A normative study of the Raven's Coloured Progressive Matrices for South African children with cognitive barriers to learning
- Authors: August, Justin Oswin
- Date: 2017
- Subjects: Children -- Intelligence testing -- South Africa , Inclusive education -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19419 , vital:28869
- Description: With the changing landscape in South Africa to a full democracy, increased research has been undertaken in the psychometric field on local and national normative studies regarding various assessment measures. The Raven’s Coloured Progressive Matrices (CPM) is one of the measures that have already been extensively normed throughout the world for various population groups. In South Africa, local norms for normal populations of children have been developed by groups of researchers in the Grahamstown (Eastern Cape) as well as the Bloemfontein (Free State) areas. With a South African school educational system that focuses on Inclusive Education, there is a growing need for mainstream schools to identify learners who are at risk for learning disabilities in order to develop appropriate supportive intervention plans. The research aimed to establish psychometric normative screening data based on the Raven’s CPM, and to compare these with the established and published international and local Raven’s CPM norms. In addition, the researcher developed pilot classification scores for the early screening and detection of at risk learners in order to encourage the potential role and use of the Raven’s CPM in the identification of cognitive learning barriers. The sample consisted of 388 primary school learners identified as having cognitive barriers to learning. Archival data was used that was gathered from a Psychological clinic that provided screening services to schools in the Nelson Mandela Metropolitan area. The results of the study indicated that there was a proportional relationship between age and test performance. Gender differences were found where the males in this study outperformed the females. There was a significant difference in the Raven’s CPM test performance with respect to the grade levels of the learners. The study developed a special set of norms with cognitive classification scores that will aid in the early identification of learning disabilities.
- Full Text:
- Date Issued: 2017
- Authors: August, Justin Oswin
- Date: 2017
- Subjects: Children -- Intelligence testing -- South Africa , Inclusive education -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19419 , vital:28869
- Description: With the changing landscape in South Africa to a full democracy, increased research has been undertaken in the psychometric field on local and national normative studies regarding various assessment measures. The Raven’s Coloured Progressive Matrices (CPM) is one of the measures that have already been extensively normed throughout the world for various population groups. In South Africa, local norms for normal populations of children have been developed by groups of researchers in the Grahamstown (Eastern Cape) as well as the Bloemfontein (Free State) areas. With a South African school educational system that focuses on Inclusive Education, there is a growing need for mainstream schools to identify learners who are at risk for learning disabilities in order to develop appropriate supportive intervention plans. The research aimed to establish psychometric normative screening data based on the Raven’s CPM, and to compare these with the established and published international and local Raven’s CPM norms. In addition, the researcher developed pilot classification scores for the early screening and detection of at risk learners in order to encourage the potential role and use of the Raven’s CPM in the identification of cognitive learning barriers. The sample consisted of 388 primary school learners identified as having cognitive barriers to learning. Archival data was used that was gathered from a Psychological clinic that provided screening services to schools in the Nelson Mandela Metropolitan area. The results of the study indicated that there was a proportional relationship between age and test performance. Gender differences were found where the males in this study outperformed the females. There was a significant difference in the Raven’s CPM test performance with respect to the grade levels of the learners. The study developed a special set of norms with cognitive classification scores that will aid in the early identification of learning disabilities.
- Full Text:
- Date Issued: 2017
A systematic review of online child sexual abuse: victim risk and offender profile and methodologies
- Authors: Sleeman, Ananda
- Date: 2017
- Subjects: Child sexual abuse , Child pornography , Sexually abused children , Online sexual predators
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/10761 , vital:26821
- Description: The purpose of this treatise was to synthesize the current research, nationally and internationally, both qualitative and quantitative, concerning online child sexual abuse. The study focused on crimes of a sexual nature perpetrated against children, with or without consent, in an online environment. The aim was to clearly articulate the characteristics of victims, including both their vulnerabilities and their protective factors and to provide offender profiles, including their methodologies. Method: A systematic search for peer reviewed articles published between 2000 and 2006 was conducted. The final sample included 73 articles, which were arranged in order of publication, and the top and bottom interquartile range was selected for review and coding. Results: 36 articles were thematically coded in order to identify the most prominent themes in the articles. The result of this review was a typology of victims and offenders, as well as offender methodologies that reflects an aggregation of the most prominent research on the subject of online child sexual abuse. Conclusion: Much of the common knowledge concerning online child sexual offenders and their victims is incorrect. The typologies identified in this review show a much more diverse picture of both offenders and victims than is held in popular knowledge. This research has identified the damage that misinformation can do, and has highlighted the need for accurate, empirically sound information to be made available to parents, teachers, health care professionals and youth.
- Full Text:
- Date Issued: 2017
A systematic review of online child sexual abuse: victim risk and offender profile and methodologies
- Authors: Sleeman, Ananda
- Date: 2017
- Subjects: Child sexual abuse , Child pornography , Sexually abused children , Online sexual predators
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/10761 , vital:26821
- Description: The purpose of this treatise was to synthesize the current research, nationally and internationally, both qualitative and quantitative, concerning online child sexual abuse. The study focused on crimes of a sexual nature perpetrated against children, with or without consent, in an online environment. The aim was to clearly articulate the characteristics of victims, including both their vulnerabilities and their protective factors and to provide offender profiles, including their methodologies. Method: A systematic search for peer reviewed articles published between 2000 and 2006 was conducted. The final sample included 73 articles, which were arranged in order of publication, and the top and bottom interquartile range was selected for review and coding. Results: 36 articles were thematically coded in order to identify the most prominent themes in the articles. The result of this review was a typology of victims and offenders, as well as offender methodologies that reflects an aggregation of the most prominent research on the subject of online child sexual abuse. Conclusion: Much of the common knowledge concerning online child sexual offenders and their victims is incorrect. The typologies identified in this review show a much more diverse picture of both offenders and victims than is held in popular knowledge. This research has identified the damage that misinformation can do, and has highlighted the need for accurate, empirically sound information to be made available to parents, teachers, health care professionals and youth.
- Full Text:
- Date Issued: 2017
Activities, functions and structure of public sector pharmaceutical and therapeutics committees in the Eastern Cape Province, South Africa
- Authors: Henge-Daweti, Vatiswa
- Date: 2017
- Subjects: Medical ethics committees -- South Africa -- Eastern Cape Pharmaceutical policy -- South Africa -- Eastern Cape , Pharmaceutical services -- South Africa -- Eastern Cape Pharmaceutical ethics -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/15945 , vital:28293
- Description: The Council of Australian Therapeutic Advisory Groups (CATAG) (2013) define a Pharmaceutical and Therapeutics Committee (PTC) as a ‘multi-disciplinary team committee with a commitment to the overall governance of the medicines management system in health service organizations to ensure the judicious, appropriate, safe, effective and cost-effective use of medicines’. The multi-disciplinary team includes the health care providers, who are actively participating in the health care systems, such as doctors, pharmacists, nurses, administrators, finance officers, quality improvement managers and other staff members who participate in the medicine use processes according to their knowledge and skills. The major role of this committee is to evaluate and promote rational drug use by health care providers and consumers. In addition, this committee is responsible for developing systems and strategies to prevent adverse medicine reactions and medication errors, enhance rational prescribing and dispensing, provide educational activities and ensure the use of quality and cost-effective medicines. This is a cross-sectional study that was aimed at exploring the structure, activities and functions of public sector institutional Pharmaceutical and Therapeutics Committees (PTC) in the Eastern Cape (EC) Province in South Africa (SA). The primary objectives of the study were to (i) investigate and describe the structure, functions and the activities of the institutional PTCs, and (ii) explore and describe the perception of PTC secretariats on the functionality of the institutional PTCs. A purpose-designed questionnaire including both quantitative and qualitative aspects adapted from other international studies was piloted prior to being used for data collection. The secretariats of the institutional PTCs were requested to complete the questionnaire. Data were analysed using descriptive statistics for the quantitative aspects and thematic analysis for the qualitative component of the questionnaire. Data collection commenced after approval by the relevant ethics committees had been granted. The findings of the study reflected that the majority of the PTCs in the EC province, SA are district/sub-district PTCs which are a cluster of a number of health care institutions in close proximity. The PTC members were appointed by the executive authority as recommended by the literature and other guiding documents. As expected the nurses were dominant as the members of the PTCs in these district/sub-district PTCs. The secretariats were the pharmacists where pharmacists were available and chairperson were doctors. These findings correspond to the recommendations by the National Department of Health PTC policy (2015) and the studies conducted in other countries. A number of PTCs had sub-committees formed e.g. ABC analysis review committee, medicine utilization evaluation (MUE) committee and pharmacovigilance committee to optimise their functionality. Out of 15 PTCs only five PTCs with sub-committees reported functions and interventions, establishment of policies and SOPs. The rest had no outcomes or interventions reported. Poor production of policies and SOPs was observed which differs from other countries’ PTCs. The focus of sub-committees in other countries is the development of formulary and policies related to medicine use. These findings pose a question regarding the functionality and effectiveness of the existing institutional PTCs in the province. In addition, the basic documents that are required to run the PTC were unavailable in a number of PTCs. Barriers to the functionality of PTCs were reported i) Lack of pharmacists and training in PTCs. ii) The rural nature of the EC province and iii) Unavailability of resources including lack of re-imbursement of personal costs. These findings reveal that budget allocation for institutional PTCs is crucial for their functionality. It can be concluded that in the EC province the institutional PTCs which are active and effective are low in number and do not cover all geographical areas. Secondly there is a need for training and educating the PTC members on the role of the PTC members, role of sub-committees, development of policies, SOPs and the basic documents for the functionality of the committee. It is also important that during training the monitoring and evaluation of the effectiveness of the committee is emphasised. Therefore, the choice of the PTC objectives should be measurable as they can assist as indicators of effectiveness. Support by the executive authority has been observed.
