Attitudes of midwives towards the use of traditional medicine among pregnant women in Nelson Mandela Bay
- Simelane, Nompumelelo Andiswa
- Authors: Simelane, Nompumelelo Andiswa
- Date: 2018
- Subjects: Midwifery -- South Africa -- Nelson Mandela Bay Municipality , Pregnancy -- Alternative treatment -- South Africa -- Nelson Mandela Bay Municipality Women's health services -- Social aspects -- South Africa -- Nelson Mandela Bay Municipality Traditional medicine -- South Africa -- Nelson Mandela Bay Municipality Integrative medicine -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/23197 , vital:30452
- Description: The use of traditional medicines by pregnant women is a global concern. Despite limited theoretical evidence on the safety profile of traditional medicines to substantiate their use in pregnancy, expectant mothers are found to be widely using them. Safety concerns related to traditional medicine use in pregnancy include its use during the critical embryonic period, antenatal and intrapartum periods. These medications were associated with complications such as obstructed labour, foetal distress, emergency caesarean sections having to be performed and neonates delivered with low Apgar scorings. Midwives are usually the first and at times the only healthcare providers that come into contact with pregnant women. It was therefore necessary to investigate the midwives’ attitudes towards the use of traditional medicine among pregnant women. The objectives of this study were to: Explore and describe the attitudes of midwives towards the use of traditional medicine in Nelson Mandela Bay. Based on the findings of the study, make recommendations for midwives and nurse managers on how they could inform pregnant women of the benefits and harms of using traditional medicine during pregnancy. The study was conducted between November 2016 and January 2017, using a quantitative approach with an explorative, descriptive, and contextual design having obtained the necessary approval from the university and relevant authorities. The research population was midwives who work in maternity units in Nelson Mandela Bay. Self-administered questionnaires were used to collect data from conveniently sampled participants using set inclusion and exclusion criteria after obtaining informed consent. Data were captured by the researcher on a Microsoft Excel spread sheet and were reduced and analysed with the help of a statistician using the software package IBM SPSS Statistics 24 to ensure efficacy of the results. One hundred and twenty questionnaires were distributed and 89 were returned, yielding a 74% response rate. From the research findings, midwives in the Nelson Mandela Bay do not support the use of traditional medicine during pregnancy. Midwives acknowledged their responsibility to enquire and provide relevant information regarding the use of traditional medicine in pregnancy. Furthermore, midwives associated the use of traditional medicine with womens’ cultural diversity and lack of knowledge about pregnancy and labour. Based on these findings, recommendations for midwives and nurse managers on how they could inform pregnant women of the benefits and harms of using traditional medicine during pregnancy were made. Further recommendations were made for midwifery practice, nursing education and future research. The researcher used a literature control to ensure validation and integrity of the study. Further quality of the study was maintained by observing the principles of reliability and validity. Ethical considerations were guided by the Belmont Report adopting the principles of respect for persons, beneficence, and justice.
- Full Text:
- Date Issued: 2018
- Authors: Simelane, Nompumelelo Andiswa
- Date: 2018
- Subjects: Midwifery -- South Africa -- Nelson Mandela Bay Municipality , Pregnancy -- Alternative treatment -- South Africa -- Nelson Mandela Bay Municipality Women's health services -- Social aspects -- South Africa -- Nelson Mandela Bay Municipality Traditional medicine -- South Africa -- Nelson Mandela Bay Municipality Integrative medicine -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/23197 , vital:30452
- Description: The use of traditional medicines by pregnant women is a global concern. Despite limited theoretical evidence on the safety profile of traditional medicines to substantiate their use in pregnancy, expectant mothers are found to be widely using them. Safety concerns related to traditional medicine use in pregnancy include its use during the critical embryonic period, antenatal and intrapartum periods. These medications were associated with complications such as obstructed labour, foetal distress, emergency caesarean sections having to be performed and neonates delivered with low Apgar scorings. Midwives are usually the first and at times the only healthcare providers that come into contact with pregnant women. It was therefore necessary to investigate the midwives’ attitudes towards the use of traditional medicine among pregnant women. The objectives of this study were to: Explore and describe the attitudes of midwives towards the use of traditional medicine in Nelson Mandela Bay. Based on the findings of the study, make recommendations for midwives and nurse managers on how they could inform pregnant women of the benefits and harms of using traditional medicine during pregnancy. The study was conducted between November 2016 and January 2017, using a quantitative approach with an explorative, descriptive, and contextual design having obtained the necessary approval from the university and relevant authorities. The research population was midwives who work in maternity units in Nelson Mandela Bay. Self-administered questionnaires were used to collect data from conveniently sampled participants using set inclusion and exclusion criteria after obtaining informed consent. Data were captured by the researcher on a Microsoft Excel spread sheet and were reduced and analysed with the help of a statistician using the software package IBM SPSS Statistics 24 to ensure efficacy of the results. One hundred and twenty questionnaires were distributed and 89 were returned, yielding a 74% response rate. From the research findings, midwives in the Nelson Mandela Bay do not support the use of traditional medicine during pregnancy. Midwives acknowledged their responsibility to enquire and provide relevant information regarding the use of traditional medicine in pregnancy. Furthermore, midwives associated the use of traditional medicine with womens’ cultural diversity and lack of knowledge about pregnancy and labour. Based on these findings, recommendations for midwives and nurse managers on how they could inform pregnant women of the benefits and harms of using traditional medicine during pregnancy were made. Further recommendations were made for midwifery practice, nursing education and future research. The researcher used a literature control to ensure validation and integrity of the study. Further quality of the study was maintained by observing the principles of reliability and validity. Ethical considerations were guided by the Belmont Report adopting the principles of respect for persons, beneficence, and justice.
- Full Text:
- Date Issued: 2018
Barriers to picking and packing in pharmaceutical warehousing and distribution in South Africa
- Authors: Kemp, Nicholas
- Date: 2018
- Subjects: Pharmaceutical industry -- Materials management , Warehouses -- Management Pharmaceutical industry -- South Africa Physical distribution of goods -- Management
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/30627 , vital:30994
- Description: Barriers within the supply chain play an evident role in decreasing its efficiency. The supply chain system is not well documented in the pharmaceutical sector. The aim of this study was to identify any barriers to the movement of picking and packing operators within 6 distribution facilities throughout South Africa using a time and motion analysis. A pilot study was initially conducted to choose the stopwatch application for Android® devices and to ensure reliability of the tools utilised. The motions during the processes of fulfilling an order were identified during the case picking, bulk picking and packing processes by direct observation of operators. The direct observation was performed using a stopwatch application for Android® devices and a tool on Microsoft Excel®. The data was analysed using Microsoft Excel®, using a student’s T-test and an analysis of variance (ANOVA) approach to identify similarities and differences between the facilities. The data was further analysed using a descriptive statistics approach to identify the common barriers amongst the distribution centres. Thereafter, the data was analysed by identifying a value-quotient. The value-quotient was used to identify how much time was spent on value-adding activities with each facility. The observation of the operators was done randomly at each facility to avoid subjectivity and bias. Results: The pilot study identified which stopwatch application was to be utilised. The pilot study aided to improve upon the design of the data collection tool used for the transcribing of the timing operation. The student’s T-test and ANOVA revealed that there were statistically significant differences in case picking amongst facilities, namely using the radio frequency identification devices (RFID), picking and transfer of stock. In the bulk picking process, there was a statistically significant difference amongst the facilities, namely using the RFID, pick and transfer of stock. In the packing process there was a statistically significant difference amongst the facilities in the packing process. The analysis of barriers within the distribution centres revealed that the 16 common barriers amongst the picking processes at the facilities included raising the platform, waiting for colleagues to depart an aisle, RFID malfunctions and answering their phones. No common barriers during the packing process was identified. The value-quotient revealed that most of the facilities spent more than 50 percent of their time on value-adding activities during the case picking, bulk picking and packing processes. A time and motion analysis proved to be an effective method to identify similarities and barriers between the six facilities. It was recommended to investigate a few of the basic operations to improve upon, as well as the possibility of implementing a barcoded system to the stock.
