A best practice guideline for screening and managing chorioamnionitis
- Authors: Du Plessis, Allison Herlene
- Date: 2020
- Subjects: Bacterial diseases
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46374 , vital:39575
- Description: Due to the complex nature of chorioamnionitis, women are often misdiagnosed, undiagnosed or only diagnosed after birth when it is too late to prevent maternal and neonatal complications. A lack of a comprehensive best practice guidelinefor screening and managing women withchorioamnionitis resultsin delayed treatment and management that could minimise maternal and neonatal complications. Saving Babiesreported that unexplained intra-uterine deathsremained the main primary (obstetric) cause of death for babies with a weight above 1000g (24.4%of all deaths). Of these unexplained uterine deaths, 33% are of normal birth weight (>2500g), and,therefore,most likely term gestation. Saving Babies further reported that 22.9% of all live births in South Africa was premature and 22.8% of birthswere unexplained intra-uterine deaths. Prematurity is one major complication of chorioamnionitis. When susceptibility for chorioamnionitis is considered during early pregnancy, it is possible to intervene and prevent or even reduce the incidences and complications of chorioamnionitis.A qualitative research study was conducted in three phases. In Phase One(Part One), a theoretically constructed patient scenario of chorioamnionitis was presented to ten midwives,and semi-structured individual interviews were done to elicit information regarding how they screen for and manage chorioamnionitis. In Phase One(Part Two), experienced medical practitioners in the field of obstetrics and gynaecology were individually interviewed, also using semi-structured individual interviewsto gain their views regarding chorioamnionitis as a contributing factor to maternal morbidity and mortality. Qualitative findings in Phase Oneindicated that there is a general lack of knowledge regarding chorioamnionitis among midwives, resulting ininadequate screening, misdiagnosis and mismanagement of the condition. Experienced medical practitioners confirmed that chorioamnionitis is underdiagnosed, misdiagnosed or undiagnosed and underreported,and they hold views that it is difficult to treat and control pregnancy-related infections according to current practice.An integrative literature review was conductedin Phase Twoand literature regarding diagnostic biomarkers, screening options to diagnose chorioamnionitis and management of chorioamnionitis were extracted. After evidence synthesisofPhase Oneand Phase Twodata, a best practice guidelinefor screening and managing viiwomen withchorioamnionitiswas developed usingthe National Institute for Health and Clinical Excellence guideline development approach in Phase Three. The purpose of the best practice guideline for screening and managing women with chorioamnionitis was to provide a guideline onhow to manage women who are at risk and those who present with signs and symptoms of chorioamnionitis at any stage during their pregnancy. Five recommendations were made that involve screening for chorioamnionitisand causative factors, biomarkers to diagnose chorioamnionitis, management of chorioamnionitis that includes pharmacological and non-pharmacological management, and health education to women.Ethics for this research study were guided by the ethical principles and guidelines of the Belmont Report. The trustworthiness of this research study was adopted from Ravitch and Carl,and was based on criticality, reflexivity, collaboration, and rigour. An independent coder and reviewer wereto verify the data that were included in the best practice guideline. Expert reviewersappraised the best practice guidelineusing Appraisal of Guidelines for Research and Evaluation II tools.
- Full Text:
- Date Issued: 2020
- Authors: Du Plessis, Allison Herlene
- Date: 2020
- Subjects: Bacterial diseases
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46374 , vital:39575
- Description: Due to the complex nature of chorioamnionitis, women are often misdiagnosed, undiagnosed or only diagnosed after birth when it is too late to prevent maternal and neonatal complications. A lack of a comprehensive best practice guidelinefor screening and managing women withchorioamnionitis resultsin delayed treatment and management that could minimise maternal and neonatal complications. Saving Babiesreported that unexplained intra-uterine deathsremained the main primary (obstetric) cause of death for babies with a weight above 1000g (24.4%of all deaths). Of these unexplained uterine deaths, 33% are of normal birth weight (>2500g), and,therefore,most likely term gestation. Saving Babies further reported that 22.9% of all live births in South Africa was premature and 22.8% of birthswere unexplained intra-uterine deaths. Prematurity is one major complication of chorioamnionitis. When susceptibility for chorioamnionitis is considered during early pregnancy, it is possible to intervene and prevent or even reduce the incidences and complications of chorioamnionitis.A qualitative research study was conducted in three phases. In Phase One(Part One), a theoretically constructed patient scenario of chorioamnionitis was presented to ten midwives,and semi-structured individual interviews were done to elicit information regarding how they screen for and manage chorioamnionitis. In Phase One(Part Two), experienced medical practitioners in the field of obstetrics and gynaecology were individually interviewed, also using semi-structured individual interviewsto gain their views regarding chorioamnionitis as a contributing factor to maternal morbidity and mortality. Qualitative findings in Phase Oneindicated that there is a general lack of knowledge regarding chorioamnionitis among midwives, resulting ininadequate screening, misdiagnosis and mismanagement of the condition. Experienced medical practitioners confirmed that chorioamnionitis is underdiagnosed, misdiagnosed or undiagnosed and underreported,and they hold views that it is difficult to treat and control pregnancy-related infections according to current practice.An integrative literature review was conductedin Phase Twoand literature regarding diagnostic biomarkers, screening options to diagnose chorioamnionitis and management of chorioamnionitis were extracted. After evidence synthesisofPhase Oneand Phase Twodata, a best practice guidelinefor screening and managing viiwomen withchorioamnionitiswas developed usingthe National Institute for Health and Clinical Excellence guideline development approach in Phase Three. The purpose of the best practice guideline for screening and managing women with chorioamnionitis was to provide a guideline onhow to manage women who are at risk and those who present with signs and symptoms of chorioamnionitis at any stage during their pregnancy. Five recommendations were made that involve screening for chorioamnionitisand causative factors, biomarkers to diagnose chorioamnionitis, management of chorioamnionitis that includes pharmacological and non-pharmacological management, and health education to women.Ethics for this research study were guided by the ethical principles and guidelines of the Belmont Report. The trustworthiness of this research study was adopted from Ravitch and Carl,and was based on criticality, reflexivity, collaboration, and rigour. An independent coder and reviewer wereto verify the data that were included in the best practice guideline. Expert reviewersappraised the best practice guidelineusing Appraisal of Guidelines for Research and Evaluation II tools.
- Full Text:
- Date Issued: 2020
A psychobiographical case study: Amelia Dyer in a search for glory
- Authors: April, Heather
- Date: 2020
- Subjects: Serial murderers--Psychology
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/50857 , vital:43008
- Description: The study is a psychobiographical case study based on the life of a Victorian baby farmer Amelia Dyer (1837-1896). She was executed for the murder of babies who were placed in her care over a period of 30 years. Psychobiography is a qualitative method of enquiry which explores the life of a unique individual subject through the lens of a psychological theory for the purpose of creating a coherent psychological case study. The psychoanalytic theoretical lens of Karen Horney was used to trace the evolution of Amelia Dyer’s sense of self within the Victorian culture of respectability. Baby farming referred to an unregulated business of adoption and fostering of infants, mostly illegitimate infants for a fee. Insufficient social structures and support for unwed mothers and children encouraged the business practice as women had very little choice for childcare. Baby farming was open to abuse and exploitation and hundreds of babies lost their lives due to insufficient care or infanticide. Amelia Dyer showed special talents and creativity from a young age, was ambitious and wanted to be self-reliant in a culture that did not provide women with opportunities to live out their ambitions. Baby farming became a business venture for her in the early stages of her life which later evolved into sadistic abuse and murder of the infants. Her evolution from a creative and hardworking young girl to a sadistic murderer of children is what qualifies her as a suitable subject for the exploration of Karen Horney’s dynamic theory of neuroses and the development of the neurotic self within culture. Extensive biographical data was collected and processed into salient themes. The study integrates the theory of Karen Horney, the life experiences of Amelia Dyer and Victorian respectability and demonstrates the value of using psychobiography as the method of inquiry into the exploration of the unique individual. The findings of the study demonstrated that Amelia Dyer and her social context were inextricably bound by a vicious cycle of psychic and emotional vi conflicts related to fear, control and self-hatred by the internalization of gender stereotypes and norms. The contribution of the study as a whole rests with its demonstration of the value of a holistic and reflexive exploration of the unique individual woman. It demonstrates the value of Horney’s in-depth theoretical understanding of the ambivalent core of selfhood that lies behind observable acts of behavior. The study as a whole contributes towards building upon holistic and integrative therapeutic frameworks in the understanding of diversity amongst women and mothers in culture.
- Full Text:
- Date Issued: 2020
- Authors: April, Heather
- Date: 2020
- Subjects: Serial murderers--Psychology
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/50857 , vital:43008
- Description: The study is a psychobiographical case study based on the life of a Victorian baby farmer Amelia Dyer (1837-1896). She was executed for the murder of babies who were placed in her care over a period of 30 years. Psychobiography is a qualitative method of enquiry which explores the life of a unique individual subject through the lens of a psychological theory for the purpose of creating a coherent psychological case study. The psychoanalytic theoretical lens of Karen Horney was used to trace the evolution of Amelia Dyer’s sense of self within the Victorian culture of respectability. Baby farming referred to an unregulated business of adoption and fostering of infants, mostly illegitimate infants for a fee. Insufficient social structures and support for unwed mothers and children encouraged the business practice as women had very little choice for childcare. Baby farming was open to abuse and exploitation and hundreds of babies lost their lives due to insufficient care or infanticide. Amelia Dyer showed special talents and creativity from a young age, was ambitious and wanted to be self-reliant in a culture that did not provide women with opportunities to live out their ambitions. Baby farming became a business venture for her in the early stages of her life which later evolved into sadistic abuse and murder of the infants. Her evolution from a creative and hardworking young girl to a sadistic murderer of children is what qualifies her as a suitable subject for the exploration of Karen Horney’s dynamic theory of neuroses and the development of the neurotic self within culture. Extensive biographical data was collected and processed into salient themes. The study integrates the theory of Karen Horney, the life experiences of Amelia Dyer and Victorian respectability and demonstrates the value of using psychobiography as the method of inquiry into the exploration of the unique individual. The findings of the study demonstrated that Amelia Dyer and her social context were inextricably bound by a vicious cycle of psychic and emotional vi conflicts related to fear, control and self-hatred by the internalization of gender stereotypes and norms. The contribution of the study as a whole rests with its demonstration of the value of a holistic and reflexive exploration of the unique individual woman. It demonstrates the value of Horney’s in-depth theoretical understanding of the ambivalent core of selfhood that lies behind observable acts of behavior. The study as a whole contributes towards building upon holistic and integrative therapeutic frameworks in the understanding of diversity amongst women and mothers in culture.
- Full Text:
- Date Issued: 2020
A psychobiography of Viktor Emil Frankl
- Authors: Bushkin, Hanan
- Date: 2020
- Subjects: Frankl, Viktor Emil
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46440 , vital:39566
- Description: The first study conducted in South Africa of a prominent figure traces back as far as 1939. Since then, extensive research has been done in the field of psychobiography, resulting in a growing interest in this field and evolving into an established research genre in South Africa. Despite the increase in the use of psychobiographies as a research approach internationally and specifically in South Africa, its use is still considered relatively under-utilised and, therefore, the pursuit of further development of psychobiographies in South Africa is required. In light of South Africa’s effort to promote and advance the use of psychobiographies, South African researchers may be motivated to continue studying significant and exceptional lives in South Africa and abroad. Viktor Frankl was selected for this study based on his uniqueness, significance and his interesting life. He is also considered an exceptional individual who has shaped modern psychological thinking. Frankl had written over 40 books on his theory and many studies have been conducted based on his existential theory. Frankl’s contribution to the academic world has been recognised and acknowledged by significant institutions through his own and others’ research. Although much has been written on the life and work of Frankl, none of the literature utilises specific psychological focus and no psychobiographical study of the life of Frankl exists. Therefore, the researcher selected Frankl as the subject for this psychobiography through purposive sampling. The aim of the study was to provide a psychological exploration and description of Frankl’s life against the backdrop of his socio-cultural context. In order to achieve this aim, the researcher employed two psychological frameworks to guide in the description and exploration of his life. The psychological frameworks included Levinson’s life structure theory of adult development and Frankl’s existential theory. The study aimed to describe Frankl’s development with the use of Levinson’s theory while describing how he attained meaning in his life with the use of his own existential theory. Due to the exploratory-descriptive nature of this study, the objective fell within the inductive research approach. The researcher utilised a systematic coding method to arrange the data. The theoretical framework of Levinson’s life structure theory guided the coding system, as well as the key concepts of Frankl’s existential theory. In addition, the researcher utilised Alexander’s guidelines for the extraction of salient data, together with McAdam’s methods and recommendations for managing the data. Lastly, the researcher followed the 12-step method of conducting a psychobiography, as proposed by Du Plessis. Findings from this study found a correlation between Frankl’s life and the eras and transitional periods as theorised by Levinson’s theory. The findings of this study, therefore, support the use of Levinson’s theory with regards to the time frames and its use in understanding Frankl’s development. Also, the researcher found that Levinson’s theory was useful in understanding Frankl’s personality development within his context throughout his lifespan. With regards to Frankl’s existential theory, the researcher found that the use of the theory was suitable in understanding Frankl’s search for meaning. Frankl’s concepts of freedom of will, will to meaning, meaning of life, existential vacuum, supra-meaning, dimensional ontology, the three triads and noö-dynamics assisted in explaining Frankl’s drive to find meaning in his life, take responsibility to attain such meaning and to strive for transcendence beyond his suffering. The researcher found Frankl’s theory useful in explaining his drive, motives, needs and patterns of behaviour within this context. The holistic and integrative approach of the study allowed for an in-depth exploration and description of Frankl’s life and development within his socio-historical context. In addition to contributing to the existing body of knowledge on Frankl, his life and his theory, the study also contributed to the growing field of psychobiographical research. The study acknowledged and highlighted that further in-depth examination of the lives of extraordinary personalities could significantly contribute to psychobiographical studies. Based on the psychological frameworks used to explore and describe Frankl’s life, recommendations are made for future research.
