lack the skill and ability to effectively DDN to their patients. Due to lack of data specific to sub-Saharan Africa and to help us develop an appropriate training tool for this geographical area, we sought to explore what challenges and barriers residents at our institution faced when they deliver difficult news to their patients.

حذف العاطف دون المعطوف والمعطوف عليه في الدرس النحوي, مأمون مباركه

Hebron University Research Journal-B (Humanities) - (مجلة جامعة الخليل للبحوث- ب (العلوم الانسانيه

Deleting the conjunction and keeping the two other elements, i.e. the conjunctive and the conjoined was a controversial issue for ancient grammarians and syntacticions. It was used mainly to interpret a set of grammatical evidences and rules in a way that changes the meaning of the Arabic sentence including Quranic verses when the conjunction is deleted and/or rejected. Grammarians had their own excuses for deleting it, and those who rejected it had their own justifications, too. Nowadays, this controversial issue has been moderately tackled; modern scholars have not provided an adequate and a thorough conceptualization of the topic. They have …

Magnitude Of Screening For Gestational Diabetes Mellitus In An Urban Setting In Tanzania; A Cross-Sectional Analytic Study, Akampa Mukuve, Mariam Noorani, Ibrahim Sendagire, Miriam Mgonja

Family Medicine, East Africa

Background: Medical screening detects risk factors for disease or presence of disease in otherwise well persons in order to intervene early and reduce morbidity and mortality. During antenatal care (ANC) it is important to detect conditions that complicate pregnancy, like gestational diabetes mellitus (GDM). Despite international and local guidelines recommending screening for GDM during ANC, there is evidence to suggest that the practice was not being carried out adequately. A major challenge may be lack of consensus on uniform GDM screening and diagnostic guidelines internationally and locally.

The primary objective was to determine the magnitude of screening for GDM among …

Introduction Of An Advanced Practice Nurse Program In Kenya: A New Era In Nursing Education, Sheila Shaibu, Eunice Ndirangu, Eunice Pallangyo, Gladys Mbuthia, Rachel Kimani, Isabel Kambo

School of Nursing & Midwifery, East Africa

Purpose: The purpose of this presentation is to share the intra and interprofessional collaborative process of developing an Advanced Practice Nursing (APN) program to be offered in 2020 in Kenya, a low middle-income country.

Methods: Engagement with stakeholders (students, clinicians, regulators and educators) affirmed the need for an APN program. Faculty from Schools of Nursing and Midwifery in three East African countries developed an APN curriculum with input from local and international agencies such as the Nursing Council of Kenya with linkages to the ICN, the Nursing Now Team and partner universities in the UK and USA. The …

The Impact Of Government Spending And Taxation On Economic Growth In Tanzania (1967 €“ 2017), Ngong'ho Sende, Wilhelm M. Ngasamiaku

Business Management Review

This study seeks to examine the effect of government spending and taxation on economic growth in Tanzania for the 1967-2017 period. To achieve this objective, the study utilized secondary data and analyzed it using Augmented Dickey Fuller Test (ADF) and Phillips-Perron test statistics for unit root test and ARDL model for assessing effects on economic growth. Augmented Dickey Fuller Test and Phillips-Perron Test revealed that development expenditure, recurrent expenditure and income tax were initially not stationary at level but they became stationary after first differencing while real GDP was initially stationary at level. ARDL approach to co-integration bound test revealed …

Effects Of Human Resources Management Practices On Supply Chain Flexibility: Evidence From Tourist Hotels In Tanzania, Gerald Bernard Magova, Severine S. Kessy

Business Management Review

The study was designed to examine the effects of human resource management practices on supply chain flexibility. Specifically, it sought to determine the influence of participation practices, selective hiring practices, compensation practices, job security practices and teamwork practices on supply chain flexibility of tourist hotels in Tanzania. The study adopted a cross-sectional survey approach, where 228 respondents were involved. Hypotheses linking human resources management practices and supply chain flexibility were developed and tested using a structural equation modelling technique. The findings indicate that selective hiring practices, job security practices and teamwork practices have a significant positive influence on supply chain …

Income Tax Law Simplification And Tax Compliance: A Case Of Medium Taxpayers In Zanzibar, Shuweikha S. Khalfan, Ernest Kitindi, Henry Chalu