- Full Text:
- Date Issued: 2018
- Authors: Kemp, Nicholas
- Date: 2018
- Subjects: Pharmaceutical industry -- Materials management , Warehouses -- Management Pharmaceutical industry -- South Africa Physical distribution of goods -- Management
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/30627 , vital:30994
- Description: Barriers within the supply chain play an evident role in decreasing its efficiency. The supply chain system is not well documented in the pharmaceutical sector. The aim of this study was to identify any barriers to the movement of picking and packing operators within 6 distribution facilities throughout South Africa using a time and motion analysis. A pilot study was initially conducted to choose the stopwatch application for Android® devices and to ensure reliability of the tools utilised. The motions during the processes of fulfilling an order were identified during the case picking, bulk picking and packing processes by direct observation of operators. The direct observation was performed using a stopwatch application for Android® devices and a tool on Microsoft Excel®. The data was analysed using Microsoft Excel®, using a student’s T-test and an analysis of variance (ANOVA) approach to identify similarities and differences between the facilities. The data was further analysed using a descriptive statistics approach to identify the common barriers amongst the distribution centres. Thereafter, the data was analysed by identifying a value-quotient. The value-quotient was used to identify how much time was spent on value-adding activities with each facility. The observation of the operators was done randomly at each facility to avoid subjectivity and bias. Results: The pilot study identified which stopwatch application was to be utilised. The pilot study aided to improve upon the design of the data collection tool used for the transcribing of the timing operation. The student’s T-test and ANOVA revealed that there were statistically significant differences in case picking amongst facilities, namely using the radio frequency identification devices (RFID), picking and transfer of stock. In the bulk picking process, there was a statistically significant difference amongst the facilities, namely using the RFID, pick and transfer of stock. In the packing process there was a statistically significant difference amongst the facilities in the packing process. The analysis of barriers within the distribution centres revealed that the 16 common barriers amongst the picking processes at the facilities included raising the platform, waiting for colleagues to depart an aisle, RFID malfunctions and answering their phones. No common barriers during the packing process was identified. The value-quotient revealed that most of the facilities spent more than 50 percent of their time on value-adding activities during the case picking, bulk picking and packing processes. A time and motion analysis proved to be an effective method to identify similarities and barriers between the six facilities. It was recommended to investigate a few of the basic operations to improve upon, as well as the possibility of implementing a barcoded system to the stock.
- Full Text:
- Date Issued: 2018
Black South African men’s adjustment to divorce: a divorce-stress-adjustment model
- Muchena, Kudakwashe Christopher
- Authors: Muchena, Kudakwashe Christopher
- Date: 2018
- Subjects: Divorce -- Psychological aspects , Social psychology Men -- Psychology
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/50121 , vital:42048
- Description: The decision to divorce marks a turning point for each individual involved. It can be viewed as more than just a legal process. From a psychological perspective, it does not matter who initiated the divorce, it always comes with emotional ramifications for all those involved. Statistically there is a high rate of divorce in South Africa and there have been significant shifts in trends over time. However, black South African men’s experience of, action in, and adjustment to divorce has been relatively neglected in the divorce research, yet it is important for understanding contemporary social arrangements and processes, as well as for broadening the understanding of black South African men’s lives. How black South African men describe their situations and respond to marital dissolution may point to their positions in the gender-structured community and to how they interpret the nature of social practice, marriages, divorce and their position in society. The present study aimed at exploring black South African men’s experience of, and adjustment to, divorce. More specifically, the study developed a divorce-stress-adjustment model for divorced black South African men. The theoretical framework underpinning this study was that of Symbolic Interactionism that was complemented and enhanced by Erikson’s Psychosocial Theory, focusing specifically on identity development in adulthood. This was a qualitative study using an Interpretative Phenomenological Analysis (IPA) as both the research design and data analytic theory and process. The eight participants were volunteers who were recruited purposively. In accordance with IPA guidelines, data for the study was collected using biographical questionnaires and semi-structured interviews. The emerging themes were grouped into four superordinate themes, that is, pre-divorce experiences, experiencing divorce, adjustment process and post-divorce experience. Each superordinate theme had corresponding subordinate themes and subthemes. The themes were then used to develop the divorce-stress adjustment model indicating that the experience of divorce is an interconnected process. Weed’s recommendations for interpretative synthesis of interview data were used.
- Full Text:
- Date Issued: 2018
- Authors: Muchena, Kudakwashe Christopher
- Date: 2018
- Subjects: Divorce -- Psychological aspects , Social psychology Men -- Psychology
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/50121 , vital:42048
- Description: The decision to divorce marks a turning point for each individual involved. It can be viewed as more than just a legal process. From a psychological perspective, it does not matter who initiated the divorce, it always comes with emotional ramifications for all those involved. Statistically there is a high rate of divorce in South Africa and there have been significant shifts in trends over time. However, black South African men’s experience of, action in, and adjustment to divorce has been relatively neglected in the divorce research, yet it is important for understanding contemporary social arrangements and processes, as well as for broadening the understanding of black South African men’s lives. How black South African men describe their situations and respond to marital dissolution may point to their positions in the gender-structured community and to how they interpret the nature of social practice, marriages, divorce and their position in society. The present study aimed at exploring black South African men’s experience of, and adjustment to, divorce. More specifically, the study developed a divorce-stress-adjustment model for divorced black South African men. The theoretical framework underpinning this study was that of Symbolic Interactionism that was complemented and enhanced by Erikson’s Psychosocial Theory, focusing specifically on identity development in adulthood. This was a qualitative study using an Interpretative Phenomenological Analysis (IPA) as both the research design and data analytic theory and process. The eight participants were volunteers who were recruited purposively. In accordance with IPA guidelines, data for the study was collected using biographical questionnaires and semi-structured interviews. The emerging themes were grouped into four superordinate themes, that is, pre-divorce experiences, experiencing divorce, adjustment process and post-divorce experience. Each superordinate theme had corresponding subordinate themes and subthemes. The themes were then used to develop the divorce-stress adjustment model indicating that the experience of divorce is an interconnected process. Weed’s recommendations for interpretative synthesis of interview data were used.
- Full Text:
- Date Issued: 2018
Black South African men’s adjustment to divorce: a divorce-stress-adjustment model
- Muchena, Christopher Kudakwashe
- Authors: Muchena, Christopher Kudakwashe
- Date: 2018
- Subjects: Divorced men -- Psychological aspects , Adjustment (Psychology)
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/17933 , vital:28543
- Description: The decision to divorce marks a turning point for each individual involved. It can be viewed as more than just a legal process. From a psychological perspective, it does not matter who initiated the divorce, it always comes with emotional ramifications for all those involved. Statistically there is a high rate of divorce in South Africa and there have been significant shifts in trends over time. However, black South African men’s experience of, action in, and adjustment to divorce has been relatively neglected in the divorce research, yet it is important for understanding contemporary social arrangements and processes, as well as for broadening the understanding of black South African men’s lives. How black South African men describe their situations and respond to marital dissolution may point to their positions in the gender-structured community and to how they interpret the nature of social practice, marriages, divorce and their position in society. The present study aimed at exploring black South African men’s experience of, and adjustment to, divorce. More specifically, the study developed a divorce-stress-adjustment model for divorced black South African men. The theoretical framework underpinning this study was that of Symbolic Interactionism that was complemented and enhanced by Erikson’s Psychosocial Theory, focusing specifically on identity development in adulthood. This was a qualitative study using an Interpretative Phenomenological Analysis (IPA) as both the research design and data analytic theory and process. The eight participants were volunteers who were recruited purposively. In accordance with IPA guidelines, data for the study was collected using biographical questionnaires and semi-structured interviews. The emerging themes were grouped into four superordinate themes, that is, pre-divorce experiences, experiencing divorce, adjustment process and post-divorce experience. Each superordinate theme had corresponding subordinate themes and subthemes. The themes were then used to develop the divorce-stress-adjustment model indicating that the experience of divorce is an interconnected process. Weed’s recommendations for interpretative synthesis of interview data were used.