- Full Text:
- Date Issued: 2020
- Authors: Bushkin, Hanan
- Date: 2020
- Subjects: Frankl, Viktor Emil
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46440 , vital:39566
- Description: The first study conducted in South Africa of a prominent figure traces back as far as 1939. Since then, extensive research has been done in the field of psychobiography, resulting in a growing interest in this field and evolving into an established research genre in South Africa. Despite the increase in the use of psychobiographies as a research approach internationally and specifically in South Africa, its use is still considered relatively under-utilised and, therefore, the pursuit of further development of psychobiographies in South Africa is required. In light of South Africa’s effort to promote and advance the use of psychobiographies, South African researchers may be motivated to continue studying significant and exceptional lives in South Africa and abroad. Viktor Frankl was selected for this study based on his uniqueness, significance and his interesting life. He is also considered an exceptional individual who has shaped modern psychological thinking. Frankl had written over 40 books on his theory and many studies have been conducted based on his existential theory. Frankl’s contribution to the academic world has been recognised and acknowledged by significant institutions through his own and others’ research. Although much has been written on the life and work of Frankl, none of the literature utilises specific psychological focus and no psychobiographical study of the life of Frankl exists. Therefore, the researcher selected Frankl as the subject for this psychobiography through purposive sampling. The aim of the study was to provide a psychological exploration and description of Frankl’s life against the backdrop of his socio-cultural context. In order to achieve this aim, the researcher employed two psychological frameworks to guide in the description and exploration of his life. The psychological frameworks included Levinson’s life structure theory of adult development and Frankl’s existential theory. The study aimed to describe Frankl’s development with the use of Levinson’s theory while describing how he attained meaning in his life with the use of his own existential theory. Due to the exploratory-descriptive nature of this study, the objective fell within the inductive research approach. The researcher utilised a systematic coding method to arrange the data. The theoretical framework of Levinson’s life structure theory guided the coding system, as well as the key concepts of Frankl’s existential theory. In addition, the researcher utilised Alexander’s guidelines for the extraction of salient data, together with McAdam’s methods and recommendations for managing the data. Lastly, the researcher followed the 12-step method of conducting a psychobiography, as proposed by Du Plessis. Findings from this study found a correlation between Frankl’s life and the eras and transitional periods as theorised by Levinson’s theory. The findings of this study, therefore, support the use of Levinson’s theory with regards to the time frames and its use in understanding Frankl’s development. Also, the researcher found that Levinson’s theory was useful in understanding Frankl’s personality development within his context throughout his lifespan. With regards to Frankl’s existential theory, the researcher found that the use of the theory was suitable in understanding Frankl’s search for meaning. Frankl’s concepts of freedom of will, will to meaning, meaning of life, existential vacuum, supra-meaning, dimensional ontology, the three triads and noö-dynamics assisted in explaining Frankl’s drive to find meaning in his life, take responsibility to attain such meaning and to strive for transcendence beyond his suffering. The researcher found Frankl’s theory useful in explaining his drive, motives, needs and patterns of behaviour within this context. The holistic and integrative approach of the study allowed for an in-depth exploration and description of Frankl’s life and development within his socio-historical context. In addition to contributing to the existing body of knowledge on Frankl, his life and his theory, the study also contributed to the growing field of psychobiographical research. The study acknowledged and highlighted that further in-depth examination of the lives of extraordinary personalities could significantly contribute to psychobiographical studies. Based on the psychological frameworks used to explore and describe Frankl’s life, recommendations are made for future research.
- Full Text:
- Date Issued: 2020
Mothers’ perceptions of the effects of the babies in mind programme on maternal mental health and mother-infant attachment: a South African narrative study
- Naicker, Samantha, Cronje, Johan
- Authors: Naicker, Samantha , Cronje, Johan
- Date: 2020
- Subjects: Mother and infant
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46414 , vital:39590
- Description: The focus of this study is on mothers, motherhood and the Babies in Mind programme as an early intervention strategy for mothers in South Africa. The rate of maternal mental ill health in our country is alarming. Research consistently confirms that maternal mental health directly affects infant and child mental health. One of the major determinants of mental health is mother-infant attachment. Studies have indicated the range of deleterious effects that maternal mental ill-health and mother-infant attachment issues have on offspring from infancy to adulthood. This has implications for the mental health of future generations and society at large. Researchers have called for evidence-based interventions that address maternal mental health and mother-infant attachment, especially in developing countries. South Africa has no national prevention or treatment programme to address these needs. This study investigated the Babies in Mind programme as an early intervention option to address the gap in promoting maternal mental health and mother-infant attachment. A social constructionist, narrative study was employed to meet the objectives of the study. The aim was to explore mothers’ perceptions of the impact of the Babies in Mind programme, with particular reference to their mental health and their relationships to their infants. Focus was placed on understanding the social constructions of motherhood at the community level and how these constructions were reconstructed through the programme. Purposive sampling was employed and focus groups were conducted to collect the relevant data. The data was analysed using thematic analysis. The findings indicated that mothers’ experiences of the Babies in Mind programme were positive and there were improvements in their mental health and relationships to their infants. A relationship model for mothers was developed based on the themes that emerged from the data analysis. A platform for continued support and discussion was organised via a social media (Whatsapp) support group. Twelve 7guidelines were suggested for the implementation of intervention programmes such as the Babies in Mind programme at the community level.
- Full Text:
- Date Issued: 2020
- Authors: Naicker, Samantha , Cronje, Johan
- Date: 2020
- Subjects: Mother and infant
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46414 , vital:39590
- Description: The focus of this study is on mothers, motherhood and the Babies in Mind programme as an early intervention strategy for mothers in South Africa. The rate of maternal mental ill health in our country is alarming. Research consistently confirms that maternal mental health directly affects infant and child mental health. One of the major determinants of mental health is mother-infant attachment. Studies have indicated the range of deleterious effects that maternal mental ill-health and mother-infant attachment issues have on offspring from infancy to adulthood. This has implications for the mental health of future generations and society at large. Researchers have called for evidence-based interventions that address maternal mental health and mother-infant attachment, especially in developing countries. South Africa has no national prevention or treatment programme to address these needs. This study investigated the Babies in Mind programme as an early intervention option to address the gap in promoting maternal mental health and mother-infant attachment. A social constructionist, narrative study was employed to meet the objectives of the study. The aim was to explore mothers’ perceptions of the impact of the Babies in Mind programme, with particular reference to their mental health and their relationships to their infants. Focus was placed on understanding the social constructions of motherhood at the community level and how these constructions were reconstructed through the programme. Purposive sampling was employed and focus groups were conducted to collect the relevant data. The data was analysed using thematic analysis. The findings indicated that mothers’ experiences of the Babies in Mind programme were positive and there were improvements in their mental health and relationships to their infants. A relationship model for mothers was developed based on the themes that emerged from the data analysis. A platform for continued support and discussion was organised via a social media (Whatsapp) support group. Twelve 7guidelines were suggested for the implementation of intervention programmes such as the Babies in Mind programme at the community level.
- Full Text:
- Date Issued: 2020
Psychological and emotional effects of repeated exposure to violent crimes on victims residing in a high crime community in Nelson Mandela Metropolitan in the Eastern Cape
- Authors: De Klerk, Ulricha
- Date: 2020
- Subjects: Post-traumatic stress disorder
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46413 , vital:39582
- Description: Traumatic Stress Disorder (PTSD). While the literature provides detailed and comprehensive approaches and counselling modalities to working with clients who experience traumatic events, there is not much evidence on the experiences of individuals who reside in high crime communities. It follows, that the psychological and emotional experiences, as well as needs of such individuals may present with specific requirements from the therapeutic alliance. This study aimed to explore the psychological and emotional effects of repeated exposure to high crime and violence and the implications this posed to traumatic experiences. The study further aimed to develop a set of guidelines that can be drawn upon when working therapeutically with clients who reside in high crime communities. The study draws on a qualitative methodology and 17 participants were interviewed. The transcripts were analysed using thematic analysis and five themes were identified, relevant to the aims and objectives that were set. The findings suggest that the psychological and emotional experiences of individuals who reside in high crime communities, is experienced at a more heightened and prolonged period, thus making the psychotherapeutic intervention employed, more specific. To this effect, the guidelines developed provide specific strategies and approaches thatwere developed based on the themes identified and verified by a panel of psychological experts. The study contributes to the field of trauma, counselling and violence, in that it focuses on an area of trauma that has not been adequately focused on withinthe South African context, as well as in global contexts.
- Full Text:
- Date Issued: 2020
- Authors: De Klerk, Ulricha
- Date: 2020
- Subjects: Post-traumatic stress disorder
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46413 , vital:39582
- Description: Traumatic Stress Disorder (PTSD). While the literature provides detailed and comprehensive approaches and counselling modalities to working with clients who experience traumatic events, there is not much evidence on the experiences of individuals who reside in high crime communities. It follows, that the psychological and emotional experiences, as well as needs of such individuals may present with specific requirements from the therapeutic alliance. This study aimed to explore the psychological and emotional effects of repeated exposure to high crime and violence and the implications this posed to traumatic experiences. The study further aimed to develop a set of guidelines that can be drawn upon when working therapeutically with clients who reside in high crime communities. The study draws on a qualitative methodology and 17 participants were interviewed. The transcripts were analysed using thematic analysis and five themes were identified, relevant to the aims and objectives that were set. The findings suggest that the psychological and emotional experiences of individuals who reside in high crime communities, is experienced at a more heightened and prolonged period, thus making the psychotherapeutic intervention employed, more specific. To this effect, the guidelines developed provide specific strategies and approaches thatwere developed based on the themes identified and verified by a panel of psychological experts. The study contributes to the field of trauma, counselling and violence, in that it focuses on an area of trauma that has not been adequately focused on withinthe South African context, as well as in global contexts.
- Full Text:
- Date Issued: 2020
Socio-ecological, contextual effects in Raven’s Colour Progressive Matrices scores: Developing an index for guiding test selection and interpretation
- Authors: August, Justin Oswin
- Date: 2020
- Subjects: Ecological Systems Theory
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46401 , vital:39563
- 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. Given that the Raven’s Coloured Progressive Matrices (CPM)is purported to be culture-free and not heavily dependent on verbal and language skills;it has been extensively normed throughout the world for various population groups. While norms for normal populations of children have been developed in South Africa, these studies were based on race and gender predominantly and without taking into consideration the effects of socio-ecological factors on test performance. The research study aimed to understand the influence of socio-ecological factors on the expression of cognitive scores amongst a geographically diverse sample of South African learners. Through this study, research on the interplay between context and cognition was to be located within the Ecological Systems model of Bronfenbrenner. A secondary aim of the study was to develop an index that will guide test selection and interpretation of assessment results, taking into account the influence of socio-ecological factors and providing a conceptual framework for future test development. The study employed a quantitative methodology on a South African sample consisting of primary school children aged between the ages of 6 years to 11 years. The sample was drawn from schools in the Port Elizabeth areain South Africa that wereclassified into low, medium and high opportunity, based on context. The results indicated that the type of school had a significant impact on test performance, suggesting that contextual factors were influential in this process.The item analysisconductedfurther indicated that learners from a low opportunity school performed significantly lower than the other two schoolsin the sample. The index development provides a foundation for further research that would enhance the interpretation of test results. In the South African context, this is considered important, given our political history and our diversity wherea“one size fits all” approach is not possible.
- Full Text:
- Date Issued: 2020
- Authors: August, Justin Oswin
- Date: 2020
- Subjects: Ecological Systems Theory
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46401 , vital:39563
- 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. Given that the Raven’s Coloured Progressive Matrices (CPM)is purported to be culture-free and not heavily dependent on verbal and language skills;it has been extensively normed throughout the world for various population groups. While norms for normal populations of children have been developed in South Africa, these studies were based on race and gender predominantly and without taking into consideration the effects of socio-ecological factors on test performance. The research study aimed to understand the influence of socio-ecological factors on the expression of cognitive scores amongst a geographically diverse sample of South African learners. Through this study, research on the interplay between context and cognition was to be located within the Ecological Systems model of Bronfenbrenner. A secondary aim of the study was to develop an index that will guide test selection and interpretation of assessment results, taking into account the influence of socio-ecological factors and providing a conceptual framework for future test development. The study employed a quantitative methodology on a South African sample consisting of primary school children aged between the ages of 6 years to 11 years. The sample was drawn from schools in the Port Elizabeth areain South Africa that wereclassified into low, medium and high opportunity, based on context. The results indicated that the type of school had a significant impact on test performance, suggesting that contextual factors were influential in this process.The item analysisconductedfurther indicated that learners from a low opportunity school performed significantly lower than the other two schoolsin the sample. The index development provides a foundation for further research that would enhance the interpretation of test results. In the South African context, this is considered important, given our political history and our diversity wherea“one size fits all” approach is not possible.