- Full Text:
- Date Issued: 2017
- Authors: Henge-Daweti, Vatiswa
- Date: 2017
- Subjects: Medical ethics committees -- South Africa -- Eastern Cape Pharmaceutical policy -- South Africa -- Eastern Cape , Pharmaceutical services -- South Africa -- Eastern Cape Pharmaceutical ethics -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/15945 , vital:28293
- Description: The Council of Australian Therapeutic Advisory Groups (CATAG) (2013) define a Pharmaceutical and Therapeutics Committee (PTC) as a ‘multi-disciplinary team committee with a commitment to the overall governance of the medicines management system in health service organizations to ensure the judicious, appropriate, safe, effective and cost-effective use of medicines’. The multi-disciplinary team includes the health care providers, who are actively participating in the health care systems, such as doctors, pharmacists, nurses, administrators, finance officers, quality improvement managers and other staff members who participate in the medicine use processes according to their knowledge and skills. The major role of this committee is to evaluate and promote rational drug use by health care providers and consumers. In addition, this committee is responsible for developing systems and strategies to prevent adverse medicine reactions and medication errors, enhance rational prescribing and dispensing, provide educational activities and ensure the use of quality and cost-effective medicines. This is a cross-sectional study that was aimed at exploring the structure, activities and functions of public sector institutional Pharmaceutical and Therapeutics Committees (PTC) in the Eastern Cape (EC) Province in South Africa (SA). The primary objectives of the study were to (i) investigate and describe the structure, functions and the activities of the institutional PTCs, and (ii) explore and describe the perception of PTC secretariats on the functionality of the institutional PTCs. A purpose-designed questionnaire including both quantitative and qualitative aspects adapted from other international studies was piloted prior to being used for data collection. The secretariats of the institutional PTCs were requested to complete the questionnaire. Data were analysed using descriptive statistics for the quantitative aspects and thematic analysis for the qualitative component of the questionnaire. Data collection commenced after approval by the relevant ethics committees had been granted. The findings of the study reflected that the majority of the PTCs in the EC province, SA are district/sub-district PTCs which are a cluster of a number of health care institutions in close proximity. The PTC members were appointed by the executive authority as recommended by the literature and other guiding documents. As expected the nurses were dominant as the members of the PTCs in these district/sub-district PTCs. The secretariats were the pharmacists where pharmacists were available and chairperson were doctors. These findings correspond to the recommendations by the National Department of Health PTC policy (2015) and the studies conducted in other countries. A number of PTCs had sub-committees formed e.g. ABC analysis review committee, medicine utilization evaluation (MUE) committee and pharmacovigilance committee to optimise their functionality. Out of 15 PTCs only five PTCs with sub-committees reported functions and interventions, establishment of policies and SOPs. The rest had no outcomes or interventions reported. Poor production of policies and SOPs was observed which differs from other countries’ PTCs. The focus of sub-committees in other countries is the development of formulary and policies related to medicine use. These findings pose a question regarding the functionality and effectiveness of the existing institutional PTCs in the province. In addition, the basic documents that are required to run the PTC were unavailable in a number of PTCs. Barriers to the functionality of PTCs were reported i) Lack of pharmacists and training in PTCs. ii) The rural nature of the EC province and iii) Unavailability of resources including lack of re-imbursement of personal costs. These findings reveal that budget allocation for institutional PTCs is crucial for their functionality. It can be concluded that in the EC province the institutional PTCs which are active and effective are low in number and do not cover all geographical areas. Secondly there is a need for training and educating the PTC members on the role of the PTC members, role of sub-committees, development of policies, SOPs and the basic documents for the functionality of the committee. It is also important that during training the monitoring and evaluation of the effectiveness of the committee is emphasised. Therefore, the choice of the PTC objectives should be measurable as they can assist as indicators of effectiveness. Support by the executive authority has been observed.
- Full Text:
- Date Issued: 2017
Anthropometric indicators in identifying malnutrition risk among children younger than two years in Motherwell, Nelson Mandela Metropolitan Municipality
- Authors: McLaren, Shawn William
- Date: 2017
- Subjects: Nutrition disorders in children -- South Africa -- Nelson Mandela Bay Municipality , Malnutrition in children -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/19256 , vital:28811
- Description: Introduction: South Africa is burdened with a high prevalence of childhood malnutrition. The World Health Organisation (WHO) endorses weight for length (WFL) Z-scores and mid-upper arm circumference (MUAC) as tools for identifying children who are malnourished. The MUAC measurement offers many advantages for its use in community nutrition, and may aid in the early identification of malnourished children. More accurate and comprehensive data on child anthropometric status are needed in the Nelson Mandela Bay Health District (NMBHD), as well as assessment of the efficacy of using a simplified tool such as MUAC to screen for malnutrition. Aim: This study aimed to synthesise a profile of the nutritional status of children younger than two years old in Motherwell, Nelson Mandela Metropolitan Municipality (NMMM) to assess the value of MUAC as a predictor of malnutrition risk and develop malnutrition screening recommendations relevant to this population. Methods: This study followed a cross-sectional design using a quantitative approach. A convenience sample (n=419) of children below 24 months of age was selected from clinics and creches in Motherwell between October 2015 and February 2016 (Ethics approval: H15-HEA-DIET-002). Primary caregivers provided informed written consent for study participation. Trained fieldworkers performed anthropometric measurements according to standardised methods and completed a structured questionnaire. Data was described using means and standard deviations. Linear regression was used to assess relationships within the data. The MUAC’s ability to identify malnutrition was described using sensitivity and specificity probabilities. Results: Only 6% of the sample of children (n=23) were classified as stunted and 3% of the children (n=12) were severely stunted. The WHZ Z-score identified 0% (n=1) child with severe acute malnutrition (SAM), and 1% (n=3) children as MAM. The MUAC identified more children as SAM (2%) and MAM (3%). It was found that 16% of the children (n=65) were overweight or obese according to WHZ. It was found that there is a strong linear relationship between WHZ and MUAC (r=0.739). Using the least squares regression equation, a MUAC cut off value of 13,80cm for males and 13,5cm for females between six and 24 months old was projected. The male cut-off value has a 100% sensitivity and 94,5% specificity for MAM and SAM while the female MUAC cut off had a specificity of 96,4%. Low birth weight children had significantly (p<0.0005) lower mean WAZ and HAZ scores than normal birth weight children. Conclusions and recommendations The prevalence of overweight and obesity among children younger than two years was high in Motherwell, while stunting and wasting prevalence were lower than expected for the population. Raising the MUAC cut-off values from 12,5cm for MAM to 13,80cm for males and 13,47cm for females may increase the number of children younger than two years who are included in nutrition interventions. It is recommended that healthcare workers focus on breastfeeding and appropriate complementary feeding practices to reduce the risk of overweight in infants and young children.
- Full Text:
- Authors: McLaren, Shawn William
- Date: 2017
- Subjects: Nutrition disorders in children -- South Africa -- Nelson Mandela Bay Municipality , Malnutrition in children -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/19256 , vital:28811
- Description: Introduction: South Africa is burdened with a high prevalence of childhood malnutrition. The World Health Organisation (WHO) endorses weight for length (WFL) Z-scores and mid-upper arm circumference (MUAC) as tools for identifying children who are malnourished. The MUAC measurement offers many advantages for its use in community nutrition, and may aid in the early identification of malnourished children. More accurate and comprehensive data on child anthropometric status are needed in the Nelson Mandela Bay Health District (NMBHD), as well as assessment of the efficacy of using a simplified tool such as MUAC to screen for malnutrition. Aim: This study aimed to synthesise a profile of the nutritional status of children younger than two years old in Motherwell, Nelson Mandela Metropolitan Municipality (NMMM) to assess the value of MUAC as a predictor of malnutrition risk and develop malnutrition screening recommendations relevant to this population. Methods: This study followed a cross-sectional design using a quantitative approach. A convenience sample (n=419) of children below 24 months of age was selected from clinics and creches in Motherwell between October 2015 and February 2016 (Ethics approval: H15-HEA-DIET-002). Primary caregivers provided informed written consent for study participation. Trained fieldworkers performed anthropometric measurements according to standardised methods and completed a structured questionnaire. Data was described using means and standard deviations. Linear regression was used to assess relationships within the data. The MUAC’s ability to identify malnutrition was described using sensitivity and specificity probabilities. Results: Only 6% of the sample of children (n=23) were classified as stunted and 3% of the children (n=12) were severely stunted. The WHZ Z-score identified 0% (n=1) child with severe acute malnutrition (SAM), and 1% (n=3) children as MAM. The MUAC identified more children as SAM (2%) and MAM (3%). It was found that 16% of the children (n=65) were overweight or obese according to WHZ. It was found that there is a strong linear relationship between WHZ and MUAC (r=0.739). Using the least squares regression equation, a MUAC cut off value of 13,80cm for males and 13,5cm for females between six and 24 months old was projected. The male cut-off value has a 100% sensitivity and 94,5% specificity for MAM and SAM while the female MUAC cut off had a specificity of 96,4%. Low birth weight children had significantly (p<0.0005) lower mean WAZ and HAZ scores than normal birth weight children. Conclusions and recommendations The prevalence of overweight and obesity among children younger than two years was high in Motherwell, while stunting and wasting prevalence were lower than expected for the population. Raising the MUAC cut-off values from 12,5cm for MAM to 13,80cm for males and 13,47cm for females may increase the number of children younger than two years who are included in nutrition interventions. It is recommended that healthcare workers focus on breastfeeding and appropriate complementary feeding practices to reduce the risk of overweight in infants and young children.
- Full Text:
Antibacterial activities of both combined and individual medicinal plants extracts traditionally used to treat pneumonia
- Authors: Mhango, Immaculate
- Date: 2017
- Subjects: Antibacterial agents , Pneumonia -- Treatment
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19762 , vital:28959
- Description: Pneumonia is one of the five major leading causes of death in children under-fives years and the elderly worldwide. Antibiotics used for its treatment are less potent due to bacteria development of bacteria resistant to antibiotics. This has led to a surge in search of novel drugs. There are already some drugs in clinical use that have natural products and derivatives such as quinine, morphine, vincristine, and taxol among others. The healing value of medicinal plants has been well accepted since Stone Age across the globe. This plant therapy has been prescribed and prepared independently or in combination. The following plants: Terminalia sericea, Warburgia salutaris, Dodonea angustofolia, Eucalyptus camaldulensis, Ballota africana, Kigelia africana and Acorus gramineus. These plants are most commonly used for treatment of pneumonia and other ailment, were studied to validate their antimicrobial activity based on scientific determination. The primary aim of this study was to evaluate the efficacy of these plants against bacteria pneumonia pathogens. Seven medicinal plants, independently and in combinations were relatively analysed for their antimicrobial activity against Staphylococcus aureus, Streptococcus pyogenes, and Klebsiella pneumoniae. Ground plant material of roots, bark and leafs were prepared with acetone, ethanol and distilled water. Dimethyl sulfoxide (10 &100%) was used as a reconstitution solvent and ciprofloxacin (10 %) as a positive control. The antimicrobial efficacy was determined using agar well diffusion and microtiter plate methods. Interaction between plants was evaluated by calculating fraction inhibitory concentration index (ΣFIC). Noteworthy activity for individual studies with all test organisms was observed with T. sericea. However, highest ZOI (30 mm) was observed for B. africana ethanol extract for S. pyogenes. Weak microbial activity was noted in W. salutaris and D. angustofolia extracts with all test organisms. Good antimicrobial activity was observed in combination studies with all organisms. The potency of different plant combinations varied with highest ZOI observed with B. africana and W. salutaris ranging from 33-35 mm, conversely ZOI of 35 mm was also noted for S. aureus in B. africana and E. camaldulensis ethanol extract. Noteworthy antimicrobial activity was observed in T. sericea and D. angustofolia against all test pathogens. weak antimicrobial activity with highest MICs was observed in combinations where W. salutaris was involved. After calculating ΣFICs, strongest synergistic effect was displayed for W. salutaris and D. angustofolia against all test organisms (lowest ΣFICs 0.0491). Most plant extract combinations, displayed either synergistic, additive or indifferent effect, with few demonstrating antagonistic interactions. Significant antagonism effect was noted for S. pyogenes with T. sericea ethanol extract ΣFIC value of 15.51. Based on results of this study use of plants in combination increase antimicrobial efficacy. The antimicrobial activities; synergistic and additive effects observed adds credibility in the use of plant combination for therapeutic value in treatment of pneumonia. Future studies are recommended to identify and isolate specific active compounds involved in plant combination interactions. The importance of combination studies for possible development of new antimicrobials that can succumb bacterial resistance need to be highlighted.