- Full Text:
- Date Issued: 2018
- Authors: Muchena, Christopher Kudakwashe
- Date: 2018
- Subjects: Divorced men -- Psychological aspects , Adjustment (Psychology)
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/17933 , vital:28543
- Description: The decision to divorce marks a turning point for each individual involved. It can be viewed as more than just a legal process. From a psychological perspective, it does not matter who initiated the divorce, it always comes with emotional ramifications for all those involved. Statistically there is a high rate of divorce in South Africa and there have been significant shifts in trends over time. However, black South African men’s experience of, action in, and adjustment to divorce has been relatively neglected in the divorce research, yet it is important for understanding contemporary social arrangements and processes, as well as for broadening the understanding of black South African men’s lives. How black South African men describe their situations and respond to marital dissolution may point to their positions in the gender-structured community and to how they interpret the nature of social practice, marriages, divorce and their position in society. The present study aimed at exploring black South African men’s experience of, and adjustment to, divorce. More specifically, the study developed a divorce-stress-adjustment model for divorced black South African men. The theoretical framework underpinning this study was that of Symbolic Interactionism that was complemented and enhanced by Erikson’s Psychosocial Theory, focusing specifically on identity development in adulthood. This was a qualitative study using an Interpretative Phenomenological Analysis (IPA) as both the research design and data analytic theory and process. The eight participants were volunteers who were recruited purposively. In accordance with IPA guidelines, data for the study was collected using biographical questionnaires and semi-structured interviews. The emerging themes were grouped into four superordinate themes, that is, pre-divorce experiences, experiencing divorce, adjustment process and post-divorce experience. Each superordinate theme had corresponding subordinate themes and subthemes. The themes were then used to develop the divorce-stress-adjustment model indicating that the experience of divorce is an interconnected process. Weed’s recommendations for interpretative synthesis of interview data were used.
- Full Text:
- Date Issued: 2018
Black women’s narratives of womanhood: before and after hysterectomy
- Kota-Nyati, Phumeza Patricia
- Authors: Kota-Nyati, Phumeza Patricia
- Date: 2018
- Subjects: Hysterectomy -- psychological aspects , Women -- psychological aspects Gender identity Intersectionality (Sociology)
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/29995 , vital:30807
- Description: The removal of the uterus, medically referred to as a hysterectomy, is a permanent and irreversible procedure that potentially results in a number of immediate and significant effects. Performing a hysterectomy is at times the only medical option to a long and traumatic history of pelvic pains and surgeries. The decision to undergo this very costly, painful, and life-changing procedure can have an influence on the way women view themselves. Women’s narratives of womanhood before and after hysterectomy need to be understood within the context of women’s socially constructed identities. Gendered identity has been closely linked to genital and/or reproductive organs and the removal of these organs may influence the way women and societies define womanhood.The interpretive paradigm of constructionism with a narrative inquiry design was used as the lens to examine the women’s experiences. In-depth interviews were analysed through thematic analysis. The findings of this research revealed negative experiences resulting from severe symptoms before hysterectomy, exposed multi-layered structures of power and dominance during treatment, and indicated positive outcomes of hysterectomy. The findings should inform medical and allied practitioners regarding hysterectomy as a treatment option and add to the theoretical debate on the relationships between hysterectomy, womanhood, and identity.
- Full Text:
- Date Issued: 2018
- Authors: Kota-Nyati, Phumeza Patricia
- Date: 2018
- Subjects: Hysterectomy -- psychological aspects , Women -- psychological aspects Gender identity Intersectionality (Sociology)
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/29995 , vital:30807
- Description: The removal of the uterus, medically referred to as a hysterectomy, is a permanent and irreversible procedure that potentially results in a number of immediate and significant effects. Performing a hysterectomy is at times the only medical option to a long and traumatic history of pelvic pains and surgeries. The decision to undergo this very costly, painful, and life-changing procedure can have an influence on the way women view themselves. Women’s narratives of womanhood before and after hysterectomy need to be understood within the context of women’s socially constructed identities. Gendered identity has been closely linked to genital and/or reproductive organs and the removal of these organs may influence the way women and societies define womanhood.The interpretive paradigm of constructionism with a narrative inquiry design was used as the lens to examine the women’s experiences. In-depth interviews were analysed through thematic analysis. The findings of this research revealed negative experiences resulting from severe symptoms before hysterectomy, exposed multi-layered structures of power and dominance during treatment, and indicated positive outcomes of hysterectomy. The findings should inform medical and allied practitioners regarding hysterectomy as a treatment option and add to the theoretical debate on the relationships between hysterectomy, womanhood, and identity.
- Full Text:
- Date Issued: 2018
Bone mineral density of female long distance runners in Nelson Mandela Bay
- Authors: Meier, Catherine Anne
- Date: 2018
- Subjects: Running -- Physiological aspects , Marathon running -- South Africa -- Nelson Mandela Bay Municipality Bones -- Metabolism Mineral metabolism Running -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/22946 , vital:30153
- Description: Long distance running may present positive and negative effects on the bone mineral density (BMD) of such participants. The advantage of high impact loads placed on the body of these runners may be neutralised or reversed, as too high a load may cause a decreased BMD. Furthermore, competitive female runners are generally considered to be leaner than their peers due to the nature of the sport. Therefore, it is expected that the majority of these runners would have a low body fat percentage (BF%) and body mass index (BMI) which may negatively affect the BMD, resulting in impaired bone quality. Due to the general inaccessibility of BMD assessments because of the cost involved, the incidence of risk for lowered BMD among long distance runners and particularly female runners are not readily known. The primary aim of the present study was therefore to determine the BMD rating and its association with body composition (BF% and BMI) and other selected factors among female long distance runners in Nelson Mandela Bay (NMB). The study utilized a quantitative approach and was exploratory, descriptive and non-experimental in nature. Non-probability, convenience sampling was implemented. A total of 40 female long distance runners between the age of 25 and 68 years (with a mean age of 43.6 ± 9.67 years) who have completed at least two marathon events were included in the study. The study utilized a questionnaire to collect demographic and other relevant information from the participants; a stadiometer and an electronic scale to measure height and weight and ultimately calculate BMI; and a bone densitometer with Dual-Energy X-ray Absorptiometry (DXA) (Hologic Discovery W) to determine the various BMD variables required as well as the BF%. Three densitometry scans were performed by a qualified radiographer which presented four analyses namely that of the relevant BMD variables for the hip, lumbar spine and total body, respectively, as well as of the BF% for the total body. The results of the study in respect of the overall BMD profile of the female long distance runners was considered to be normal except for the lumbar spine, found to be osteopenic when considering the mean T-score for this region of those 50 years and older. Overall the participants had an ‘average’ BF% (26.71 ± 6.33%) classification according to the ACSM classification rating system and were classified as ‘normal’ (22.80 ± 2.58 kg/m²) in respect of the BMI category rating. Significant correlations (r ≥ 0.312) were found between BMI and BMD related Z-scores for the hip, lumbar spine and total body, respectively. When considering the effect of selected variables on the various BMD variables, BF% and BMI, respectively, the following significant (p < .05; d > 0.2) results were found: (1) BMD (one or more rating and or Z-score) was positively influenced (had higher ratings) in runners who were overweight, consumed alcoholic beverages of five or less per week and who ran less than 51 km/week, respectively; (2) BMD (one or more rating and or Z-score) was negatively influenced (had lower ratings) in runners who had more full-term pregnancies and among those who were menopausal, respectively; (3) BF% and BMI were both found to be lower in runners who: were not menopausal, competed in six or more ultra-marathon events, completed marathons in less than or equal to three hours and 50 minutes, had an incidence of breaking a bone due to a traumatic event, and engaged in an average weekly running distance of more than 50 km/week, respectively.
