Determinants of Type 2 diabetes mellitus among HIV/AIDS patients on antiretroviral drugs in the OR Tambo District, South Africa
- Authors: Bam, Nokwanda Edith
- Date: 2018
- Subjects: HIV/AIDS Diabetes mellitus (DM) -- Patients Antiretroviral drugs -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , PhD Health Sciences
- Identifier: http://hdl.handle.net/11260/1476 , vital:35976
- Description: Type 2 diabetes mellitus (DM) is a frequent adverse effect of antiretroviral drugs for those who are on ARVS. People with type 2 DM can suffer multiple complications that hinder the quality of life. In South Africa research has shown significant increase in neuropathy, heart and kidney diseases among patients living with type 2 DM and HIV/AIDS compared to DM without HIV. Accessed knowledge lacked consistency on the predictors of DM in HIV/AIDS patients with regards to the type of ARVS with higher risks of DM. Research needed to be done to find the determinants of type 2 DM in HIV/AIDS context. The purpose of this study was to describe the determinants of type 2 DM among HIV/AIDS patients on ARVS in the OR Tambo District, SA in order to develop intervention strategies to mitigate the long-term effects of type 2 DM. A quantitative research methodology using a case control retrospective study was used. A sample of 177 (33%) cases with HIV/AIDS and type 2 DM was selected using a one stage stratified sampling with allocation proportional to size of each stratum of the four sub-districts of OR Tambo District. Two non-diabetic patients with HIV/AIDS were selected as controls per case unpaired and totalled up to 354 (67%) controls. A self-administration questionnaire adopted from the WHO (2011) STEPwise surveillance tool for chronic diseases was used for data collection. Stata (standard version 13.0, Stata Corp., Lakeway Drive USA) was used for data management and analysis. Findings of the study revealed determinants of type 2 DM grouped as the socio-demographic determinants; tertiary education and marital status, levels of physical activities; lack of vigorous activity and sport, types of diets; high fruits and vegetables and healthy eating out at restaurants, arterial blood pressure; lack of routine BP check and known HPT and types of ARVS used in HIV/AIDS therapy. Compared with patients who received FDC, the risk of type 2 DM was 43 times and 22 higher when a tri-therapy regimen contained Ritonavir and Lopinavir respectively . The majority of DM patients (n=177) were diagnosed type 2 DM after ARVS at n=108 (61%). In managing the diabetic patients a shift from a single disease to multiple-chronic disease focus is required to mitigate the complex drug interactions that exist in the control of NCDs such as HIV/AIDS, DM, HPT and other long-term diseases. The HIV/AIDS and type 2 DM awareness and care intervention strategy is recommended as healthy lifestyle, monitoring of side effects and drug interactions, enhanced FDC roll out and elimination of unsafe ARVS to improve the health outcomes of type 2 DM patients in an HIV/AIDS context in OR Tambo District.