- Full Text:
- Date Issued: 2017
- Authors: Mhango, Immaculate
- Date: 2017
- Subjects: Antibacterial agents , Pneumonia -- Treatment
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19762 , vital:28959
- Description: Pneumonia is one of the five major leading causes of death in children under-fives years and the elderly worldwide. Antibiotics used for its treatment are less potent due to bacteria development of bacteria resistant to antibiotics. This has led to a surge in search of novel drugs. There are already some drugs in clinical use that have natural products and derivatives such as quinine, morphine, vincristine, and taxol among others. The healing value of medicinal plants has been well accepted since Stone Age across the globe. This plant therapy has been prescribed and prepared independently or in combination. The following plants: Terminalia sericea, Warburgia salutaris, Dodonea angustofolia, Eucalyptus camaldulensis, Ballota africana, Kigelia africana and Acorus gramineus. These plants are most commonly used for treatment of pneumonia and other ailment, were studied to validate their antimicrobial activity based on scientific determination. The primary aim of this study was to evaluate the efficacy of these plants against bacteria pneumonia pathogens. Seven medicinal plants, independently and in combinations were relatively analysed for their antimicrobial activity against Staphylococcus aureus, Streptococcus pyogenes, and Klebsiella pneumoniae. Ground plant material of roots, bark and leafs were prepared with acetone, ethanol and distilled water. Dimethyl sulfoxide (10 &100%) was used as a reconstitution solvent and ciprofloxacin (10 %) as a positive control. The antimicrobial efficacy was determined using agar well diffusion and microtiter plate methods. Interaction between plants was evaluated by calculating fraction inhibitory concentration index (ΣFIC). Noteworthy activity for individual studies with all test organisms was observed with T. sericea. However, highest ZOI (30 mm) was observed for B. africana ethanol extract for S. pyogenes. Weak microbial activity was noted in W. salutaris and D. angustofolia extracts with all test organisms. Good antimicrobial activity was observed in combination studies with all organisms. The potency of different plant combinations varied with highest ZOI observed with B. africana and W. salutaris ranging from 33-35 mm, conversely ZOI of 35 mm was also noted for S. aureus in B. africana and E. camaldulensis ethanol extract. Noteworthy antimicrobial activity was observed in T. sericea and D. angustofolia against all test pathogens. weak antimicrobial activity with highest MICs was observed in combinations where W. salutaris was involved. After calculating ΣFICs, strongest synergistic effect was displayed for W. salutaris and D. angustofolia against all test organisms (lowest ΣFICs 0.0491). Most plant extract combinations, displayed either synergistic, additive or indifferent effect, with few demonstrating antagonistic interactions. Significant antagonism effect was noted for S. pyogenes with T. sericea ethanol extract ΣFIC value of 15.51. Based on results of this study use of plants in combination increase antimicrobial efficacy. The antimicrobial activities; synergistic and additive effects observed adds credibility in the use of plant combination for therapeutic value in treatment of pneumonia. Future studies are recommended to identify and isolate specific active compounds involved in plant combination interactions. The importance of combination studies for possible development of new antimicrobials that can succumb bacterial resistance need to be highlighted.
- Full Text:
- Date Issued: 2017
Antimicrobial activity of selected plants and their combined preparations against pathogens causing respiratory infections
- Authors: Onyebuchi, Ukwuoma Collins
- Date: 2017
- Subjects: Anti-infective agents , Respiratory infections -- Alternative treatment
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/21197 , vital:29455
- Description: Bacterial infection of the respiratory system is one of the leading causes of death in the world’s population, killing over four million people annually. Treatment of respiratory infections is usually by antibiotics administration. The emergence of multi-drug-resistant pathogens has led to the search for more effective therapeutic agents especially from medicinal plants, as compounds from plants have been shown to possess some therapeutic potential. The aim of this study is to determine the antimicrobial activity of three plants, Tetradenia riparia, Leonotis leonurus and Salvia africana-lutea and the activity of their various combined preparations against 27 pathogens usually associated with respiratory ailments. Various solvents were used for extraction of the dried powdered plant materials. The agar disc diffusion antimicrobial assay and the micro-dilution assay methods were used to determine the inhibitory activity and the minimum inhibitory concentration of the plant extracts. The nature of phytochemicals present in the extracts was determined by thin layer chromatography. The results obtained in this study, showed that ethanol produced the highest average extract yield in both the individual and combined plant preparations. A two-way analysis of variance for the disc diffusion assay showed no significant difference in the inhibition zones (Appendix 1 and 2). MIC of 0.8 mg/ml was obtained with S. africana-lutea against S. pneumoniae ATCC 49619 and B. cereus ATCC 10976 strains, indicating a strong antibacterial activity. Synergistic interaction (FIC index ranging from 0.20 – 0.50) and a strong antimicrobial activity (MIC values ranging from 0.4 – 0.8 mg/ml), was obtained with the acetone extract of the 1:1 combination of L. leonurus with S. africana-lutea. The XEA and CEF solvent systems eluted the most number of compound spots and produced the best separations. The results obtained in this study validate the traditional use of these plants and their combinations for the treatment of respiratory ailments.
- Full Text:
- Date Issued: 2017
- Authors: Onyebuchi, Ukwuoma Collins
- Date: 2017
- Subjects: Anti-infective agents , Respiratory infections -- Alternative treatment
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/21197 , vital:29455
- Description: Bacterial infection of the respiratory system is one of the leading causes of death in the world’s population, killing over four million people annually. Treatment of respiratory infections is usually by antibiotics administration. The emergence of multi-drug-resistant pathogens has led to the search for more effective therapeutic agents especially from medicinal plants, as compounds from plants have been shown to possess some therapeutic potential. The aim of this study is to determine the antimicrobial activity of three plants, Tetradenia riparia, Leonotis leonurus and Salvia africana-lutea and the activity of their various combined preparations against 27 pathogens usually associated with respiratory ailments. Various solvents were used for extraction of the dried powdered plant materials. The agar disc diffusion antimicrobial assay and the micro-dilution assay methods were used to determine the inhibitory activity and the minimum inhibitory concentration of the plant extracts. The nature of phytochemicals present in the extracts was determined by thin layer chromatography. The results obtained in this study, showed that ethanol produced the highest average extract yield in both the individual and combined plant preparations. A two-way analysis of variance for the disc diffusion assay showed no significant difference in the inhibition zones (Appendix 1 and 2). MIC of 0.8 mg/ml was obtained with S. africana-lutea against S. pneumoniae ATCC 49619 and B. cereus ATCC 10976 strains, indicating a strong antibacterial activity. Synergistic interaction (FIC index ranging from 0.20 – 0.50) and a strong antimicrobial activity (MIC values ranging from 0.4 – 0.8 mg/ml), was obtained with the acetone extract of the 1:1 combination of L. leonurus with S. africana-lutea. The XEA and CEF solvent systems eluted the most number of compound spots and produced the best separations. The results obtained in this study validate the traditional use of these plants and their combinations for the treatment of respiratory ailments.
- Full Text:
- Date Issued: 2017
Culturally informed conceptions of traumatic experience and coping strategies among the mole-dagbon of Ghana
- Authors: Thompson, Sandra
- Date: 2017
- Subjects: Cultural psychiatry -- Ghana , Post-traumatic stress disorder -- Ghana , Dagbani (African people)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/9327 , vital:26578
- Description: Culture is important to an individual’s understanding of traumatic events and the symptoms that ensue after such events. Cultural understandings also inform how individuals cope with the traumatic stress symptoms they experience. A great deal is known about the understanding of traumatic experiences and effective coping mechanisms used in Western cultures, but non-Western cultures are generally understudied. Valuable lessons are learnt from conducting studies with understudied non-Western cultures. The research sought to explore and describe the culturally informed conceptions of traumatic experience and coping strategies in one such understudied population - the Mole-Dagbon of Ghana. The research used a qualitative exploratory descriptive interpretive methodology. Purposive nonprobability sampling was used to gain access to individuals who could comment on the knowledge objectives of the study. Data was collected using focus group discussions with cultural leaders, and semi-structured interviews with traumatized individuals. All interviews were audio-recorded, transcribed, translated and analyzed using interpretive phenomenological analysis. The findings indicated that traumatic experiences and the coping strategies are influenced by a number of cultural factors. Participants’ understanding of traumatic experiences and symptoms relied heavily on normative traditional African cultural understandings, but explanations also utilized monotheistic (from Islam and Christianity) worldviews. It was also evident that not all explanations were purely spiritual and events and symptoms were also explained using a natural/scientific framework. Some aspects of this system indicated parallels with the Western cognitive understanding of traumatic stress symptoms. The Mole-Dagbon did not focus naturally on explaining the events and symptoms and in the current sample such explanations were often deferred to authoritative individuals in the society (especially the soothsayers from the Traditional African Religion). However, there was an easy focus on coping with the symptoms after a traumatic event and in this last aspect there was a great degree of agreement between participants. A clear hierarchy of coping emerged with community and family social support being considered the most important aspect. Irrespective of religious affiliation, individuals also considered a visit to the soothsayer and completing prescribed rituals as important in the process. Even where an individual did not wish to include this practice from African Traditional Religion because of religious affiliation, they acknowledged the existence and effectiveness of these practices. Finally, it was thought important that a traumatized individual consult a religious leader for counselling (again irrespective of the actual religion). While there were elements of cognitive understanding and a recognition of counselling by religious leaders, Western based treatment modalities were not mentioned as options for the treatment of the symptoms of PTSD. Practitioners that come into contact with the Mole-Dagbon may need to use collaborative treatment strategies that respects and utilizes cultural treatment strategies for PTSD. One interesting element that needs further exploration is whether the cognitive understandings of the Mole-Dagbon can be used in a cognitive therapeutic paradigm. Even though these cognitive appraisals are present in explaining symptoms, there are no direct cultural remedies that rely on them.