- Full Text:
- Date Issued: 2020
Strategies for the facilitation of implementation of best practice guidelines in operating theatres at public hospitals
- Owolabi, Olukemi Olufunmilayo
- Authors: Owolabi, Olukemi Olufunmilayo
- Date: 2020
- Subjects: Operating rooms—Safety measures
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46422 , vital:39594
- Description: Best practice guidelines (BPGs) are the use of scientific evidence to direct patient care and guide clinical care to integrate best patient outcomes. The implementation of BPGs in operating theatre nursing improves patient safety and quality of care and enhances patient outcomes. Although BPGs are crucial, the implementation thereof is not well operationalised in clinical practice, especially in an area such as the operating theatres in public hospitals in the Nelson Mandela Bay Health District(NMHD)in the Eastern Cape Province. The study thus developed strategies that could be used to facilitate the implementation of best practice guidelines in the operating theatres at public hospitals in the NMBHD. Understanding registered nurses’ knowledge, attitudes, and practices (KAP) with regard to implementing BPGs in the operating theatre is important, as it will assist in the development of strategies to facilitate the implementation of BPGs.The study was conducted in three phases. Phase One comprised of a quantitative approach. Data collection was achieved by means of a self-administered questionnaire which was distributed to registered nurses in the operating theatres of public hospitals in the NMBHD. The purpose of the questionnaire was to establish their knowledge, attitude and practice with regard to best practice guidelines and the implementation thereof. Recommendations made by participants for strategies to facilitate the implementation of BPGs in operating theatres were also explored. Descriptive and inferential statistics were utilised to analyse and describe the data. Descriptive statistics were used to describe the profile of the sample, including the demographic data measures of central tendency, for example the mean and standard deviation (SD) and correlation techniques.Chi²analysis was performed to test for significance of the associations between the registered nurses’ demographic variables and their KAP. Data were categorised into three levels, namely lower (score < quartile 1 i.e. bottom 25%). Middle (quartile1 ≤ score ≤quartile i.e. in the middle 50%) and higher (score > quartile 3 i.e. top 25%).Findings from this research study revealed the limited knowledge, attitude and practice of OT nurses about BPGs. During Phase Two an integrative literature review approach was followed in order to identify the best available evidence with regard to the facilitation of the implementation of best practice guidelines in operating theatres. Lastly, Phase Three: strategies that could be used to facilitate the implementation of best practice guidelines in operating theatres were developed. The researcher developed the conceptual framework using the six elements of Dickoff, James and Weidenbach (1968:422). The conceptual framework informed the development of strategies. The strategies are a synthesis of the conclusions drawn from the research findings (phase one and two) and the conceptualization thereof. The strategies were reviewed by six-panel members. Each panel member was supplied with the format for evaluation of the strategies which was based on the criteria established by Chinn and Kramer (2018:156) the results of which included in chapter 7. The researcher ensured that the data obtained was valid and reliable, necessary to assist the researcher to produce quality research. Ethical considerations were maintained throughout. In general, the results of this thesis indicate that the developed strategies that could be used to facilitate the implementation of best practice guidelines, in operating theatres at public hospitals in the NMBHDare unique and could be implemented in theatres in public hospitals. The researcher succeeded in achieving the purpose for this study, because the strategies which are understandable, clear, simple, applicable and significant to operating theatre unit has been developed for use by operating theatre nurses, to facilitate the implementation of best practice guidelines in operating theatres at public hospitals in the NMBHD.
- Full Text:
- Date Issued: 2020
- Authors: Owolabi, Olukemi Olufunmilayo
- Date: 2020
- Subjects: Operating rooms—Safety measures
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46422 , vital:39594
- Description: Best practice guidelines (BPGs) are the use of scientific evidence to direct patient care and guide clinical care to integrate best patient outcomes. The implementation of BPGs in operating theatre nursing improves patient safety and quality of care and enhances patient outcomes. Although BPGs are crucial, the implementation thereof is not well operationalised in clinical practice, especially in an area such as the operating theatres in public hospitals in the Nelson Mandela Bay Health District(NMHD)in the Eastern Cape Province. The study thus developed strategies that could be used to facilitate the implementation of best practice guidelines in the operating theatres at public hospitals in the NMBHD. Understanding registered nurses’ knowledge, attitudes, and practices (KAP) with regard to implementing BPGs in the operating theatre is important, as it will assist in the development of strategies to facilitate the implementation of BPGs.The study was conducted in three phases. Phase One comprised of a quantitative approach. Data collection was achieved by means of a self-administered questionnaire which was distributed to registered nurses in the operating theatres of public hospitals in the NMBHD. The purpose of the questionnaire was to establish their knowledge, attitude and practice with regard to best practice guidelines and the implementation thereof. Recommendations made by participants for strategies to facilitate the implementation of BPGs in operating theatres were also explored. Descriptive and inferential statistics were utilised to analyse and describe the data. Descriptive statistics were used to describe the profile of the sample, including the demographic data measures of central tendency, for example the mean and standard deviation (SD) and correlation techniques.Chi²analysis was performed to test for significance of the associations between the registered nurses’ demographic variables and their KAP. Data were categorised into three levels, namely lower (score < quartile 1 i.e. bottom 25%). Middle (quartile1 ≤ score ≤quartile i.e. in the middle 50%) and higher (score > quartile 3 i.e. top 25%).Findings from this research study revealed the limited knowledge, attitude and practice of OT nurses about BPGs. During Phase Two an integrative literature review approach was followed in order to identify the best available evidence with regard to the facilitation of the implementation of best practice guidelines in operating theatres. Lastly, Phase Three: strategies that could be used to facilitate the implementation of best practice guidelines in operating theatres were developed. The researcher developed the conceptual framework using the six elements of Dickoff, James and Weidenbach (1968:422). The conceptual framework informed the development of strategies. The strategies are a synthesis of the conclusions drawn from the research findings (phase one and two) and the conceptualization thereof. The strategies were reviewed by six-panel members. Each panel member was supplied with the format for evaluation of the strategies which was based on the criteria established by Chinn and Kramer (2018:156) the results of which included in chapter 7. The researcher ensured that the data obtained was valid and reliable, necessary to assist the researcher to produce quality research. Ethical considerations were maintained throughout. In general, the results of this thesis indicate that the developed strategies that could be used to facilitate the implementation of best practice guidelines, in operating theatres at public hospitals in the NMBHDare unique and could be implemented in theatres in public hospitals. The researcher succeeded in achieving the purpose for this study, because the strategies which are understandable, clear, simple, applicable and significant to operating theatre unit has been developed for use by operating theatre nurses, to facilitate the implementation of best practice guidelines in operating theatres at public hospitals in the NMBHD.
- Full Text:
- Date Issued: 2020
The development of a set of guidelines for the revision of psychological tests and the use of revised psychological tests
- Authors: Cronje, Johan Herman
- Date: 2020
- Subjects: Psychological tests
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46350 , vital:39567
- Description: The psychological testindustry has produced a wide variety of psychological tests that are used by professionals to facilitate measurement and decision-making. Tests are updated and revised periodically in order to remain current, valid and reliable in what is a competitive psychometric industry. Despite the prevalence of test revisions, especially in recent years, a number of authors have commented on the lack of comprehensive guidelines for test revision. Guidelines shouldcover aspects such as what the different types of revision are, when to embark on a revision, whatprocessto followand how test users should use revised tests. Test revision differs from test construction in a number of ways. There are external factors that affect the regularity with which a test should be revised. Test revision also involves more role players than test construction, including the opinions of those test users who may be resistant to any change in the previous test edition. Finally, revised tests sometimes have to contend with requirements from the test publisher who purchased the test or distribution rights from the developer. Test revision is expensive and time consuming, which leaves little scope for experimentation or trial-and-error. The availability of expertise, as well as the human and financial resources required to complete test revisionscan make such projects unaffordable, especiallyforprofessionals indeveloping countries, such as South Africa.It may be more feasible for such professionalsto collaborate with international revision projects. By doing so they cangain experience in test revision, contribute indigenous information that could shapethe revision ofan international test, increase opportunities to engage with international users, and potentially source international funding for research in their own country. The current studydevelopeda comprehensive and practical set of 30 guidelines to assist those involved in test revision. These guidelines were peer-reviewed and refined. Finally, the guidelines were field-tested using a case study of a recently revised ivdevelopmentaltest, the Griffiths III. Professionals from South Africa, including the present researcher,formed part of the international team for the extensive revision of the Griffiths III, which makes this test an ideal case study from both the perspectives of the developed test revision guidelines as well as collaboration of professionals from a developing country in an international test revision. The knowledge gainedfrom the development of guidelines and international collaboration in test revision is reflected on.
- Full Text:
- Date Issued: 2020
- Authors: Cronje, Johan Herman
- Date: 2020
- Subjects: Psychological tests
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46350 , vital:39567
- Description: The psychological testindustry has produced a wide variety of psychological tests that are used by professionals to facilitate measurement and decision-making. Tests are updated and revised periodically in order to remain current, valid and reliable in what is a competitive psychometric industry. Despite the prevalence of test revisions, especially in recent years, a number of authors have commented on the lack of comprehensive guidelines for test revision. Guidelines shouldcover aspects such as what the different types of revision are, when to embark on a revision, whatprocessto followand how test users should use revised tests. Test revision differs from test construction in a number of ways. There are external factors that affect the regularity with which a test should be revised. Test revision also involves more role players than test construction, including the opinions of those test users who may be resistant to any change in the previous test edition. Finally, revised tests sometimes have to contend with requirements from the test publisher who purchased the test or distribution rights from the developer. Test revision is expensive and time consuming, which leaves little scope for experimentation or trial-and-error. The availability of expertise, as well as the human and financial resources required to complete test revisionscan make such projects unaffordable, especiallyforprofessionals indeveloping countries, such as South Africa.It may be more feasible for such professionalsto collaborate with international revision projects. By doing so they cangain experience in test revision, contribute indigenous information that could shapethe revision ofan international test, increase opportunities to engage with international users, and potentially source international funding for research in their own country. The current studydevelopeda comprehensive and practical set of 30 guidelines to assist those involved in test revision. These guidelines were peer-reviewed and refined. Finally, the guidelines were field-tested using a case study of a recently revised ivdevelopmentaltest, the Griffiths III. Professionals from South Africa, including the present researcher,formed part of the international team for the extensive revision of the Griffiths III, which makes this test an ideal case study from both the perspectives of the developed test revision guidelines as well as collaboration of professionals from a developing country in an international test revision. The knowledge gainedfrom the development of guidelines and international collaboration in test revision is reflected on.
- Full Text:
- Date Issued: 2020
A co-constructed practice model for supporting parents of children in conflict with the law
- Authors: Abdulla, Zurina
- Date: 2019
- Subjects: Children's rights -- South Africa , Children -- Legal status, laws, etc --South Africa , Parent and child -- Research -- South Africa , Social work with youth -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/30474 , vital:30949
- Description: The unique historical stressors linked to South Africa’s apartheid legacy, continues to manifest in the form of economic exclusion, social exclusion, inequality and poverty, with parents being subjugated to service users and extenders rather than included as service advocates, particularly in the child justice system. Furthermore, policies and practices do not include, engage and support parents on an intra and interpersonal level. Parents of children in conflict with the law, experience their children’s charge or arrest as well as their subsequent journey through the child justice system as a crisis resulting in their need for emotional, informational, practical and professional support during the child justice process. The similarities and differences between the contexts of child protection and child justice in supporting parents illuminates the existing gaps in child justice legislation, policy and practice resulting in a lack of support for parents during the child justice process. In the Children’s Act 38 of 2005, it is recognised that parents have a legal responsibility towards their children and that in fulfilling this responsibility parents can access support services to assist them when they face challenges in fulfilling this responsibility. In contrast, despite 80 percent of children in conflict with the law being released into parental care and parents expressing the need for support in fulfilling their parental responsibility, in this regard the Child Justice Act 75 of 2008 fails to make provision for parents to access support services. The child justice system’s narrow focus on parents as service extenders contributes to parents’ being excluded from targeted support services resulting in parents’ support needs not being addressed. The lack of programmes and services aimed at supporting parents highlight the need for coordinated services that address the multiple stressors parents are exposed to. To this end, this study was aimed at coconstructing a practice model for supporting parents of children in conflict with the law. The theoretical lenses employed in the current study namely; the Ecological systems model and the Buffering effect model describes the various systems parents need support from and the type of support they need from their family, community and professionals. Guided by a qualitative approach, the present study integrated applied research, in particular intervention design and development with participatory action research as it allowed systematic collaboration during the research process to ensure rigour. This study involved participants from two research sites namely, the Nerina One- Stop Child Justice Centre in Port Elizabeth and the Reception, Assessment and Referral office at the Uitenhage magistrates’ court. Employing a non-probability purposive sampling method, this study facilitated the participation of parents of children in conflict with the law and child justice officials who met the inclusion criteria, in the co-design and development of a practice model for supporting parents of children in conflict with the law. Participants assumed an expert and collaborative role, which enabled the co-construction of knowledge, meaning and innovation of the practice model. Qualitative data collection methods namely, twelve focus groups and thirty two participant observations, were used to explore, co-construct, describe and design a practice model for supporting parents of children in conflict with the law during the child justice process. Thematic analyses was employed to condense the data, search for codes, categories, themes, relationships and patterns in the data. Due to the research approach and design, data analysis was ongoing and informed design and development of the practice model. Based on the thematic analysis and synthesis both descriptive and analytic themes emerged. To ensure trustworthiness, this study employed various strategies to strengthen commitment, rigour, transparency and coherence. In addition, the participative research process, the inclusion of multiple forms of qualitative inquiry and the significance of the study contributed to the validity and quality of the study. Ethical considerations applicable to the study included participants’ voluntary participation, their informed consent and ensuring participants’ privacy or maintaining confidentially. Various strategies were employed to prevent or minimise risk to participants. The findings showed that formal sources of support, in particular, offer opportunities for parents to access individual and family counselling, parenting advice, and peer support. The study also highlighted the importance of recognising parents as a subsystem in the child justice system offers potential opportunities for inclusion of parents as co-facilitators of parenting programmes or support groups, as peer supporters during the child justice process. Parents’ inclusion as a partner in the child justice system is highlighted as an opportunity for parents to be able to vi participate in child justice fora, oversight committees and accreditation committees to influence policy, services and budget allocations for services to support parents of children in conflict with the law. This study’s contribution to the existing body of knowledge is an integrated, multidisciplinary, multi-phase co-constructed practice model that would enable inclusion of, and support for, parents of children in conflict with the law prior to, during and after the child justice. The co-constructed practice model (a) involves a continuum of parent-centred support for and inclusion of parents prior to, during and after the child justice process; (b) advances an inclusive and collaborative child justice system that views parents as important stakeholders in determining the type of services they need and being involved in developing practice; and (c) promotes parents as equal partners in decision making and policy making to influence legislation, policy and practice in the child justice system.