Business Management Review

Tax law simplification was among tax reform strategies formulated to address tax law complexity and improve tax compliance. Although it is about two decades of implementation of the new tax laws, little is known on the effect of such simplification on tax compliance. This paper examined the influence of the Income Tax Law (ITL) simplification on tax compliance in Zanzibar. A survey was conducted among 367 medium taxpayers registered with TRA €“ Zanzibar. Descriptive and Structural Equation Model were used for data analysis. The findings reveal that tax compliance level of medium taxpayers is high and the ITL simplification positively …

Are Households In Kagera Region In Tanzania Vulnerable To Poverty?, Innocent Pantaleo

Business Management Review

This paper uses the six wave Kagera Health and Demographic Survey (KHDS) panel data to examine whether or not households in Kagera Region were vulnerable to poverty in the period 1991 - 2010. Using the Kagera poverty lines for 1991 and 2010, the paper examines the extent to which variability in households ' incomes and consumption engendered the risks (as a measure of vulnerability) to poverty. The results show that risk to poverty was relatively low for the 1991 poverty line and high for the 2010 poverty line. This difference indicates that the risk of households falling into poverty tends …

Human Resource Management Practices And Employees ' Engagement In Small And Medium Enterprises In Tanzania, Judith J. Msangi, Severine S. Kessy, Ernest Kitindi

Business Management Review

Employees ' engagement is a very important concept in business management. It plays a vital role in determining the performance of business organizations including small and medium enterprises (SMEs). Despite its importance in business management, there is limited knowledge on how human resource management (HRM) practices influence the two major categories of employees ' engagement: job engagement and organizational engagement. This study examined the influence of HRM practices on employees ' engagement in Tanzanian SMEs. Data were collected from 483 SMEs using survey method and analyzed using Structural Equation Modeling (SEM). The results revealed that employees ' communication had positive …

Determinants Of Soft Drink Customer Satisfaction And Purchase Intentions: Comparison Between Tanzania ' S And South Korea ' S Customers, Raina Marius, Robert Suphian, Dev Jani

Business Management Review

The purpose of the study was to determine the influence of quality, social value, price, and attitude towards soft drinks on customer satisfaction and purchase intention by comparing Tanzanian and South Korean customers to reflect different business contexts. Data were collected using self-administered structured questionnaire directed to university students in the two countries. The data was subjected to Structured Equation Modeling using SmartPLS3 with multi-group analysis performed to decipher country differences in the hypothesized relationships. In the overall, attitude, price, and quality had a significant direct effect on satisfaction and indirect effect on purchase intention. Comparatively, attitude, price, and quality …

Examining The Ability Of Tanzanian Small And Medium Enterprises (Smes) To Increase Their Penetration Into Export Markets, Beatrice Mkenda, John Rand

Business Management Review

Tanzanian Small and Medium Enterprises (SMEs) face a number of hurdles that constrain their ability to increase their penetration into export markets. This finding emanates from analysing a sample of Tanzanian exporting SMEs from the World Bank ' s Enterprise Survey Data for 2013. The analysis shows that only a few among the sampled exporting SMEs had internationally recognized quality certificates, used technology licensed from a foreign-owned company, spent on research and development (R&D) in the previous three years; and many were unable to enter export markets within three years of being established, that is, they are not born-global firms. …

Negative Appendectomy Rate In Urban Referral Hospitals In Tanzania: A Cross-Sectional Analysis Of Associated Factors, Nyamuryekung’E Klint Masawa, Authar Ali, Miten Ramesh Patel, Aidan Njau, Omar Sherman, Ahmed Jusabani, Ali Akbar Zehri

Faculty of Health Sciences, East Africa

Background:

Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negative appendectomy rates (NAR). This study aimed to establish NAR and explore the associated factors and possible attainable solutions to reduce it in urban referral hospitals in Tanzania.

Methods:

This was a crosssectional study with 91 consecutive patients, aged 10 years and older undergoing appendectomy for suspected AA with histological evaluation of specimens. The study was powered to detect the NAR …

Negative Appendectomy Rate In Urban Referral Hospitals In Tanzania: A Cross-Sectional Analysis Of Associated Factors, Masawa Klint Nyamuryekung’E, Ali Syed Muhammad Akhtar, Miten Ramesh Patel, Aidan Njau, Omar Sherman, Ahmed Jusabani, Ali Akbar Zehri

General Surgery, East Africa

Background: Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negative appendectomy rates (NAR). This study aimed to establish NAR and explore the associated factors and possible attainable solutions to reduce it in urban referral hospitals in Tanzania.