- Full Text:
- Date Issued: 2018
- Authors: Meier, Catherine Anne
- Date: 2018
- Subjects: Running -- Physiological aspects , Marathon running -- South Africa -- Nelson Mandela Bay Municipality Bones -- Metabolism Mineral metabolism Running -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/22946 , vital:30153
- Description: Long distance running may present positive and negative effects on the bone mineral density (BMD) of such participants. The advantage of high impact loads placed on the body of these runners may be neutralised or reversed, as too high a load may cause a decreased BMD. Furthermore, competitive female runners are generally considered to be leaner than their peers due to the nature of the sport. Therefore, it is expected that the majority of these runners would have a low body fat percentage (BF%) and body mass index (BMI) which may negatively affect the BMD, resulting in impaired bone quality. Due to the general inaccessibility of BMD assessments because of the cost involved, the incidence of risk for lowered BMD among long distance runners and particularly female runners are not readily known. The primary aim of the present study was therefore to determine the BMD rating and its association with body composition (BF% and BMI) and other selected factors among female long distance runners in Nelson Mandela Bay (NMB). The study utilized a quantitative approach and was exploratory, descriptive and non-experimental in nature. Non-probability, convenience sampling was implemented. A total of 40 female long distance runners between the age of 25 and 68 years (with a mean age of 43.6 ± 9.67 years) who have completed at least two marathon events were included in the study. The study utilized a questionnaire to collect demographic and other relevant information from the participants; a stadiometer and an electronic scale to measure height and weight and ultimately calculate BMI; and a bone densitometer with Dual-Energy X-ray Absorptiometry (DXA) (Hologic Discovery W) to determine the various BMD variables required as well as the BF%. Three densitometry scans were performed by a qualified radiographer which presented four analyses namely that of the relevant BMD variables for the hip, lumbar spine and total body, respectively, as well as of the BF% for the total body. The results of the study in respect of the overall BMD profile of the female long distance runners was considered to be normal except for the lumbar spine, found to be osteopenic when considering the mean T-score for this region of those 50 years and older. Overall the participants had an ‘average’ BF% (26.71 ± 6.33%) classification according to the ACSM classification rating system and were classified as ‘normal’ (22.80 ± 2.58 kg/m²) in respect of the BMI category rating. Significant correlations (r ≥ 0.312) were found between BMI and BMD related Z-scores for the hip, lumbar spine and total body, respectively. When considering the effect of selected variables on the various BMD variables, BF% and BMI, respectively, the following significant (p < .05; d > 0.2) results were found: (1) BMD (one or more rating and or Z-score) was positively influenced (had higher ratings) in runners who were overweight, consumed alcoholic beverages of five or less per week and who ran less than 51 km/week, respectively; (2) BMD (one or more rating and or Z-score) was negatively influenced (had lower ratings) in runners who had more full-term pregnancies and among those who were menopausal, respectively; (3) BF% and BMI were both found to be lower in runners who: were not menopausal, competed in six or more ultra-marathon events, completed marathons in less than or equal to three hours and 50 minutes, had an incidence of breaking a bone due to a traumatic event, and engaged in an average weekly running distance of more than 50 km/week, respectively.
- Full Text:
- Date Issued: 2018
Care and handling of surgical instruments by professional nurses in the operating rooms in the Nelson Mandela Bay
- Bloemetje, Virginia Victoria
- Authors: Bloemetje, Virginia Victoria
- Date: 2018
- Subjects: Surgical nursing -- South Africa -- Nelson Mandela Bay Municipality , Operating room nursing -- South Africa -- Nelson Mandela Bay Municipality Surgical instruments and apparatus
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/21779 , vital:29776
- Description: Hospital-acquired infections (HAIs), caused by viral, bacterial and fungal pathogens, can have a devastating effect on patients, families and health-care organisations. Furthermore, dealing with HAIs can be costly and add to an increase in hospital stays, medical costs, as well as the rates of morbidity and mortality. Operating rooms (OR) are dynamic units that pose a high risk for surgical infections in health-care organisations. In order to minimise surgical-site infections (SSI) and other related infections in ORs, it is important to care for and handle surgical instruments correctly and in accordance with what is considered to be best practice. This research study was conducted to explore and describe the knowledge of professional nurses related to the care and handling of surgical instruments in the ORs in the medical facilities both in the private and public sectors in Nelson Mandela Bay (NMB). The research design was quantitative, explorative, descriptive and contextual in nature. The research sample comprised of professional nurses in the ORs in the public and private hospitals, who made themselves available and who were willing to participate in the study. The data was collected by means of a structured self-administered questionnaire that was based on a narrative literature review. Descriptive statistics were used to analyse the responses from the professional nurses in the OR, collected using the questionnaire. Ethical considerations have been applied throughout the research study and all the relevant findings have been disseminated accordingly. Recommendations, based on best-practice guidelines, were developed to optimise the care and handling of surgical instruments by professional nurses in the ORs. Professional nurses in the ORs who are involved in cleaning surgical instruments should know how to manage certain cleaning procedures. Disinfection and the sterilisation of surgical instruments can only be achieved by following efficient cleaning procedures. When performed properly, cleaning can effectively reduce the growth of microorganisms on surgical instruments, in order to prepare the instruments for disinfection and sterilisation. The importance of this step cannot be overemphasised since organic material, soil and debris can block the disinfectant or sterilising agent from making complete contact with the surface of the instruments. Additionally, cleaning allows for the safe handling of the instruments by professional nurses.
- Full Text:
- Date Issued: 2018
- Authors: Bloemetje, Virginia Victoria
- Date: 2018
- Subjects: Surgical nursing -- South Africa -- Nelson Mandela Bay Municipality , Operating room nursing -- South Africa -- Nelson Mandela Bay Municipality Surgical instruments and apparatus
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/21779 , vital:29776
- Description: Hospital-acquired infections (HAIs), caused by viral, bacterial and fungal pathogens, can have a devastating effect on patients, families and health-care organisations. Furthermore, dealing with HAIs can be costly and add to an increase in hospital stays, medical costs, as well as the rates of morbidity and mortality. Operating rooms (OR) are dynamic units that pose a high risk for surgical infections in health-care organisations. In order to minimise surgical-site infections (SSI) and other related infections in ORs, it is important to care for and handle surgical instruments correctly and in accordance with what is considered to be best practice. This research study was conducted to explore and describe the knowledge of professional nurses related to the care and handling of surgical instruments in the ORs in the medical facilities both in the private and public sectors in Nelson Mandela Bay (NMB). The research design was quantitative, explorative, descriptive and contextual in nature. The research sample comprised of professional nurses in the ORs in the public and private hospitals, who made themselves available and who were willing to participate in the study. The data was collected by means of a structured self-administered questionnaire that was based on a narrative literature review. Descriptive statistics were used to analyse the responses from the professional nurses in the OR, collected using the questionnaire. Ethical considerations have been applied throughout the research study and all the relevant findings have been disseminated accordingly. Recommendations, based on best-practice guidelines, were developed to optimise the care and handling of surgical instruments by professional nurses in the ORs. Professional nurses in the ORs who are involved in cleaning surgical instruments should know how to manage certain cleaning procedures. Disinfection and the sterilisation of surgical instruments can only be achieved by following efficient cleaning procedures. When performed properly, cleaning can effectively reduce the growth of microorganisms on surgical instruments, in order to prepare the instruments for disinfection and sterilisation. The importance of this step cannot be overemphasised since organic material, soil and debris can block the disinfectant or sterilising agent from making complete contact with the surface of the instruments. Additionally, cleaning allows for the safe handling of the instruments by professional nurses.
