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Sickle Cell Disease Education and Screening in Kenya

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Sickle Cell Disease (SCD) is a prevalent genetic disease in Africa, and specifically in Kenya. The lack of available relevant disease education and screening mean that most don't understand the importance of getting testing and many children die before they

Sickle Cell Disease (SCD) is a prevalent genetic disease in Africa, and specifically in Kenya. The lack of available relevant disease education and screening mean that most don't understand the importance of getting testing and many children die before they can get prophylactic care. This project was designed to address the lack of knowledge with supplemental educational materials to be partnered with an engineering capstone project that provides a low cost diagnostic test.

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2014-05

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A novel, low-cost viral load diagnostic for HIV-1 and assessing barriers to adoption of technology in Tanzania

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HIV/AIDS is the sixth leading cause of death worldwide and the leading cause of death among women of reproductive age living in low-income countries. Clinicians in industrialized nations monitor the efficacy of antiretroviral drugs and HIV disease progression with the

HIV/AIDS is the sixth leading cause of death worldwide and the leading cause of death among women of reproductive age living in low-income countries. Clinicians in industrialized nations monitor the efficacy of antiretroviral drugs and HIV disease progression with the HIV-1 viral load assay, which measures the copy number of HIV-1 RNA in blood. However, viral load assays are not widely available in sub-Saharan Africa and cost between 50-$139 USD per test on average where available. To address this problem, a mixed-methods approach was undertaken to design a novel and inexpensive viral load diagnostic for HIV-1 and to evaluate barriers to its adoption in a developing country. The assay was produced based on loop-mediated isothermal amplification (LAMP). Blood samples from twenty-one individuals were spiked with varying concentrations of HIV-1 RNA to evaluate the sensitivity and specificity of LAMP. Under isothermal conditions, LAMP was performed with an initial reverse-transcription step (RT-LAMP) and primers designed for HIV-1 subtype C. Each reaction generated up to a few billion copies of target DNA within an hour. Presence of target was detected through naked-eye observation of a fluorescent indicator and verified by DNA gel electrophoresis and real-time fluorescence. The assay successfully detected the presence of HIV in samples with a broad range of HIV RNA concentration, from over 120,000 copies/reaction to 120 copies/reaction. In order to better understand barriers to adoption of LAMP in developing countries, a feasibility study was undertaken in Tanzania, a low-income country facing significant problems in healthcare. Medical professionals in Northern Tanzania were surveyed for feedback regarding perspectives of current HIV assays, patient treatment strategies, availability of treatment, treatment priorities, HIV transmission, and barriers to adoption of the HIV-1 LAMP assay. The majority of medical providers surveyed indicated that the proposed LAMP assay is too expensive for their patient populations. Significant gender differences were observed in response to some survey questions. Female medical providers were more likely to cite stigma as a source problem of the HIV epidemic than male medical providers while males were more likely to cite lack of education as a source problem than female medical providers.

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2011

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Schooling experiences and perceptions of resettled sub-Saharan African refugee middle school students in a southwest U.S. state

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ABSTRACT This study examined the schooling experiences and perceptions of resettled sub-Saharan African middle school refugee students in a metropolitan area of the United States Southwest. The research questions underpinning this study included: What are the schooling experiences and perceptions

ABSTRACT This study examined the schooling experiences and perceptions of resettled sub-Saharan African middle school refugee students in a metropolitan area of the United States Southwest. The research questions underpinning this study included: What are the schooling experiences and perceptions of resettled sub-Saharan African middle school refugee students in a southwestern U.S. state? 1a) How do they view their relationships with their teachers and peers? 1b) Can they identify a teacher or school staff member in their school community who is a significant resource for them? and 1c) What factors contribute to their challenges and successes in their school community? This qualitative study documented and analyzed the schooling experiences and perceptions of resettled refugee middle school students, who are relatively new to the U.S. educational system. Purposive and convenience sampling were sources utilized in selecting participants for this study. Semi-structured interviews and focus groups were used to capture the stories of 10 resettled sub-Saharan African refugee students enrolled in 7th and 8th grade, who have lived in the U.S. not more than 10 years and not less than three years. Among the participants, half were male and half female. They came from six countries: Burundi, Democratic Republic of Congo, Liberia, Rwanda, Sierra Leone and Somalia. Findings of the study revealed six major themes: teachers' helpfulness, positive perceptions of school, friends as resources at school, disruptive students in the classroom, need for better teachers, and before and after school activities. Overall, the participants in the study expressed a positive perception of their teachers and their schools, yet presented a dichotomous view of their schooling experiences and perceptions.

