List of Titles

Fundal pressure during the second stage of labour

- Hofmeyr, Georges Justus, Vogel, Joshua. P, Cuthbert, Anna, Singata, Mandisa

Authors: Hofmeyr, Georges Justus , Vogel, Joshua. P , Cuthbert, Anna , Singata, Mandisa
Date: 03-2017
Subjects: South Africa Pregnancy Computer File
Language: English
Type: text , article
Identifier: http://hdl.handle.net/11260/5766 , vital:44640 , https://DOI:10.1002/14651858.CD006067.pub3
Description: Background Fundal pressure during the second stage of labour (also known as the 'Kristeller manoeuvre') involves application of manual pressure to the uppermost part of the uterus directed towards the birth canal, in an attempt to assist spontaneous vaginal birth and avoid prolonged second stage orthe need for operative birth. Fundal pressure has also been applied using an inflatable belt. Fundal pressure is widely used, however methods of its use vary widely. Despite strongly held opinions in favour of and against the use of fundal pressure, there is limited evidence regarding its maternal and neonatal benefits and harms. There is a need for objective evaluation of the eGectiveness and safety of fundal pressure in the second stage of labour. Objectives To determine if fundal pressure is eGective in achieving spontaneous vaginal birth, and preventing prolonged second stage or the need for operative birth, and to explore maternal and neonatal adverse eGects related to fundal pressure. Search methods We searched Cochrane Pregnancy and Childbirth's Trials Register (30 November 2016) and reference lists of retrieved studies. Selection criteria Randomised and quasi-randomised controlled trials of fundal pressure (manual or by inflatable belt) versus no fundal pressure in women in the second stage of labour with singleton cephalic presentation. Data collection and analysis Two or more review authors independently assessed potential studies for inclusion and quality. We extracted data using a pre-designed form. We entered data into Review Manager 5 soAware and checked for accuracy. Main results Nine trials are included in this updated review. Five trials (3057 women) compared manual fundal pressure versus no fundal pressure. Four trials (891 women) compared fundal pressure by means of an inflatable belt versus no fundal pressure. It was not possible to blind women and staG to this intervention. We assessed two trials as being at high risk of attrition bias and another at high risk of reporting bias. All other trials were low or unclear for other risk of bias domains. Most of the trials had design limitations. Heterogeneity was high for the majority of outcomes. Manual fundal pressure versus no fundal pressure Manual fundal pressure was not associated with changes in: spontaneous vaginal birth within a specified time (risk ratio (RR) 0.96, 95% confidence interval (CI) 0.71 to 1.28; 120 women; 1 trial; very low-quality evidence), instrumental births (RR 3.28, 95% CI 0.14 to 79.65; 197 women; 1 trial), caesarean births (RR 1.10, 95% CI 0.07 to 17.27; 197 women; 1 trial), operative birth (average RR 0.66, 95% CI 0.12 to 3.55; 317 women; 2 studies; I2 = 43%; Tau2 = 0.71; very low-quality evidence), duration of second stage (mean diGerence (MD) -0.80 minutes, 95% CI -3.66 to 2.06 minutes; 194 women; 1 study; very low-quality evidence), low arterial cord pH in newborn babies (RR 1.07, 95% CI 0.72 to 1.58; 297 women; 2 trials; very low-quality evidence), or Apgar scores less than seven at five minutes (average RR 4.48, 95% CI 0.28 to 71.45; 2759 infants; 4 trials; I2 = 89%; Tau2 = 3.55; very low-quality evidence). More women who received manual fundal pressure had cervical tears than in the control group (RR 4.90, 95% CI 1.09 to 21.98; 295 women; 1 trial). No neonatal deaths occurred in either of the two studies reporting this outcome (very low-quality evidence). No trial reported the outcome severe maternal morbidity or death. Fundal pressure by inflatable belt versus no fundal pressure Fundal pressure by inflatable belt did not reduce the number of women havinginstrumental births (average RR 0.73, 95% CI 0.52 to 1.02; 891 women; 4 trials; I2 = 52%; Tau2 = 0.05) or operative births (average RR 0.62, 95% CI 0.38 to 1.01; 891 women; 4 trials; I2 = 78%; Tau2 = 0.14; very low-quality evidence). Heterogeneity was high for both outcomes. Duration of second stage was reported in two trials, which both showed that inflatable belts shortened duration of labour in nulliparous women (average MD -50.80 minutes, 95% CI -94.85 to -6.74 minutes; 253 women; 2 trials; I2 = 97%; Tau2 = 975.94; very low-quality evidence). No data on this outcome were available for multiparous women. The inflatable belt did not make any diGerence to rates of caesarean births (average RR 0.56, 95% CI 0.14 to 2.26; 891 women; 4 trials; I2 = 70%; Tau2 = 0.98), low arterial cord pHin newborn babies (RR 0.47, 95% CI 0.09 to 2.55; 461 infants; 1 trial; low-quality evidence), or Apgar scores less than seven atfive minutes (RR 4.62, 95% CI 0.22 to 95.68; 500 infants; 1 trial; very low-quality evidence). Third degree perinealtears were increased in the inflatable belt group (RR 15.69, 95% CI 2.10 to 117.02; 500 women; 1 trial). Spontaneous vaginal birth within a specified time, neonatal death, andsevere maternal morbidity or death were not reported in any trial. Authors' conclusions There is insuGicient evidence to draw conclusions on the beneficial or harmful eGects of fundal pressure, either manually or by inflatable belt. Fundal pressure by an inflatable belt during the second stage of labour may shorten duration of second stage for nulliparous women, and lower rates of operative birth. However, existing studies are small and their generalizability is uncertain. There is insuGicient evidence regarding safety for the baby. There is no evidence on the use of fundal pressure in specific clinical settings such as inability of the mother to bear down due to exhaustion or unconsciousness. There is currently insuGicient evidence for the routine use of fundal pressure by any method on women in the second stage of labour. Because of current widespread use of the procedure and the potential for use in settings where other methods of assisted birth are not available, further good quality trials are needed. Further evaluation in other groups of women (such as multiparous women) will also be required. Future research should describe in detail how fundal pressure was applied and consider safety of the unborn baby, perineal outcomes, longer-term maternal and infant outcomes and maternal satisfaction.
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Date Issued: 03-2017