- Full Text:
- Date Issued: 2017
- Authors: Thompson, Sandra
- Date: 2017
- Subjects: Cultural psychiatry -- Ghana , Post-traumatic stress disorder -- Ghana , Dagbani (African people)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/9327 , vital:26578
- Description: Culture is important to an individual’s understanding of traumatic events and the symptoms that ensue after such events. Cultural understandings also inform how individuals cope with the traumatic stress symptoms they experience. A great deal is known about the understanding of traumatic experiences and effective coping mechanisms used in Western cultures, but non-Western cultures are generally understudied. Valuable lessons are learnt from conducting studies with understudied non-Western cultures. The research sought to explore and describe the culturally informed conceptions of traumatic experience and coping strategies in one such understudied population - the Mole-Dagbon of Ghana. The research used a qualitative exploratory descriptive interpretive methodology. Purposive nonprobability sampling was used to gain access to individuals who could comment on the knowledge objectives of the study. Data was collected using focus group discussions with cultural leaders, and semi-structured interviews with traumatized individuals. All interviews were audio-recorded, transcribed, translated and analyzed using interpretive phenomenological analysis. The findings indicated that traumatic experiences and the coping strategies are influenced by a number of cultural factors. Participants’ understanding of traumatic experiences and symptoms relied heavily on normative traditional African cultural understandings, but explanations also utilized monotheistic (from Islam and Christianity) worldviews. It was also evident that not all explanations were purely spiritual and events and symptoms were also explained using a natural/scientific framework. Some aspects of this system indicated parallels with the Western cognitive understanding of traumatic stress symptoms. The Mole-Dagbon did not focus naturally on explaining the events and symptoms and in the current sample such explanations were often deferred to authoritative individuals in the society (especially the soothsayers from the Traditional African Religion). However, there was an easy focus on coping with the symptoms after a traumatic event and in this last aspect there was a great degree of agreement between participants. A clear hierarchy of coping emerged with community and family social support being considered the most important aspect. Irrespective of religious affiliation, individuals also considered a visit to the soothsayer and completing prescribed rituals as important in the process. Even where an individual did not wish to include this practice from African Traditional Religion because of religious affiliation, they acknowledged the existence and effectiveness of these practices. Finally, it was thought important that a traumatized individual consult a religious leader for counselling (again irrespective of the actual religion). While there were elements of cognitive understanding and a recognition of counselling by religious leaders, Western based treatment modalities were not mentioned as options for the treatment of the symptoms of PTSD. Practitioners that come into contact with the Mole-Dagbon may need to use collaborative treatment strategies that respects and utilizes cultural treatment strategies for PTSD. One interesting element that needs further exploration is whether the cognitive understandings of the Mole-Dagbon can be used in a cognitive therapeutic paradigm. Even though these cognitive appraisals are present in explaining symptoms, there are no direct cultural remedies that rely on them.
- Full Text:
- Date Issued: 2017
Employee Assistance Program (EAP) as a context for social work practice placement
- Authors: Cummings, Nicki
- Date: 2017
- Subjects: Social service -- Fieldwork -- South Africa Social work education -- South Africa , Employee assistance programs -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/15314 , vital:28218
- Description: The Bachelor of Social Work degree is a four year course consisting of classroom and field practicum training. In 2013, the Automotive Information and Development Centre (AIDC) and Nelson Mandela Metropolitan University agreed upon placing fourth year social work students within the Employee Assistance Programs affiliated with the AIDC. The research goal of this study is to enhance an understanding of Employee Assistance Programs (EAP) as a context for practicum training for (4th) fourth year social work students by exploring and describing the perceptions and experiences of students, campus supervisors and EAP company representatives. In this respect, the study seeks to determine whether EAP provides the opportunity to meet the Exit Level Outcomes for the Bachelor of Social Work degree. This study is focussed on the practical application of social work knowledge and skills; it is framed within the principles of the Outcomes Based Educational Approach to Education. It was thus considered relevant to introduce a literature review on this particular approach with the focus on the achievement of outcomes. In order to understand whether EAP is an effective learning context the researcher needed to understand how students apply the experience and bridge the gap between theory and practice to gain meaning and understanding and, essentially, learn from the practicum training experience thus further enhancing the framework. The experiential learning cycle presented by Kolb (1984) extended the framework to provide an appropriate model for facilitating learning by linking practice to theory and knowledge. Kolb’s experiential learning cycle was thus explored. The study utilised an exploratory, descriptive, qualitative approach, which is contextual in nature. Non-probability, purposive sampling was utilised to select fourth year social work students, supervisors and company representatives who were involved with EAPs and fourth year social work students at their company. Data collection incorporated semi-structured interviews. Data analysis resulted in themes, sub-themes, categories and sub-categories emerging. Upon analysis of these themes, it was clear that with the appropriate support and creativity, students were able to meet the required Exit Level Outcomes of the Bachelor of Social Work degree. The study concludes that the overall the experience of fourth year social work students placed at EAP companies has been a positive one, with students meeting the Exit Level Outcomes for the Bachelor of Social Work degree. Although this was a positive experience, greater preparation is required and communication between the relevant parties needs to be improved.
- Full Text:
- Date Issued: 2017
- Authors: Cummings, Nicki
- Date: 2017
- Subjects: Social service -- Fieldwork -- South Africa Social work education -- South Africa , Employee assistance programs -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/15314 , vital:28218
- Description: The Bachelor of Social Work degree is a four year course consisting of classroom and field practicum training. In 2013, the Automotive Information and Development Centre (AIDC) and Nelson Mandela Metropolitan University agreed upon placing fourth year social work students within the Employee Assistance Programs affiliated with the AIDC. The research goal of this study is to enhance an understanding of Employee Assistance Programs (EAP) as a context for practicum training for (4th) fourth year social work students by exploring and describing the perceptions and experiences of students, campus supervisors and EAP company representatives. In this respect, the study seeks to determine whether EAP provides the opportunity to meet the Exit Level Outcomes for the Bachelor of Social Work degree. This study is focussed on the practical application of social work knowledge and skills; it is framed within the principles of the Outcomes Based Educational Approach to Education. It was thus considered relevant to introduce a literature review on this particular approach with the focus on the achievement of outcomes. In order to understand whether EAP is an effective learning context the researcher needed to understand how students apply the experience and bridge the gap between theory and practice to gain meaning and understanding and, essentially, learn from the practicum training experience thus further enhancing the framework. The experiential learning cycle presented by Kolb (1984) extended the framework to provide an appropriate model for facilitating learning by linking practice to theory and knowledge. Kolb’s experiential learning cycle was thus explored. The study utilised an exploratory, descriptive, qualitative approach, which is contextual in nature. Non-probability, purposive sampling was utilised to select fourth year social work students, supervisors and company representatives who were involved with EAPs and fourth year social work students at their company. Data collection incorporated semi-structured interviews. Data analysis resulted in themes, sub-themes, categories and sub-categories emerging. Upon analysis of these themes, it was clear that with the appropriate support and creativity, students were able to meet the required Exit Level Outcomes of the Bachelor of Social Work degree. The study concludes that the overall the experience of fourth year social work students placed at EAP companies has been a positive one, with students meeting the Exit Level Outcomes for the Bachelor of Social Work degree. Although this was a positive experience, greater preparation is required and communication between the relevant parties needs to be improved.
- Full Text:
- Date Issued: 2017
Evaluating neuropsychiatric symptomology in HIV-positive patients on efavirenz in public-sector clinics and psychiatric hospitals
- Gaida, Razia, Grobler, Christoffel
- Authors: Gaida, Razia , Grobler, Christoffel
- Date: 2017
- Subjects: Drugs -- Side effects -- South Africa , HIV (Viruses) -- Enzymes , Antiretroviral agents -- South Africa , Anti-infective agents -- Side effects -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/29772 , vital:30776
- Description: Background: South Africa has the highest number of people living with human immunodeficiency virus (HIV) infection in the world. In 2014, an estimated 10.2% of the population was HIV-positive which amounted to 5.51 million people. Efavirenz forms part of the triple therapy backbone used in South Africa and is part of the firstline treatment for HIV. Efavirenz has been strongly associated with causing neuropsychiatric side effects in at least 50.0% of patients to whom it is prescribed. These side effects cause hesitation amongst healthcare professionals to prescribe this agent to patients with active mental illnesses. Aim: The aim of the study was to evaluate the neuropsychiatric side effects of efavirenz in HIV-positive psychiatric and non-psychiatric patients and to determine whether this drug may be recommended for use in an HIV-positive psychiatric patient population. Method: The study was divided into two parts, namely a quantitative portion and a qualitative portion. The quantitative study was a prospective drug utilisation study, while the qualitative portion consisted of semi-structured interviews carried out with healthcare professionals working with people living with HIV/AIDS (PLWHA). The study included five municipal clinics in the Nelson Mandela Metropole as well as two public-sector psychiatric facilities in the Eastern Cape where medical records were reviewed to obtain the information required. Patients were followed in both instances for a period of 24 weeks with follow-up assessments carried out at two, four, 12 and 24 week intervals. In terms of the qualitative study, nurses at the clinics and doctors at the hospitals were contacted and appointments for interviews were made. The interviews were recorded using a voice recorder and were transcribed and analysed using theoretical framework analysis. Results: The review of 126 medical records at the clinics revealed that no patient had suffered from or complained of a neuropsychiatric side effect. This may indicate that patients were not suffering from clinically significant side effects, side effects were not being adequately recorded by healthcare staff, or the healthcare staff were not questioning patients regarding side effects. A total of 26 hospitalised patients were followed for 24 weeks in the psychiatric facilities. Almost half of the patients using efavirenz experienced an improvement in symptoms to the extent that they were iii discharged from the facility. The majority of patients (66.7%) not on an efavirenzcontaining regimen did not improve to the point of discharge. Healthcare staff were vague when providing a definition of neuropsychiatric side effects. There were conflicting ideas on whether or not efavirenz should be used in patients with an active psychiatric illness. Conclusions: Further studies need to be performed in public-sector institutions to obtain a clearer picture of the side effects experienced by patients using efavirenz. Healthcare staff need to be encouraged to keep complete records to allow for meaningful analysis. The further integration of mental health services into existing HIV programmes is essential for holistic treatment. Patients in psychiatric hospitals demonstrated that even patients with psychiatric disorders on efavirenz can experience positive outcomes and stabilisation of psychiatric symptoms, which may indicate that these may not have due to efavirenz use. Further elucidation concerning the use of efavirenz in patients with psychiatric disorders, a description of the neuropsychiatric side effects, as well as management strategies must be provided in subsequent HIV guidelines.
