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Esophageal squamous cell cancer in a highly endemic region

World Journal of Gastroenterology 2016年第9期22卷 2811-2817页

作者： Akwi W Asombang violet kayamba Mpala M Lisulo Kathryn Trinkaus Victor Mudenda Edford Sinkala Stayner Mwanamakondo Themba Banda Rose Soko Paul Kelly Division of Gastroenterology and Hepatology University of Missouri School of Medicine Department of Internal Medicine University of Zambia School of Medicine University Teaching Hospital Tropical Gastroenterology and Nutrition Group University of Zambia School of Medicine University Teaching Hospital Washington University School of Medicine Biostatistics Shared Resource Siteman Cancer Center Department of Pathology University of Zambia School of Medicine Blizard Institute Barts and The London School of Medicine Queen Mary University of London

AIM: To identify risk factors associated with esophageal cancer in Zambia and association between dietary intake and urinary 8-iso prostaglandin F2α(8-iso PGF2α).METHODS: We conducted a prospective, case control study at the University Teaching Hospital. Subjects included both individuals admitted to the hospital and those presenting for an outpatient upper endoscopy. Esophageal cancer cases were compared to age and sex-matched controls. Cases were defined as patients with biopsy proven esophageal cancer; controls were defined as subjects without endoscopic evidence ofesophageal cancer. Clinical and dietary data were collected using a standard questionnaire, developed a priori. Blood was collected for human immunodeficiency virus(HIV) serology. Urine was collected, and 8-iso PGF2α was measured primarily by enzyme-linked immunosorbent assay and expressed as a ratio to ***: Forty five controls(mean age 54.2 ± 15.3, 31 male) and 27 cases(mean age 54.6 ± 16.4, 17 males) were studied. Body mass index was lower in cases(median 16.8) than controls(median 23.2), P = 0.01. Histopathologically, 25/27(93%) were squamous cell carcinoma and 2/27(7%) adenocarcinoma. More cases smoked cigarettes(OR = 11.24, 95%CI: 1.37-92.4, P = 0.02) but alcohol consumption and HIV seropositivity did not differ significantly(P = 0.14 for both). Fruit, vegetables and fish consumption did not differ significantly between groups(P = 0.11, 0.12, and 0.10, respectively). Mean isoprostane level was significantly higher in cases(0.03 ng/mg creatinine) than controls(0.01 ng/mg creatinine)(OR = 2.35, 95%CI: 1.19-4.65, P = 0.014).CONCLUSION: Smoking and isoprostane levels were significantly associated with esophageal cancer in Zambians, but diet, HIV status, and alcohol consumption were not.

关键词： Gastrointestinal cancer Non-communicable diseases Zambia

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Contextualisation of Early and Enhanced Clinical Exposure Model through Development of Curricula for Advanced Practice Nursing and Midwifery

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Open Journal of Nursing 2022年第7期12卷 525-536页

作者： Katowa-Mukwato Patricia Mwiinga-Kalusopa Victoria Maimbolwa Margaret Connie Kabinga-Makukula Marjorie kayamba violet Kafumukache Elliot Simuyemba Moses Musenge Emmanuel Mwiinga Christabel Linda Kampata Selestine H. Nzala Cosmas Zyaambo Trevor Kaile Goma Fastone School of Nursing Sciences University of Zambia Lusaka Zambia School of Medicine University of Zambia Lusaka Zambia School of Public Health University of Zambia Lusaka Zambia School of Medicine South Valley University Mazabuka Zambia School of Medicine and Health Sciences Eden University Lusaka Zambia

Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognized globally. This paper describes the process, which was undertaken by School of Nursing Sciences, University of Zambia in reviewing and developing advanced practice nursing and midwifery curricula which will be implemented using the Early and Enhanced Clinical Exposure model (EECE). Materials and Methods: The curricula development/review process utilized a modified Taba’s Model which followed a step-by-step approach including: 1) desk review, 2) diagnosis of needs (needs assessment), 3) stakeholder consultations, 4) content development, 5) validations and approval from which several lessons were learnt and recommendations made. Findings and recommendations from different stages were used as a basis for reviewing and developing advanced practice nursing and midwifery curricula. Results: Desk review needs assessment and stakeholder consultations identified both strengths and weaknesses in the existing curricula. Major strengths were duration and core courses which met the minimum requirement for postgraduate nursing and midwifery training. Major weaknesses/gaps included some content that was too basic for the master’s level and the delayed exposure to practicum sites which limited the development of advanced practice skills. Others were inadequate competence for advanced practice, inadequate research methodology course, lack of content to foster development of personal soft skills and predominant use of traditional teaching methods. Stakeholders recommended implementing advanced, clinical and hands-on Masters of Nursing and Midwifery programmes which resulted in the review of four existing and development of five demand-driven curricula. Conclusion: The reviewed and developed curricula were strengthened to close the identified gaps. Both the reviewed and d

关键词： Advanced Practice Nursing/Midwifery Curricula Development Early Enhanced Clinical Exposure Model

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Enhancing Evidence-Based Practice and Critical Thinking Skills of Nursing Students: Lessons from the Review of the Bachelor of Science in Nursing Curriculum of the University of Zambia

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Open Journal of Nursing 2022年第2期12卷 155-169页

作者： Mwiinga-Kalusopa Victoria Maimbolwa Margret Connie Wahila Ruth Katowa-Mukwato Patricia Vwalika Bellington Nzala Selestine Kabinga-Makukula Marjorie Chigunta Micheal Kampata Linda kayamba violet Kafumukache Elliot Simuyemba Moses Musenge Emmanuel Mwiinga Christabel Goma Fastone School of Nursing Sciences The University of Zambia Lusaka Zambia School of Medicine The University of Zambia Lusaka Zambia School of Public Health The University of Zambia Lusaka Zambia School of Medicine and Health Sciences Eden University Lusaka Zambia

Background: Making changes in the existing curriculum aims, objectives, course contents learning outcomes and assessment strategies have become a fact of life for nurse educators. Purpose: To enhance the existing Bachelor of Science (BSc) in nursing curriculum through integration of evidence-based practice (EBP) and teaching of critical thinking skills. Materials and Methods: A needs analysis was conducted using a five-phased approach to review the BSc in nursing Curriculum. Kern’s six-step model was adapted and introduced through a series of workshop exercises that highlighted the application of each step: 1) Desk review of the BSc curriculum offered globally;2) Administration of the needs assessment questionnaire to key informants;3) Strengths, weakness, opportunities and threat analysis;4) Consultative meeting with major stakeholders;5) Curriculum review. Results: The five-phased approach established some gaps in existing curricula, and identified critical core competences and best practices in integrating EPB and critical thinking in the BSc undergraduate curriculum and some “A” level content that was not in tandem with the practice of nurses. New courses were developed to support students in academic writing and enhance professionalism and duration of training was reduced from 5 to 4 years. Conclusion: The process demonstrated that BSc curriculum review, in fact, should be thoroughly scrutinized to encourage positive changes to the curriculum, provide opportunities for team building and the development of leadership skills and a whole-of course perspective on the curriculum.

关键词： Bachelor of Science Nursing Curriculum Evidence-Based Practice Critical Thinking Review

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