- Full Text:
- Date Issued: 2019
- Authors: Abdulla, Zurina
- Date: 2019
- Subjects: Children's rights -- South Africa , Children -- Legal status, laws, etc --South Africa , Parent and child -- Research -- South Africa , Social work with youth -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/30474 , vital:30949
- Description: The unique historical stressors linked to South Africa’s apartheid legacy, continues to manifest in the form of economic exclusion, social exclusion, inequality and poverty, with parents being subjugated to service users and extenders rather than included as service advocates, particularly in the child justice system. Furthermore, policies and practices do not include, engage and support parents on an intra and interpersonal level. Parents of children in conflict with the law, experience their children’s charge or arrest as well as their subsequent journey through the child justice system as a crisis resulting in their need for emotional, informational, practical and professional support during the child justice process. The similarities and differences between the contexts of child protection and child justice in supporting parents illuminates the existing gaps in child justice legislation, policy and practice resulting in a lack of support for parents during the child justice process. In the Children’s Act 38 of 2005, it is recognised that parents have a legal responsibility towards their children and that in fulfilling this responsibility parents can access support services to assist them when they face challenges in fulfilling this responsibility. In contrast, despite 80 percent of children in conflict with the law being released into parental care and parents expressing the need for support in fulfilling their parental responsibility, in this regard the Child Justice Act 75 of 2008 fails to make provision for parents to access support services. The child justice system’s narrow focus on parents as service extenders contributes to parents’ being excluded from targeted support services resulting in parents’ support needs not being addressed. The lack of programmes and services aimed at supporting parents highlight the need for coordinated services that address the multiple stressors parents are exposed to. To this end, this study was aimed at coconstructing a practice model for supporting parents of children in conflict with the law. The theoretical lenses employed in the current study namely; the Ecological systems model and the Buffering effect model describes the various systems parents need support from and the type of support they need from their family, community and professionals. Guided by a qualitative approach, the present study integrated applied research, in particular intervention design and development with participatory action research as it allowed systematic collaboration during the research process to ensure rigour. This study involved participants from two research sites namely, the Nerina One- Stop Child Justice Centre in Port Elizabeth and the Reception, Assessment and Referral office at the Uitenhage magistrates’ court. Employing a non-probability purposive sampling method, this study facilitated the participation of parents of children in conflict with the law and child justice officials who met the inclusion criteria, in the co-design and development of a practice model for supporting parents of children in conflict with the law. Participants assumed an expert and collaborative role, which enabled the co-construction of knowledge, meaning and innovation of the practice model. Qualitative data collection methods namely, twelve focus groups and thirty two participant observations, were used to explore, co-construct, describe and design a practice model for supporting parents of children in conflict with the law during the child justice process. Thematic analyses was employed to condense the data, search for codes, categories, themes, relationships and patterns in the data. Due to the research approach and design, data analysis was ongoing and informed design and development of the practice model. Based on the thematic analysis and synthesis both descriptive and analytic themes emerged. To ensure trustworthiness, this study employed various strategies to strengthen commitment, rigour, transparency and coherence. In addition, the participative research process, the inclusion of multiple forms of qualitative inquiry and the significance of the study contributed to the validity and quality of the study. Ethical considerations applicable to the study included participants’ voluntary participation, their informed consent and ensuring participants’ privacy or maintaining confidentially. Various strategies were employed to prevent or minimise risk to participants. The findings showed that formal sources of support, in particular, offer opportunities for parents to access individual and family counselling, parenting advice, and peer support. The study also highlighted the importance of recognising parents as a subsystem in the child justice system offers potential opportunities for inclusion of parents as co-facilitators of parenting programmes or support groups, as peer supporters during the child justice process. Parents’ inclusion as a partner in the child justice system is highlighted as an opportunity for parents to be able to vi participate in child justice fora, oversight committees and accreditation committees to influence policy, services and budget allocations for services to support parents of children in conflict with the law. This study’s contribution to the existing body of knowledge is an integrated, multidisciplinary, multi-phase co-constructed practice model that would enable inclusion of, and support for, parents of children in conflict with the law prior to, during and after the child justice. The co-constructed practice model (a) involves a continuum of parent-centred support for and inclusion of parents prior to, during and after the child justice process; (b) advances an inclusive and collaborative child justice system that views parents as important stakeholders in determining the type of services they need and being involved in developing practice; and (c) promotes parents as equal partners in decision making and policy making to influence legislation, policy and practice in the child justice system.
- Full Text:
- Date Issued: 2019
A comprehensive support programme for professional nurses performing HIV counselling and testing at primary health care clinics in the rural Eastern Cape
- Authors: Madolo, Agrinette Nomboniso
- Date: 2019
- Subjects: HIV-positive persons -- Counseling of , AIDS (Disease) -- Patients -- Counseling of , Primary health care -- South Africa -- Eastern Cape , Community health nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/40746 , vital:36232
- Description: The increase in global rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) has had far reaching effects on healthcare services around the world. According to the 2017 statistics released by UNAIDS, South Africa has the largest HIV epidemic in the world. The South African Department of Health provides an HIV counselling and testing (HCT) service to patients in order that they may know their HIV status and endeavours to educate patients so that they may adapt their behaviours and lifestyles. The goal of this study is to develop a support programme for nurses to assist them in coping emotionally with their day-to-day activities when providing HCT services to patients attending primary healthcare clinics. The paradigm used as a lens to view the phenomenon is Kinlaw’s cyclical growth of empowerment theory. The researcher used a qualitative,explorative, descriptive and contextual design. The study involves three phases: (a) empirical research that explores nurses’ experiences of performing HCT in primary healthcare rural clinics, (b) the development of a conceptual framework for a support programme using the survey list of Dickoff et al. (1968:427). (c) the formalisation of the Comprehensive Support Programme to help nurses to cope emotionally with working with HCT on a long-term basis. Chinn and Kramer (2005118) were used to evaluate the programme. . The empirical findings revealed registered nurses experienced HCT both positively and negatively. They felt overwhelmed by the expectation that all patients attending primary healthcare clinics should be offered HCT routinely and the time constraints involved. They described how the emotional trauma attached to HCT affected their work patterns, leading to low productivity, and affected them outside work, leading to stress and sleep disturbances. They feltl disturbed that even when informed, people choose not to adopt safer sex practices and that how patients responded to a positive diagnosis cannot be predicted. Participants showed signs of stress, frustration, despair and sadness because most tested clients show positive test results and the number of clients testing positive is increasing. While participants felt helpless to improve the situation, at the same time, HCT was experienced as rewarding because it enabled diagnosis of medical conditions of which people weree not aware. The goal of the study was achieved with the development and formalisation of an extensive, relevant and applicable Comprehensive Support Programme for implementation for registered nurses to enable them cope emotionally when conducting HCT based on the empirical findings.
- Full Text:
- Date Issued: 2019
- Authors: Madolo, Agrinette Nomboniso
- Date: 2019
- Subjects: HIV-positive persons -- Counseling of , AIDS (Disease) -- Patients -- Counseling of , Primary health care -- South Africa -- Eastern Cape , Community health nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/40746 , vital:36232
- Description: The increase in global rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) has had far reaching effects on healthcare services around the world. According to the 2017 statistics released by UNAIDS, South Africa has the largest HIV epidemic in the world. The South African Department of Health provides an HIV counselling and testing (HCT) service to patients in order that they may know their HIV status and endeavours to educate patients so that they may adapt their behaviours and lifestyles. The goal of this study is to develop a support programme for nurses to assist them in coping emotionally with their day-to-day activities when providing HCT services to patients attending primary healthcare clinics. The paradigm used as a lens to view the phenomenon is Kinlaw’s cyclical growth of empowerment theory. The researcher used a qualitative,explorative, descriptive and contextual design. The study involves three phases: (a) empirical research that explores nurses’ experiences of performing HCT in primary healthcare rural clinics, (b) the development of a conceptual framework for a support programme using the survey list of Dickoff et al. (1968:427). (c) the formalisation of the Comprehensive Support Programme to help nurses to cope emotionally with working with HCT on a long-term basis. Chinn and Kramer (2005118) were used to evaluate the programme. . The empirical findings revealed registered nurses experienced HCT both positively and negatively. They felt overwhelmed by the expectation that all patients attending primary healthcare clinics should be offered HCT routinely and the time constraints involved. They described how the emotional trauma attached to HCT affected their work patterns, leading to low productivity, and affected them outside work, leading to stress and sleep disturbances. They feltl disturbed that even when informed, people choose not to adopt safer sex practices and that how patients responded to a positive diagnosis cannot be predicted. Participants showed signs of stress, frustration, despair and sadness because most tested clients show positive test results and the number of clients testing positive is increasing. While participants felt helpless to improve the situation, at the same time, HCT was experienced as rewarding because it enabled diagnosis of medical conditions of which people weree not aware. The goal of the study was achieved with the development and formalisation of an extensive, relevant and applicable Comprehensive Support Programme for implementation for registered nurses to enable them cope emotionally when conducting HCT based on the empirical findings.
- Full Text:
- Date Issued: 2019
An assessment of school food and nutrition environments for strengthening the integrated school health policy in the Eastern Cape, South Africa
- Authors: Okeyo, Alice Phelgona
- Date: 2019
- Subjects: Nutrition policy -- South Africa -- Eastern Cape School health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/17039 , vital:40836
- Description: The 2012 Integrated School Health Policy (ISHP) offers a framework for adequate school food environment. It aims to contribute to the improvement of the general health of school-going children and to address health barriers to learning in order to improve education outcomes. This study assessed the school food and nutrition environment and critically appraised the position of nutrition within ISHP in order to make recommendations for best practice and promotion of healthy-eating in quintiles 1 – 3 secondary school learners of the Eastern Cape, South Africa. Areas evaluated included the school food environment (National School Food Nutrition Programme, NSNP, tuck-shop, vendor, lunch box, and school vegetable garden); eating practice; nutrition knowledge; and nutrition status. A quantitative and qualitative cross-sectional design was applied in data collection. Data was collected from 1,357 learners at 18 secondary schools in three districts: Buffalo City Metropolitan Municipality, Chris Hani and OR Tambo, using semi-structured questionnaires. Five major food items provided in the school food and nutrition environment included: beans, pap, sour-milk, rice, and samp (maize) (NSNP); chips, sandwich, pap, biscuits, and cake (tuck-shop); chips, sandwich, pap, cake, and pop-corn (vendor); and samp (maize), noodles, fat-cake, chips, and Russian/Viennas (lunch boxes). Only three of the 16 schools had school vegetable gardens which produced vegetables and no fruits. Five most frequently eaten foods for breakfast were porridge, rusks, stiff-pap, bread-with-spread, eggs, and polony. Learners from quintile 3 (60.8percent) significantly ate more cooked porridge than learners from quintiles 1 and 2 (51.9percent) (p = 0.015). Leaners from quintile 3 (59.4percent) significantly ate more brown bread-with-spread than learners from quintiles 1 and 2 (50.4) (p = 0.022). The majority of learners (72.7percent) ate breakfast; more male learners (24.4percent) than female learners (29.1percent) skipped breakfast. The majority (62.2percent) of learners had poor nutritional knowledge; significantly, more male (35percent) than female (27percent) learners had poor nutritional knowledge (p = 0.003). Nutritional knowledge increased with age; significantly more grade 8 learners had poor (42.6percent) nutritional knowledge than grade 12 learners (14.1percent) (p < 0.001). Leaners from quintile 3 had good (23.5percent) nutritional knowledge than learners from quintiles 1 and 2 (15.7percent) (p < 0.001). School lessons, books and television were the most important source for nutritional information to learners. The most significant source was lessons (72.0percent; p < 0.001); followed by television (69.4percent; p < 0.001) and books (67.8percent; p = 0.014), in that ranking order. The majority of learners (64percent) had normal body weight. The prevalence of underweight, overweight and obesity was 13.0percent, 15.0percent and 8.0percent, respectively. The prevalence of overweight and obesity was higher in females than males (21.3percent vs 5.3percent; overweight; p < 0.001)) and (11.6percent vs 1.2percent; obesity; p < 0.001), respectively; while the prevalence in terms of underweight was significantly higher in male (21.3percent) learners than in female learners (8.1percent); p < 0.001. The study indicated that the school food environment was not supported by ISHP. The Integrated School Health Policy did not include on-site package for nutritional assessment, thus, there is need to offer nutritional interventions in schools.