- Full Text:
- Date Issued: 2017
- Authors: Gaida, Razia , Grobler, Christoffel
- Date: 2017
- Subjects: Drugs -- Side effects -- South Africa , HIV (Viruses) -- Enzymes , Antiretroviral agents -- South Africa , Anti-infective agents -- Side effects -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/29772 , vital:30776
- Description: Background: South Africa has the highest number of people living with human immunodeficiency virus (HIV) infection in the world. In 2014, an estimated 10.2% of the population was HIV-positive which amounted to 5.51 million people. Efavirenz forms part of the triple therapy backbone used in South Africa and is part of the firstline treatment for HIV. Efavirenz has been strongly associated with causing neuropsychiatric side effects in at least 50.0% of patients to whom it is prescribed. These side effects cause hesitation amongst healthcare professionals to prescribe this agent to patients with active mental illnesses. Aim: The aim of the study was to evaluate the neuropsychiatric side effects of efavirenz in HIV-positive psychiatric and non-psychiatric patients and to determine whether this drug may be recommended for use in an HIV-positive psychiatric patient population. Method: The study was divided into two parts, namely a quantitative portion and a qualitative portion. The quantitative study was a prospective drug utilisation study, while the qualitative portion consisted of semi-structured interviews carried out with healthcare professionals working with people living with HIV/AIDS (PLWHA). The study included five municipal clinics in the Nelson Mandela Metropole as well as two public-sector psychiatric facilities in the Eastern Cape where medical records were reviewed to obtain the information required. Patients were followed in both instances for a period of 24 weeks with follow-up assessments carried out at two, four, 12 and 24 week intervals. In terms of the qualitative study, nurses at the clinics and doctors at the hospitals were contacted and appointments for interviews were made. The interviews were recorded using a voice recorder and were transcribed and analysed using theoretical framework analysis. Results: The review of 126 medical records at the clinics revealed that no patient had suffered from or complained of a neuropsychiatric side effect. This may indicate that patients were not suffering from clinically significant side effects, side effects were not being adequately recorded by healthcare staff, or the healthcare staff were not questioning patients regarding side effects. A total of 26 hospitalised patients were followed for 24 weeks in the psychiatric facilities. Almost half of the patients using efavirenz experienced an improvement in symptoms to the extent that they were iii discharged from the facility. The majority of patients (66.7%) not on an efavirenzcontaining regimen did not improve to the point of discharge. Healthcare staff were vague when providing a definition of neuropsychiatric side effects. There were conflicting ideas on whether or not efavirenz should be used in patients with an active psychiatric illness. Conclusions: Further studies need to be performed in public-sector institutions to obtain a clearer picture of the side effects experienced by patients using efavirenz. Healthcare staff need to be encouraged to keep complete records to allow for meaningful analysis. The further integration of mental health services into existing HIV programmes is essential for holistic treatment. Patients in psychiatric hospitals demonstrated that even patients with psychiatric disorders on efavirenz can experience positive outcomes and stabilisation of psychiatric symptoms, which may indicate that these may not have due to efavirenz use. Further elucidation concerning the use of efavirenz in patients with psychiatric disorders, a description of the neuropsychiatric side effects, as well as management strategies must be provided in subsequent HIV guidelines.
- Full Text:
- Date Issued: 2017
Evaluation of medicine safety reporting systems in South Africa
- Thornborrow-Geswind, Kirsten
- Authors: Thornborrow-Geswind, Kirsten
- Date: 2017
- Subjects: Drugs -- Side effects -- Research -- South Africa Pharmacoepidemiology -- Research -- South Africa , Medicine -- South Africa -- Safety measures Public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/21439 , vital:29517
- Description: Pharmacovigilance is “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem”. To date, no comprehensive study has been performed to evaluate the pharmacovigilance system in the public health sector in South Africa. The primary aim of this study was to evaluate the current status of pharmacovigilance systems within the public healthcare sector in South Africa, and the level of functioning of these systems, in order to provide relevant recommendations, where necessary, for improvement, using the Indicator-based Pharmacogivilance Assessment Tool (IPAT). National and provincial entities were deemed compulsory (n=14), while facilities were selected via random, stratified sampling to obtain a representation at each facility level (n=101). The IPAT was amended for relevance at each level of data collection. Indicators are classified as core and supplementary and compliance with core indicators shows the level of functioning National entities obtained an IPAT score of 36 out of a maximum of 72, achieving 50% compliance. Province D and Province G obtained overall IPAT scores of 29 and 12 respectively out of a maximum of 40, achieving an overall 72.5% and 30% compliance respectively Results at provincial and facility levels were not fully representative due to a limited response rate of 22.2% and 65.3% respectively. Regional/tertiary facilities and district facilities displayed increased awareness and implementation of pharmacovigilance activity than the lower levels of Community Health Centres (CHCs) and Primary Health Centres (PHCs). South Africa”s public healthcare system possesses the infrastructure for a well functioning pharmacovigilance system. However there are gaps in level of functioning at a national, provincial and facility level. Addressing these gaps would show a marked improvement in the system and go a long way towards the contribution of medicine safety information not only locally, but to aid other developing nations.
- Full Text:
- Date Issued: 2017
- Authors: Thornborrow-Geswind, Kirsten
- Date: 2017
- Subjects: Drugs -- Side effects -- Research -- South Africa Pharmacoepidemiology -- Research -- South Africa , Medicine -- South Africa -- Safety measures Public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/21439 , vital:29517
- Description: Pharmacovigilance is “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem”. To date, no comprehensive study has been performed to evaluate the pharmacovigilance system in the public health sector in South Africa. The primary aim of this study was to evaluate the current status of pharmacovigilance systems within the public healthcare sector in South Africa, and the level of functioning of these systems, in order to provide relevant recommendations, where necessary, for improvement, using the Indicator-based Pharmacogivilance Assessment Tool (IPAT). National and provincial entities were deemed compulsory (n=14), while facilities were selected via random, stratified sampling to obtain a representation at each facility level (n=101). The IPAT was amended for relevance at each level of data collection. Indicators are classified as core and supplementary and compliance with core indicators shows the level of functioning National entities obtained an IPAT score of 36 out of a maximum of 72, achieving 50% compliance. Province D and Province G obtained overall IPAT scores of 29 and 12 respectively out of a maximum of 40, achieving an overall 72.5% and 30% compliance respectively Results at provincial and facility levels were not fully representative due to a limited response rate of 22.2% and 65.3% respectively. Regional/tertiary facilities and district facilities displayed increased awareness and implementation of pharmacovigilance activity than the lower levels of Community Health Centres (CHCs) and Primary Health Centres (PHCs). South Africa”s public healthcare system possesses the infrastructure for a well functioning pharmacovigilance system. However there are gaps in level of functioning at a national, provincial and facility level. Addressing these gaps would show a marked improvement in the system and go a long way towards the contribution of medicine safety information not only locally, but to aid other developing nations.
- Full Text:
- Date Issued: 2017
Experiences of analogue-trained radiographers utilising digital imaging in projection radiography
- Authors: Campbell, Sydney
- Date: 2017
- Subjects: Radiography, Medical -- Digital techniques Angiography , Image processing -- Digital techniques Radiography
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/14796 , vital:27851
- Description: The professional work of a radiographer encompasses both patient care and the use of technology. The technology employed could either be analogue or digital technology. Since 1973, the analogue imaging system has slowly been replaced by digital radiography imaging systems. Despite the many advantages of digital imaging it does present the radiographer with added responsibilities. Furthermore, analogue-trained radiographers have found adjusting to digital imaging especially challenging. The aim of the study was to explore and describe the experiences of analogue-trained radiographers utilising digital imaging in projection radiography with the intention of developing guidelines to equip radiography managers to assist analogue-trained radiographers to better utilise digital imaging. The researcher used Schlossberg’s Transition Theory as a lens to look at the experiences of analogue-trained radiographers using digital imaging to produce radiographs. The research study used a qualitative design which was explorative, descriptive and contextual in nature. The target population included all diagnostic radiographers (public and private) in the local municipality who were registered with the Health Professions Council of South Africa. Purposive sampling was employed to select the radiographers that represented all radiographers in the Nelson Mandela Bay Health District. The sample included all radiographers who fulfilled the identified selection criteria. The selected participants were recruited to take part in in-depth, semi-structured individual interviews. The data was analysed using a computer-aided qualitative data analysis software package, ATLAS.ti. The trustworthiness of this study was ensured by applying Guba’s model of trustworthiness that includes credibility, transferability, dependability and confirmability. The ethical principles of respect for persons, beneficence and justice, as espoused by the Belmont Report, were adhered to in order to ensure that the study was conducted in an ethical manner. Two themes emanated from the data, namely the evolution of the radiographer when faced with the advances in technology as well the role that the work environment played in the manner that the participants experienced the change. The experiences of the participants were described using direct quotations from the interviews and a literature control was used to verify the participants’ experiences. Evidence was found of radiographer indifference towards exposure selection, dose optimisation and placement of anatomical side markers when utilising digital imaging. Finally, guidelines were developed to equip radiography managers to assist analogue-trained radiographers to better utilise digital imaging. In addition, the guidelines will assist all other radiographers to better utilise digital imaging.
- Full Text:
- Date Issued: 2017
- Authors: Campbell, Sydney
- Date: 2017
- Subjects: Radiography, Medical -- Digital techniques Angiography , Image processing -- Digital techniques Radiography
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/14796 , vital:27851
- Description: The professional work of a radiographer encompasses both patient care and the use of technology. The technology employed could either be analogue or digital technology. Since 1973, the analogue imaging system has slowly been replaced by digital radiography imaging systems. Despite the many advantages of digital imaging it does present the radiographer with added responsibilities. Furthermore, analogue-trained radiographers have found adjusting to digital imaging especially challenging. The aim of the study was to explore and describe the experiences of analogue-trained radiographers utilising digital imaging in projection radiography with the intention of developing guidelines to equip radiography managers to assist analogue-trained radiographers to better utilise digital imaging. The researcher used Schlossberg’s Transition Theory as a lens to look at the experiences of analogue-trained radiographers using digital imaging to produce radiographs. The research study used a qualitative design which was explorative, descriptive and contextual in nature. The target population included all diagnostic radiographers (public and private) in the local municipality who were registered with the Health Professions Council of South Africa. Purposive sampling was employed to select the radiographers that represented all radiographers in the Nelson Mandela Bay Health District. The sample included all radiographers who fulfilled the identified selection criteria. The selected participants were recruited to take part in in-depth, semi-structured individual interviews. The data was analysed using a computer-aided qualitative data analysis software package, ATLAS.ti. The trustworthiness of this study was ensured by applying Guba’s model of trustworthiness that includes credibility, transferability, dependability and confirmability. The ethical principles of respect for persons, beneficence and justice, as espoused by the Belmont Report, were adhered to in order to ensure that the study was conducted in an ethical manner. Two themes emanated from the data, namely the evolution of the radiographer when faced with the advances in technology as well the role that the work environment played in the manner that the participants experienced the change. The experiences of the participants were described using direct quotations from the interviews and a literature control was used to verify the participants’ experiences. Evidence was found of radiographer indifference towards exposure selection, dose optimisation and placement of anatomical side markers when utilising digital imaging. Finally, guidelines were developed to equip radiography managers to assist analogue-trained radiographers to better utilise digital imaging. In addition, the guidelines will assist all other radiographers to better utilise digital imaging.
