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Clinical Presentations of Lassa Fever in Non-Endemic Parts of the World: A Systematic Review

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International Journal of Clinical Medicine 2022年第9期13卷 415-427页

作者： ethel Nkechi Chime Peter Ekpunobi Chime Basil Chukwuemeka Ezeanolue Department of Otorhinolaryngology University of Nigeria Teaching Hospital Enugu Nigeria Department of Otorhinolaryngology Enugu State University of Science and Technology Teaching Hospital Enugu Nigeria Department of Medicine Enugu State University of Science and Technology Teaching Hospital Enugu Nigeria

Background: Lassa fever cases outside Africa are seen as imported cases of Lassa fever. Timely diagnosis of imported Lassa fever is important for timely intervention necessary to reduce the morbidity and mortality associated with Lassa fever, and this requires the knowledge of the clinical manifestations of Lassa fever. Purpose: This review was done to see how clinical diagnosis of imported Lassa fever can be facilitated based on the clinical presentations of imported cases of Lassa fever in Lassa fever non-endemic region. Methods: The relevant articles for the review were obtained from the databases of PubMed and Google Scholar. Results: The clinical presentations of the imported Lassa fever cases consisted of multisystem involvement and were similar to those of Lassa fever patients who were treated in the Lassa fever endemic region. Conclusions: History of recent travel to, or residence in, Lassa fever endemic region is an important clue for clinical diagnosis of Lassa fever. The 2011 CDC surveillance case definition and the modified Khan case definition for Lassa fever may aid clinical diagnosis of Lassa fever. Any clinically suspected case of Lassa fever should have a laboratory confirmation.

关键词： Imported Lassa Fever Clinical Features of Lassa Fever Clinical Diagnosis of Lassa Fever

公司治理机制对企业业绩的影响 ——在加纳证券交易所上市的非金融公司的证据

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公司治理机制对企业业绩的影响 ——在加纳证券交易所上市的非金...

作者： ethel Dzidefo Asimah 江苏大学

学位级别：硕士

由于金融危机的蔓延,导致一些世界领先的企业和公司倒闭,公司治理的概念受到了工业界和学术界的广泛关注。公司治理机制在公司实体到期和存续中的作用已成为全球公司治理结构的重要组成部分。该研究考察了公司治理机制对加纳公司绩效的... 详细信息

由于金融危机的蔓延,导致一些世界领先的企业和公司倒闭,公司治理的概念受到了工业界和学术界的广泛关注。公司治理机制在公司实体到期和存续中的作用已成为全球公司治理结构的重要组成部分。该研究考察了公司治理机制对加纳公司绩效的影响。本研究以加纳非金融行业28家上市公司为研究对象,旨在探索上市公司良好的公司治理机制对公司业绩的影响,从而推动加纳的经济增长和发展。本研究使用了具有代表性的面板数据,以2008-2018年期间在加纳证券交易所上市的28家非金融行业上市公司为研究样本。本研究设定了五个具体目标,并对相关假设进行了阐述和检验。公司业绩通过总资产回报率(ROA)、净资产回报率(ROE)以及每股收益(EPS)来衡量。相关性研究结果表明公司治理与公司绩效具有相关性。多元回归分析发现董事会规模、独立非执行董事和CEO任期对公司绩效有显著的正向影响,而CEO二元性对公司绩效没有显著的影响。研究结果进一步表明,审计委员会规模对绩效有显著的正向影响。本研究建议,需要充分加强公司治理、董事会结构、文化、纪律和社会意识,以达到理想的公司治理水平,加纳非金融行业上市公司表明并没有致力于公司治理的所有领域。董事会结构必须保持强大和独立性,以促进信任和增强投资者信心,鼓励本地公司向跨国公司学习,并在其年度报告中提供详细的公司治理报告。

关键词：公司治理董事会构成 CEO双重性公司绩效

Hearing Loss in Lassa Fever: A Systematic Review

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Open Journal of Preventive Medicine 2022年第11期12卷 239-247页

作者： ethel Nkechi Chime Peter Ekpunobi Chime Jones Ndubuisi Nwosu Department of Otorhinolaryngology University of Nigeria Teaching Hospital Ituku-Ozalla Nigeria Department of Otorhinolaryngology Enugu State University of Science and Technology Teaching Hospital Parklane Nigeria Department of Medicine Enugu State University of Science and Technology Teaching Hospital Parklane Nigeria

Background: Lassa fever is a viral haemorrhagic fever associated with several complications which include hearing loss. Hearing loss in Lassa fever may become residual with its negative impact on the quality of life. Purpose: This paper is a review of various studies on Lassa fever related hearing loss. Methods: Systematic literature review was done on articles on Lassa fever patients and Lassa fever survivors. Relevant articles published in English between 1969 and 2021 were searched for using Google Scholar and PubMed databases. Eight studies which met the inclusion criteria were finally selected and included in the review. The variables of interest were extracted from the full-text articles. Results: Lassa fever related hearing loss occurs in both sexes and in all age groups. The incidence of self-reported hearing loss ranged from 12.5% to 30% with a mean of 17.6%. The incidence of audiometrically determined sensorineural hearing loss ranged from 13.5% to 29% with a mean of 22.1%. Hearing loss persisted in 64% of those that were followed up. Cases of hearing loss varied in severity, ranging from mild to profound. No successful specific treatment for Lassa fever related hearing loss was reported apart from hearing rehabilitation. Conclusion: Hearing loss among Lassa fever patients remains a major challenge. Lack of effective treatment for Lassa fever related hearing loss is a serious gap in the management of Lassa fever patients which should be addressed in future research.