Iodine nutrition status in Africa: Potentially high prevalence of iodine deficiency in pregnancy even in countries classified as iodine sufficient

- Charles Bitamazire Businge, Benjamin Longo-Mbenza, Andre Pascal Kengne

Authors: Charles Bitamazire Businge , Benjamin Longo-Mbenza , Andre Pascal Kengne
Date: 03-8-2020
Language: English
Type: text , article
Identifier: http://hdl.handle.net/11260/3377 , vital:43336 , https://www.cambridge.org/core/journals/public-health-nutrition/article/iodine-nutrition-status-in-africa-potentially-high-prevalence-of-iodine-deficiency-in-pregnancy-even-in-countries-classified-as-iodine-sufficient/B3DCB06E75CDDD8EAD410BE090198BA4
Description: Objective: To assess the burden of iodine deficiency in pregnancy in Africa using estimated pregnancy median urinary iodine concentration (pMUIC). Design: pMUIC for each African country was estimated using a regression equation derived by correlating the school-age children (SAC) median UIC (mUIC) and pMUIC from countries around the globe, and the SAC mUIC data for African countries obtained from the Iodine Global Network (IGN) 2017 and 2019 Score cards. Setting: Iodine deficiency was endemic in many African countries before the introduction of iodine fortification, mainly through universal salt iodisation programmes about 25 years ago. There is a scarcity of data on the level of iodine nutrition in pregnancy in Africa. Women living in settings with pMUIC below 150 μg/l are at risk of iodine deficiency-related pregnancy complications. Participants: Fifty of the fifty-five African countries that had data on iodine nutrition status. Results: A cut-off school age mUIC ≤ 175 μg/l is correlated with insufficient iodine intake in pregnancy (pregnancy mUIC ≤ 150 μg/l). Twenty-two African countries had SAC mUIC less than 175 μg/l, which correlated with insufficient iodine intake during pregnancy (pMUIC less than 150 μg/l). However, nine of these twenty-two countries had adequate iodine intake based on SAC mUIC. Conclusions: There is likely a high prevalence of insufficient iodine intake in pregnancy, including in some African countries classified as having adequate iodine intake in the general population. A SAC mUIC ≤ 175 μ
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Date Issued: 03-8-2020