Methods: This was a crosssectional study with 91 consecutive patients, aged 10 years and older undergoing appendectomy for suspected AA with histological evaluation of specimens. The study was powered to detect the NAR …

Negative Appendectomy Rate In Urban Referral Hospitals In Tanzania: A Cross-Sectional Analysis Of Associated Factors, Nyamuryekung'e Klint Masawa, Authar Ali, Miten Ramesh Pate, Aidan Njau, Omar Sherman, Ahmed Jusabani, Ali Akbar Zehri

General Surgery, East Africa

Background: Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negative appendectomy rates (NAR). This study aimed to establish NAR and explore the associated factors and possible attainable solutions to reduce it in urban referral hospitals in Tanzania.

Methods: This was a crosssectional study with 91 consecutive patients, aged 10 years and older undergoing appendectomy for suspected AA with histological evaluation of specimens. The study was powered to detect the NAR …

Mercury Levels Of Seafood Commonly Consumed In Taiwan, Y.C. Chen, M.H. Chen

Journal of Food and Drug Analysis

In this study, the mercury level in 25 commonly consumed seafood species was identified and used to evaluate the mercury intake for Taiwan population. Total mercury concentrations were determined by using furnace-gold amalgation mercury analyzer. The results indicated that mercury concentrations of the 25 seafood species ranged from 0.002 to 0.198 mg/kg wet wt. and varied significantly across species (p < 0.05). All mercury concentrations of the 25 seafood species were below the safety standards, 0.5 mg/kg, set by TWDOH, EC and FAO/WHO. Mercury intake from seafood consumption for female and male adults in Taiwan was estimated to be 21 and 30 μg/week, respectively, which was well below the PTWI. Among the seafood items tested, fish was the major source of total mercury intake for Taiwan population (74-83%). The marine fish contributed the most, followed by shellfish and freshwater fish. The highest mercury level was found in tuna. The mercury intake could be within the PTWI if general population weighted 65 kg consumed daily 90 g of seafood with mercury concentration as 0.17 mg/kg.

Determination Of Reference Intervals For Common Chemistry And Immunoassay Tests For Kenyan Adults Based On An Internationally Harmonized Protocol And Up-To-Date Statistical Methods, Geoffrey Omuse, Kiyoshi Ichihara, Daniel Maina, Mariza Hoffman, Elizabeth Kagotho, Alice Kanyua, Jane Mwangi, Caroline Wambua, Angela Amayo, Peter Ojwang, Zul Premji, Rajiv Erasmus

Pathology, East Africa

Background: Due to a lack of reliable reference intervals (RIs) for Kenya, we set out to determine RIs for 40 common chemistry and immunoassay tests as part of the IFCC global RI project.

Methods: Apparently healthy adults aged 18–65 years were recruited according to a harmonized protocol and samples analyzed using Beckman-Coulter analyzers. Value assigned serum panels were measured to standardize chemistry results. The need for partitioning reference values by sex and age was based on between-subgroup differences expressed as standard deviation ratio (SDR) or bias in lower or upper limits (LLs and ULs) of the RI. RIs …

Covid-19 And Stroke In Sub-Saharan Africa: Case Series From Dar Es Salaam, Philip Adebayo, Nadeem Kassam, Omar Aziz, Ahmed Jusabani, Samina Somji, Mugisha Clement

Internal Medicine, East Africa

Low and middle-income countries including those in sub-Saharan (SSA) Africa are experiencing a steady increase in the number of COVID-19 cases. To the best of our knowledge, reports of COVID-19 related strokes are scarce in SSA. The peculiar situation of stroke care in SSA makes COVID-19 associated stroke a bothersome entity as it adds other dynamics that tilt the prognostic balance. We present a case series of COVID -19 related stroke in 3 patients from Tanzania. We emphasized protected code stroke protocol.

Investigating The Direct And Indirect Effects Of Forest Fragmentation On Plant Functional Diversity, Jenny Zambrano, Norbert J. Cordeiro, Carol Garzon-Lopez, Lauren Yeager, Claire Fortunel, Henry J. Ndangalasi, Noelle G. Beckman

Biology Faculty Publications

Ongoing habitat loss and fragmentation alter the functional diversity of forests. Generalising the magnitude of change in functional diversity of fragmented landscapes and its drivers is challenging because of the multiple scales at which landscape fragmentation takes place. Here we propose a multi-scale approach to determine whether fragmentation processes at the local and landscape scales are reducing functional diversity of trees in the East Usambara Mountains, Tanzania. We employ a structural equation modelling approach using five key plant traits (seed length, dispersal mode, shade tolerance, maximum tree height, and wood density) to better understand the functional responses of trees to …

Furrowed Tongue, Fatten Lip And Facial Droop, Philip Adebayo, Hanifa Mbithe

Internal Medicine, East Africa

No abstract provided.