- Full Text:
- Date Issued: 2019
- Authors: Okeyo, Alice Phelgona
- Date: 2019
- Subjects: Nutrition policy -- South Africa -- Eastern Cape School health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/17039 , vital:40836
- Description: The 2012 Integrated School Health Policy (ISHP) offers a framework for adequate school food environment. It aims to contribute to the improvement of the general health of school-going children and to address health barriers to learning in order to improve education outcomes. This study assessed the school food and nutrition environment and critically appraised the position of nutrition within ISHP in order to make recommendations for best practice and promotion of healthy-eating in quintiles 1 – 3 secondary school learners of the Eastern Cape, South Africa. Areas evaluated included the school food environment (National School Food Nutrition Programme, NSNP, tuck-shop, vendor, lunch box, and school vegetable garden); eating practice; nutrition knowledge; and nutrition status. A quantitative and qualitative cross-sectional design was applied in data collection. Data was collected from 1,357 learners at 18 secondary schools in three districts: Buffalo City Metropolitan Municipality, Chris Hani and OR Tambo, using semi-structured questionnaires. Five major food items provided in the school food and nutrition environment included: beans, pap, sour-milk, rice, and samp (maize) (NSNP); chips, sandwich, pap, biscuits, and cake (tuck-shop); chips, sandwich, pap, cake, and pop-corn (vendor); and samp (maize), noodles, fat-cake, chips, and Russian/Viennas (lunch boxes). Only three of the 16 schools had school vegetable gardens which produced vegetables and no fruits. Five most frequently eaten foods for breakfast were porridge, rusks, stiff-pap, bread-with-spread, eggs, and polony. Learners from quintile 3 (60.8percent) significantly ate more cooked porridge than learners from quintiles 1 and 2 (51.9percent) (p = 0.015). Leaners from quintile 3 (59.4percent) significantly ate more brown bread-with-spread than learners from quintiles 1 and 2 (50.4) (p = 0.022). The majority of learners (72.7percent) ate breakfast; more male learners (24.4percent) than female learners (29.1percent) skipped breakfast. The majority (62.2percent) of learners had poor nutritional knowledge; significantly, more male (35percent) than female (27percent) learners had poor nutritional knowledge (p = 0.003). Nutritional knowledge increased with age; significantly more grade 8 learners had poor (42.6percent) nutritional knowledge than grade 12 learners (14.1percent) (p < 0.001). Leaners from quintile 3 had good (23.5percent) nutritional knowledge than learners from quintiles 1 and 2 (15.7percent) (p < 0.001). School lessons, books and television were the most important source for nutritional information to learners. The most significant source was lessons (72.0percent; p < 0.001); followed by television (69.4percent; p < 0.001) and books (67.8percent; p = 0.014), in that ranking order. The majority of learners (64percent) had normal body weight. The prevalence of underweight, overweight and obesity was 13.0percent, 15.0percent and 8.0percent, respectively. The prevalence of overweight and obesity was higher in females than males (21.3percent vs 5.3percent; overweight; p < 0.001)) and (11.6percent vs 1.2percent; obesity; p < 0.001), respectively; while the prevalence in terms of underweight was significantly higher in male (21.3percent) learners than in female learners (8.1percent); p < 0.001. The study indicated that the school food environment was not supported by ISHP. The Integrated School Health Policy did not include on-site package for nutritional assessment, thus, there is need to offer nutritional interventions in schools.
- Full Text:
- Date Issued: 2019
An exploration of HIV and aids disclosure among HIV-serodiscordant married couples in the Eastern Cape Province, South Africa
- Authors: Ndlela, Joshua Bongani
- Date: 2019
- Subjects: HIV infections -- Psychological aspects -- South Africa -- Eastern Cape , Stigma (Social psychology) , AIDS (Disease) -- Psychological aspects , HIV-positive persons -- Mental health , Disclosure of information , AIDS (Disease) -- Patients -- Family relationships
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/41774 , vital:36580
- Description: Sub-Saharan Africa has the highest prevalence and incidence of HIV infection worldwide, mostly attributed to heterosexual transmission. Transmission in HIV-serodiscordant couples who have received joint voluntary counselling and testing ranges from 3% to 7% per year and only about 20% know that they are living in a discordant relationship. Disclosure is seen as a cornerstone for the prevention of HIV transmission between in HIV-serodiscordant married partners. It is argued that numbers of HIV-serodiscordant couples are most likely increasing; however, limited or no support is given to these couples as most because counselling interventions in South Africa do not provide for married heterosexual HIV-serodiscordant couples. The aim of the study was to identify the impact of disclosure of HIV and AIDS status on partners in HIV-serodiscordant married relationships. The second aim was to synthesize the findings to guide the development of contextualized counselling guidelines for married couples in HIV-serodiscordant relationships. Five HIV-serodiscordant married couples and 6 HIV and AIDS counsellors from a variety of settings in Nelson Mandela Bay, participated in this study. In this interpretive qualitative study, non-probability criteria, purposive sampling was used. Both participant groups are isiXhosa-speaking adults between the ages of 21 and 65 years and include both males and females. Qualitative data were gathered by means of audio-recorded semi structured interviews. Thematic analysis was used to analyse the data, while Guba’s guidelines were used to enhance the trustworthiness of the research. Semi-structured interviews with HIV-serodiscordant married couples revealed 5 common themes and were: (a) confused environment of couples in HIV disclosure, (b) inconsistent delivery of healthcare information to HIV-serodiscordant couples, (c) relationship predicaments post disclosure, (d) partner support on sexual intimacy for married couples and (e) reactions of family, children and friends towards the HIV disclosure. The HIV and AIDS counsellors 3 common themes and were: (a) basic HIV and AIDS counselling skills, (b) organisational resources support of HIV counsellors and (c) suggestions to support HIV counsellors.. This study supports the view that further research be done in other related areas (gay, lesbians, bi-sexual relationships) and demystify this unknown or misunderstood notion needs to take place at a larger scale and probably incorporate quantitative surveys to supplement the current qualitative research. Implications for practise and avenues for research are considered in this study.
- Full Text:
- Date Issued: 2019
- Authors: Ndlela, Joshua Bongani
- Date: 2019
- Subjects: HIV infections -- Psychological aspects -- South Africa -- Eastern Cape , Stigma (Social psychology) , AIDS (Disease) -- Psychological aspects , HIV-positive persons -- Mental health , Disclosure of information , AIDS (Disease) -- Patients -- Family relationships
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/41774 , vital:36580
- Description: Sub-Saharan Africa has the highest prevalence and incidence of HIV infection worldwide, mostly attributed to heterosexual transmission. Transmission in HIV-serodiscordant couples who have received joint voluntary counselling and testing ranges from 3% to 7% per year and only about 20% know that they are living in a discordant relationship. Disclosure is seen as a cornerstone for the prevention of HIV transmission between in HIV-serodiscordant married partners. It is argued that numbers of HIV-serodiscordant couples are most likely increasing; however, limited or no support is given to these couples as most because counselling interventions in South Africa do not provide for married heterosexual HIV-serodiscordant couples. The aim of the study was to identify the impact of disclosure of HIV and AIDS status on partners in HIV-serodiscordant married relationships. The second aim was to synthesize the findings to guide the development of contextualized counselling guidelines for married couples in HIV-serodiscordant relationships. Five HIV-serodiscordant married couples and 6 HIV and AIDS counsellors from a variety of settings in Nelson Mandela Bay, participated in this study. In this interpretive qualitative study, non-probability criteria, purposive sampling was used. Both participant groups are isiXhosa-speaking adults between the ages of 21 and 65 years and include both males and females. Qualitative data were gathered by means of audio-recorded semi structured interviews. Thematic analysis was used to analyse the data, while Guba’s guidelines were used to enhance the trustworthiness of the research. Semi-structured interviews with HIV-serodiscordant married couples revealed 5 common themes and were: (a) confused environment of couples in HIV disclosure, (b) inconsistent delivery of healthcare information to HIV-serodiscordant couples, (c) relationship predicaments post disclosure, (d) partner support on sexual intimacy for married couples and (e) reactions of family, children and friends towards the HIV disclosure. The HIV and AIDS counsellors 3 common themes and were: (a) basic HIV and AIDS counselling skills, (b) organisational resources support of HIV counsellors and (c) suggestions to support HIV counsellors.. This study supports the view that further research be done in other related areas (gay, lesbians, bi-sexual relationships) and demystify this unknown or misunderstood notion needs to take place at a larger scale and probably incorporate quantitative surveys to supplement the current qualitative research. Implications for practise and avenues for research are considered in this study.
- Full Text:
- Date Issued: 2019
Attachment styles, coping strategies, personal meaning, and mental health in nonclinical adults
- Authors: Gerber, Ora
- Date: 2019
- Subjects: Attachment behavior -- South Africa , Mental illness -- South Africa Psychology, Applied
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/30485 , vital:30950
- Description: Meaning in life can be attained through a variety of sources. A limited amount of research has investigated the association between attachment and personal meaning while no studies have investigated the association between attachment, personal meaning, and sources of meaning. The current study aimed to investigate the association between different attachment styles, personal meaning, and sources of meaning in order to develop a deeper understanding of their relationships. A quantitative exploratory-descriptive design was used to collect the data using standardized questionnaires from 226 participants. Statistical analysis of the data suggests that a secure attachment style is positively associated with personal meaning and presented with meaning sources consisting of breadth and depth. A fearful attachment style was associated with a lack of personal meaning and sources of meaning while a preoccupied attachment style was associated with a lack of personal meaning and presented with sources of meaning lacking in depth and breadth. No significant association was found between a dismissive attachment style and personal meaning, but associations were found with sources of meaning, including feeling financially secure, experiencing personal growth, meeting basic everyday needs, and leaving a legacy for the next generation. Recommendations for psychotherapy based on the findings of the study were offered.
- Full Text:
- Date Issued: 2019
- Authors: Gerber, Ora
- Date: 2019
- Subjects: Attachment behavior -- South Africa , Mental illness -- South Africa Psychology, Applied
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/30485 , vital:30950
- Description: Meaning in life can be attained through a variety of sources. A limited amount of research has investigated the association between attachment and personal meaning while no studies have investigated the association between attachment, personal meaning, and sources of meaning. The current study aimed to investigate the association between different attachment styles, personal meaning, and sources of meaning in order to develop a deeper understanding of their relationships. A quantitative exploratory-descriptive design was used to collect the data using standardized questionnaires from 226 participants. Statistical analysis of the data suggests that a secure attachment style is positively associated with personal meaning and presented with meaning sources consisting of breadth and depth. A fearful attachment style was associated with a lack of personal meaning and sources of meaning while a preoccupied attachment style was associated with a lack of personal meaning and presented with sources of meaning lacking in depth and breadth. No significant association was found between a dismissive attachment style and personal meaning, but associations were found with sources of meaning, including feeling financially secure, experiencing personal growth, meeting basic everyday needs, and leaving a legacy for the next generation. Recommendations for psychotherapy based on the findings of the study were offered.
- Full Text:
- Date Issued: 2019
Culturally-informed coping strategies of posttraumatic stress disorders among the black Africans in the greater Accra region of Ghana and black Africans in the eastern cape of South Africa
- Authors: Thompson, Sandra
- Date: 2019
- Subjects: Posttraumatic stress disorder
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/44625 , vital:38154
- Description: The influence of culture in coping with Posttraumatic Stress Disorders (PTSD) has been highlighted in literature. However, these culture specific coping strategies are not as yet, extensively explored. The research sought to explore and describe the culturally - informed coping strategies of PTS D among the black Africans in the Greater Accra Region of Ghana and black Africans in the Eastern Cape of South Africa. A qualitative methodological approach was used to explore the phenomenon under study. Purposive non - probability sampling was employed to obtain access to participants who could inform the objectives of the study. Data was collected using semi - structured interviews with traumatised individuals and focus group discussions with cultural leaders. All interviews were audio - recorded, transcribed, translated and analysed using thematic content analysis to facilitate the description and comparison of the similarities and distinctive features emerging from the two African communities. The findings indicated that a number of cultural factors influence interpretation of symptoms of PTSD and the adopted coping strategies. Participants’ understanding of symptoms of PTSD relied heavily on Christian Religious and African cultural understandings. It was evident that almost all explanations were purely spiritual and minimal knowledge was expressed on cognitive interpretations. A great deal of emphasis by the Ghanaians and isiXhosa of South Africa, was on dreams and such interpretations were deferred to an authoritative individual (especially the traditional healer). An obvious hierarchy for coping emerged with the traditional healer playing a major role for the Ghanaian and isiXhosa participants. Performing rites and the use of plants were essential to healing for these group of individuals. Whereas, the Coloured - Afrikaans made reference to a higher power “God”. An outstanding observation was the extent to which Ghanaian and isiXhosa participants have incorporated Christian and traditional practices (i.e. praying to God, performing rites and using herbs or plants). Even where an individual did not wish to mix practice because of upbringing, they acknowledged the existence and effectiveness of these practices. Colonisation was drawn on as an explanation for such mixed practices. The advent of Christianity was explained as having established Western culture (specifically Christianity) that is incorporated by participants. The Coloured - Afrikaans on the other hand, were consistent with the Christian practices “prayers to God”. A great deal of consistency however existed among all participants. Social support was considered very important. Talking with family and friends were relevant to the healing process as it gets rid of distorted thought patterns and avoids isolation considered as a serious current threat to healing. While there was an element of cognitive understanding, Western based treatment using cognitive restructuring was not a treatment option. Clinical practitioners or Psychologists that come into contact with the black Ghanaians and black South Africans should consider collaborative treatment strategies using the draft checklist as a guide.