- Full Text:
- Date Issued: 2018
- Authors: Bam, Nokwanda Edith
- Date: 2018
- Subjects: HIV/AIDS Diabetes mellitus (DM) -- Patients Antiretroviral drugs -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , PhD Health Sciences
- Identifier: http://hdl.handle.net/11260/1476 , vital:35976
- Description: Type 2 diabetes mellitus (DM) is a frequent adverse effect of antiretroviral drugs for those who are on ARVS. People with type 2 DM can suffer multiple complications that hinder the quality of life. In South Africa research has shown significant increase in neuropathy, heart and kidney diseases among patients living with type 2 DM and HIV/AIDS compared to DM without HIV. Accessed knowledge lacked consistency on the predictors of DM in HIV/AIDS patients with regards to the type of ARVS with higher risks of DM. Research needed to be done to find the determinants of type 2 DM in HIV/AIDS context. The purpose of this study was to describe the determinants of type 2 DM among HIV/AIDS patients on ARVS in the OR Tambo District, SA in order to develop intervention strategies to mitigate the long-term effects of type 2 DM. A quantitative research methodology using a case control retrospective study was used. A sample of 177 (33%) cases with HIV/AIDS and type 2 DM was selected using a one stage stratified sampling with allocation proportional to size of each stratum of the four sub-districts of OR Tambo District. Two non-diabetic patients with HIV/AIDS were selected as controls per case unpaired and totalled up to 354 (67%) controls. A self-administration questionnaire adopted from the WHO (2011) STEPwise surveillance tool for chronic diseases was used for data collection. Stata (standard version 13.0, Stata Corp., Lakeway Drive USA) was used for data management and analysis. Findings of the study revealed determinants of type 2 DM grouped as the socio-demographic determinants; tertiary education and marital status, levels of physical activities; lack of vigorous activity and sport, types of diets; high fruits and vegetables and healthy eating out at restaurants, arterial blood pressure; lack of routine BP check and known HPT and types of ARVS used in HIV/AIDS therapy. Compared with patients who received FDC, the risk of type 2 DM was 43 times and 22 higher when a tri-therapy regimen contained Ritonavir and Lopinavir respectively . The majority of DM patients (n=177) were diagnosed type 2 DM after ARVS at n=108 (61%). In managing the diabetic patients a shift from a single disease to multiple-chronic disease focus is required to mitigate the complex drug interactions that exist in the control of NCDs such as HIV/AIDS, DM, HPT and other long-term diseases. The HIV/AIDS and type 2 DM awareness and care intervention strategy is recommended as healthy lifestyle, monitoring of side effects and drug interactions, enhanced FDC roll out and elimination of unsafe ARVS to improve the health outcomes of type 2 DM patients in an HIV/AIDS context in OR Tambo District.
- Full Text:
- Date Issued: 2018
Literary representations of Zimbabwean migrants’ lives in selected texts
- Authors: Mpofu, Tarisai
- Date: 2018
- Subjects: Human rights -- Zimbabwe , Homelessness in literature , African diaspora in literature
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/3402 , vital:43340
- Description: It has been nearly two decades since Zimbabwe has been engulfed in both political and economic crises which have had untold hardships to the majority of ordinary people. As the hardships worsened it pushed Zimbabweans to migrate to “greener pastures” as a survival strategy. Due to the sheer numbers of people who left the country, migration became a social phenomenon in the country that even literary writers also explored. It is the purpose of this study to analyse literary reactions to migration in Zimbabwe from the turn of the new millennium to date, with particular reference to selected Zimbabwean fiction in the form of the short story and novel. The dissertation examines how Zimbabwean literature represents life in Zimbabwe in the context of this economic malaise that emerged after the year 2000 and the resultant lives of migrants who left the country as a result of this political and economic crisis. Similar to the majority of African literatures, Zimbabwean literature emerges from specific historical events and this study therefore sought to describe literary representations of people’s responses to the crisis and the life of Zimbabwean migrants in the margins of host communities. This study reveals the intricate relationship between literary responses and the conditions that most migrants found themselves in especially as they fled the country and what obtained in host countries. , Thesis (MA) -- Faculty of Humanities, Social Sciences and Law, 2018
- Full Text:
- Date Issued: 2018
- Authors: Mpofu, Tarisai
- Date: 2018
- Subjects: Human rights -- Zimbabwe , Homelessness in literature , African diaspora in literature
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/3402 , vital:43340