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2012

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Zooarchaeological and taphonomic analyses of Pleistocene vertebrate fauna from the Middle and Later Stone Age occupations at Contrebandiers Cave, Atlantic coast, Morocco

Description

This dissertation research describes the hunting behavior of early modern humans through the analysis of vertebrate faunal remains from Contrebandiers Cave, Morocco. Contrebandiers Cave is located in the town of Témara and is roughly 250 meters from the current shoreline

This dissertation research describes the hunting behavior of early modern humans through the analysis of vertebrate faunal remains from Contrebandiers Cave, Morocco. Contrebandiers Cave is located in the town of Témara and is roughly 250 meters from the current shoreline of the Atlantic Ocean. The cave was excavated in the 1950s and 1970s by l’Abbé Roche, and again starting in 2007 by Dibble and El Hajraoui with total station plotting of finds. Contrebandiers Cave contains Middle Stone Age (MSA) deposits dated to Marine Isotope Stages (MIS) 5e, 5d and 5c, ~120,000 to ~96,000 years ago. The Later Stone Age (LSA) deposits are dated to MIS 2, ~20,000 years ago. The entirety of the ~12,000 vertebrate faunal remains from Dibble and El Hajraoui’s excavation were analyzed for taxonomic and taphonomic identification.

A total of 67 vertebrate taxa were identified and include ungulates, carnivores, lagomorphs, birds, tortoises, snakes and fish. The faunal remains from Contrebandiers Cave preserve surface modification that indicates both humans and carnivores acted as agents of prey accumulation. Skeletal element representation and surface modification of ungulate remains suggest that humans had primary access to small, medium and large-bodied prey. In the MSA levels, carnivore skeletal remains preserve surface modification that is interpreted as being indicative of behavior associated with skinning for fur removal.

The vertebrate faunal remains from MIS 5e and 5d indicate that humans were hunting grazers and mixed feeders from open habitats and suids from mixed habitats. The faunal remains from MIS 5c indicate that humans focused less on suids and more on mixed feeders from open habitats. The vertebrate faunal remains from MIS 2 reveal humans hunting grazers from dry, open habitats. This research provides a description of human hunting behavior in North Africa, and contributes to our understanding of early modern human behavior prior to dispersal out of Africa.

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2018

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Stable isotope analysis of archaeological and modern micromammals from the Greater Cape Floristic Region near Pinnacle Point, on the south coast of South Africa

Description

The Middle Stone Age archaeological record from the south coast of South Africa contains significant evidence for early modern human behavior. The south coast is within the modern Greater Cape Floristic Region (GCFR), which in the present-day encompasses the entirety

The Middle Stone Age archaeological record from the south coast of South Africa contains significant evidence for early modern human behavior. The south coast is within the modern Greater Cape Floristic Region (GCFR), which in the present-day encompasses the entirety of South Africa’s Winter Rainfall Zone (WRZ) and contains unique vegetation elements that have been hypothesized to be of high utility to hunter-gatherer populations. Extant paleoenvironmental proxy records for the Pleistocene in the region often indicate evidence for more open environments during the past than occur in the area in the present-day, while climate models suggest glacial presence of the WRZ that would support maintenance of C3-predominant GCFR vegetation.

These paleoenvironmental proxies sample past environments at geographic scales that are often regional. The GCFR flora is hyper-diverse, and glacial climate change-driven impacts on local vegetation could have been highly variable over relatively small geographic scales. Proxy records that are circumscribed in their geographic scale are thus key to our understanding of ancient environments at particular MSA archaeological localities.

Micromammal fossil teeth are now recognized as an abundant potential reservoir of paleoenvironmental proxy data at an extremely local scale. This study analyzed modern micromammal teeth obtained from raptor pellets at three locations on the south coast. Stable carbon isotope analysis indicates that the modern micromammals from the taxa sampled consume a wide range of δ13Cplant on the landscape when it is available, and thus stable carbon isotope analysis of micromammal teeth should act as a proxy for the range of available δ13Cdiet in a circumscribed area of vegetation.

Micromammal stable carbon isotope data obtained from specimens from one of the few well-dated MIS6-MIS5 sequences in the region (Pinnacle Point sites 13B, 30, and 9C). δ13Cenamel values for the taxa sampled indicate diets that are primarily C3, and there is almost no evidence for a dietary C4 grass component in any of the sampled specimens. This indicates that, at a minimum, pockets of C3 vegetation associated with the GCFR were likely available to hunter-gatherers at Pinnacle Point throughout the Middle and Late Pleistocene.