- Full Text:
- Date Issued: 2019
- Authors: Thompson, Sandra
- Date: 2019
- Subjects: Posttraumatic stress disorder
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/44625 , vital:38154
- Description: The influence of culture in coping with Posttraumatic Stress Disorders (PTSD) has been highlighted in literature. However, these culture specific coping strategies are not as yet, extensively explored. The research sought to explore and describe the culturally - informed coping strategies of PTS D among the black Africans in the Greater Accra Region of Ghana and black Africans in the Eastern Cape of South Africa. A qualitative methodological approach was used to explore the phenomenon under study. Purposive non - probability sampling was employed to obtain access to participants who could inform the objectives of the study. Data was collected using semi - structured interviews with traumatised individuals and focus group discussions with cultural leaders. All interviews were audio - recorded, transcribed, translated and analysed using thematic content analysis to facilitate the description and comparison of the similarities and distinctive features emerging from the two African communities. The findings indicated that a number of cultural factors influence interpretation of symptoms of PTSD and the adopted coping strategies. Participants’ understanding of symptoms of PTSD relied heavily on Christian Religious and African cultural understandings. It was evident that almost all explanations were purely spiritual and minimal knowledge was expressed on cognitive interpretations. A great deal of emphasis by the Ghanaians and isiXhosa of South Africa, was on dreams and such interpretations were deferred to an authoritative individual (especially the traditional healer). An obvious hierarchy for coping emerged with the traditional healer playing a major role for the Ghanaian and isiXhosa participants. Performing rites and the use of plants were essential to healing for these group of individuals. Whereas, the Coloured - Afrikaans made reference to a higher power “God”. An outstanding observation was the extent to which Ghanaian and isiXhosa participants have incorporated Christian and traditional practices (i.e. praying to God, performing rites and using herbs or plants). Even where an individual did not wish to mix practice because of upbringing, they acknowledged the existence and effectiveness of these practices. Colonisation was drawn on as an explanation for such mixed practices. The advent of Christianity was explained as having established Western culture (specifically Christianity) that is incorporated by participants. The Coloured - Afrikaans on the other hand, were consistent with the Christian practices “prayers to God”. A great deal of consistency however existed among all participants. Social support was considered very important. Talking with family and friends were relevant to the healing process as it gets rid of distorted thought patterns and avoids isolation considered as a serious current threat to healing. While there was an element of cognitive understanding, Western based treatment using cognitive restructuring was not a treatment option. Clinical practitioners or Psychologists that come into contact with the black Ghanaians and black South Africans should consider collaborative treatment strategies using the draft checklist as a guide.
- Full Text:
- Date Issued: 2019
Culturally-informed coping strategies of posttraumatic stress disorders among the black Africans in the greater Accra region of Ghana and black Africans in the eastern cape of South Africa
- Authors: Thompson, Sandra
- Date: 2019
- Subjects: Post-traumatic stress disorder -- Ghana -- Accra , Post-traumatic stress disorder -- South Africa -- Eastern Cape Cultural psychiatry Psychoanalysis and culture
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/45160 , vital:38259
- Description: The influence of culture in coping with Posttraumatic Stress Disorders (PTSD) has been highlighted in literature. However, these culture specific coping strategies are not as yet, extensively explored. The research sought to explore and describe the culturally-informed coping strategies of PTSD among the black Africans in the Greater Accra Region of Ghana and black Africans in the Eastern Cape of South Africa. A qualitative methodological approach was used to explore the phenomenon under study. Purposive non-probability sampling was employed to obtain access to participants who could inform the objectives of the study. Data was collected using semi-structured interviews with traumatised individuals and focus group discussions with cultural leaders. All interviews were audio-recorded, transcribed, translated and analysed using thematic content analysis to facilitate the description and comparison of the similarities and distinctive features emerging from the two African communities. The findings indicated that a number of cultural factors influence interpretation of symptoms of PTSD and the adopted coping strategies. Participants’ understanding of symptoms of PTSD relied heavily on Christian Religious and African cultural understandings. It was evident that almost all explanations were purely spiritual and minimal knowledge was expressed on cognitive interpretations. A great deal of emphasis by the Ghanaians and isiXhosa of South Africa, was on dreams and such interpretations were deferred to an authoritative individual (especially the traditional healer). An obvious hierarchy for coping emerged with the traditional healer playing a major role for the Ghanaian and isiXhosa participants. Performing rites and the use of plants were essential to healing for these group of individuals. Whereas, the Coloured-Afrikaans made reference to a higher power “God”. An outstanding observation was the extent to which Ghanaian and isiXhosa participants have incorporated Christian and traditional practices (i.e. praying to God, performing rites and using herbs or plants). Even where an individual did not wish to mix practice because of upbringing, they acknowledged the existence and effectiveness of these practices. Colonisation was drawn on as an explanation for such mixed practices. The advent of Christianity was explained as having established Western culture (specifically Christianity) that is incorporated by participants. The Coloured-Afrikaans on the other hand, were consistent with the Christian practices “prayers to God”. A great deal of consistency however existed among all participants. Social support was considered very important. Talking with family and friends were relevant to the healing process as it gets rid of distorted thought patterns and avoids isolation considered as a serious current threat to healing. While there was an element of cognitive understanding, Western based treatment using cognitive restructuring was not a treatment option. Clinical practitioners or Psychologists that come into contact with the black Ghanaians and black South Africans should consider collaborative treatment strategies using the draft checklist as a guide.
- Full Text:
- Date Issued: 2019
- Authors: Thompson, Sandra
- Date: 2019
- Subjects: Post-traumatic stress disorder -- Ghana -- Accra , Post-traumatic stress disorder -- South Africa -- Eastern Cape Cultural psychiatry Psychoanalysis and culture
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/45160 , vital:38259
- Description: The influence of culture in coping with Posttraumatic Stress Disorders (PTSD) has been highlighted in literature. However, these culture specific coping strategies are not as yet, extensively explored. The research sought to explore and describe the culturally-informed coping strategies of PTSD among the black Africans in the Greater Accra Region of Ghana and black Africans in the Eastern Cape of South Africa. A qualitative methodological approach was used to explore the phenomenon under study. Purposive non-probability sampling was employed to obtain access to participants who could inform the objectives of the study. Data was collected using semi-structured interviews with traumatised individuals and focus group discussions with cultural leaders. All interviews were audio-recorded, transcribed, translated and analysed using thematic content analysis to facilitate the description and comparison of the similarities and distinctive features emerging from the two African communities. The findings indicated that a number of cultural factors influence interpretation of symptoms of PTSD and the adopted coping strategies. Participants’ understanding of symptoms of PTSD relied heavily on Christian Religious and African cultural understandings. It was evident that almost all explanations were purely spiritual and minimal knowledge was expressed on cognitive interpretations. A great deal of emphasis by the Ghanaians and isiXhosa of South Africa, was on dreams and such interpretations were deferred to an authoritative individual (especially the traditional healer). An obvious hierarchy for coping emerged with the traditional healer playing a major role for the Ghanaian and isiXhosa participants. Performing rites and the use of plants were essential to healing for these group of individuals. Whereas, the Coloured-Afrikaans made reference to a higher power “God”. An outstanding observation was the extent to which Ghanaian and isiXhosa participants have incorporated Christian and traditional practices (i.e. praying to God, performing rites and using herbs or plants). Even where an individual did not wish to mix practice because of upbringing, they acknowledged the existence and effectiveness of these practices. Colonisation was drawn on as an explanation for such mixed practices. The advent of Christianity was explained as having established Western culture (specifically Christianity) that is incorporated by participants. The Coloured-Afrikaans on the other hand, were consistent with the Christian practices “prayers to God”. A great deal of consistency however existed among all participants. Social support was considered very important. Talking with family and friends were relevant to the healing process as it gets rid of distorted thought patterns and avoids isolation considered as a serious current threat to healing. While there was an element of cognitive understanding, Western based treatment using cognitive restructuring was not a treatment option. Clinical practitioners or Psychologists that come into contact with the black Ghanaians and black South Africans should consider collaborative treatment strategies using the draft checklist as a guide.
- Full Text:
- Date Issued: 2019
Descriptive guidelines for mediation to enhance the parental involvement of unmarried fathers
- Authors: Nordien-Lagardien, Razia
- Date: 2019
- Subjects: Mediation , Unmarried fathers -- South Africa Father and child -- South Africa Unmarried mothers -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/30462 , vital:30948
- Description: A significant change brought about by the Children’s Act 38 of 2005 (RSA, 2006), is that of the status of unmarried fathers. The parental rights of unmarried fathers have evolved in South Africa, especially since the Children’s Act 38 of 2005 (RSA, 2006) now recognises that unmarried fathers should have inherent right of contact, guardianship and care. These rights are, however, not automatic and need to be acquired through a process of mediation. While this legislation aims to facilitate the parental involvement of fathers by giving them rights as per Section 21 of the Children’s Act 38 of 2005 (RSA, 2006), the reality is that many unmarried fathers still remain challenged in this regard despite the change in their legal position as fathers. Unmarried fathers are often compelled to take the matter further through protracted court processes. Unmarried fathers face unique challenges with parental involvement after separation and they often need to negotiate their involvement with the mother after separation. Given that mediation between unmarried parents is in its infancy in South Africa, very little research has been done in this area. It was envisaged that this study would highlight the important aspects of mediation which need to be considered in order for mediation outcomes to be more successful and to enhance the co-parenting relationship. The study employed a qualitative research approach that was exploratory, descriptive and contextual in design. The research study consisted of three phases. Phase 1 employed a multiple case study design in order to develop an understanding of the experiences and perceptions of unmarried fathers and mothers, as well as mediators, regarding the parental responsibilities of unmarried fathers in addition to their experiences of mediation. The data collection process comprised in-depth semi-structured interviews with three sample groups, namely unmarried fathers, and mothers, and mediators. The data collected from the interviews were transcribed, coded and analysed by the researcher through the use of two techniques, namely: within-case analysis and cross-case synthesis. An independent coder was utilised to verify the coding and analysis process. The analysis of the data in Phase 1 revealed that the construction of the role of unmarried fathers is influenced by various factors such as cultural and religious influences; childhood experiences of fatherhood; societal constructions of the father’s role, and the perception of the legal rights of unmarried fathers. The new legislation pertaining to the responsibilities and rights of unmarried fathers, as contained in the Children’s Act 38 of 2005 (RSA, 2006), has resulted in increased parental conflict between parents after separation owing to their lack of awareness and confusion regarding the changes in legislation pertaining to the rights of unmarried fathers and the role of customary law in this regard. This has resulted in misconceptions about the legal rights of unmarried fathers, which have influenced unmarried parents’ attitudes and receptiveness to mediation. A significant barrier to father involvement emanating from the findings was relationship conflict experienced after separation, which was also identified as a significant challenge in mediation. The discussion of the themes reflected both positive and negative experiences of mediation for the study participants. While the parents derived educational and therapeutic benefits from mediation; there were also several factors such as relationship conflict, cultural barriers, influences of the extended family, and the approach and skills of the mediator, which influenced the mediation process. In Phase 2 of the study an integrative literature review and synthesis of the literature was conducted and critically appraised in terms of emergent themes and relevant research in the area of family mediation, which would inform the process of developing the descriptive guidelines for mediation with unmarried parents. The empirical findings from the study were synthesised with the findings from the integrative literature review, thus enabling conclusions to be drawn in order to generate descriptive guidelines for mediation. Phase 3 of the study describes the guidelines for mediation which emanated from the synthesis of the findings in Phase 1 and Phase 2 of the study. As part of a qualitative evaluation, the guidelines were presented to an expert panel for review, after which the guidelines were finalised. The proposed guidelines for mediation to enhance the parental involvement of unmarried fathers is based on the hybrid model of mediation, which incorporates elements from the Transformative approach, the African centred approach and the co-mediation model. The guidelines are further described in terms of a phased approach to mediation.
- Full Text:
- Date Issued: 2019
- Authors: Nordien-Lagardien, Razia
- Date: 2019
- Subjects: Mediation , Unmarried fathers -- South Africa Father and child -- South Africa Unmarried mothers -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/30462 , vital:30948
- Description: A significant change brought about by the Children’s Act 38 of 2005 (RSA, 2006), is that of the status of unmarried fathers. The parental rights of unmarried fathers have evolved in South Africa, especially since the Children’s Act 38 of 2005 (RSA, 2006) now recognises that unmarried fathers should have inherent right of contact, guardianship and care. These rights are, however, not automatic and need to be acquired through a process of mediation. While this legislation aims to facilitate the parental involvement of fathers by giving them rights as per Section 21 of the Children’s Act 38 of 2005 (RSA, 2006), the reality is that many unmarried fathers still remain challenged in this regard despite the change in their legal position as fathers. Unmarried fathers are often compelled to take the matter further through protracted court processes. Unmarried fathers face unique challenges with parental involvement after separation and they often need to negotiate their involvement with the mother after separation. Given that mediation between unmarried parents is in its infancy in South Africa, very little research has been done in this area. It was envisaged that this study would highlight the important aspects of mediation which need to be considered in order for mediation outcomes to be more successful and to enhance the co-parenting relationship. The study employed a qualitative research approach that was exploratory, descriptive and contextual in design. The research study consisted of three phases. Phase 1 employed a multiple case study design in order to develop an understanding of the experiences and perceptions of unmarried fathers and mothers, as well as mediators, regarding the parental responsibilities of unmarried fathers in addition to their experiences of mediation. The data collection process comprised in-depth semi-structured interviews with three sample groups, namely unmarried fathers, and mothers, and mediators. The data collected from the interviews were transcribed, coded and analysed by the researcher through the use of two techniques, namely: within-case analysis and cross-case synthesis. An independent coder was utilised to verify the coding and analysis process. The analysis of the data in Phase 1 revealed that the construction of the role of unmarried fathers is influenced by various factors such as cultural and religious influences; childhood experiences of fatherhood; societal constructions of the father’s role, and the perception of the legal rights of unmarried fathers. The new legislation pertaining to the responsibilities and rights of unmarried fathers, as contained in the Children’s Act 38 of 2005 (RSA, 2006), has resulted in increased parental conflict between parents after separation owing to their lack of awareness and confusion regarding the changes in legislation pertaining to the rights of unmarried fathers and the role of customary law in this regard. This has resulted in misconceptions about the legal rights of unmarried fathers, which have influenced unmarried parents’ attitudes and receptiveness to mediation. A significant barrier to father involvement emanating from the findings was relationship conflict experienced after separation, which was also identified as a significant challenge in mediation. The discussion of the themes reflected both positive and negative experiences of mediation for the study participants. While the parents derived educational and therapeutic benefits from mediation; there were also several factors such as relationship conflict, cultural barriers, influences of the extended family, and the approach and skills of the mediator, which influenced the mediation process. In Phase 2 of the study an integrative literature review and synthesis of the literature was conducted and critically appraised in terms of emergent themes and relevant research in the area of family mediation, which would inform the process of developing the descriptive guidelines for mediation with unmarried parents. The empirical findings from the study were synthesised with the findings from the integrative literature review, thus enabling conclusions to be drawn in order to generate descriptive guidelines for mediation. Phase 3 of the study describes the guidelines for mediation which emanated from the synthesis of the findings in Phase 1 and Phase 2 of the study. As part of a qualitative evaluation, the guidelines were presented to an expert panel for review, after which the guidelines were finalised. The proposed guidelines for mediation to enhance the parental involvement of unmarried fathers is based on the hybrid model of mediation, which incorporates elements from the Transformative approach, the African centred approach and the co-mediation model. The guidelines are further described in terms of a phased approach to mediation.