- Full Text:
- Date Issued: 2018
Challenges experienced by the Sarah Baartman District Municipality in the rendering of environmental health services
- Authors: Somi, Zoleka
- Date: 2018
- Subjects: Environmental health -- South Africa -- Eastern Cape , Public health -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/35469 , vital:33735
- Description: This study highlights challenges experienced by the Sarah Baartman District Municipality in the rendering of environmental health services. Although the Sarah Baartman District Municipality (SBDM) is primarily responsible for the rendering of environmental health services, the local municipalities that have environmental health practitioners within their areas of jurisdiction were appointed to act as its agents in the rendering of municipal health services. Sarah Baartman District Municipality therefore currently utilises the external service delivery mechanism. In 2004 the Sarah Baartman District Municipality was allocated powers and functions for the rendering of municipal health services which were previously a shared responsibility between the Eastern Cape Department of Health, the district municipality and local municipalities. In terms of section 78 (1) of the Municipal Systems Act, 2000 (Act 32 of 2000), on the allocation of new powers and functions, a municipality is required to assess conditions and capacity to deliver the service. In 2008 Sarah Baartman District Municipality appointed the Klyveld, Peat, Marwick and Groerdeler (KPMG) accounting firm to assess these conditions. The assessment identified a number of challenges regarding the current external service delivery mechanism. Based on the outcomes of this section 78 assessment, it was quite clear that the current external service delivery mechanism is the foundation for challenges in the effective rendering of Environmental Health Services at Sarah Baartman District Municipality. The aim of this study was to identify, explore and describe the challenges experienced by the Sarah Baartman District Municipality in the rendering of environmental health services in terms of its current external service delivery mechanism. The study was qualitative, with explorative and descriptive designs by nature. It was conducted at Sarah Baartman District Municipality which is made up of seven local municipalities. The target population for this study was 21 environmental health practitioners practicing within the SBDM (N=21). A purposive sample of eight (n=8) environmental health practitioners were identified to participate in the study. In-depth interviews and focus group discussions were used to collect data. A semi-structured interview guide was used to conduct the in-depth interviews and a focus group. Data was analysed using Tesch’s method of data analysis. The study revealed that the current external service delivery mechanism is the foundation for challenges in the effective rendering of environmental health services at SBDM. This study proposes that Sarah Baartman District Municipality should bring back the function of environmental health from the local municipalities and utilise the internal service delivery mechanism in the rendering of environmental health services.
- Full Text:
- Date Issued: 2018
- Authors: Somi, Zoleka
- Date: 2018
- Subjects: Environmental health -- South Africa -- Eastern Cape , Public health -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/35469 , vital:33735
- Description: This study highlights challenges experienced by the Sarah Baartman District Municipality in the rendering of environmental health services. Although the Sarah Baartman District Municipality (SBDM) is primarily responsible for the rendering of environmental health services, the local municipalities that have environmental health practitioners within their areas of jurisdiction were appointed to act as its agents in the rendering of municipal health services. Sarah Baartman District Municipality therefore currently utilises the external service delivery mechanism. In 2004 the Sarah Baartman District Municipality was allocated powers and functions for the rendering of municipal health services which were previously a shared responsibility between the Eastern Cape Department of Health, the district municipality and local municipalities. In terms of section 78 (1) of the Municipal Systems Act, 2000 (Act 32 of 2000), on the allocation of new powers and functions, a municipality is required to assess conditions and capacity to deliver the service. In 2008 Sarah Baartman District Municipality appointed the Klyveld, Peat, Marwick and Groerdeler (KPMG) accounting firm to assess these conditions. The assessment identified a number of challenges regarding the current external service delivery mechanism. Based on the outcomes of this section 78 assessment, it was quite clear that the current external service delivery mechanism is the foundation for challenges in the effective rendering of Environmental Health Services at Sarah Baartman District Municipality. The aim of this study was to identify, explore and describe the challenges experienced by the Sarah Baartman District Municipality in the rendering of environmental health services in terms of its current external service delivery mechanism. The study was qualitative, with explorative and descriptive designs by nature. It was conducted at Sarah Baartman District Municipality which is made up of seven local municipalities. The target population for this study was 21 environmental health practitioners practicing within the SBDM (N=21). A purposive sample of eight (n=8) environmental health practitioners were identified to participate in the study. In-depth interviews and focus group discussions were used to collect data. A semi-structured interview guide was used to conduct the in-depth interviews and a focus group. Data was analysed using Tesch’s method of data analysis. The study revealed that the current external service delivery mechanism is the foundation for challenges in the effective rendering of environmental health services at SBDM. This study proposes that Sarah Baartman District Municipality should bring back the function of environmental health from the local municipalities and utilise the internal service delivery mechanism in the rendering of environmental health services.
- Full Text:
- Date Issued: 2018
Comparison of contraceptive discontinuation in users of a copper intrauterine device against depot medroxyprogesterone acetate injectable
- Authors: Dekile-Yonto, Nolusindiso
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15520 , vital:40422
- Description: The dynamics of continued contraceptive use, switches to alternatives, or the outright failure of contraception is strong indicators of the effectiveness of health care programmes for women or couples (Ali, Cleland & Shah, 2012:6). Furthermore, unplanned pregnancies often lead to undesirable health, economic, social, and psychological consequences for women (Sedgh, Singh & Hussain., 2014). There is a need to better understand the reasons for discontinuation of contraception to enable health care workers to address the gaps in the provision of family planning services. For this reason, the researcher embarked on a follow-up study of a randomised, controlled trial, which compared the effects on depression and sexual functioning of women after childbirth of a Copper Intrauterine Contraceptive Device (Cu-IUD) with Depot Medroxyprogesterone Acetate (DMPA), (Singata-Madliki, 2014:5). The objectives of the follow-up study was to do a once-off follow-up of the original participants, three years after randomisation.
- Full Text:
- Date Issued: 2018
- Authors: Dekile-Yonto, Nolusindiso
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15520 , vital:40422
- Description: The dynamics of continued contraceptive use, switches to alternatives, or the outright failure of contraception is strong indicators of the effectiveness of health care programmes for women or couples (Ali, Cleland & Shah, 2012:6). Furthermore, unplanned pregnancies often lead to undesirable health, economic, social, and psychological consequences for women (Sedgh, Singh & Hussain., 2014). There is a need to better understand the reasons for discontinuation of contraception to enable health care workers to address the gaps in the provision of family planning services. For this reason, the researcher embarked on a follow-up study of a randomised, controlled trial, which compared the effects on depression and sexual functioning of women after childbirth of a Copper Intrauterine Contraceptive Device (Cu-IUD) with Depot Medroxyprogesterone Acetate (DMPA), (Singata-Madliki, 2014:5). The objectives of the follow-up study was to do a once-off follow-up of the original participants, three years after randomisation.