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2015

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NGOs in the global conservation movement: can they prevent extinction? : (African apes as an example)

Description

Development throughout the course of history has traditionally resulted in the demise of biodiversity. As humans strive to develop their daily livelihoods, it is often at the expense of nearby wildlife and the environment. Conservation non-governmental organizations (NGOs), among other

Development throughout the course of history has traditionally resulted in the demise of biodiversity. As humans strive to develop their daily livelihoods, it is often at the expense of nearby wildlife and the environment. Conservation non-governmental organizations (NGOs), among other actors in the global agenda, have blossomed in the past century with the realization that there is an immediate need for conservation action. Unlike government agencies, conservation NGOs have an independent, potentially more objective outlook on procedures and policies that would benefit certain regions or certain species the most. They often have national and international government support, in addition to the credibility and influencing power to sway policy decisions and participate in international agendas. The key to their success lies in the ability to balance conservation efforts with socioeconomic development efforts. One cannot occur without the other, but they must work in coordination. This study looks at the example of African Great Apes. Eight ape-focused NGOs and three unique case studies will be examined in order to describe the impact that NGOs have. Most of these NGOs have been able to build the capacity from an initial conservation agenda, to incorporating socioeconomic factors that benefit the development of local communities in addition to the apes and habitat they set out to influence. This being the case, initiatives by conservation NGOs could be the key to a sustainable future in which humans and biodiversity coexist harmoniously.

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2019

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Management of feeding and swallowing disorders in Malawi

Description

ABSTRACT

Malawi, as a low and middle income country (LMIC), with one of the lowest per capita gross domestic products, faces challenges in the provision of healthcare to its citizens. According to the Centers for Disease Control (CDC), leading causes

ABSTRACT

Malawi, as a low and middle income country (LMIC), with one of the lowest per capita gross domestic products, faces challenges in the provision of healthcare to its citizens. According to the Centers for Disease Control (CDC), leading causes of death include but are not limited to, lower respiratory disease, stroke, cancer, neonatal disorders, and nutritional deficiencies. Feeding and swallowing disorders can present as a symptom to any of these medical diagnoses. Currently, there are no known studies focusing on the service provision for feeding and swallowing disorders in Malawi.

This pilot study was designed to provide a baseline on how feeding and swallowing disorders are currently being provided for in an emerging country like Malawi. Malawian healthcare professionals who see patients with feeding and swallowing disorders completed a survey and interview pertaining to their personal demographics, caseload, opinions, experiences, and treatment recommendations regarding the management of swallowing disorders (dysphagia).

Results indicate a wide range of occupations (Otolaryngoloists, Rehabilitation Technicians, Audiology Technicians, and Nurses) are involved in feeding and swallowing care. Participants expressed a high obligation to provide services for feeding and swallowing disorders, as well as a high concern for their patients. Generally, participants expressed high confidence in their treatment abilities, which did not correspond to knowledge of treatment recommendations that meet U.S. standards of care. Specifically, there was no variation in treatment recommendations across severities and a general lack of resources and tools for assessing and treating dysphagia. Treatment recommendations tended to align with resources currently available in Malawi.

Implications for the utilization of NGOs (non-governmental organizations) and the education of healthcare providers on feeding and swallowing disorders in the social and cultural contexts of this country are discussed.

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Date Created
2018

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The decline of democracy: how the state uses control of food production to undermine free society

Description

This work explores the underlying dynamics of democracies in the context of underdevelopment, arguing that when society has not attained a substantial degree of economic independence from the state, it undermines democratic quality and stability. Economic underdevelopment and political oppression

This work explores the underlying dynamics of democracies in the context of underdevelopment, arguing that when society has not attained a substantial degree of economic independence from the state, it undermines democratic quality and stability. Economic underdevelopment and political oppression are mutually reinforcing, and both are rooted in the structure of the agriculture sector, the distribution of land, and the rural societies that emerge around this order. These systems produce persistent power imbalances that militate toward their continuance, encourage dependency, and foster the development of neopatrimonialism and corruption in the government, thereby weakening key pillars of democracy such as accountability and representativeness. Through historical analysis of a single case study, this dissertation demonstrates that while this is partly a result of actor choices at key points in time, it is highly influenced by structural constraints embedded in earlier time periods. I find that Ghana’s historical development from the colonial era to present day closely follows this trajectory.

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2019