Applicability of the doctrine of Res Ipsa Loquitur in medical negligence in Nigeria

Medical negligence or malpractice is a recurrent challenge in the field of medical practice. This occurs as a result of failure to exercise due diligence in the acts or omissions of medical practitioners while discharging their duties in the treatment and care of their patients. Before a patient can obtain damages from the medical practitioner/doctor or hospital (defendant) for injury suffered, he has to prove that the defendant’s negligence is the cause of the injury. However, majority of medical negligence/malpractice cases are difficult to prove by the plaintiff, hence, the latter relies on the doctrine of Res Ipsa Loquitur which shifts the onus of proof to the defendant. Thus, this paper examines the elements of negligence in tort; and medical negligence; the concepts of vicarious liability, occupier’s liability, contributory negligence; and the principle of Res Ipsa Loquitur and its elements. It further discusses the synergy between Res Ipsa Loquitur and medical negligence; and finally concludes by making few recommendations.Keywords: Medical Negligence/Malpractice, Duty of Care, Breach of Duty, Damages, Res Ipsa Loquitur, Nigeri

Transient flow modelling of carbon dioxide (CO2) injection into depleted gas fields

The internationally agreed global climate deal reached at the Paris Climate Conference in 2015 is intended to limit the increase in global average temperatures to ‘well below’ 2°C above pre-industrial levels. This comes in addition to the European Union ambition for 80% to 95% reduction in the 1990 greenhouse gas emissions by 2050 in order to avoid dangerous climate change. Most scenario studies indicate that Carbon Capture and Storage (CCS) is essential for achieving such ambitious reductions. In CCS operations, depleted gas fields represent prime targets for large-scale storage of the captured CO2. Considering the relatively low wellhead pressure of such fields, the uncontrolled injection of the high-pressure dense phase CO2 will result in its rapid, quasi-adiabatic Joule-Thomson expansion leading to significant temperature drops. This could pose several risks, including blockage due to hydrate and ice formation following contact of the cold sub-zero CO2 with the interstitial water around the wellbore and the formation water in the perforations at the near well zone, thermal stress shocking and fracture of the wellbore casing steel and over-pressurisation accompanied by CO2 backflow into the injection system due to the violent evaporation of the superheated liquid CO2 upon entry into the wellbore. In order to minimise the above risks and develop best-practice guidelines for the injection of CO2, the accurate prediction of the CO2 pressure and temperature along the well during the injection process is of paramount importance. This thesis deals with the development and verification of a Homogeneous Equilibrium Mixture (HEM) model and a Homogenous Equilibrium Relaxation Mixture (HERM) model for simulating the transient flow phenomena taking place during the injection of dense phase CO2 into depleted gas fields. The HEM model assumes instantaneous interface mass, momentum and energy exchange between the constituent CO2 liquid and vapour phases. As such they remain at the same pressure, temperature and velocity, whence the corresponding fluid-flow may be described using a single set of mass, momentum and energy conservation equations. The HERM on the other hand presents an additional equation which accounts for the thermodynamic non-equilibrium thorough the introduction of a relaxation time. It also accounts for phase and flow dependent fluid/wall friction and heat transfer, variable well cross sectional area as well as deviation of the well from the vertical. At the well inlet, the opening of the upstream flow regulator valve is modelled as an isenthalpic expansion process; whilst at the well outlet, a formation-specific pressure-mass flow rate correlation is adopted to characterise the storage site injectivity. The testing of the models is based on their application to CO2 injection into the depleted 2582 m deep Goldeneye Gas Reservoir at Hewett field in the North Sea for which the required design and operational data are publically available. Varying injection scenarios involving the rapid (5 mins), medium (30 mins) and slow (2 hrs) linear ramping up of the injected CO2 flow rate to the peak nominal value of 33.5 kg/s are simulated. In each case, the simulated pressure and temperature transients at the top and bottom of the well are used to ascertain the risks of well-bore thermal shocking or interstitial ice formation leading to well blockage due to the rapid cooling of the CO2. Detailed sensitivity analysis of the most important parameters affecting the CO2 in-well flow behaviour, including the wellbore diameter variations, well inclination, upstream temperature, pressure and time variant injection mass flow rate are conducted. The simulation results obtained for a slow (2 hrs) flowrate ramp-up case using the HEM model produce a minimum wellhead temperature of - 11 oC. The corresponding minimum temperature using the HERM model on the other hand is - 21 oC, demonstrating the importance of accounting for non-equilibrium effects and the model’s usefulness as a tool for the development of optimal injection strategies for minimising the risks associated with the injection of CO2 into depleted gas fields

Jet Fire Analysis of Highly Flammable Hydrocarbons Part I: High Pressure Natural Gas Transportation