- Description: It has been nearly two decades since Zimbabwe has been engulfed in both political and economic crises which have had untold hardships to the majority of ordinary people. As the hardships worsened it pushed Zimbabweans to migrate to “greener pastures” as a survival strategy. Due to the sheer numbers of people who left the country, migration became a social phenomenon in the country that even literary writers also explored. It is the purpose of this study to analyse literary reactions to migration in Zimbabwe from the turn of the new millennium to date, with particular reference to selected Zimbabwean fiction in the form of the short story and novel. The dissertation examines how Zimbabwean literature represents life in Zimbabwe in the context of this economic malaise that emerged after the year 2000 and the resultant lives of migrants who left the country as a result of this political and economic crisis. Similar to the majority of African literatures, Zimbabwean literature emerges from specific historical events and this study therefore sought to describe literary representations of people’s responses to the crisis and the life of Zimbabwean migrants in the margins of host communities. This study reveals the intricate relationship between literary responses and the conditions that most migrants found themselves in especially as they fled the country and what obtained in host countries. , Thesis (MA) -- Faculty of Humanities, Social Sciences and Law, 2018
- Full Text:
- Date Issued: 2018
Perceptions of school based support teams about providing support to Foundation Phase Teachers in two Butterworth Primary Schools, Eastern Cape
- Authors: Luningo, Mziwonke
- Date: 2018
- Subjects: School based support--Teams Foundation phase--Teachers--Eastern Cape Education support--Primary schools
- Language: English
- Type: Thesis , Doctoral , D Ed
- Identifier: http://hdl.handle.net/11260/1410 , vital:34373
- Description: The policy on Inclusive Education acknowledges that all children can learn if they are given the necessary support. In order to achieve this goal, the Department of Education (DoE) introduced the establishment of SBSTs whose main function is to support teaching and learning in schools. This study used interpretive paradigm to explore perceptions of SBST about providing support to foundation phase (FP) teachers and to interpret what they said. Nonetheless, there seemed to be challenges on how to support learners experiencing barriers to learning among the members of the SBST. The aim of this study was to explore the perceptions of the School-Based Support Teams (SBSTs) about providing support to the foundation phase teachers in two Butterworth Primary Schools in the Eastern Cape. This study used the qualitative mode of inquiry and a case study as a research design. Semi-structured interviews using one on one, observations and document analysis were used to collect the data from the SBSTs about their perceptions of providing support to the FP teachers. Purposeful sampling was used where two mainstream primary schools were conveniently selected with six SBST participants from each school, making a total of six participants. Twelve SBST members were interviewed. Data were analysed and common themes emerged. The findings revealed that the SBSTs did not have enough knowledge and skills to support the FP teachers. Some of the challenges they cited included inadequate training, lack of communication, overcrowding and lack of support from the parents. In an attempt to alleviate the above-raised challenges, a model was proposed. These are some of the recommendations that resulted from the findings: all schools should have SBSTs, they should be composed of all the important stakeholders as proposed by the DoE, frequent SBST meetings should be held and further recommendations are made.
- Full Text:
- Date Issued: 2018
- Authors: Luningo, Mziwonke
- Date: 2018
- Subjects: School based support--Teams Foundation phase--Teachers--Eastern Cape Education support--Primary schools
- Language: English
- Type: Thesis , Doctoral , D Ed
- Identifier: http://hdl.handle.net/11260/1410 , vital:34373
- Description: The policy on Inclusive Education acknowledges that all children can learn if they are given the necessary support. In order to achieve this goal, the Department of Education (DoE) introduced the establishment of SBSTs whose main function is to support teaching and learning in schools. This study used interpretive paradigm to explore perceptions of SBST about providing support to foundation phase (FP) teachers and to interpret what they said. Nonetheless, there seemed to be challenges on how to support learners experiencing barriers to learning among the members of the SBST. The aim of this study was to explore the perceptions of the School-Based Support Teams (SBSTs) about providing support to the foundation phase teachers in two Butterworth Primary Schools in the Eastern Cape. This study used the qualitative mode of inquiry and a case study as a research design. Semi-structured interviews using one on one, observations and document analysis were used to collect the data from the SBSTs about their perceptions of providing support to the FP teachers. Purposeful sampling was used where two mainstream primary schools were conveniently selected with six SBST participants from each school, making a total of six participants. Twelve SBST members were interviewed. Data were analysed and common themes emerged. The findings revealed that the SBSTs did not have enough knowledge and skills to support the FP teachers. Some of the challenges they cited included inadequate training, lack of communication, overcrowding and lack of support from the parents. In an attempt to alleviate the above-raised challenges, a model was proposed. These are some of the recommendations that resulted from the findings: all schools should have SBSTs, they should be composed of all the important stakeholders as proposed by the DoE, frequent SBST meetings should be held and further recommendations are made.
