Managing university records and documents in the world of governance, audit and risk: Case studies from South Africa and Malawi

There are enormous benefits for any organisation from practising sound records management. In the context of a public university, the importance of good records management includes: facilitating the achievement the university’s mandate; enhancing efficiency of the university; maintaining a reliable institutional memory; promoting trust; responding to an audit culture; enhancing university competitiveness; supporting the university’s fiduciary duty; demonstrating transparency and accountability; and fighting corruption. Records scholars and commentators posit that effective recordkeeping is an essential underpinning of good governance. Although there is a portrayal of positive correlation, recordkeeping struggles to get the same attention as that given to the governance. Evidence abounds of cases of neglect of recordkeeping in universities and other institutions in Sub-Saharan Africa. The apparent absence of sound recordkeeping provided a rationale for revisiting some universities in South Africa and Malawi in order to critically explore the place of recordkeeping in an organisation’s strategy in order to develop an alternative framework for managing records and documents in an era where good governance is a global agenda. The research is a collective case study in which multiple cases are used to critically explore the relationship between recordkeeping and governance. As qualitative research that belongs in the interpretive tradition of enquiry, it is not meant to suggest prescriptive solutions to general recordkeeping problems but rather to provide an understanding of the challenges and opportunities that arise in managing records and documents in the world of governance, audit and risk. That is: what goes on in the workplace; what are the problems; and what alternative approaches might address any existing problem situations. Research findings show that some institutions are making good use of their governance structures and other drivers for recordkeeping to put in place sound recordkeeping systems. Key governance structures and other drivers for recordkeeping identified include: laws and regulations; governing bodies; audit; risk; technology; reforms; and workplace culture. Other institutions are not managing their records and documents well despite efforts to improve their governance systems. They lack recordkeeping capacity. Areas that determine recordkeeping capacity include: availability of records management policy; capacity for digital records; availability of a records management unit; senior management support; level of education and training of records management staff; and systems and procedures for storage, retrieval and dispositions of records. Although this research reveals that the overall recordkeeping in the selected countries has slightly improved compared with the situation other researchers found a decade ago, it remains unsatisfactory and disjointed from governance. The study therefore proposes governance recordkeeping as an approach to managing records and documents in the world of governance, audit and risk. The governance recordkeeping viewpoint considers recordkeeping as a governance function that should be treated in the same manner as other governance functions such as audit and risk management. Additionally, recordkeeping and governance should be considered as symbiotic elements of a strategy. A strategy that neglects recordkeeping may not fulfil the organisation’s objectives effectively.

Lifestyle factors, adiposity and cardiometabolic risk factors in South Asian women living in Scotland

South Asians migrating to the Western world have a 3 to 5-fold higher risk of developing type 2 diabetes and double the risk of cardiovascular disease (CVD) than the background population of White European descent, without exhibiting a proportional higher prevalence of conventional cardiometabolic risk factors. Notably, women of South Asian descent are more likely to be diagnosed with type 2 diabetes as they grow older compared with South Asian men and, in addition, they have lost the cardio-protective effects of being females. Despite South Asian women in Western countries being a high risk group for developing future type 2 diabetes and CVD, they have been largely overlooked. The aims of this thesis were to compare lifestyle factors, body composition and cardiometabolic risk factors in healthy South Asian and European women who reside in Scotland, to examine whether ethnicity modifies the associations between modifiable environmental factors and cardiometabolic risks and to assess whether vascular reactivity is altered by ethnicity or other conventional and novel CVD risks. I conducted a cross-sectional study and recruited 92 women of South Asian and 87 women of White European descent without diagnosed diabetes or CVD. Women on hormone replacement therapy or hormonal contraceptives were excluded too. Age and body mass index (BMI) did not differ between the two ethnic groups. Physical activity was assessed and with self-reported questionnaires and objectively with the use of accelerometers. Cardiorespiratory fitness was quantified with the predicted maximal oxygen uptake (VO2 max) during a submaximal test (Chester step test). Body composition was assessed with skinfolds measured at seven body sites, five body circumferences, measurement of abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) with the use of magnetic resonance imaging (MRI) and liver fat with the use MR spectroscopy. Dietary density was assessed with food frequency questionnaires. Vascular response was assessed by measuring the response to acetylcholine and sodium nitroprusside with the use of Laser Doppler Imaging with Iontophoresis (LDI-ION) and the response to shear stress with the use of Peripheral Arterial Tonometry (EndoPAT). The South Asian women exhibited a metabolic profile consistent with the insulin resistant phenotype, characterised by greater levels of fasting insulin, lower levels of high density lipoprotein (HDL) and higher levels of triglycerides (TG) compared with their European counterparts. In addition, the South Asians had greater levels of glycated haemoglobin (HbA1c) for any given level of fasting glucose. The South Asian women engaged less time weekly with moderate to vigorous physical activity (MVPA) and had lower levels of cardiorespiratory fitness for any given level of physical activity than the women of White descent. In addition, they accumulated more fat centrally for any given BMI. Notably, the South Asians had equivalent SAT with the European women but greater VAT and hepatic fat for any given BMI. Dietary density did not differ among the groups. Increasing central adiposity had the largest effect on insulin resistance in both ethic groups compared with physical inactivity or decreased cardiorespiratory fitness. Interestingly, ethnicity modified the association between central adiposity and insulin resistance index with a similar increase in central adiposity having a substantially larger effect on insulin resistance index in the South Asian women than in the Europeans. I subsequently examined whether ethnic specific thresholds are required for lifestyle modifications and demonstrated that South Asian women need to engage with MVPA for around 195 min.week-1 in order to equate their cardiometabolic risk with that of the Europeans exercising 150 min.week-1. In addition, lower thresholds of abdominal adiposity and BMI should apply for the South Asians compared with the conventional thresholds. Although the South Asians displayed an adverse metabolic profile, vascular reactivity measured with both methods did not differ among the two groups. An additional finding was that menopausal women with hot flushing of both ethnic groups showed a paradoxical vascular profile with enhanced skin perfusion (measured with LDI-ION) but decreased reactive hyperaemia index (measured with EndoPAT) compared with asymptomatic menopausal women. The latter association was independent of conventional CVD risk factors. To conclude, South Asian women without overt disease who live in Scotland display an adverse metabolic profile with steeper associations between lifestyle risk factors and adverse cardiometabolic outcomes compared with their White counterparts. Further work in exploring ethnic specific thresholds in lifestyle interventions or in disease diagnosis is warranted.