- Full Text:
- Date Issued: 2017
Experiences of health care professionals at Mdantsane sub-district primary health care clinics regarding the unavailability of medicines
- Authors: Mpengesi, Luvokazi
- Date: 2017
- Subjects: Physician and patient -- South Africa -- East London Primary care (Medicine) -- South Africa -- East London , Communication in medicine
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19619 , vital:28907
- Description: Medicine unavailability, also known as stock-outs is a global problem. South Africa is not exempt from this problem which impacts negatively on the way in which healthcare services are rendered, more especially in the public sector. Communities are complaining about the unavailability of medicines at public health facilities particularly in primary health care clinics. In an effort to address this problem, the Minister of Health has declared medicine availability as one of the six priorities of the Department of Health. The aim of this study was to explore and describe the experiences and perceptions of healthcare professionals practicing at primary healthcare clinics in a peri-urban area of the Eastern Cape regarding the unavailability of medicines. Understanding the experiences and perceptions was expected to assist in addressing the problem at hand and help management in developing ways to address the problem and support the employees. Semi-structured interviews were conducted with healthcare professionals working at primary health care clinics in and around Mdantsane Township in the Eastern Cape. The main findings of the study can be divided into the following topics: perceived causes of medicine stock-outs, the implications of stock shortages, actions taken in the case of stock-outs and the role to play by in mitigating the impact of stock shortages. The limitations of the study include the research sample which was not truly representative of all healthcare professionals working at Mdantsane sub-district primary healthcare clinics. The study recommends various strategies that management should follow to assist in addressing medicine shortages. The researcher recommends further research to describe the experiences of healthcare professional regarding medicine unavailability.
- Full Text:
- Date Issued: 2017
- Authors: Mpengesi, Luvokazi
- Date: 2017
- Subjects: Physician and patient -- South Africa -- East London Primary care (Medicine) -- South Africa -- East London , Communication in medicine
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19619 , vital:28907
- Description: Medicine unavailability, also known as stock-outs is a global problem. South Africa is not exempt from this problem which impacts negatively on the way in which healthcare services are rendered, more especially in the public sector. Communities are complaining about the unavailability of medicines at public health facilities particularly in primary health care clinics. In an effort to address this problem, the Minister of Health has declared medicine availability as one of the six priorities of the Department of Health. The aim of this study was to explore and describe the experiences and perceptions of healthcare professionals practicing at primary healthcare clinics in a peri-urban area of the Eastern Cape regarding the unavailability of medicines. Understanding the experiences and perceptions was expected to assist in addressing the problem at hand and help management in developing ways to address the problem and support the employees. Semi-structured interviews were conducted with healthcare professionals working at primary health care clinics in and around Mdantsane Township in the Eastern Cape. The main findings of the study can be divided into the following topics: perceived causes of medicine stock-outs, the implications of stock shortages, actions taken in the case of stock-outs and the role to play by in mitigating the impact of stock shortages. The limitations of the study include the research sample which was not truly representative of all healthcare professionals working at Mdantsane sub-district primary healthcare clinics. The study recommends various strategies that management should follow to assist in addressing medicine shortages. The researcher recommends further research to describe the experiences of healthcare professional regarding medicine unavailability.
- Full Text:
- Date Issued: 2017
Experiences of primary caregivers of children with Down syndrome in the Kwazakhele community
- Authors: Gobeni, Babalwa Cynthia
- Date: 2017
- Subjects: Children with mental disabilities -- Care -- South Africa -- Port Elizabeth , Caregivers -- South Africa -- Port Elizabeth , Down syndrome -- Care -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/15127 , vital:28142
- Description: The unique physical features of the child with Down syndrome (DS) may lead to stigmatization and social isolation of the child, as well as their entire families. A child with DS may require some help and constant attention from the primary caregiver and may even be permanently dependent, depending on the severity of DS. The researcher has explored and described the experiences of primary caregivers of children with DS in the Kwazakhele community while caring for these children. The research study employed a qualitative, exploratory, descriptive and contextual research design. The research population included primary caregivers of children with DS who were between ages of two years and older because a DS diagnosis can be delayed and only be discovered later in life. Purposive sampling was used to select the research participants. The data was collected using in-depth one-on-one interviews, and all interviews were recorded using a voice recorder. Thematic analysis as a version of content analysis was used, meaning the researcher used themes and sub-themes to analyze data with the help of an independent coder. A pilot study was conducted before undertaking the actual research using the same methods and designs as those of the main study. Strategies were implemented throughout the study to ensure trustworthiness and adherence to ethical principles. The study findings revealed that the participants experienced diverse emotions upon initially finding out that their child has DS. The participants indicated that they had to modify their lives including having to give up their personal lives just to ensure that their children got the best care and their full attention. It appeared that some participants got full support from their partners and families, while other participants had no support system. With further exploration, it emerged that the study participants shared some positive experiences with their children with DS. However, they indicated a need for relevant education facilities for their children as well as community support. Recommendations were made with regard to nursing education, nursing practice and nursing research.
- Full Text:
- Date Issued: 2017
- Authors: Gobeni, Babalwa Cynthia
- Date: 2017
- Subjects: Children with mental disabilities -- Care -- South Africa -- Port Elizabeth , Caregivers -- South Africa -- Port Elizabeth , Down syndrome -- Care -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/15127 , vital:28142
- Description: The unique physical features of the child with Down syndrome (DS) may lead to stigmatization and social isolation of the child, as well as their entire families. A child with DS may require some help and constant attention from the primary caregiver and may even be permanently dependent, depending on the severity of DS. The researcher has explored and described the experiences of primary caregivers of children with DS in the Kwazakhele community while caring for these children. The research study employed a qualitative, exploratory, descriptive and contextual research design. The research population included primary caregivers of children with DS who were between ages of two years and older because a DS diagnosis can be delayed and only be discovered later in life. Purposive sampling was used to select the research participants. The data was collected using in-depth one-on-one interviews, and all interviews were recorded using a voice recorder. Thematic analysis as a version of content analysis was used, meaning the researcher used themes and sub-themes to analyze data with the help of an independent coder. A pilot study was conducted before undertaking the actual research using the same methods and designs as those of the main study. Strategies were implemented throughout the study to ensure trustworthiness and adherence to ethical principles. The study findings revealed that the participants experienced diverse emotions upon initially finding out that their child has DS. The participants indicated that they had to modify their lives including having to give up their personal lives just to ensure that their children got the best care and their full attention. It appeared that some participants got full support from their partners and families, while other participants had no support system. With further exploration, it emerged that the study participants shared some positive experiences with their children with DS. However, they indicated a need for relevant education facilities for their children as well as community support. Recommendations were made with regard to nursing education, nursing practice and nursing research.
- Full Text:
- Date Issued: 2017
Experiences of professional nurses regarding the implementation of the re-engineering of the primary health care programme in the Nelson Mandela Bay Health District
- Authors: Reid, Nolita
- Date: 2017
- Subjects: Nurses -- South Africa -- Nelson Mandela Bay Municipality Primary health care -- South Africa -- Nelson Mandela Bay Municipality , Public health -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/19927 , vital:29009
- Description: As a clinic supervisor overseeing a cluster of clinics in the Nelson Mandela Bay Health District (NMBHD), the researcher observed a number of problems with the implementation of the re-engineering of the primary health care (RPHC) programme. The problems observed include inadequate supervision of RPHC staff, poor communication and conflict between clinic and RPHC staff, failure to filter RPHC statistics into clinic statistics and the incorrect management of patients by RPHC staff. Therefore, the purpose of this study is to explore and describe the experiences of professional nurses regarding the implementation of the RPHC programme in the NMBHD and to make recommendations the district manager could use to address the research findings. The study used a qualitative, exploratory, descriptive and contextual design. The research population consisted of professional nurses who are implementing the RPHC programme in the NMBHD, and the sampling technique was a non-probability, purposive technique for the selection of the research sample. Semi-structured interviews were used to collect the data and Tesch’s model respectively. The researcher adhered to ethical considerations throughout the study and ensured trustworthiness of the data by using the criteria of credibility, transferability, dependability and conformability. Three themes were identified; namely; the professional nurses expression of their concerns regarding poor working conditions; issues regarding the community health workers and their positive experiences associated with the RPHC programme. The study concludes with recommendations made to the District manager with regard to nursing practice, as well as recommendations to nursing education and research.
- Full Text:
- Date Issued: 2017
- Authors: Reid, Nolita
- Date: 2017
- Subjects: Nurses -- South Africa -- Nelson Mandela Bay Municipality Primary health care -- South Africa -- Nelson Mandela Bay Municipality , Public health -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/19927 , vital:29009
- Description: As a clinic supervisor overseeing a cluster of clinics in the Nelson Mandela Bay Health District (NMBHD), the researcher observed a number of problems with the implementation of the re-engineering of the primary health care (RPHC) programme. The problems observed include inadequate supervision of RPHC staff, poor communication and conflict between clinic and RPHC staff, failure to filter RPHC statistics into clinic statistics and the incorrect management of patients by RPHC staff. Therefore, the purpose of this study is to explore and describe the experiences of professional nurses regarding the implementation of the RPHC programme in the NMBHD and to make recommendations the district manager could use to address the research findings. The study used a qualitative, exploratory, descriptive and contextual design. The research population consisted of professional nurses who are implementing the RPHC programme in the NMBHD, and the sampling technique was a non-probability, purposive technique for the selection of the research sample. Semi-structured interviews were used to collect the data and Tesch’s model respectively. The researcher adhered to ethical considerations throughout the study and ensured trustworthiness of the data by using the criteria of credibility, transferability, dependability and conformability. Three themes were identified; namely; the professional nurses expression of their concerns regarding poor working conditions; issues regarding the community health workers and their positive experiences associated with the RPHC programme. The study concludes with recommendations made to the District manager with regard to nursing practice, as well as recommendations to nursing education and research.
- Full Text:
- Date Issued: 2017
Experiences of professional nurses regarding the use of mobile technology for accessing information at the point of care clinical decision making
- Authors: Lindi, Ntombizodwa
- Date: 2017
- Subjects: Nursing -- South Africa -- Eastern Cape Mobile communication systems -- South Africa -- Eastern Cape , Rural health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/45399 , vital:38613
- Description: The research has provided valuable insight into the experiences of professional nurses regarding use of mobile technology for accessing health information at the point of care in clinical decision making at rural primary health clinics. The ability to access health information enabled them to render accurate and safe patient care. Recommendations were made with regard to nursing practice, education and research. Innovative strategies such as the use of mobile technology have been employed in order to access health information at the point of care for clinical decision making in 2012 in the rural primary health care clinics by the Department of Health in the Eastern Cape Province. Retrieval of information from mobile technology is perceived as being useful for clinical decision making and could result in positive patient outcomes. In this study the researcher explored and described the professional nurses’ experiences of using smart for accessing information in clinical decision making at rural primary health care clinics.