关键词： Hearing Loss Hearing Impairment Lassa Fever

Experience of Conducting Objective Structured Clinical Evaluation (OSCE) in Malawi

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Open Journal of Nursing 2014年第10期4卷 705-713页

作者： Tiwonge ethel Mbeya Munkhondya Gladys Msiska Evelyn Chilemba Maureen Daisy Majamanda Kamuzu College of Nursing University of Malawi Lilongwe Malawi

In Malawi various nursing educational institutions have increased the enrollment of nursing students in order to respond to the rampant nursing shortage prevalent in the Malawian clinical settings. With this increase in intake, nurse educators are met with so many questions as to whether the nurses being trained are competent and fit for practice. To ensure that these nurses have appropriate competences, Objective Structured Clinical Evaluation (OSCE) has been embraced as a key strategy to evaluate student’s competence. The paper describes the lessons learnt from conducting OSCE to undergraduate student nurses at Kamuzu College of Nursing in Malawi. The paper considers the background and context of the school, the preparation of students, the formulation of OSCE tasks, recruitment of examiner and simulated patients and the evaluation of the OSCE. The paper concludes that OSCE can be a worthwhile valid strategy of teaching and assessing nursing students as long as it is properly designed. Nonetheless, profound commitment of all stakeholders involved is very vital.

关键词： OSCE Student Nurses Undergraduates

Vocal Cord Paralysis Secondary to Carotid Artery Dissection: A Case Report

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Journal of Biosciences and Medicines 2022年第3期10卷 8-12页

作者： ethel Nkechi Chime Peter Ekpunobi Chime John C. Eze Department of Otorhinolaryngology University of Nigeria Teaching Hospital Ituku-Ozalla Enugu Nigeria Department of Otorhinolaryngology Enugu State University of Science and Technology Teaching Hospital Parklane Enugu Nigeria Department of Medicine Enugu State University of Science and Technology Teaching Hospital Parklane Enugu Nigeria Cardiothoracic Unit Department of Surgery University of Nigeria Ituku-Ozalla Campus Ituku-Ozalla Enugu State Nigeria

Background and Objective: Vocal cord paralysis results in impairment of breathing and/or speech. One of the causes of vocal cord paralysis is the disruption of vagus nerve innervation to the vocal cords by the mass effect of a neighbouring structure. We report a rare case of vocal cord paralysis secondary to internal carotid artery dissection. Method: The diagnosis was based on clinical history, physical examination and imaging studies. Literature review was done. Case Report: This was a 53-year-old female with a history of unremitting, progressive hoarseness and mild dysphagia to liquid, who was clinically found to have impaired left vocal cord mobility, a left-sided pulsatile neck mass and left carotid artery dissection based on imaging studies. Symptoms abated after conservative treatment with Aspirin and she has remained symptom free since two years of follow-up. Conclusion: Vocal cord paralysis can be a consequence of carotid artery dissection causing mass effect on the vagus nerve. Thus, carotid artery dissection should not be forgotten as a possible cause of vocal cord paralysis in some cases of vocal cord paralysis of uncertain etiology. Treatment with anti-platelet drug can bring about resolution of symptoms and return of vocal cord mobility.

关键词： Vocal Cord Paralysis Internal Carotid Artery Dissection/Aneurysm

Sources of Stress among Undergraduate Nursing Students during Clinical Practice: A Malawian Perspective

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Open Journal of Nursing 2019年第1期9卷 1-13页

作者： Gladys Msiska Martha Kamanga Evelyn Chilemba Annie Msosa Tiwonge ethel Munkhondya Kamuzu College of Nursing University of Malawi Lilongwe Malawi

Purpose: The purpose of this study was to explore undergraduate nursing students’ perceptions of their clinical learning experience, and the reported findings emerged from narratives of their experience. Design: This was a hermeneutic phenomenological study which took place at a university nursing college in Malawi. Participants for the study were purposively selected from third- and fourth-year undergraduate nursing students and the data were collected through in-depth interviews. A framework developed by modifying Colaizzi’s procedural steps guided the phenomenological analysis. Findings: The study reveals factors which cause stress among undergraduate nursing students during their clinical practice. The following themes emerged from the study: lecturer/nurse interaction with students: stress associated with patient care and stress associated with objective structured clinical examination (OSCE). The lecturer is perceived to significantly induce stress, and this is common when the student perceives that the lecturer’s interaction is in a “policing” manner. The primary stressors associated with patient care include lack of life-saving medication which sometimes leads to death of a patient, taking care of critically ill patients unsupervised, and fear of contracting infections such as HIV and tuberculosis, and death of a patient. Factors associated with stress during OSCE include use of examiners whom students are not familiar with and the conduct of OSCE in the skills lab which has better resources than the clinical settings where students practice. Conclusions: The study reveals sources of stress during nursing students’ clinical practice and its effects on their learning and motivation. Consistent with existing literature, these findings confirm that nursing students experience considerable levels of stress during clinical practice. Recommendations: The study suggests that nursing education can be quite a stressful experience to the learners. It is therefore esse