- Full Text:
- Date Issued: 2018
Conflict narratives of young males in the Blue Crane Route Municipality who experienced domestic violence during childhood
- Authors: Martin, Jonathan Malvin
- Date: 2018
- Subjects: Family violence , Abusive men -- Psychology , Abusive men -- Rehabilitation
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/31863 , vital:31855
- Description: Domestic Violence is a growing concern globally and currently one of the most dominant negative social forces in South Africa. Many children are experiencing or witnessing Domestic Violence in their households or community, with potentially devastating consequences (Dawes, Long, Alexander & Ward, 2007; Burton, 2007). This study investigates the personal conflict narratives of eleven young adult males who experienced Domestic Violence as children. The young men completed a self-administered questionnaire which included a request for a personal conflict narrative or story. The study then engaged these young men in a two-day workshop of an international conflict management programme, known as the Alternatives to Violence Project (AVP), which teaches attitudes and strategies to manage conflict (such as self-awareness, empathy and community-building). After the workshop, the participants were asked to re-write their conflict narratives and any changes in their attitudes and strategies to conflict were discussed in group interviews. The study was qualitative; that is, exploratory, descriptive and contextual in nature. Non-probability purposive sampling was employed to identify suitable young adult males between 18-35 years of age from the Blue Crane Route Municipality (Somerset East and Pearston), who experienced Domestic Violence during their childhood. Workers at Victim Support Centres in the Blue Crane Route Municipality assisted with the recruitment of potential participants and requested permission to provide the researcher with their personal information. In analysing the data obtained, the study used a narrative analysis approach to the participants’ pre- and post-AVP workshop conflict narratives. The trustworthiness of the research process and findings was enhanced by employing a variety of data verification strategies.
- Full Text:
- Date Issued: 2018
- Authors: Martin, Jonathan Malvin
- Date: 2018
- Subjects: Family violence , Abusive men -- Psychology , Abusive men -- Rehabilitation
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/31863 , vital:31855
- Description: Domestic Violence is a growing concern globally and currently one of the most dominant negative social forces in South Africa. Many children are experiencing or witnessing Domestic Violence in their households or community, with potentially devastating consequences (Dawes, Long, Alexander & Ward, 2007; Burton, 2007). This study investigates the personal conflict narratives of eleven young adult males who experienced Domestic Violence as children. The young men completed a self-administered questionnaire which included a request for a personal conflict narrative or story. The study then engaged these young men in a two-day workshop of an international conflict management programme, known as the Alternatives to Violence Project (AVP), which teaches attitudes and strategies to manage conflict (such as self-awareness, empathy and community-building). After the workshop, the participants were asked to re-write their conflict narratives and any changes in their attitudes and strategies to conflict were discussed in group interviews. The study was qualitative; that is, exploratory, descriptive and contextual in nature. Non-probability purposive sampling was employed to identify suitable young adult males between 18-35 years of age from the Blue Crane Route Municipality (Somerset East and Pearston), who experienced Domestic Violence during their childhood. Workers at Victim Support Centres in the Blue Crane Route Municipality assisted with the recruitment of potential participants and requested permission to provide the researcher with their personal information. In analysing the data obtained, the study used a narrative analysis approach to the participants’ pre- and post-AVP workshop conflict narratives. The trustworthiness of the research process and findings was enhanced by employing a variety of data verification strategies.
- Full Text:
- Date Issued: 2018
Couples’ perceptions of the effectiveness of imago enrichment workshops on relationship satisfaction
- Authors: O’Keeffe, Shanna-Lee
- Date: 2018
- Subjects: Interpersonal relations -- Psychological aspects , Couples therapy -- Research Marital psychotherapy
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/34454 , vital:33381
- Description: Romance is a prevalent component of the human relationship. The magnitude of research and literature on what constitutes relationship satisfaction, demonstrates the importance placed on understanding relationship satisfaction, and consequently a means to understanding its effect on the family unit. Relationship enrichment workshops are designed to strengthen the relationship satisfaction of romantic committed couples, thereby improving the couples’ overall well-being. However, limited research has been conducted on Imago workshops in the South African context, particularly in understanding couples’ unique experiences of these workshops. The primary aim of the research study was to explore and describe couples’ perceptions and experiences of the Imago Getting the Love You Want (GTLYW) relationship enrichment workshop on their relationship satisfaction. More specifically, the study explored how couples experienced relationship satisfaction in relation to having attended the Imago GTLYW workshop. This exploratory-descriptive study was conducted using qualitative methods, adopting the four guidelines of phenomenological analysis. Participants were obtained through purposive sampling methods and the data was gathered via semi-structured interviews, whereby it was analysed according to Braun and Clarkes six phases of thematic analysis. The three main themes identified were; Couples’ expectations of the workshop, Couples’ experience and understanding of the workshop and Couples’ shared vision of their relationship ahead. The couples reported improved experiences of relationship satisfaction post-workshop and reflected on their perceptions of significant aspects of the workshop that assisted them in achieving improved satisfaction within the relationship.
- Full Text:
- Date Issued: 2018
Couples’ perceptions of the effectiveness of imago enrichment workshops on relationship satisfaction
- Authors: O’Keeffe, Shanna-Lee
- Date: 2018
- Subjects: Interpersonal relations -- Psychological aspects , Couples therapy -- Research Marital psychotherapy
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/34454 , vital:33381
- Description: Romance is a prevalent component of the human relationship. The magnitude of research and literature on what constitutes relationship satisfaction, demonstrates the importance placed on understanding relationship satisfaction, and consequently a means to understanding its effect on the family unit. Relationship enrichment workshops are designed to strengthen the relationship satisfaction of romantic committed couples, thereby improving the couples’ overall well-being. However, limited research has been conducted on Imago workshops in the South African context, particularly in understanding couples’ unique experiences of these workshops. The primary aim of the research study was to explore and describe couples’ perceptions and experiences of the Imago Getting the Love You Want (GTLYW) relationship enrichment workshop on their relationship satisfaction. More specifically, the study explored how couples experienced relationship satisfaction in relation to having attended the Imago GTLYW workshop. This exploratory-descriptive study was conducted using qualitative methods, adopting the four guidelines of phenomenological analysis. Participants were obtained through purposive sampling methods and the data was gathered via semi-structured interviews, whereby it was analysed according to Braun and Clarkes six phases of thematic analysis. The three main themes identified were; Couples’ expectations of the workshop, Couples’ experience and understanding of the workshop and Couples’ shared vision of their relationship ahead. The couples reported improved experiences of relationship satisfaction post-workshop and reflected on their perceptions of significant aspects of the workshop that assisted them in achieving improved satisfaction within the relationship.
- Full Text:
- Date Issued: 2018
Delivery of pharmaceutical services and care at three primary healthcare clinics with different dispensing models in the Nelson Mandela Bay Health District
- Authors: Bobbins, Amy Claire
- Date: 2018
- Subjects: National health insurance -- South Africa , Community health services -- South Africa Pharmaceutical services -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/23580 , vital:30583
- Description: As South Africa moves into an era of National Health Insurance (NHI), the idea of primary health care (PHC) re-engineering is placed at the forefront; however, the role of the pharmacist in this process remains vague. Task-shifting of the dispensing process to pharmacist’s assistants and nurses in PHC clinics is a common phenomenon, but the implications of this on the provision of pharmaceutical services and care to patients is largely unstudied. Thus, this study aims to explore these pharmacist-based, pharmacist’s assistant-based and nurse-based dispensing models present in PHC clinics. A two-phase, mixed methods approach was utilised, comprising of a pharmaceutical services audit and semi-structured interviews. The interviews provided insight into the lived experiences of personnel and patients of pharmaceutical care provision. Results revealed that although basic pharmaceutical services may be available at clinics with each of the three dispensing models, the quality is of a varying standard due to challenges in infrastructure and maintenance and poor personnel support. Furthermore, the provision of quality pharmaceutical care is minimal with all three dispensing models, resulting in a missed opportunity to optimise patient health outcomes in patient-centred PHC.