This study is based on the analysis of predicted jet fire occurrence following the puncture or rupture of a high pressure natural gas pipeline. A case study of high pressure pipeline transporting natural gas at 8.9 MPa (89 bar) with pipeline diameter of 720 mm (0.72 m), and assumed puncture sizes of 0.1 m, 0.2 m and 0.3 m and a full bore rupture (FBR) are considered. The severity of a jet fire is dependent on the puncture size, flame length and its impingement on nearby equipment, accompanied heat fluxes and the distance between flame zone and target (humans/equipment). Research has shown that 6.3 kW/m2 is the maximum bearable heat flux recommended for humans, buildings and other facilities. As such it is recommended that a safe distance be maintained between the pipeline facility and humans/equipment based on this bearable heat flux. Applying a modified Chamberlin’s jet fire model, the results obtained from this analysis showed that for puncture sizes of 0.1 m, 0.2 m, 0.3 m and FBR, the minimum safe distances to receive 6.3 kW/m2 heat radiations are 38.5 m, 60 m, 79.5 m and 95.5 m respectively. However, a highly busy major road with residential houses is 10 m away from our case study pipeline. Therefore, calculating the heat fluxes based on that distance for puncture sizes of 0.1 m, 0.2 m, 0.3 m and FBR. The results were 104.05 kW/m2, 288.91 kW/m2, 395.39 kW/m2 and 593.09 kW/m2 respectively. Keywords: heat flux, jet fire, natural gas, pipeline, safe distanc

Traditional healers' perceptions of the integration of their practices. into the South African national health system.

Thesis (M.A.)-University of Natal, Pietermaritzburg, 2000.This study was aimed at identifying and exploring the perceptions of traditional healers particularly izangoma and izinyanga, on the integration of their practices into the South African National Health System. The main reason behind this research was to establish the position of traditional healers as well as to study their opinions on the issue of integration. The paucity of previous research studies on the 'perceptions of traditional healers on the integration of their practice-s into the national health care system, was the main motivation behind this study. Participants were drawn from the Pietermaritzburg area and selection was based on purposeful sampling. The data of the study was collected by means of semi-structured interviews, which employed open- ended questions. This study was conceptualized within the African world-view and cosmology. The interactive model design by Maxwell (1996) was employed in the design of this study. According to this model the purpose, conceptual context, research questions and methods as well as issues of validity and reliability, are all essential for the coherence of any qualitative study. The ethical considerations of this study were mainly around the issue of informed consent, and this was negotiated and discussed with the participants until they could understand the process of consent. The results of the study reflect the fact that traditional healers are positive about the process of integration. However, the participants were in favol of integration as a process of collaboration and co-operation as opposed to total integration, which was perceived as a process in which one system w0ll-Id dominate and oppress the other. The participants in this study perceive themselves as equal to their western counterparts because oftheir training and ability to treat "spiritual illnesses". Further, they view their role as that of providing alternative healing as well as acting as a medium between people and their ancestors. Education and negotiations were identified as the possible solutions to most problems in the process of integration. The findings of this study further reveal that there is mistrust and suspicion about western healers form traditional healers. As a result of this, improved collaboration between traditional and modem health care systems seems to be the only process, which could benefit all the people of the country

Genetic variation between and within six selected South African sheep breeds using random amplified polymorphic DNA and protein markers

Dissertation submitted in partial fulfilment of the requirements for the degree of MASTERS OF SCIENCE IN ANIMAL PRODUCTION DEPARTMENT OF AGRICULTURE FACULTY OF SCIENCE AND AGRICULTURE UNIVERSITY OF ZULULAND, 2011.Six South Africa sheep breeds comprised of indigenous, imported and locally developed sheep were sampled. These breeds include Nguni sheep (Zulu, Swazi and Pedi), South African Merino, Damara and Dorper. Nguni goats were used as an out group. The first objective of this study was to determine the intra and inter-population genetic relationships among six South African (SA) sheep breeds using random amplified polymorphic DNA (RAPD) and protein markers. The second objective was to compare the efficiency between RAPD and protein markers in assessing the genetic variation. The Nei‟s genetic distance produced by the RAPD analysis ranged from 0.0430 – 0.1193 for the six selected sheep breeds. The results indicated that Zulu and Swazi breeds were the most genetically identical with a genetic distance of 0.0430. The second closest sheep breeds were the SA Merino and Damara with a genetic distance of 0.0595. The Pedi was related to the Dorper sheep breed with a genetic distance of 0.0814. The greatest genetic distance was between the Pedi and the SA Merino (0.1193) indicating that these two breeds are relatively distant from one another. Genetic identity was the largest (0.9579) between Swazi and Zulu breeds, followed by 0.9423 between SA Merino and Damara breeds. On the UPGMA dendogram the Zulu sheep formed a cluster with the Swazi sheep and the Damara clustered with the SA Merino. The Nguni goats did not cluster with the sheep breeds. The degree of genetic similarity within the sheep breeds ranged from 66.48 - 88.48 percent. The relationship within the Zulu sheep breed was 72.77%, Pedi 70.76%, Dorper 75.38% and Damara 83.24%. The Swazi sheep breed demonstrated the lowest percentage (66.48%) of genetic similarities between the individuals. On the other hand, the SA Merino breed with 88.48% showed the highest percentage of genetic similarity. When using the iso-enzymes of transferrin, the Damara and SA Merino formed a cluster with a genetic similarity of 97.13%. Just as in the RAPD results, the Pedi did not form a cluster with other Nguni sheep. The transferrin profile was able to characterise the Nguni goats as an out group species. The dendogram constructed using the data of the protein profile could not differentiate clearly between the sheep breeds and the Nguni goats. It can be concluded that although genetic relationships exist, the genetic distances vary among the six sheep breeds. The RAPD analysis demonstrated that these breeds can be treated differently. The genetic variation gave an indication that some breeds such as South African Merino are more uniform. The study showed that the RAPD markers can be used as a tool to estimate the genetic diversity and phylogenetic relationships among breeds of sheep. However, the protein markers must be used with caution. It is recommended that more research should be done to determine the genetic origin of the three Nguni sheep breeds (Zulu, Swazi and Pedi).National Research Fund (NRF