- Full Text:
- Date Issued: 2019
Perspectives of South African women and midwives on clinical practice in public maternity units: facilitating the scaling-up of such clinical practices
- Authors: Wibbelink, Margreet
- Date: 2019
- Subjects: Physician practice patterns , Midwives -- South Africa -- Attitudes Pregnant women -- South Africa -- Attitudes Midwifery -- South Africa
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/44422 , vital:37168
- Description: Despite a steady drop globally in maternal and newborn deaths since 1990, thousands of women and newborns still die each year during pregnancy and childbirth. South Africa, together with other countries, failed to achieve the Millennium Development Goal of reducing maternal mortality by three quarters by 2015. This is despite the positive efforts made in the country towards achieving these goals. However, much more still needs to be done. For that reason, proper and safe care of labouring women remains the identified major focus to prevent these deaths. The current study was the culmination of an investigation into the problem of poor performance regarding maternal and perinatal outcomes as identified by the researcher. The aim of this research study was to understand the experiences and perceptions of the women and the midwives regarding the clinical practices in public maternity units in South Africa in order to facilitate the scaling-up of the midwifery practice. A mixed-methods (sequential exploratory) design was used to answer the research question and objectives, and the study was conducted in three phases. In Phase One, a qualitative research design was implemented. The population were all the midwives in the Eastern Cape who had been working in public maternity units and women who had delivered in those settings. Non-probability purposive sampling with inclusion criteria assisted in selecting a suitable sample. Data collection was done using semi-structured audio-recorded interviews from eleven public sector midwives and eleven women receiving care from the midwives in the Eastern Cape, a province of South Africa. On data analysis, three themes emerged, namely participants had diverse experiences of the midwifery practice, midwives highlighted the burden with regard to the shortage of skilled midwives, and midwives identified managerial issues that affect their performance. Phase Two of the study comprised the quantitative research. The population was the midwives in South Africa who were working in public maternity units and nonprobability purposive sampling criteria were used to select participants. Data collection was done by means of a survey that used a tool adapted from the Hennessy-Hicks Training Needs Analysis Questionnaire. Questions for the survey tool were based on the results of Phase One. A total number of 314 questionnaires were completed, returned and analysed. Phase Three of the study comprised the integration of the results of the first two phases. The study found that midwives were committed to provide quality care but major factors needed to be addressed to facilitate scaling-up of clinical midwifery practices. The midwifery profession needed to be strengthened and an enabling working environment provided. Based on the results of the study as well as the theoretical, conceptual and contextual framework, two strategies were developed: Strategy 1: Empowering midwives to deliver woman-centred care in public sector maternity units Strategy 2: Creating an enabling work environment in order to deliver womancentred care in public sector maternity units.
- Full Text:
- Date Issued: 2019
- Authors: Wibbelink, Margreet
- Date: 2019
- Subjects: Physician practice patterns , Midwives -- South Africa -- Attitudes Pregnant women -- South Africa -- Attitudes Midwifery -- South Africa
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/44422 , vital:37168
- Description: Despite a steady drop globally in maternal and newborn deaths since 1990, thousands of women and newborns still die each year during pregnancy and childbirth. South Africa, together with other countries, failed to achieve the Millennium Development Goal of reducing maternal mortality by three quarters by 2015. This is despite the positive efforts made in the country towards achieving these goals. However, much more still needs to be done. For that reason, proper and safe care of labouring women remains the identified major focus to prevent these deaths. The current study was the culmination of an investigation into the problem of poor performance regarding maternal and perinatal outcomes as identified by the researcher. The aim of this research study was to understand the experiences and perceptions of the women and the midwives regarding the clinical practices in public maternity units in South Africa in order to facilitate the scaling-up of the midwifery practice. A mixed-methods (sequential exploratory) design was used to answer the research question and objectives, and the study was conducted in three phases. In Phase One, a qualitative research design was implemented. The population were all the midwives in the Eastern Cape who had been working in public maternity units and women who had delivered in those settings. Non-probability purposive sampling with inclusion criteria assisted in selecting a suitable sample. Data collection was done using semi-structured audio-recorded interviews from eleven public sector midwives and eleven women receiving care from the midwives in the Eastern Cape, a province of South Africa. On data analysis, three themes emerged, namely participants had diverse experiences of the midwifery practice, midwives highlighted the burden with regard to the shortage of skilled midwives, and midwives identified managerial issues that affect their performance. Phase Two of the study comprised the quantitative research. The population was the midwives in South Africa who were working in public maternity units and nonprobability purposive sampling criteria were used to select participants. Data collection was done by means of a survey that used a tool adapted from the Hennessy-Hicks Training Needs Analysis Questionnaire. Questions for the survey tool were based on the results of Phase One. A total number of 314 questionnaires were completed, returned and analysed. Phase Three of the study comprised the integration of the results of the first two phases. The study found that midwives were committed to provide quality care but major factors needed to be addressed to facilitate scaling-up of clinical midwifery practices. The midwifery profession needed to be strengthened and an enabling working environment provided. Based on the results of the study as well as the theoretical, conceptual and contextual framework, two strategies were developed: Strategy 1: Empowering midwives to deliver woman-centred care in public sector maternity units Strategy 2: Creating an enabling work environment in order to deliver womancentred care in public sector maternity units.
- Full Text:
- Date Issued: 2019
Physiological and mechanistic characteristics of all-out running using the critical speed concept
- Authors: Kramer, Mark
- Date: 2019
- Subjects: Aerobic exercises , Physical fitness Running Exercise
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/40511 , vital:36178
- Description: The studies described in this thesis, as far as could be ascertained, were the first to investigate the physiological and mechanistic characteristics of all-out running using the critical speed concept specifically applied to field-sport athletes. In the first study the oxygen uptake (𝑉̇𝑂2) kinetics of linear and shuttle all-out running were investigated. The 𝑉̇𝑂2 kinetic parameters were also related to parameters derived from a graded exercise test. No differences were observed in all 𝑉̇ 𝑂2 kinetic parameters between all-out linear and shuttle running, even though differences in all-out testing parameters were evident. The study was novel in that it was, as far as could be ascertained, the first to implement and investigate differences in 𝑉̇𝑂2 kinetics applied to all-out running. The second study investigated whether the parameters derived from all-out linear and shuttle running were representative of aerobic fitness, and the extent to which the all-out test (AOT) related to already established evaluations of aerobic fitness (e.g., graded exercise test [GXT] and the Yo-Yo intermittent recovery test [YYIR1]). It was also investigated whether the parameters from the AOTs could be used to predict the time to completion (tLIM) of shuttle-based performances. The outcomes of this study showed that both the linear and 50-m AOTs were indeed valid for the aerobic assessment of fitness by showing high correlations with maximal pulmonary oxygen uptake (𝑉̇𝑂2𝑚𝑎𝑥). Both the linear and 50-m AOT could therefore be used as surrogates for the evaluation of aerobic fitness. Interestingly, in terms of the tLIM prediction, the 25-m AOT showed the greatest utility. This study was novel on several fronts in that it was the first to: (1) investigate the physiological link between linear and shuttle AOTs and the GXT, (2) investigate the difference between AOTs and the YYIR1, and (3) investigate the application of the AOT methodology to field-based athletes such as rugby players. The third study investigated the energetic cost (EC) of locomotion as well as the metabolic power (𝑃̇) required to run at given speeds. The energetic approach provides a more robust evaluation of the differences between linear and shuttle running due to the all-out nature of the tests. Conventional methods of energy assessment often fall short due to the preclusion of a physiological steady-state, hence requiring more robust mathematical models to evaluate all-out running performance. The results of this study showed that differences between linear and shuttle AOTs are more likely neuromuscular as opposed to physiological. Peak EC and 𝑃̇ were significantly greater for shuttle running compared to linear running, showing clear non-linear increases with each successive increase in running speed. However, the mean EC and 𝑃̇ were not different, showing that all-out shuttle running ‘balances’ the lower running speeds (implying a lower physiological load compared to linear running) with the higher metabolic load imposed by the intense directional changes. This study was novel as it was, as far as could be ascertained, the first to apply the energetic approach to all-out running as well as investigate the differences in energetics between linear and shuttle AOTs. The fourth study provided a means by which the speed-time characteristics of all-out running could be objectively quantified. A novel bi-exponential model was applied to both the linear and shuttle speed-time curves and allowed various mechanistic aspects of the speed-time curve to be characterized. Conventional assessment of the AOT allows for the derivation of only two key parameters, namely critical speed (CS) and the finite distance achievable at speeds exceeding CS (D’). The application of the bi-exponential model expands the number of useful parameters that can be derived from an AOT to seven. The additional useful parameters include: maximum speed [𝑆𝑚𝑎𝑥], time to maximum speed [𝑡𝑐], amplitude of the difference between 𝑆𝑚𝑎𝑥 and CS [𝐴𝑑], curvature constant of the exponential decay [𝜏𝑑] and the asymptote of the exponential decay function [𝑆0], fatigue index showing the percent decline between 𝑆𝑚𝑎𝑥 and CS [FI%], and the finite capacity for running at speeds exceeding CS [D’; representing the area under the curve that is above CS]. The CS and D’ parameters derived from the bi-exponential model were not different to the CS and D’ parameters derived using the conventional method of analysis, thereby showing that the bi-exponential model is a valid means of assessing the curvature characteristics of the AOT, as well as providing additional information that cannot be gleaned from the traditional approach.
- Full Text:
- Date Issued: 2019
- Authors: Kramer, Mark
- Date: 2019
- Subjects: Aerobic exercises , Physical fitness Running Exercise
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/40511 , vital:36178
- Description: The studies described in this thesis, as far as could be ascertained, were the first to investigate the physiological and mechanistic characteristics of all-out running using the critical speed concept specifically applied to field-sport athletes. In the first study the oxygen uptake (𝑉̇𝑂2) kinetics of linear and shuttle all-out running were investigated. The 𝑉̇𝑂2 kinetic parameters were also related to parameters derived from a graded exercise test. No differences were observed in all 𝑉̇ 𝑂2 kinetic parameters between all-out linear and shuttle running, even though differences in all-out testing parameters were evident. The study was novel in that it was, as far as could be ascertained, the first to implement and investigate differences in 𝑉̇𝑂2 kinetics applied to all-out running. The second study investigated whether the parameters derived from all-out linear and shuttle running were representative of aerobic fitness, and the extent to which the all-out test (AOT) related to already established evaluations of aerobic fitness (e.g., graded exercise test [GXT] and the Yo-Yo intermittent recovery test [YYIR1]). It was also investigated whether the parameters from the AOTs could be used to predict the time to completion (tLIM) of shuttle-based performances. The outcomes of this study showed that both the linear and 50-m AOTs were indeed valid for the aerobic assessment of fitness by showing high correlations with maximal pulmonary oxygen uptake (𝑉̇𝑂2𝑚𝑎𝑥). Both the linear and 50-m AOT could therefore be used as surrogates for the evaluation of aerobic fitness. Interestingly, in terms of the tLIM prediction, the 25-m AOT showed the greatest utility. This study was novel on several fronts in that it was the first to: (1) investigate the physiological link between linear and shuttle AOTs and the GXT, (2) investigate the difference between AOTs and the YYIR1, and (3) investigate the application of the AOT methodology to field-based athletes such as rugby players. The third study investigated the energetic cost (EC) of locomotion as well as the metabolic power (𝑃̇) required to run at given speeds. The energetic approach provides a more robust evaluation of the differences between linear and shuttle running due to the all-out nature of the tests. Conventional methods of energy assessment often fall short due to the preclusion of a physiological steady-state, hence requiring more robust mathematical models to evaluate all-out running performance. The results of this study showed that differences between linear and shuttle AOTs are more likely neuromuscular as opposed to physiological. Peak EC and 𝑃̇ were significantly greater for shuttle running compared to linear running, showing clear non-linear increases with each successive increase in running speed. However, the mean EC and 𝑃̇ were not different, showing that all-out shuttle running ‘balances’ the lower running speeds (implying a lower physiological load compared to linear running) with the higher metabolic load imposed by the intense directional changes. This study was novel as it was, as far as could be ascertained, the first to apply the energetic approach to all-out running as well as investigate the differences in energetics between linear and shuttle AOTs. The fourth study provided a means by which the speed-time characteristics of all-out running could be objectively quantified. A novel bi-exponential model was applied to both the linear and shuttle speed-time curves and allowed various mechanistic aspects of the speed-time curve to be characterized. Conventional assessment of the AOT allows for the derivation of only two key parameters, namely critical speed (CS) and the finite distance achievable at speeds exceeding CS (D’). The application of the bi-exponential model expands the number of useful parameters that can be derived from an AOT to seven. The additional useful parameters include: maximum speed [𝑆𝑚𝑎𝑥], time to maximum speed [𝑡𝑐], amplitude of the difference between 𝑆𝑚𝑎𝑥 and CS [𝐴𝑑], curvature constant of the exponential decay [𝜏𝑑] and the asymptote of the exponential decay function [𝑆0], fatigue index showing the percent decline between 𝑆𝑚𝑎𝑥 and CS [FI%], and the finite capacity for running at speeds exceeding CS [D’; representing the area under the curve that is above CS]. The CS and D’ parameters derived from the bi-exponential model were not different to the CS and D’ parameters derived using the conventional method of analysis, thereby showing that the bi-exponential model is a valid means of assessing the curvature characteristics of the AOT, as well as providing additional information that cannot be gleaned from the traditional approach.