- Full Text:
- Date Issued: 2018
The perceptions of Nursing service and Operational Managers on the role of nursing sub-professionals in the Health Service System at Mhlontlo Municipality
- Authors: Mpini, Minah Malakiwe
- Date: 2018
- Subjects: Health service management -- South Africa -- Eastern Cape Nursing sub-professional
- Language: English
- Type: Thesis , Masters , M Nursing
- Identifier: http://hdl.handle.net/11260/1341 , vital:32258
- Description: South Africa is experiencing a serious shortage of nurses, especially nursing sub-professionals. The Eastern Cape Province is among the provinces with highest percentage of vacancies for nurses in all nursing categories. Nursing shortage has compromised South African health care services as health services are mostly supported by this group of health professionals. As a result of this shortage, rural health services have for a long time depended on the nursing sub-professionals to perform basic nursing services. This category is however also decreasing, which makes it difficult for nursing professionals to cope with the amount of work. South African rural health centres put pressure on professional nurses to do some of the health care activities that are meant to be done by medical doctors. The aim of the study was to explore the role and value of nursing sub-professionals in the health care system as viewed by the nursing managers. A qualitative exploratory study was conducted to get the perceptions of nursing service managers and operational managers on the role and value of nursing sub-professionals in the health service. A purposive sample of 23 participants was selected and interviewed. Most of the participants viewed the retention of nursing sub-professionals as crucial in the health service system. The participants saw sub-professionals as playing a vital role in the health services as the latter have a scope of practice that enables them to work independently. The reasons they put forth in support of their retention include reduction of litigations, easing the work load of professional nurses, sometimes performing non-nursing duties during crisis periods, reduction in the waiting time for patients/clients, and enabling professional nurses to perform more sophisticated professional duties which include management. Few managers viewed the existence of sub-professional nurses as increasing the work of nursing professionals. They felt that nursing sub-professionals worked under the supervision of nursing professionals. This, according to them, resulted in more work for nursing professionals who had to check and/or repeat what had been done in the name of supervision.
- Full Text:
- Date Issued: 2018
- Authors: Mpini, Minah Malakiwe
- Date: 2018
- Subjects: Health service management -- South Africa -- Eastern Cape Nursing sub-professional
- Language: English
- Type: Thesis , Masters , M Nursing
- Identifier: http://hdl.handle.net/11260/1341 , vital:32258
- Description: South Africa is experiencing a serious shortage of nurses, especially nursing sub-professionals. The Eastern Cape Province is among the provinces with highest percentage of vacancies for nurses in all nursing categories. Nursing shortage has compromised South African health care services as health services are mostly supported by this group of health professionals. As a result of this shortage, rural health services have for a long time depended on the nursing sub-professionals to perform basic nursing services. This category is however also decreasing, which makes it difficult for nursing professionals to cope with the amount of work. South African rural health centres put pressure on professional nurses to do some of the health care activities that are meant to be done by medical doctors. The aim of the study was to explore the role and value of nursing sub-professionals in the health care system as viewed by the nursing managers. A qualitative exploratory study was conducted to get the perceptions of nursing service managers and operational managers on the role and value of nursing sub-professionals in the health service. A purposive sample of 23 participants was selected and interviewed. Most of the participants viewed the retention of nursing sub-professionals as crucial in the health service system. The participants saw sub-professionals as playing a vital role in the health services as the latter have a scope of practice that enables them to work independently. The reasons they put forth in support of their retention include reduction of litigations, easing the work load of professional nurses, sometimes performing non-nursing duties during crisis periods, reduction in the waiting time for patients/clients, and enabling professional nurses to perform more sophisticated professional duties which include management. Few managers viewed the existence of sub-professional nurses as increasing the work of nursing professionals. They felt that nursing sub-professionals worked under the supervision of nursing professionals. This, according to them, resulted in more work for nursing professionals who had to check and/or repeat what had been done in the name of supervision.
