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Browsing Journals by Subject "African"

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    The afya bora fellowship in global health leadership: dual mentorship to strengthen the next generation of African health leaders
    (Annals of Global Health, 2015-02) Mashalla, Yohana J.
    Program/Project Purpose Mentorship is critical to develop effective leaders. The Afya Bora Fellowship in Global Health Leadership program, a consortium of four African and four U.S. universities formed in 2008, has incorporated a robust dual mentorship component into its training of over 70 fellows. Each Fellow was assigned two mentors to guide professional growth over the fellowship period. Here, we evaluate 39 Fellows’ experiences with their mentors between 2012 and 2014, and identify how these relationships prepare Fellows to lead major health programs in Botswana, Kenya, Tanzania, and Uganda. Structure/Method/Design As part of their 12-month training, Afya Bora Fellows participate in two 4.5 month experiential learning attachments in the African countries. The attachments take place at pre-accredited “attachment sites”, which include governmental (Ministries of Health) and non-governmental organizations (NGOs). Fellows were assigned a Primary Mentor, who is an academic member of the Fellowship Working Group, and a Site Mentor, who is a senior supervisor at the Fellow's attachment site. Mentors assist in providing support to each Fellow to achieve Fellowship objectives and personal goals, and to gain insight into the realities of building a successful career. Evaluations from the Fellows on both mentors were collected once after the first attachment site rotation (January) and again after the second rotation (June). Outcomes & Evaluation Content analysis of Fellow interview and journal data showed Fellows were positively impacted by their relationships with mentors. Key domains of mentor influence included relationship attributes (“friendship and support”), scientific knowledge and skills (“teaching/guiding me on how to conduct official research”), provision of feedback (“he gives constructive feedback to my work every time we meet”), career or other guidance (“she advised me to apply for a job...luckily I was taken for that position”), and professionalism (“keeps his word and time despite busy schedule”). Fellows reported some differences between Site and Primary Mentors. Primary Mentors were better able to provide emotional support for professional issues (“discussed culture shock/adjustment”) and encouragement for Fellows to go outside their comfort zone (“urged me to work tall and take up distinctive tasks...without fear/hesitation”). Site Mentors were better able to serve as an advocate for attachment site assignments (“prepared the ground for orientation, information, and technical assistance from her and other staff”). Going Forward Dual mentorship can provide a rich range of complementary skills and expertise that is valuable to Fellows, including modeling professional behaviors and teaching specific skills. This aspect of the Afya Bora Fellowship is of great value to participants and will continue for future cohorts. Funding The President's Emergency Program for AIDS Relief, Office of AIDS Research, and US Health Resources and Services Administration
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    Determinants of hyperleptinaemia in an African population.
    (East African medical journal, 2003-02-17) Mashalla, Yohana J.
    Objective: To examine the determinants for elevated plasma leptin concentration in normal weight (NW), obese (OB), and morbidly obese (MO) individuals in Tanzania. Design: Cross-sectional epidemiological study, the CARDIAC study. Setting: Three areas in Tanzania; Dar es Salaam, urban(U), Handeni, rural(R) and Monduli, pastoralists(P), in August 1998. Subjects: Five hundred and forty five participants from a random sample of 600 people aged 46-58 years. Main outcome measures: Plasma leptin concentrations, height, weight, body mass index (BMI), lipid profiles, haemoglobin Alc (HBA1c), and blood pressure (BP). Results: Plasma leptin concentrations were higher in women than in men (women; 16.0 ng/ mL, men; 3.1 ng/mL; p<0.0001). Women showed a higher mean body mass index (BMI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) than men. In both genders, plasma leptin concentration, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), systolic BP (SBP) and diastolic BP (DBP) were significantly higher in OB than in NW participants. MO women had significantly higher leptin concentration, SBP and DBP compared with the other two groups. In NW men, log leptin concentrations showed a direct correlation with weight, BMI, HBAlc, TC, LDL-C, TG, SBP and DBP (all p<0.0001 except TG; p<0.001), while among NW women and OB men, weight and BMI correlated positively with log leptin (all p<0.05). OB women observed a positive correlation between log leptin and weight, BMI and LDL-C. Regression analysis indicated that among NW subjects, gender, BMI and TC explained 53.9% of the variation in log leptin. In OB subjects, gender, BMI and LDL-C explained 51.7% of the variability in leptin levels. No relationship was found between log leptin and CVD risk factors among MO subjects. Conclusion: The most important determinants for hyperleptinaemia in NW participants were gender, BMI, TC, while in addition to these LDL-C, was an important determinant of leptin concentration in OB individuals. In MO women, the high leptin concentrations did not reflect the amount of adipose stores.