- Full Text:
- Date Issued: 2018
- Authors: Bobbins, Amy Claire
- Date: 2018
- Subjects: National health insurance -- South Africa , Community health services -- South Africa Pharmaceutical services -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/23580 , vital:30583
- Description: As South Africa moves into an era of National Health Insurance (NHI), the idea of primary health care (PHC) re-engineering is placed at the forefront; however, the role of the pharmacist in this process remains vague. Task-shifting of the dispensing process to pharmacist’s assistants and nurses in PHC clinics is a common phenomenon, but the implications of this on the provision of pharmaceutical services and care to patients is largely unstudied. Thus, this study aims to explore these pharmacist-based, pharmacist’s assistant-based and nurse-based dispensing models present in PHC clinics. A two-phase, mixed methods approach was utilised, comprising of a pharmaceutical services audit and semi-structured interviews. The interviews provided insight into the lived experiences of personnel and patients of pharmaceutical care provision. Results revealed that although basic pharmaceutical services may be available at clinics with each of the three dispensing models, the quality is of a varying standard due to challenges in infrastructure and maintenance and poor personnel support. Furthermore, the provision of quality pharmaceutical care is minimal with all three dispensing models, resulting in a missed opportunity to optimise patient health outcomes in patient-centred PHC.
- Full Text:
- Date Issued: 2018
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
Developing a model for promoting physical fitness and healthy lifestyle of primary school learners in the Eastern Cape Province, South Africa
- Authors: Gomwe, Howard
- Date: 2018
- Subjects: Physical fitness for children -- South Africa Physical education for children Schools -- Health promotion services
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10050 , vital:35307
- Description: The challenge of low level participation in physical activity and, consequently, limited physical fitness has been acknowledged as being a national public health concern in South African schools. The main aim of this study was to develop a behavioural model for promoting physical fitness and healthy lifestyle of primary school learners in the Eastern Cape Province in South Africa. The first thing was to determine their physical fitness level and body composition then develop a behavioural model based on the findings. The study was conducted in three phases. A quantitative, qualitative and theory-generating research design was conducted using questionnaires, deductive and inductive strategies and literature triangulation. The study involved primary school learners: 356 boys and 520 girls aged 9-14 years old, who were randomly selected. Anthropometric assessments were conducted using ISAK (Marfell-Jones et al., 2006) and EUROFIT (1988) test batteries.The following measurements of body mass, stature, skinfolds (triceps and subscapular), waist circumference and gluteal were taken. The percent BF was calculated from a sum of two skinfolds (triceps and subscapular), using Slaughter et al.‘ s (1988) equation to predict body fat. Physical fitness measurements included sit and reach, push-ups, sit-ups and a 20 metre shuttle run. Physical activity level and sedentary behaviour were assessed by means of self-report questionnaires. Demographic, psychological and environmental variables were also measured by a self-report questionnaire. Six focus group discussions were conducted with school learners. The physical fitness levels were categorized as hypoactive, minimal active and inactive. Sedentary behaviours were categorized by number of minutes spent on sedentary activities. Dietary intake was assessed by a Food Frequency Questionnaire (FFQ). Food intake was classified as healthy, unhealthy/junk and traditional food. Body composition was measured by calculating body mass index (BMI) (weight/height2) and waist-to-hip ratio, respectively. Categories: underweight: 0<18, normal weight: 18, 5<25, overweight: 25<30 or obese: 30 and blood pressure measurements were classified as healthy and unhealthy. The main findings were as follows: underweight 60, 25 percent: normal weight 30, 54 percent: overweight 4, 18 percent: and obese 5, 02 percent: for the peri-urban school learners. Underweight 64, 78 percent: normal 31, 52 percent: overweight 2,83 percent: and obesity 0,87 percent:for the rural school learners. 56,25 percent underweight: 36,93 percent normal weight: 5,68 percent overweight: and 1,14 percent obese for the urban school learners. The mean body mass of learners from three locations were urban 40.0±10.185; peri-urban 39.8±10.181 and rural 38.7±10.279, respectively. (Chi-square = 3.3107; P=0.191). The mean values stature of all the three residences are urban; 144.1 ±10.400 peri-urban 144.4±9.187 and rural 143.7±12.617 (Chi-square = 1.2651; P=0.5312). The mean waist circumference for urban was (78.4±9.493), peri-urban (78.4±9.399) and rural was (77.1±10.214), respectively (Z=2.474;p=0.2903). The triceps value (z=21.4565p <.0001). Urban (13.9±5.589), (12.5±6.023) for peri-urban and (12.1±6.390) for rural. Subscapular (z=4.1151;p=0.1278). Urban area had (9.3±5.426), (9.3±5.463) for peri-urban and (8.9±6.381) for rural. The mean systolic blood pressure of urban school learners was (109.2±19.512), (107.9±19.273) for peri-urban and (107.4±19.488) for rural school learners. Lumbar and hamstring flexibility (z= 57.733; p<.0001). (25.3±5.507) for urban, (23.0±6.435) for peri-urban and (26.9±6.854) for rural. Sit-up (z=9.8414;p=0.0073). (18.3±12.571) for urban, (19.7±12.323) for peri-urban and (21.7±13.782) for rural area. Push-ups (z= 37.7591p=<.00001). (15.8±10.285) for urban, (18.5±11.086) for peri-urban and (20.9±9.981) for rural area. Maximal oxygen intake (z= 163.186p=<.0001). (25.0±6.454) for urban, (29.9±7.225) for peri-urban and (35.5±11.085) for rural area. PA enjoyment (4.1±0.698) for urban, (4.0±0.764) for peri-urban, (4.0±0.799) for rural. With regard to health-related physical fitness, the learners in the rural and peri-urban better than those in urban areas. PA attitude (z=7.5507;p=0.0563), (2.5±0.792) for urban area, (2.6±0.802) for peri-urban and (2.7±0.890) for rural area. Parental role modelling in PA (z=0.3083; p=<.000). (3.1±1.008) for urban area, (3.3±0.916) for peri-urban (3.1±0.981) for rural area. Peer encouragement (z=2.5367; p=0.2813) (3.4±0.893) for urban, (3.3±1.064) for peri-urban, (3.3±1.005) for rural area. Parental encouragement (z= 7.2266p=0.027),(3.7±0.985) for urban area, (3.5±0.906) for peri-urban and (3.7±0.774 ) for rural area. Teacher encouragement (z=2.0069p=0.3668).The mean values for three residences are (3.5±0.802) for urban area, (3.4±0.784) for peri-urban, (3.5±0.733) for rural areas. Most of the school learners in all the three residences prefer unhealthy/junky food. Based on the results, an exploratory factor analysis was conducted on data to identify and analyse the factors for model development. The findings indicated that there is evidence of low level of physical fitness and high prevalence of excessive weight and obesity among primary school learners, the study, therefore, suggests the development of the behavioural model to enhance physical fitness and prevent or reduce overweight/obesity among school learners.