关键词： Stress Clinical Practice Clinical Learning Student Nurses Nursing Education

Ultrastructural Analysis of the Ontogenetic Development of Shoot Induced from Embryonic Axes of Costa Rican Bean Varieties (<i>Phaseolus vulgaris</i>L.) under <i>in Vitro</i>Conditions by Scanning Electronic Microscopy

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American Journal of Plant Sciences 2012年第4期3卷 489-494页

作者： Marisol Jiménez Andrés Gatica ethel Sánchez Marta Valdez Centro de Investigación en Estructuras Microscópicas (CIEMic) Universidad de Costa Rica San Pedro de Montes de Oca Costa Rica Laboratorio de Biotecnología y Transformación Genética de Plantas Escuela de Biología Universidad de Costa Rica San Pedro de Montes de Oca Costa Rica

Common bean (Phaseolus vulgaris L.) is an economic important crop and one of the major grain legumes for human consumption in Latin America, Africa and Asia. A morphological study of shoot induced from embryonic axes development in four Costa Rican bean varieties (Brunca, Huetar, Guaymi and Bribri) cultivated on MS media with or without 5 mg·L–1 de N6-benzylaminopurine (BAP) by scanning electron microscopy (SEM) was developed in the present work. Micrographs showed similarities and differences in the ultrastructure of the apical dome, epidermal surface, stomata and different types of trichomes in the varieties cultivated on organogenesis media. Genotypes with advantageous morphological characteristics for genetic transformation, in particular an exposed apical dome, were identified. This work will contribute to the optimization of the in vitro regeneration of four common bean varieties.

关键词： Phaseolus vulgaris L Bean In Vitro Organogenesis Shoot Scanning Electron Microscopy (SEM)

Family Centered Care versus Child Centered Care: The Malawi Context

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Health 2015年第6期7卷 741-746页

作者： Maureen Daisy Majamanda Tiwonge ethel Mbeya Munkhondya Miriam Simbota Maria Chikalipo Kamuzu College of Nursing University of Malawi Blantyre Malawi

Family Centered care is a model that is practiced and encouraged in child health care. It considers family as partners and collaborators in care of children. It aims at involving family in all aspects of child care. Family centered care also mentions involvement of child. However, emphasis is given more on family than child and does not take into account the older child’s capacity for independent decision making and right to privacy. As such, child’s needs are missed out. With child centered care, children are involved and supported at all levels of care based on their age and developmental stage. This paper aims to stress the importance of involving children within family centered care. Involving children in their care, makes them feel less threatened by the health care professional and their self esteem is promoted. Currently, no studies have been identified in Malawi that demonstrates full partnership between the family, child and the nurse. Furthermore, Family Centered Care and Child Centered Care as models are not fully practiced. It is therefore important to practice both family and child centered care in child health care if the needs of both family and children are to be addressed concurrently.

关键词： Family Centered Care Child Centered Care Child Involvement Child Participation

Factors Militating against the Delivery of Compassionate Care: A Malawian Perspective

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Open Journal of Nursing 2018年第12期8卷 889-904页

作者： Gladys Msiska Andrew Simwaka Berlington Munkhondya Ezereth Kabuluzi Tiwonge ethel Munkhondya Kamuzu College of Nursing The University of Malawi Lilongwe Malawi

Background/Objectives: Malawi is one of the countries in the world with the worst maternal mortality rate. In view of this, women are encouraged to deliver at a health facility assisted by a skilled birth attendant. However, this initiative can only be effective when health care workers manifest a professional demeanor which conveys care and compassion to patients/clients. The objective of the study was to foster the development of compassionate care among nurses/midwives working in selected maternal and child health care clinical settings. Methods: The study employed an action research (AR) approach. Focus group discussions (FGDs) were conducted with nurse/midwives from the selected health facilities. Purposive sampling was utilized to obtain the sample of participants to the eight FGDs and thematic analysis was used to analyze the data. Results: The data collected from nurses/midwives clearly indicate that it is not possible to effectively render compassionate care under the present work conditions. The study reveals the following factors which hinder the delivery of compassionate care: severe nursing shortages, gross lack of essential supplies and equipment, negative attitudes of nurses/midwives and unsupportive leadership which demotivates nurses/midwives. Conclusion: The study reveals problems which hinder the delivery of compassionate care, and there is need to address these problems. This will enhance the effectiveness of hospital delivery by a skilled birth attendant as a safe motherhood initiative aimed at lowering the high maternal mortality rate.

关键词： Compassion Compassionate Care Nursing/Midwifery Practice Action Research