- Full Text:
- Date Issued: 2018
Vulnerabilities of Coastal Tourism destinations to climate change related incidents: a case study selected holiday resorts along the wildcoast, Eastern Cape, South Africa
- Authors: Van Der Byl, Athina
- Date: 2018
- Subjects: Coastal Tourism destinations -- Wildcoast Wildcoast -- Holiday resorts -- South Africa -- Eastern Cape Climate change -- Tourism
- Language: English
- Type: Thesis , Masters , M Sc
- Identifier: http://hdl.handle.net/11260/1337 , vital:32259
- Description: Climate change is a global phenomenon with major impacts on coastlines, leaving coastal areas vulnerable to conditions such as sea level rise, flooding as well as storm surges, which results in increased damage to or loss of coastal property and infrastructure. The study examined the vulnerability of the Eastern Cape’s Wild Coast resorts to climate change related impacts. Both qualitative and quantitative methods aided by questionnaires and GIS mapping were used to identify vulnerable settlements as well as their impacts. A meta analysis of the identified vulnerabilities was studied and strategies employed to reduce the impacts was also done. Results indicated that almost 80% of the Wild Coast resorts occur within the low-lying areas of the coast and these areas were mostly affected by impacts such as sea level rise, heavy rainfall and floods accompanied by storm surges. Another alarming challenge faced by the King Sabata Dalindyebo Municipality was controlling unplanned developments within these low-lying zones of the coast. Therefore, it is recommended that relevant departments provide awareness through various platforms such as workshops, programmes and campaigns to ensure that people understand the risk of climate change on low-lying areas as well as mainstreaming climate change in long term development planning. This study highlights a need for monitoring of coastal environments vulnerable to the impact of climate change along a South African coastline.
- Full Text:
- Date Issued: 2018
- Authors: Van Der Byl, Athina
- Date: 2018
- Subjects: Coastal Tourism destinations -- Wildcoast Wildcoast -- Holiday resorts -- South Africa -- Eastern Cape Climate change -- Tourism
- Language: English
- Type: Thesis , Masters , M Sc
- Identifier: http://hdl.handle.net/11260/1337 , vital:32259
- Description: Climate change is a global phenomenon with major impacts on coastlines, leaving coastal areas vulnerable to conditions such as sea level rise, flooding as well as storm surges, which results in increased damage to or loss of coastal property and infrastructure. The study examined the vulnerability of the Eastern Cape’s Wild Coast resorts to climate change related impacts. Both qualitative and quantitative methods aided by questionnaires and GIS mapping were used to identify vulnerable settlements as well as their impacts. A meta analysis of the identified vulnerabilities was studied and strategies employed to reduce the impacts was also done. Results indicated that almost 80% of the Wild Coast resorts occur within the low-lying areas of the coast and these areas were mostly affected by impacts such as sea level rise, heavy rainfall and floods accompanied by storm surges. Another alarming challenge faced by the King Sabata Dalindyebo Municipality was controlling unplanned developments within these low-lying zones of the coast. Therefore, it is recommended that relevant departments provide awareness through various platforms such as workshops, programmes and campaigns to ensure that people understand the risk of climate change on low-lying areas as well as mainstreaming climate change in long term development planning. This study highlights a need for monitoring of coastal environments vulnerable to the impact of climate change along a South African coastline.
- Full Text:
- Date Issued: 2018
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