- Full Text:
- Date Issued: 2017
- Authors: Lindi, Ntombizodwa
- Date: 2017
- Subjects: Nursing -- South Africa -- Eastern Cape Mobile communication systems -- South Africa -- Eastern Cape , Rural health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/45399 , vital:38613
- Description: The research has provided valuable insight into the experiences of professional nurses regarding use of mobile technology for accessing health information at the point of care in clinical decision making at rural primary health clinics. The ability to access health information enabled them to render accurate and safe patient care. Recommendations were made with regard to nursing practice, education and research. Innovative strategies such as the use of mobile technology have been employed in order to access health information at the point of care for clinical decision making in 2012 in the rural primary health care clinics by the Department of Health in the Eastern Cape Province. Retrieval of information from mobile technology is perceived as being useful for clinical decision making and could result in positive patient outcomes. In this study the researcher explored and described the professional nurses’ experiences of using smart for accessing information in clinical decision making at rural primary health care clinics.
- Full Text:
- Date Issued: 2017
Experiential learning in an undergraduate BPHARM programme: impact of an intervention on academic achievement
- Authors: McCartney, Jane Alison
- Date: 2017
- Subjects: Pharmacy -- Study and teaching -- South Africa Experiential learning -- South Africa , Academic achievement -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/19037 , vital:28767
- Description: The extended role of today’s pharmacist with the emphasis on patient-focused care has highlighted the need for increased exposure of undergraduate pharmacy students to experiential learning in patient-centred environments, and additional skills development in therapeutics, problem solving and clinical decision making. At the Nelson Mandela Metropolitan University (NMMU), final year pharmacy students complete a university-coordinated, hospital-based, structured experiential learning programme (ELP) for the exit-level module, Pharmacology4. However, the students consistently experience difficulties in the application of pharmacological knowledge during the transition from lecture-based learning to the patient-focused clinical setting. The student population at the NMMU is diverse, with varied cultural, ethnic, language and secondary level education backgrounds, as well as different learning preferences and approaches. The extent to which these factors affect academic achievement in the experiential learning environment is unknown. Central research question The central research question for this study was therefore, “What would be the effect of an intervention aimed at supporting undergraduate pharmacy students during clinical placements, on academic achievement in, and student attitudes towards, experiential learning programmes (ELP)?” In order to explore the research question, several factors which may influence academic achievement in ELPs were investigated, namely: academic achievement (pre-university, in the BPharm programme and, in pharmacology); the admission route into the BPharm programme and the subsequent rate of academic progression; English reading comprehension ability; learning styles; problem solving ability; the extent to which students are prepared for application of knowledge in the ELP, in terms of assessment methods used prior to the final year and previous pharmacy work-based experience. In addition, the students’ lived experience of the ELP was explored, and the need for, and nature of, an intervention was determined. The research was based in a pragmatic paradigm, using an advanced mixed methods approach. An intervention-based, two-phase, quasi-experimental design was employed with an initial exploratory Preliminary Phase (in 2013) preceding the larger experimental framework (Phases One and Two, in 2014 and 2015 respectively). The research design was primarily quantitative, with pre- and post- testing conducted before and after the ELP. The ELP was completed by the comparator cohort in Phase One and the experimental cohort in Phase Two. Supplementary qualitative data was collected before, during and after the ELP. The intervention, in the form of supplementary academic support sessions, was developed from the qualitative data using an iterative approach, and implemented during the ELP in Phase Two. Attitudes and expectations of the students towards the hospital-based ELP were generally positive and realistic. Areas of concern included the difficulties experienced in the application and integration of pharmacological knowledge, both in the clinical setting and the clinical case study-based assessments; students feeling overwhelmed, inadequate and inferior in the clinical environment, compounded by an absence of clinical pharmacists as role models; and feeling unprepared for patient-focused care. The qualitative data strongly supported the need for supplementary academic support sessions. The intervention was developed and implemented in Phase Two, using patient case-based, active learning strategies. The majority of students (91.0%; n = 104) reported improved case analysis skills. A statistically significant (p = .030, Cohen’s d = 0.34) improvement was noted in the summative Pharmacology4 assessment marks obtained by the experimental cohort post-intervention, although of small practical significance. Predictors of academic achievement in the ELP were found to be language, specifically English reading comprehension skills, academic achievement in the BPharm programme and pharmacology, the university admission score, the rate of academic progression, and problem solving ability. Previous pharmacy-based work experience and assessment questions requiring application of knowledge were also found to influence achievement in the ELP. The need for an intervention in the form of supplementary academic support sessions was confirmed. The intervention was subsequently developed and successfully implemented, with student-reported self-perceived improvements in patient case analysis skills. These positive findings were supported by quantitative data which showed a statistically significant improvement in academic achievement in the ELP. Several predictors of academic achievement in the ELP were identified, and invaluable insight was gained into the nature of the difficulties experienced by pharmacy students in the transition from lecture-based learning to experiential learning in patient-focused environments.
- Full Text:
- Date Issued: 2017
- Authors: McCartney, Jane Alison
- Date: 2017
- Subjects: Pharmacy -- Study and teaching -- South Africa Experiential learning -- South Africa , Academic achievement -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/19037 , vital:28767
- Description: The extended role of today’s pharmacist with the emphasis on patient-focused care has highlighted the need for increased exposure of undergraduate pharmacy students to experiential learning in patient-centred environments, and additional skills development in therapeutics, problem solving and clinical decision making. At the Nelson Mandela Metropolitan University (NMMU), final year pharmacy students complete a university-coordinated, hospital-based, structured experiential learning programme (ELP) for the exit-level module, Pharmacology4. However, the students consistently experience difficulties in the application of pharmacological knowledge during the transition from lecture-based learning to the patient-focused clinical setting. The student population at the NMMU is diverse, with varied cultural, ethnic, language and secondary level education backgrounds, as well as different learning preferences and approaches. The extent to which these factors affect academic achievement in the experiential learning environment is unknown. Central research question The central research question for this study was therefore, “What would be the effect of an intervention aimed at supporting undergraduate pharmacy students during clinical placements, on academic achievement in, and student attitudes towards, experiential learning programmes (ELP)?” In order to explore the research question, several factors which may influence academic achievement in ELPs were investigated, namely: academic achievement (pre-university, in the BPharm programme and, in pharmacology); the admission route into the BPharm programme and the subsequent rate of academic progression; English reading comprehension ability; learning styles; problem solving ability; the extent to which students are prepared for application of knowledge in the ELP, in terms of assessment methods used prior to the final year and previous pharmacy work-based experience. In addition, the students’ lived experience of the ELP was explored, and the need for, and nature of, an intervention was determined. The research was based in a pragmatic paradigm, using an advanced mixed methods approach. An intervention-based, two-phase, quasi-experimental design was employed with an initial exploratory Preliminary Phase (in 2013) preceding the larger experimental framework (Phases One and Two, in 2014 and 2015 respectively). The research design was primarily quantitative, with pre- and post- testing conducted before and after the ELP. The ELP was completed by the comparator cohort in Phase One and the experimental cohort in Phase Two. Supplementary qualitative data was collected before, during and after the ELP. The intervention, in the form of supplementary academic support sessions, was developed from the qualitative data using an iterative approach, and implemented during the ELP in Phase Two. Attitudes and expectations of the students towards the hospital-based ELP were generally positive and realistic. Areas of concern included the difficulties experienced in the application and integration of pharmacological knowledge, both in the clinical setting and the clinical case study-based assessments; students feeling overwhelmed, inadequate and inferior in the clinical environment, compounded by an absence of clinical pharmacists as role models; and feeling unprepared for patient-focused care. The qualitative data strongly supported the need for supplementary academic support sessions. The intervention was developed and implemented in Phase Two, using patient case-based, active learning strategies. The majority of students (91.0%; n = 104) reported improved case analysis skills. A statistically significant (p = .030, Cohen’s d = 0.34) improvement was noted in the summative Pharmacology4 assessment marks obtained by the experimental cohort post-intervention, although of small practical significance. Predictors of academic achievement in the ELP were found to be language, specifically English reading comprehension skills, academic achievement in the BPharm programme and pharmacology, the university admission score, the rate of academic progression, and problem solving ability. Previous pharmacy-based work experience and assessment questions requiring application of knowledge were also found to influence achievement in the ELP. The need for an intervention in the form of supplementary academic support sessions was confirmed. The intervention was subsequently developed and successfully implemented, with student-reported self-perceived improvements in patient case analysis skills. These positive findings were supported by quantitative data which showed a statistically significant improvement in academic achievement in the ELP. Several predictors of academic achievement in the ELP were identified, and invaluable insight was gained into the nature of the difficulties experienced by pharmacy students in the transition from lecture-based learning to experiential learning in patient-focused environments.
- Full Text:
- Date Issued: 2017
Factors relating to academic success in the first semester of the bachelor of pharmacy degree at NMMU
- Authors: Nagel, Timothy Shaun
- Date: 2017
- Subjects: Pharmacy -- Study and teaching , College students -- South Africa Academic achievement
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/14201 , vital:27446
- Description: Student throughput rates and academic achievement at universities are a concern at a national level in South Africa. Statistics have shown that on average, only ±17% of students who enrolled at a university, managed to graduate. The aim of the study was to determine the factors pertaining to student achievement and success in the first semester of the first year Bachelor of Pharmacy degree at the Nelson Mandela Metropolitan University. This study was a longitudinal, observational study which incorporated only quantitative aspects. Factors included in the investigation were: student motivation; learning styles; prior academic achievement; language use and sources of financial support. In order to determine student motivation, an Academic Motivation Scale (AMS) was used. Learning styles were assessed using a Kolb Learning Style Inventory (LSI) tool. The student’s National Senior Certificate (NSC) results were compared to the students 2016 semester one final marks, to correlate student readiness and prior academic achievement with current academic achievement. Home language and sources of financial support were also evaluated using a purpose-designed questionnaire. Results showed that only the Life Sciences module was practically and statistically significant as a predictor of academic success, with a p-value of .001 and a correlation coefficient |r| value of .369. The minimum entry requirements for the BPharm Degree do not include Life Science, however, based on this study, inclusion of Life Sciences at a specific achievement level should be considered.
- Full Text:
- Date Issued: 2017
- Authors: Nagel, Timothy Shaun
- Date: 2017
- Subjects: Pharmacy -- Study and teaching , College students -- South Africa Academic achievement
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/14201 , vital:27446
- Description: Student throughput rates and academic achievement at universities are a concern at a national level in South Africa. Statistics have shown that on average, only ±17% of students who enrolled at a university, managed to graduate. The aim of the study was to determine the factors pertaining to student achievement and success in the first semester of the first year Bachelor of Pharmacy degree at the Nelson Mandela Metropolitan University. This study was a longitudinal, observational study which incorporated only quantitative aspects. Factors included in the investigation were: student motivation; learning styles; prior academic achievement; language use and sources of financial support. In order to determine student motivation, an Academic Motivation Scale (AMS) was used. Learning styles were assessed using a Kolb Learning Style Inventory (LSI) tool. The student’s National Senior Certificate (NSC) results were compared to the students 2016 semester one final marks, to correlate student readiness and prior academic achievement with current academic achievement. Home language and sources of financial support were also evaluated using a purpose-designed questionnaire. Results showed that only the Life Sciences module was practically and statistically significant as a predictor of academic success, with a p-value of .001 and a correlation coefficient |r| value of .369. The minimum entry requirements for the BPharm Degree do not include Life Science, however, based on this study, inclusion of Life Sciences at a specific achievement level should be considered.