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A Review of Arterial Stiffness and HIV Infection in Adult Africans

- Awotedu, Kofoworola Olajire, Iputo, Jehu

Authors: Awotedu, Kofoworola Olajire , Iputo, Jehu
Date: 09-06-2016
Language: English
Type: text , article
Identifier: http://hdl.handle.net/11260/3484 , vital:43615 , https://www.hilarispublisher.com/open-access/a-review-of-arterial-stiffness-and-hiv-infection-in-adult-africans-2167-1095-1000221.pdf
Description: Aim: To review the impact of the human immunodeficiency virus and antiretroviral therapy on the vasculature. Objectives: This review seeks to identify the burden which the human immunodeficiency virus and antiretroviral therapy have on the vasculature. Method: Medline/PubMed and Google scholar were searched. There were over 100 publications reviewed. Some people who worked in similar fields were also contacted. The present review summarized current understanding of Human immunodeficiency virus, antiretroviral therapy and effect on the vasculature such as arterial stiffness. Atherosclerosis, endothelial dysfunction, the strengths and weaknesses of current testing strategies, and their potential applications in clinical research and patient care. The association of inflammatory biomarkers, blood pressure and ageing with arterial stiffness were also reviewed. Conclusion: Available literature shows that HIV and antiretroviral agents have a great impact on the vasculature and its progression.
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Date Issued: 09-06-2016

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Medical Education in Decentralized Settings: How Medical Students Contribute to Health Care in 10 Sub-Saharan African Countries

- Talib, Zohray, van Schalkwyk, Susan, Cooper , I, Pattanaik , Swaha, Turay , Khadija, Sagay, Atiene S, Baingana , Rhona, Baird , Sarah, Gaede , Bernhard, Iputo, Jehu, Kibore , Minnie, Manongi , Rachel, Matsika , Antony, Mogodi , Mpho, Ramucesse , Jeremais, Ross, Heather, Simuyeba, Moses, Haile-Mariam, Damen

Authors: Talib, Zohray , van Schalkwyk, Susan , Cooper , I , Pattanaik , Swaha , Turay , Khadija , Sagay, Atiene S , Baingana , Rhona , Baird , Sarah , Gaede , Bernhard , Iputo, Jehu , Kibore , Minnie , Manongi , Rachel , Matsika , Antony , Mogodi , Mpho , Ramucesse , Jeremais , Ross, Heather , Simuyeba, Moses , Haile-Mariam, Damen
Date: 10-2017
Subjects: Sub Sahara Africa Medical Education Health Care Medical Students Computer File
Language: English
Type: text , article
Identifier: http://hdl.handle.net/11260/5786 , vital:44644 , https://doi:10.1097/ACM.0000000000002003
Description: Purpose: African medical schools are expanding, straining resources at tertiary health facilities. Decentralizing clinical training can alleviate this tension. This study assessed the impact of decentralized training and contribution of undergraduate medical students at health facilities. Method: Participants were from 11 Medical Education Partnership Initiative-funded medical schools in 10 African countries. Each school identified two clinical training sites-one rural and the other either peri-urban or urban. Qualitative and quantitative data collection tools were used to gather information about the sites, student activities, and staff perspectives between March 2015 and February 2016. Interviews with site staff were analyzed using a collaborative directed approach to content analysis, and frequencies were generated to describe site characteristics and student experiences. Results: The clinical sites varied in level of care but were similar in scope of clinical services and types of clinical and nonclinical student activities. Staff indicated that students have a positive effect on job satisfaction and workload. Respondents reported that students improved the work environment, institutional reputation, and introduced evidence-based approaches. Students also contributed to perceived improvements in quality of care, patient experience, and community outreach. Staff highlighted the need for resources to support students. Conclusions: Students were seen as valuable resources for health facilities. They strengthened health care quality by supporting overburdened staff and by bringing rigor and accountability into the work environment. As medical schools expand, especially in low-resource settings, mobilizing new and existing resources for decentralized clinical training could transform health facilities into vibrant service and learning environments.
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Date Issued: 10-2017