COVID-19-Related Testing, Knowledge and Behaviors among Severe and Chronic Non-Communicable Disease Patients in Neno District, Malawi: A Prospective Cohort Study

COVID-19-related knowledge and behaviors remain essential for controlling the spread of disease, especially among vulnerable patients with advanced, chronic diseases. We prospectively assessed changes over 11 months in COVID-19-related testing, knowledge, and behaviors among patients with non-communicable diseases in rural Malawi using four rounds of telephone interviews between November 2020 to October 2021. The most commonly reported COVID-19-related risks among patients included visiting health facilities (35–49%), attending mass gatherings (33–36%), and travelling outside the district (14–19%). Patients reporting having experienced COVID-like symptoms increased from 30% in December 2020 to 41% in October 2021. However, only 13% of patients had ever received a COVID-19 test by the end of the study period. Respondents answered 67–70% of the COVID-19 knowledge questions correctly, with no significant changes over time. Hand washing, wearing face masks and maintaining a safe distance were the most frequently reported strategies to prevent the spreading of COVID-19. Wearing face masks significantly improved over time (p < 0.001). Although the majority reported accurate knowledge about COVID-19 and enhanced adherence to infection prevention measures over time, patients commonly visited locations where they could be exposed to COVID-19. Government and other stakeholders should increase COVID-19 testing accessibility to primary and secondary facilities

Prevalence and correlates of internalized stigma among adults with HIV and major depressive disorder in rural Malawi

Internalized stigma is common among individuals with sexually transmitted infections such as HIV and among those with mental health conditions such as major depressive disorder (MDD). As part of a cluster randomized trial, we investigated the prevalence and correlates of internalized stigma among adults living with comorbid HIV and MDD in rural Malawi (n = 339). We found heightened stigma toward HIV and mental illness among those in the cohort: more than half of respondents (54%) endorsed negative perceptions associated with each health condition. Internalized HIV-related stigma was higher among those with no education (p = 0.04), younger adults (p = 0.03), and those with less social support (p = 0.001). Mental illness-related stigma was elevated among those with no source of income (p = 0.001), and it was also strongly associated with HIV-related stigma (p < 0.001). Our findings highlight potential avenues for reducing internalized stigma associated with high-prevalence health conditions in Malawi.Trial registration: ClinicalTrials.gov identifier: NCT04777006

Synthesis and Characterization of Nanosized Graphene and Conductive Polymers (Polyaniline) using some Ionic Liquids and Conventional Solvents

MSc (Chemistry), North-West University, Mafikeng Campus, 2013The graphene/polyaniline nanocomposites were synthesized in four different imidazolium based ionic liquids (1-butyl-2,3-dimethylimidazolium tetrafluoroborate, 1-butyl-3-methylimidazolium tetrafluoroborate' l-butyl-3-methylimidazolium hexafluorophosphate, and l-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl) imide) as well as in five organic conventional solvents (toluene, acetone, tetrahydrofuran, dimethylsulphoxide, and dimethylchloride). Polyaniline was crafted on the surface of graphene oxide resulting in graphene oxide/polyaniline nanocomposites which were later reduced into graphene/polyaniline nanocomposites. The graphene/polyaniline composites were characterized using Scanning Electron Microscopy (SEM), Energy Dispersive Spectroscopy (EDS), Fourier Transform Infrared Spectroscopy (FTIR), Ultraviolet Spectroscopy (UV-Vis), X-Ray Diffractometry (XRD) and Thermogravimetric analysis (TGA). The SEM micrographs of composites synthesized in ionic liquids showed that the Polyaniline (PANI) nanofibers were nucleated and agglomerated in between the graphene sheets, while the PANI in composites synthesized in organic liquids formed slippery flakes in between the graphene (GR) sheets. The XRD distinctively identified the crystalline structures for GR/PANI nanocomposites synthesized in both ionic liquids and conventional solvents. The crystalline sizes ranged between 89-950 nm and 29-250 nm for composites synthesized in ionic liquids and organic solvents respectively. The FTIR and UY-Vis results shown that graphene was incorporated into the graphene/polyaniline nanocomposite structures. EDS and TGA depict that the graphene/polyaniline nanocomposites synthesized in the presence of ionic liquids have similar properties to those synthesized in organic solvents. Hence, this method could be employed to produce graphene based conducting polymer nanocomposites as a measure of producing materials in environmentally benign conditions.Master