- Full Text:
- Date Issued: 2019
Socio-ecological, contextual effects in Raven’s Colour Progressive Matrices scores: developing an index for guiding test selection and interpretation
- Authors: August, Justin Oswin
- Date: 2019
- Subjects: Psychological testing
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/50214 , vital:42071
- Description: With the changing landscape in South Africa to full democracy, increased research has been undertaken in the psychometric field on local and national normative studies regarding various assessment measures. Given that the Raven’s Coloured Progressive Matrices (CPM) is purported to be culture-free and not heavily dependent on verbal and language skills; it has been extensively normed throughout the world for various population groups. While norms for normal populations of children have been developed in South Africa, these studies were based on race and gender predominantly and without taking into consideration the effects of socio-ecological factors on test performance. The research study aimed to understand the influence of socio-ecological factors on the expression of cognitive scores amongst a geographically diverse sample of South African learners. Through this study, research on the interplay between context and cognition was to be located within the Ecological Systems model of Bronfenbrenner. A secondary aim of the study was to develop an index that will guide test selection and interpretation of assessment results, taking into account the influence of socio-ecological factors and providing a conceptual framework for future test development. The study employed a quantitative methodology on a South African sample consisting of primary school children aged between the ages of 6 years to 11 years. The sample was drawn from schools in the Port Elizabeth area in South Africa that were classified into low, medium, and high opportunity, based on context. The results indicated that the type of school had a significant impact on test performance, suggesting that contextual factors were influential in this process. The item analysis conducted further indicated that learners from a low opportunity school performed significantly lower than the other two schools in the sample. The index development provides a foundation for further research that would enhance the interpretation of test results. In the South African context, this is considered important, given our political history and our diversity where a “one size fits all” approach is not possible.
- Full Text:
- Date Issued: 2019
- Authors: August, Justin Oswin
- Date: 2019
- Subjects: Psychological testing
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/50214 , vital:42071
- Description: With the changing landscape in South Africa to full democracy, increased research has been undertaken in the psychometric field on local and national normative studies regarding various assessment measures. Given that the Raven’s Coloured Progressive Matrices (CPM) is purported to be culture-free and not heavily dependent on verbal and language skills; it has been extensively normed throughout the world for various population groups. While norms for normal populations of children have been developed in South Africa, these studies were based on race and gender predominantly and without taking into consideration the effects of socio-ecological factors on test performance. The research study aimed to understand the influence of socio-ecological factors on the expression of cognitive scores amongst a geographically diverse sample of South African learners. Through this study, research on the interplay between context and cognition was to be located within the Ecological Systems model of Bronfenbrenner. A secondary aim of the study was to develop an index that will guide test selection and interpretation of assessment results, taking into account the influence of socio-ecological factors and providing a conceptual framework for future test development. The study employed a quantitative methodology on a South African sample consisting of primary school children aged between the ages of 6 years to 11 years. The sample was drawn from schools in the Port Elizabeth area in South Africa that were classified into low, medium, and high opportunity, based on context. The results indicated that the type of school had a significant impact on test performance, suggesting that contextual factors were influential in this process. The item analysis conducted further indicated that learners from a low opportunity school performed significantly lower than the other two schools in the sample. The index development provides a foundation for further research that would enhance the interpretation of test results. In the South African context, this is considered important, given our political history and our diversity where a “one size fits all” approach is not possible.
- Full Text:
- Date Issued: 2019
The anti-proliferative activity of drimia altissima and a novel isolated flavonoid glycoside against hela cervical cancer cells
- Authors: Nyambe, Mutenta Nsokolo
- Date: 2019
- Subjects: Cancer -- Research , Cervix uteri -- Cancer , Cervix uteri -- Cancer -- Diagnosis -- Developing countries
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/42770 , vital:36690
- Description: Cancer is one of the leading causes of mortality worldwide. About 44% of all cancer morbidity and 53% of all cancer mortality occur in countries with a low to medium Human Development Index (HDI). Thus, cancer is rapidly emerging as a serious threat to public health in Africa and most especially, sub-Saharan Africa. The International Agency for Research on Cancer (IARC) projects that there will be 1.28 million new cancer cases and 970 000 cancer deaths in Africa by the year 2030 owing to the increase in economic development associated lifestyles. The dominant types of cancer in Africa are those related to infectious diseases such as Kaposi’s sarcoma and cervical, hepatic and urinary bladder carcinomas. The main challenge to cancer treatment in Africa is the unavailability of efficacious anticancer drugs. This is because most developing countries can only afford to procure the most basic anticancer drugs, which are also frequently unavailable due to intermittent supplies. This results in patients progressing to more advanced cancer states. One way of combating this African problem is to focus on research that aims at discovering efficacious and cost effective cancer therapies from available natural resources within the African continent. This study investigated the potential anti-proliferative activity (against HeLa cervical cancer cells) of four plants (Adansonia digitata, Ceiba pentandra, Maytenus senegalensis and Drimia altissima) commonly used in the African traditional treatment of malignancies. After in vitro bio-assay screening using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, M. senegalensis root extract (MS-R) and D. altissima bulb extract (DA-B) showed anti-proliferative activity against HeLa cervical cancer cells with IC50 values of 25 μg/mL and 1.1 μg/mL respectively. By possessing the strongest anti-proliferative activity among the tested extracts, D. altissima was selected for further studies. Liquid-liquid partitioning of the Drimia altissima bulb extract with n-hexane, ethyl acetate, and n-butanol, yielded partitions 79a – d, with the n-butanol fraction, 79d, exhibiting the strongest cytotoxic activity (IC50 = 0.497 μg/mL). Through High Content Analysis (HCA) screening, fraction 79d was found to induce marked early mitotic cell cycle arrest. Fractionation of 79d using Diaion® HP-20 open column chromatography and a stepwise gradient of reducing polarity (water-methanol-ethanol-ethyl acetate) yielded cytotoxic fractions 82b, 82c, 82d and 82e, all with significant anti-proliferative activities at the tested concentrations of 0.1, 1.0 and 10 μg/mL. Bio-assay guided fractionation of 82c (the most effective fraction at the lowest tested concentration of 0.1 μg/mL) using Sephadex® LH-20 open column chromatography and 50% MeOH led to the isolation of compound 3.17. After structural elucidation using 1D and 2D Nuclear Magnetic Resonance spectroscopy (NMR), High resolution Mass spectrometry (HRMS), Fourier-Transform Infrared spectroscopy (FT-IR), ultraviolet spectroscopy (UV) and Circular Dichroism (CD), compound 3.17 was identified as a novel C-glucosylflavonoid-O-glucoside, 6-C-[-apio-α-D-furanosyl-(1→6)-β-glucopyranosyl]-4′, 5, 7-trihydroxyflavone (Altissimin, 3.17). Compound 3.17 exhibited a dose dependant anti-proliferative activity with an IC50 of 2.44 μM. The mechanism of action for compound 3.17 was investigated through cell cycle arrest, phosphatidylserine translocation (PS), caspase activation and mitochondrial membrane depolarization. The mechanism of cell death elicited by compound 3.17 in HeLa cells was found to involve the induction of M phase cell cycle arrest with consequent activation of apoptotic cell death which was evident from annexin V staining, mitochondrial membrane potential (ΔΨm) collapse and the activation of caspases -8 and -3. In silico computational techniques were employed to virtually determine potential biological targets of compound 3.17. Target fishing using the Similarity Ensemble Approach (SEA) target prediction gave human aldose reductase (hAR, AKR1B1) the highest ranking with a p value of 2.85 x 10-24, a max Tc of 0.35 and a Z-score of 41.8217. Using AutoDock4 and the AutoDock tools suite (ADT), molecular docking of compound 3.17 in the hAR binding pocket was successfully achieved with a lower ΔG free energy binding (-9.4 kcal/mol) than that of positive control ligand 393 (-8.7 kcal/mol). In conclusion, this study identified the genus Drimia and particularly D. altissima as a potential source for novel cytotoxic compounds. The discovery of altissimin (3.17), the first flavonoid glycoside to be isolate from D. altissima, enquires into the possible existence of similar compounds within the species. In addition to the observed in vitro cytotoxic activity against HeLa cells, the potential of altissimin (3.17) as a hAR enzyme inhibitor opens up the possibility of its use as an adjunct to increase cancer cell sensitivity to chemotherapy. Thus, altissimin (3.17) shows promise as a potential anticancer agent.
- Full Text:
- Date Issued: 2019
- Authors: Nyambe, Mutenta Nsokolo
- Date: 2019
- Subjects: Cancer -- Research , Cervix uteri -- Cancer , Cervix uteri -- Cancer -- Diagnosis -- Developing countries
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/42770 , vital:36690
- Description: Cancer is one of the leading causes of mortality worldwide. About 44% of all cancer morbidity and 53% of all cancer mortality occur in countries with a low to medium Human Development Index (HDI). Thus, cancer is rapidly emerging as a serious threat to public health in Africa and most especially, sub-Saharan Africa. The International Agency for Research on Cancer (IARC) projects that there will be 1.28 million new cancer cases and 970 000 cancer deaths in Africa by the year 2030 owing to the increase in economic development associated lifestyles. The dominant types of cancer in Africa are those related to infectious diseases such as Kaposi’s sarcoma and cervical, hepatic and urinary bladder carcinomas. The main challenge to cancer treatment in Africa is the unavailability of efficacious anticancer drugs. This is because most developing countries can only afford to procure the most basic anticancer drugs, which are also frequently unavailable due to intermittent supplies. This results in patients progressing to more advanced cancer states. One way of combating this African problem is to focus on research that aims at discovering efficacious and cost effective cancer therapies from available natural resources within the African continent. This study investigated the potential anti-proliferative activity (against HeLa cervical cancer cells) of four plants (Adansonia digitata, Ceiba pentandra, Maytenus senegalensis and Drimia altissima) commonly used in the African traditional treatment of malignancies. After in vitro bio-assay screening using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, M. senegalensis root extract (MS-R) and D. altissima bulb extract (DA-B) showed anti-proliferative activity against HeLa cervical cancer cells with IC50 values of 25 μg/mL and 1.1 μg/mL respectively. By possessing the strongest anti-proliferative activity among the tested extracts, D. altissima was selected for further studies. Liquid-liquid partitioning of the Drimia altissima bulb extract with n-hexane, ethyl acetate, and n-butanol, yielded partitions 79a – d, with the n-butanol fraction, 79d, exhibiting the strongest cytotoxic activity (IC50 = 0.497 μg/mL). Through High Content Analysis (HCA) screening, fraction 79d was found to induce marked early mitotic cell cycle arrest. Fractionation of 79d using Diaion® HP-20 open column chromatography and a stepwise gradient of reducing polarity (water-methanol-ethanol-ethyl acetate) yielded cytotoxic fractions 82b, 82c, 82d and 82e, all with significant anti-proliferative activities at the tested concentrations of 0.1, 1.0 and 10 μg/mL. Bio-assay guided fractionation of 82c (the most effective fraction at the lowest tested concentration of 0.1 μg/mL) using Sephadex® LH-20 open column chromatography and 50% MeOH led to the isolation of compound 3.17. After structural elucidation using 1D and 2D Nuclear Magnetic Resonance spectroscopy (NMR), High resolution Mass spectrometry (HRMS), Fourier-Transform Infrared spectroscopy (FT-IR), ultraviolet spectroscopy (UV) and Circular Dichroism (CD), compound 3.17 was identified as a novel C-glucosylflavonoid-O-glucoside, 6-C-[-apio-α-D-furanosyl-(1→6)-β-glucopyranosyl]-4′, 5, 7-trihydroxyflavone (Altissimin, 3.17). Compound 3.17 exhibited a dose dependant anti-proliferative activity with an IC50 of 2.44 μM. The mechanism of action for compound 3.17 was investigated through cell cycle arrest, phosphatidylserine translocation (PS), caspase activation and mitochondrial membrane depolarization. The mechanism of cell death elicited by compound 3.17 in HeLa cells was found to involve the induction of M phase cell cycle arrest with consequent activation of apoptotic cell death which was evident from annexin V staining, mitochondrial membrane potential (ΔΨm) collapse and the activation of caspases -8 and -3. In silico computational techniques were employed to virtually determine potential biological targets of compound 3.17. Target fishing using the Similarity Ensemble Approach (SEA) target prediction gave human aldose reductase (hAR, AKR1B1) the highest ranking with a p value of 2.85 x 10-24, a max Tc of 0.35 and a Z-score of 41.8217. Using AutoDock4 and the AutoDock tools suite (ADT), molecular docking of compound 3.17 in the hAR binding pocket was successfully achieved with a lower ΔG free energy binding (-9.4 kcal/mol) than that of positive control ligand 393 (-8.7 kcal/mol). In conclusion, this study identified the genus Drimia and particularly D. altissima as a potential source for novel cytotoxic compounds. The discovery of altissimin (3.17), the first flavonoid glycoside to be isolate from D. altissima, enquires into the possible existence of similar compounds within the species. In addition to the observed in vitro cytotoxic activity against HeLa cells, the potential of altissimin (3.17) as a hAR enzyme inhibitor opens up the possibility of its use as an adjunct to increase cancer cell sensitivity to chemotherapy. Thus, altissimin (3.17) shows promise as a potential anticancer agent.
- Full Text:
- Date Issued: 2019