Magnitude Of Screening For Gestational Diabetes Mellitus In An Urban Setting In Tanzania; A Cross-Sectional Analytic Study, Akampa Mukuve, Mariam Noorani, Ibrahim Sendagire, Miriam Mgonja

Faculty of Health Sciences, East Africa

Background

Medical screening detects risk factors for disease or presence of disease in otherwise well persons in order to intervene early and reduce morbidity and mortality. During antenatal care (ANC) it is important to detect conditions that complicate pregnancy, like gestational diabetes mellitus (GDM). Despite international and local guidelines recommending screening for GDM during ANC, there is evidence to suggest that the practice was not being carried out adequately. A major challenge may be lack of consensus on uniform GDM screening and diagnostic guidelines internationally and locally.

The primary objective was to determine the magnitude of screening for GDM among …

Post-Vaccination Pharyngeal-Cervical-Brachial Variant Of Guillain-Barré Syndrome, Funmilola T. Taiwo, Daniel E. Ezuduemoih, Philip Adebayo

Internal Medicine, East Africa

The pharyngeal-cervical-brachial (PCB) variant of Guillain-Barré syndrome (GBS) is very rare. It is characterized by weakness of the upper extremities associated with bulbar symptoms and facial diplegia. Documented cases were post-infectious, a post-vaccination occurrence has not been documented in the available literature. Even rarer is the occurrence of any variant of GBS following the mumps measles rubella (MMR) vaccine. The neurophysiological hallmark of PCB variant of GBS is a combination of myelinopathy and axonopathy, hence, its consideration as a subtype of the acute motor axonal neuropathy (AMAN) variant. It should be suspected in any case of acute-onset flaccid symmetrical weakness …

Video Analysis Of Newborn Resuscitations After Simulation-Based Helping Babies Breathe Training, Ingunn Anda Haug, Kari Holte, Catherine L. Chang, Carolyn Purington, Joar Eilevstjønn, Anita Yeconia, Hussein Kidanto, Hege L. Ersdal

Obstetrics and Gynaecology, East Africa

Background: Simulation-based Helping Babies Breathe (HBB) training is currently rolled-out in around 80 low-income countries with various results.

Method: Workflow was analyzed in 76 video-recorded newborn resuscitations performed by regularly HBB-trained nurse-midwives over 3 years in rural Tanzania.

Results: Actual newborn resuscitation practice deviated from HBB intention/guideline: most newborns underwent prolonged suction and stimulation before ventilation; ventilation was delayed and frequently interrupted. Nurse-midwives often worked together.

Conclusions:There is a gap between training intention and clinical practice. HBB trainings should focus more on urgency, ventilation skills, and team training. Combining clinical debriefing with HBB simulations could facilitate continuous learning and …

Postoperative Myocardial Injury In A Patient With Left Ureteric Stone And Asymptomatic Covid-19 Disease, Nadeem Kassam, Omar Aziz, Ally Zain Ismail, Rodgers Swai, Samina Somji, Robert Mvungi, Mustaafa Bapumia, Ali Akbar Zehri, Salim Surani

Internal Medicine, East Africa

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified on 8thDecember 2019 in Wuhan, Hubei, China, and has since spread globally to become an emergency of international concern. Patients infected with SARS-CoV-2 may be asymptomatic or present with symptoms ranging from mild clinical manifestations: such as fever, cough, and sore throat to moderate and severe form of the disease such as pneumonia and acute respiratory distress syndrome (ARDS). In some patients, SARS-CoV-2 can affect the heart and cause myocardial injury which is evidenced either by electrocardiographic (ECG) changes …

Invasive Liver Abscess Syndrome Caused By Klebsiella Pneumoniae: First Tanzanian Experience, Nadeem Kassam, Omar Aziz, Samina Somji, Zainab Yusuf Fidaali, Salim Ramzan Surani

Internal Medicine, East Africa

Over the past 20 years there has been growing awareness of community-acquired primary liver abscess caused by strains of Klebsiella pneumoniae (K. pneumoniae) especially in patients of Asian descent, a minority of which are characterized by metastatic spread. A common and frequent destructive complication is endophthalmitis as well as the involvement of the central nervous system (CNS), causing suppurative meningitis or brain abscess. Here we report a case of invasive liver abscess caused by K. pneumoniae in an Asian patient who presented to our hospital in Tanzania with bilateral lower limb swelling for 6 weeks with acute onset of difficulty …