- Full Text:
- Date Issued: 2017
Female university students’ perceptions of the effects of maternal loss on their identity and intimacy development
- Authors: Makalima, Phaphama
- Date: 2017
- Subjects: Intimacy (Psychology) Identity (Psychology) , Students -- South Africa -- Psychological aspects Developmental psychology -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/18090 , vital:28575
- Description: Early maternal loss and its effects on daughters’ development has generated interest internationally. Yet very few studies have been conducted within South Africa, even though the prevalence of South African children growing up with the loss of their mothers is on the increase particularly due to HIV and Aids. This field of study is particularly important as mothers play a significant developmental role in children’s wellbeing. This study focused on exploring NMMU female students’ perceptions of the effects of maternal loss before adolescence on their identity and intimacy development. A qualitative research approach was followed in order to gain in-depth understanding regarding these perceived effects. A purposive, non-probability sampling method was employed to select participants and semi-structured interviews were conducted with them to explore and describe their perceptions. Attachment theory was utilised to provide a theoretical understanding of the potential impact of such loss on identity and intimacy development. Erikson’s psychosocial development theory was employed to describe the nature of personal identity and intimacy. The role of mothers in the South African context is perceived to be of importance with much focus on daughters’ identity development. Childhood maternal loss for daughters was perceived to effect the identity formation of participants in the study. The majority of participants perceived not having been able to spend enough time with their biological mothers to have limited their self-exploration. The participants perceived that this loss also had an effect on their intimacy as it isolated them from their peers and available support systems due to the fear of experiencing losing a person again in their lives.
- Full Text:
- Date Issued: 2017
- Authors: Makalima, Phaphama
- Date: 2017
- Subjects: Intimacy (Psychology) Identity (Psychology) , Students -- South Africa -- Psychological aspects Developmental psychology -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/18090 , vital:28575
- Description: Early maternal loss and its effects on daughters’ development has generated interest internationally. Yet very few studies have been conducted within South Africa, even though the prevalence of South African children growing up with the loss of their mothers is on the increase particularly due to HIV and Aids. This field of study is particularly important as mothers play a significant developmental role in children’s wellbeing. This study focused on exploring NMMU female students’ perceptions of the effects of maternal loss before adolescence on their identity and intimacy development. A qualitative research approach was followed in order to gain in-depth understanding regarding these perceived effects. A purposive, non-probability sampling method was employed to select participants and semi-structured interviews were conducted with them to explore and describe their perceptions. Attachment theory was utilised to provide a theoretical understanding of the potential impact of such loss on identity and intimacy development. Erikson’s psychosocial development theory was employed to describe the nature of personal identity and intimacy. The role of mothers in the South African context is perceived to be of importance with much focus on daughters’ identity development. Childhood maternal loss for daughters was perceived to effect the identity formation of participants in the study. The majority of participants perceived not having been able to spend enough time with their biological mothers to have limited their self-exploration. The participants perceived that this loss also had an effect on their intimacy as it isolated them from their peers and available support systems due to the fear of experiencing losing a person again in their lives.
- Full Text:
- Date Issued: 2017
Implementation of National Health Insurance in South Africa: views of healthcare managers in a private healthcare institution
- Authors: Grewar, David Alan
- Date: 2017
- Subjects: National health insurance -- South Africa , Health care reform -- South Africa , Medical personnel -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/7503 , vital:21789
- Description: South Africa is in the process of reforming its healthcare system by implementing universal health coverage for its citizens. Universal health coverage is defined as the access of all people to comprehensive health services at an affordable cost with protection against catastrophic health expenditures leading to financial hardship. The system being implemented in South Africa is known as National Health Insurance (NHI) and is seen by the South African government as the key to addressing the shortcomings and disparities in the current public and private healthcare sectors. Healthcare managers have a crucial role to play in health reform yet are often overlooked in debate over health reform. The primary aim of this study was to better understand the views of healthcare managers, working in a private healthcare institution in South Africa, towards the implementation of the NHI. The purpose of this was to make recommendations that would assist the private healthcare institution under investigation to optimise the implementation of the NHI. A quantitative research design was used to explore and describe the views of healthcare managers. Firstly, a literature review was conducted to gain international as well as local perspectives of healthcare practitioners on universal health coverage. Secondly, a census survey in the form of an online questionnaire was developed and distributed to 193 healthcare managers representing different managerial and medical disciplines in a private healthcare institution with facilities nation-wide. A total of 63 questionnaires were returned for analysis. Quantitative data were analysed using Microsoft Excel, Statistica and SPSS Statistics. Qualitative data in the form of written comments by the participants were analysed using interpretive analysis that involved sequential steps of familiarisation and immersion, development of themes, coding, elaboration and interpretation and checking. The qualitative element of the study was limited in nature and was used merely to enrich the quantitative findings. The study found that there was a lack of knowledge amongst private healthcare managers concerning the NHI, poor communication from the government regarding the proposed NHI and high levels of negativity towards the ability of the government to successfully implement the NHI. However it was found that despite concerns regarding the NHI, the private healthcare managers surveyed showed a willingness to actively participate in its implementation. Recommendations regarding policy and practise were made for private healthcare institutions as well as for the South African government in order to assist with the implementation of the NHI.
- Full Text:
- Date Issued: 2017
- Authors: Grewar, David Alan
- Date: 2017
- Subjects: National health insurance -- South Africa , Health care reform -- South Africa , Medical personnel -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/7503 , vital:21789
- Description: South Africa is in the process of reforming its healthcare system by implementing universal health coverage for its citizens. Universal health coverage is defined as the access of all people to comprehensive health services at an affordable cost with protection against catastrophic health expenditures leading to financial hardship. The system being implemented in South Africa is known as National Health Insurance (NHI) and is seen by the South African government as the key to addressing the shortcomings and disparities in the current public and private healthcare sectors. Healthcare managers have a crucial role to play in health reform yet are often overlooked in debate over health reform. The primary aim of this study was to better understand the views of healthcare managers, working in a private healthcare institution in South Africa, towards the implementation of the NHI. The purpose of this was to make recommendations that would assist the private healthcare institution under investigation to optimise the implementation of the NHI. A quantitative research design was used to explore and describe the views of healthcare managers. Firstly, a literature review was conducted to gain international as well as local perspectives of healthcare practitioners on universal health coverage. Secondly, a census survey in the form of an online questionnaire was developed and distributed to 193 healthcare managers representing different managerial and medical disciplines in a private healthcare institution with facilities nation-wide. A total of 63 questionnaires were returned for analysis. Quantitative data were analysed using Microsoft Excel, Statistica and SPSS Statistics. Qualitative data in the form of written comments by the participants were analysed using interpretive analysis that involved sequential steps of familiarisation and immersion, development of themes, coding, elaboration and interpretation and checking. The qualitative element of the study was limited in nature and was used merely to enrich the quantitative findings. The study found that there was a lack of knowledge amongst private healthcare managers concerning the NHI, poor communication from the government regarding the proposed NHI and high levels of negativity towards the ability of the government to successfully implement the NHI. However it was found that despite concerns regarding the NHI, the private healthcare managers surveyed showed a willingness to actively participate in its implementation. Recommendations regarding policy and practise were made for private healthcare institutions as well as for the South African government in order to assist with the implementation of the NHI.
- Full Text:
- Date Issued: 2017
Knowledge, attitudes and practices of adolescents regarding contraceptives in the Maluti sub-district
- Authors: Cingo, Andiswa Linda
- Date: 2017
- Subjects: Contraceptives -- South Africa -- Eastern Cape Teenagers -- Sexual behavior -- South Africa -- Eastern Cape , Teenagers -- South Africa -- Eastern Cape -- Attitudes Adolescence -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/15302 , vital:28217
- Description: The researcher observed a high incidence of pregnancy, sexually transmitted infections and abortions, including illegal abortions among adolescents in the Maluti Sub-District in the Eastern Cape Province. The researcher noted when speaking to the adolescents about contraceptives that they appeared to have a lack of knowledge as well as some misconceptions about contraceptives. The study therefore explores the knowledge, attitudes and practices of adolescents regarding contraceptives. To achieve the purpose of this study, a quantitative, explorative and descriptive survey was used to conduct this study. The research population in this study comprised all Grade 11 and 12 female adolescents enrolled at the selected senior secondary schools in the Maluti Sub-District. Simple random sampling was used to select the research sample. A structured self-administered questionnaire was used as a data collection tool. Descriptive and inferential statistics were used with the help of a statistician to analyse the data. A pilot study was conducted prior to the actual study being conducted, using the same design and research methods. The study findings revealed that participants had a low level of knowledge about contraceptive methods and there were some misconceptions regarding contraceptives prevailing among the participants. More than half (54%) of the participants are currently sexually active and less than a third of the participants indicated that they were using contraceptives The study concludes with recommendations for nursing practice, education and research. Ethical principles have been maintained throughout the study.
- Full Text:
- Date Issued: 2017
- Authors: Cingo, Andiswa Linda
- Date: 2017
- Subjects: Contraceptives -- South Africa -- Eastern Cape Teenagers -- Sexual behavior -- South Africa -- Eastern Cape , Teenagers -- South Africa -- Eastern Cape -- Attitudes Adolescence -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/15302 , vital:28217
- Description: The researcher observed a high incidence of pregnancy, sexually transmitted infections and abortions, including illegal abortions among adolescents in the Maluti Sub-District in the Eastern Cape Province. The researcher noted when speaking to the adolescents about contraceptives that they appeared to have a lack of knowledge as well as some misconceptions about contraceptives. The study therefore explores the knowledge, attitudes and practices of adolescents regarding contraceptives. To achieve the purpose of this study, a quantitative, explorative and descriptive survey was used to conduct this study. The research population in this study comprised all Grade 11 and 12 female adolescents enrolled at the selected senior secondary schools in the Maluti Sub-District. Simple random sampling was used to select the research sample. A structured self-administered questionnaire was used as a data collection tool. Descriptive and inferential statistics were used with the help of a statistician to analyse the data. A pilot study was conducted prior to the actual study being conducted, using the same design and research methods. The study findings revealed that participants had a low level of knowledge about contraceptive methods and there were some misconceptions regarding contraceptives prevailing among the participants. More than half (54%) of the participants are currently sexually active and less than a third of the participants indicated that they were using contraceptives The study concludes with recommendations for nursing practice, education and research. Ethical principles have been maintained throughout the study.
- Full Text:
- Date Issued: 2017