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Preserving trees

- Skead, C J (Cuthbert John)

Authors: Skead, C J (Cuthbert John)
Date: 1959-05-19
Subjects: Forest degradation -- South Africa -- East London , Deforestation -- South Africa -- East London , Trees -- South Africa -- Photographs , Fort Grey forest -- South Africa -- East London
Language: English
Type: article , text
Identifier: http://hdl.handle.net/10962/60387 , vital:27775 , This item is held by the Selmar Schonland Herbarium (GRA), Grahamstown, South Africa
Description: Article written by C. J. Skead to the East London Daily Dispatch (dated 19 May 1959), bringing attention to the deforestation of the Fort Grey forest by Mr C Miles Warren (MP). The article is acompanied by a harndwitten note stating "Mr C Miles Warren, M.P. had the contract for removing the forest and did very well out of it, especially with box-wood!! Hence the letter which would have [illegible] his consumers".
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Date Issued: 1959-05-19

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Composite polyester membranes with embedded dendrimer hosts and bimetallic Fe/Ni nanoparticles: synthesis, characterisation and application to water treatment

- Malinga, S P, Arotiba, O A, Mapolie, S F, Krause, Rui W M, Diallo, M S, Mamba, Bhekie B

Authors: Malinga, S P , Arotiba, O A , Mapolie, S F , Krause, Rui W M , Diallo, M S , Mamba, Bhekie B
Date: 1968
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/123619 , vital:35465 , https://doi.org/10.1007/s11051-013-1698-y
Description: This study describes the preparation, characterization and evaluation of new composite membranes with embedded dendrimer hosts and Fe/Ni nanoparticles. These new reactive membranes consist of films of cyclodextrin–poly(propyleneimine) dendrimers (β-CD–PPI) that are deposited onto commercial polysulfone microporous supports and crosslinked with trimesoyl chloride (TMC). The membranes were subsequently loaded with Fe/Ni nanoparticles and evaluated as separation/reactive media in aqueous solutions using 2,4,6-trichlorophenol as model pollutant. The morphology and physicochemical properties of the composite membranes were characterised using high-resolution transmission electron microscopy (HR-TEM), atomic force microscopy and measurements of contact angle, water intake, porosity and water permeability. The sorption capacity and catalytic activity of the membranes were evaluated using ion chromatography, atmospheric pressure chemical ionisation-mass spectrometry and UV–Vis spectroscopy (UV–Vis). The sizes of the embedded Fe/Ni nanoparticles in the membranes ranged from 40 to 66 nm as confirmed by HR-TEM. The reaction rates for the dechlorination of 2,4,6-trichlorophenol ranged from 0.00148 to 0.00250 min−1. In all cases, we found that the reaction by-products consisted of chloride ions and mixtures of compounds including phenol (m/z = 93), 2,4-dichlorophenol (m/z = 163) and 4-chlorophenol (m/z = 128). The overall results of this study suggest that β-CD–PPI dendrimers are promising building blocks for the synthesis of composite and reactive membranes for the efficient removal of chlorinated organic pollutants from water.
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Date Issued: 1968

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The Klinghardt phonolites, South West Africa: Tertiary volcanism in western southern Africa