Performance Analysis Of Renewable Energy Resources In Rural Areas: A Case Study Of Solar Energy, Jackson Justo

Tanzania Journal of Engineering and Technology (TJET)

This paper presents an overview of the recent development trends of solar photovoltaic (PV) systems and the performance in the Tanzanian context. The two types of solar power generation that are considered in this paper are: i) solar PV systems and ii) concentrated solar power (CSP). The two are compared in terms of cost of energy and energy storage mechanism. Moreover, the effect of ambient temperature on the solar PV module is analyzed. In addition, a detailed analysis on using solar axis tracking to increase the power generation is also presented. The extent to which the cell surface temperature and …

Comminution Characteristics Of Lithium Bearing Mica Ores From Different Devices, Alphonce Wikedzi

Tanzania Journal of Engineering and Technology (TJET)

This paper highlights on the comminution and to the lesser extent liberation properties of two greisen-type lithium bearing-mica ores (L1, L2) subjected to different breakage devices; cone crusher (CC), roller crusher (RC), rotor beater mill (RBM) and a screen mill (SM). The particle size distributions (PSD) of the products from each device were evaluated to search for an appropriate PSD model using Gates-Gaudin-Schuhmann (GGS) and Rosin-Rammler (RR) functions. To determine an appropriate function, coefficients of determination (R2) were used as a criterion. Due to budget constraint, only products from rotor beater mill (RBM) were examined for mineral liberation by an …

Estimating Flood Magnitudes Of Ungauged Urban Msimbazi River Catchment In Dar Es Salaam, Tanzania, Patrick Valimba Dr

Tanzania Journal of Engineering and Technology (TJET)

More often daily climate data have been used in hydrological models to estimate flood flows in small data scarce urban and rural catchments where flow peaking and recession are quick within short periods of few hours. This study assesses magnitudes of error of using daily climate data to simulate flood flow hydrographs of a small urban river catchment, Msimbazi River. Spot discharge measurements were available for Apr-May 2014 and Mar May 2015 periods.10-minutes climate records were available at one station, daily temperatures at two stations while daily rainfall records at several stations within the catchment. Visual analysis characterise rainfall events …

Spatial And Temporal Variation Of Rainfall And Streamflow In The Kikuletwa Catchment Of Upper Pangani Basin, Tanzania, Upendo Msovu

Tanzania Journal of Engineering and Technology (TJET)

Streamflow and rainfall records from 1980 to 2015 as a (common period for the analyzed stations) were used to analyze the variations of rainfall and streamflow in the Kikuletwa catchment. Also, the analysis of the longest time series available at each station up to 2015 (referred to as the whole series in this study) was conducted to relate past rainfall and streamflow changes, at the tributaries of Kikuletwa River located above the Rundugai natural springs as recommended from previous studies. Various methods such as simple statistics of the mean, standard deviation, coefficient of variance, and graphs were used to analyze …

Modeling And Control Of Solar Pv With Battery Energy Storage For Rural Electrification, Irene Masenge

Tanzania Journal of Engineering and Technology (TJET)

In rural areas where electric power grid network is rarely available, power generation from renewable energy resource such as solar photovoltaic (PV) is mostly accomplished in standalone mode. The standalone solar PV system requires energy storage device to achieve reliable power supply to the end users. This paper presents modelling and coordination control of solar PV with battery energy storage system (BESS) for rural-electrification applications. The proposed control is accomplished via a bidirectional buck-boost converter with the objective of maintaining voltage at the DC bus constant. Simulation results based-on MATLAB/Simulink platform confirms good performance of the proposed system

Acute Toxicity, Antidiarrhoeal And Antioxidant Activities Of Methanolic Leaf Extract Of Baphia Macrocalyx In Mice, Regina Malekela, Jacob Mwakalinga, Rosta Antony, Flora Stephano

Tanzania Journal of Science

The aim of the current study was to assess the acute toxicity, antidiarrhoeal and antioxidant potentials of methanolic leaf extract of Baphia macrocalyx (BM) in mice. Acute toxicity test of BM extract was performed based on OECD guideline 423. Results revealed that the extract did not produce any changes in general behaviour, body weight or mortality of the tested mice even at the highest oral administered dose (2000 mg/kg body weight). The antidiarrhoeal effect was examined using castor oil induced diarrhoea test. Results showed that BM extract delayed the onset of diarrhoea, decreased frequency of defaecation and reduced the severity …