- Marsh, Julian S, Lock, B E

Authors: Marsh, Julian S , Lock, B E
Date: 1975
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/70164 , vital:29627
Description: Over 1OO phonolite bodies of mid-Tertiary age occur in the Klinghardt Mountains, 1OO km SE of Luderitz in Southern South West Africa the only published account of these rocks is that of Kaiser (1926) who gives a generalized map and describes briefly the mode of occurrence and petrography of the phonolites. The phonolite bodies are concentrated in an area roughly 8OO km2 and constitute an excellent example of an areal volcanic field (Rittmann, 1962), i.e. the activity occurred at a number of vents spread over a wide area and in most cases only a single eruptive episode took place at each vent.
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Date Issued: 1975

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Distribution of Ca in highly fractionated peralkaline magmas

- Marsh, Julian S

Authors: Marsh, Julian S
Date: 1976
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/132974 , vital:36914 , https://doi.org/10.1016/0012-821X(76)90106-0
Description: Many peralkaline rhyolites and granites contain less than 0.15 wt.% CaO. In contrast, strongly fractionated peralkaline nepheline syenites and phonolites usually contain greater than 0.5 wt.% CaO. Consideration of known distributions of Ca between crystals and liquid in conjunction with crystal fractionation does not provide an adequate explanation of the contrasting levels of Ca depletion observed. Examination of the suites of late-crystallizing accessory phases in peralkaline rocks suggests that Ca is more soluble in undersaturated magmas than in over-saturated magmas. Activities for CaO in silicic and phonolitic rocks are calculated and the latter have higher CaO activities than the former and this may manifest itself in the different suites of accessory phases and levels of Ca depletion noted in natural rocks.
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Date Issued: 1976

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Farm labour in the Eastern Cape, 1950-1973:

- Antrobus, Geoffrey G

Authors: Antrobus, Geoffrey G
Date: 1976
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/142850 , vital:38123 , http://opensaldru.uct.ac.za/bitstream/handle/11090/465/1976_antrobus_sflcp20.pdf?sequence=1
Description: The purpose of this paper is to, survey the farm labour conditions in the Eastern Cape over approximately two decades and to note some of the conditions of service and the attitudes of employers, and the changes which have occurred in employment and wages paid. The main source for the latter period, and in particular 1973, is a farm labour survey conducted in conjunction with E.A. Thomson in the Eastern Cape. The survey relied entirely on the willingness of members of farm study groups and Farmers' Associations as well as interested individuals for its completion. Of the approximately 1020 pre-coded questionnaires which were posted to farmers throughout the Eastern Cape in June 1973, 303 were returned of which 299 were suitable for analysis.
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Date Issued: 1976

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Base-metal mineralization in alkaline pyroclastics: the Regenstein Vent, South West Africa

- Ferreira, C A M, Jacob, Roger E, Marsh, Julian S

Authors: Ferreira, C A M , Jacob, Roger E , Marsh, Julian S
Date: 1979
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/133220 , vital:36950 , https://hdl.handle.net/10520/AJA10120750_1123
Description: Geochemical analysis of soil samples taken from the area underlain by the Regenstein alkaline diatreme indicated potential areas for Pb-Zn-Ag mineralization, and these were subsequently proved by drilling. The pipelike body, emplaced into quartzites of the Damara Supergroup, consists of lithic and volcanic breccias. The breccias have been intruded, first by phonolite dykes, and then by numerous bodies of alkaline mafic and ultramafic rocks.
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Date Issued: 1979

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New chemical analyses of the Suurberg volcanic rocks and their significance in relation to Mesozoic volcanism in Southern Africa

- Marsh, Julian S, Lock, B E, Fuchter, W H

Authors: Marsh, Julian S , Lock, B E , Fuchter, W H
Date: 1979
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/133231 , vital:36951
Description: Volcanic rocks are found associated with several of the late Mesozoic basins of southern South Africa. Bentonites are known from Plettenberg Bay and, according to an unconfirmed report, they are also found in the Worcester Basin, while vitric tuffs have been recorded from east of Oudtshoorn. The most extensive occurrences, however, are those of the Suurberg Group, which crops out sporadically around the margins of the Algoa Basin.
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Date Issued: 1979

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