- Full Text:
- Date Issued: 2018
- Authors: Gomwe, Howard
- Date: 2018
- Subjects: Physical fitness for children -- South Africa Physical education for children Schools -- Health promotion services
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10050 , vital:35307
- Description: The challenge of low level participation in physical activity and, consequently, limited physical fitness has been acknowledged as being a national public health concern in South African schools. The main aim of this study was to develop a behavioural model for promoting physical fitness and healthy lifestyle of primary school learners in the Eastern Cape Province in South Africa. The first thing was to determine their physical fitness level and body composition then develop a behavioural model based on the findings. The study was conducted in three phases. A quantitative, qualitative and theory-generating research design was conducted using questionnaires, deductive and inductive strategies and literature triangulation. The study involved primary school learners: 356 boys and 520 girls aged 9-14 years old, who were randomly selected. Anthropometric assessments were conducted using ISAK (Marfell-Jones et al., 2006) and EUROFIT (1988) test batteries.The following measurements of body mass, stature, skinfolds (triceps and subscapular), waist circumference and gluteal were taken. The percent BF was calculated from a sum of two skinfolds (triceps and subscapular), using Slaughter et al.‘ s (1988) equation to predict body fat. Physical fitness measurements included sit and reach, push-ups, sit-ups and a 20 metre shuttle run. Physical activity level and sedentary behaviour were assessed by means of self-report questionnaires. Demographic, psychological and environmental variables were also measured by a self-report questionnaire. Six focus group discussions were conducted with school learners. The physical fitness levels were categorized as hypoactive, minimal active and inactive. Sedentary behaviours were categorized by number of minutes spent on sedentary activities. Dietary intake was assessed by a Food Frequency Questionnaire (FFQ). Food intake was classified as healthy, unhealthy/junk and traditional food. Body composition was measured by calculating body mass index (BMI) (weight/height2) and waist-to-hip ratio, respectively. Categories: underweight: 0<18, normal weight: 18, 5<25, overweight: 25<30 or obese: 30 and blood pressure measurements were classified as healthy and unhealthy. The main findings were as follows: underweight 60, 25 percent: normal weight 30, 54 percent: overweight 4, 18 percent: and obese 5, 02 percent: for the peri-urban school learners. Underweight 64, 78 percent: normal 31, 52 percent: overweight 2,83 percent: and obesity 0,87 percent:for the rural school learners. 56,25 percent underweight: 36,93 percent normal weight: 5,68 percent overweight: and 1,14 percent obese for the urban school learners. The mean body mass of learners from three locations were urban 40.0±10.185; peri-urban 39.8±10.181 and rural 38.7±10.279, respectively. (Chi-square = 3.3107; P=0.191). The mean values stature of all the three residences are urban; 144.1 ±10.400 peri-urban 144.4±9.187 and rural 143.7±12.617 (Chi-square = 1.2651; P=0.5312). The mean waist circumference for urban was (78.4±9.493), peri-urban (78.4±9.399) and rural was (77.1±10.214), respectively (Z=2.474;p=0.2903). The triceps value (z=21.4565p <.0001). Urban (13.9±5.589), (12.5±6.023) for peri-urban and (12.1±6.390) for rural. Subscapular (z=4.1151;p=0.1278). Urban area had (9.3±5.426), (9.3±5.463) for peri-urban and (8.9±6.381) for rural. The mean systolic blood pressure of urban school learners was (109.2±19.512), (107.9±19.273) for peri-urban and (107.4±19.488) for rural school learners. Lumbar and hamstring flexibility (z= 57.733; p<.0001). (25.3±5.507) for urban, (23.0±6.435) for peri-urban and (26.9±6.854) for rural. Sit-up (z=9.8414;p=0.0073). (18.3±12.571) for urban, (19.7±12.323) for peri-urban and (21.7±13.782) for rural area. Push-ups (z= 37.7591p=<.00001). (15.8±10.285) for urban, (18.5±11.086) for peri-urban and (20.9±9.981) for rural area. Maximal oxygen intake (z= 163.186p=<.0001). (25.0±6.454) for urban, (29.9±7.225) for peri-urban and (35.5±11.085) for rural area. PA enjoyment (4.1±0.698) for urban, (4.0±0.764) for peri-urban, (4.0±0.799) for rural. With regard to health-related physical fitness, the learners in the rural and peri-urban better than those in urban areas. PA attitude (z=7.5507;p=0.0563), (2.5±0.792) for urban area, (2.6±0.802) for peri-urban and (2.7±0.890) for rural area. Parental role modelling in PA (z=0.3083; p=<.000). (3.1±1.008) for urban area, (3.3±0.916) for peri-urban (3.1±0.981) for rural area. Peer encouragement (z=2.5367; p=0.2813) (3.4±0.893) for urban, (3.3±1.064) for peri-urban, (3.3±1.005) for rural area. Parental encouragement (z= 7.2266p=0.027),(3.7±0.985) for urban area, (3.5±0.906) for peri-urban and (3.7±0.774 ) for rural area. Teacher encouragement (z=2.0069p=0.3668).The mean values for three residences are (3.5±0.802) for urban area, (3.4±0.784) for peri-urban, (3.5±0.733) for rural areas. Most of the school learners in all the three residences prefer unhealthy/junky food. Based on the results, an exploratory factor analysis was conducted on data to identify and analyse the factors for model development. The findings indicated that there is evidence of low level of physical fitness and high prevalence of excessive weight and obesity among primary school learners, the study, therefore, suggests the development of the behavioural model to enhance physical fitness and prevent or reduce overweight/obesity among school learners.
- Full Text:
- Date Issued: 2018
Development and evaluation of the coach-athlete relationship enhancement intervention
- Authors: Kuit, Wim
- Date: 2018
- Subjects: Interpersonal relations , Coaching (Athletics) -- Psychological aspects Sports -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/22508 , vital:29989
- Description: An expanding body of sport psychology theory and research has highlighted the central role of the coach-athlete relationship (CAR) in the performance, satisfaction and well-being of coaches as well as athletes. Models have been developed that identify the key dimensions of CAR quality and the interpersonal behaviour that maintains it, but there remains a need for interventions that support coaches and athletes to optimise their interpersonal skills. This can be done by harnessing recent advances in personality theory which emphasise a more holistic and developmental view of the person and provide a basis for greater mutual understanding and adaptive interpersonal behaviour change in the CAR. The aims of this study were to develop the Coach-Athlete Relationship Enhancement (CARE) intervention through an integration of the Enneagram personality typology with current models of the CAR, and then to evaluate the impact of the CARE intervention on CAR quality. Sixty-two university-level athletes and their nine coaches participated in the study. Quantitative and qualitative results indicate that the CARE intervention significantly enhanced CAR quality, including direct and meta-perceptions of closeness, commitment and complementarity, as well as co-orientation. Intervention outcomes included enhanced mutual understanding in the CAR, enhanced self-awareness, enhanced team relationships, and adaptive interpersonal behaviour change. These outcomes were associated with a shared awareness between coaches and athletes of their Enneagram personality type traits and motivations. Coach-athlete relationship quality was further enhanced by re-constructing coaches’ and athletes’ personal narratives based on self-descriptions of Enneagram type strengths, and a redefinition of individuals’ core motivations to incorporate adaptive interpersonal behaviour change.
- Full Text:
- Date Issued: 2018
- Authors: Kuit, Wim
- Date: 2018
- Subjects: Interpersonal relations , Coaching (Athletics) -- Psychological aspects Sports -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/22508 , vital:29989
- Description: An expanding body of sport psychology theory and research has highlighted the central role of the coach-athlete relationship (CAR) in the performance, satisfaction and well-being of coaches as well as athletes. Models have been developed that identify the key dimensions of CAR quality and the interpersonal behaviour that maintains it, but there remains a need for interventions that support coaches and athletes to optimise their interpersonal skills. This can be done by harnessing recent advances in personality theory which emphasise a more holistic and developmental view of the person and provide a basis for greater mutual understanding and adaptive interpersonal behaviour change in the CAR. The aims of this study were to develop the Coach-Athlete Relationship Enhancement (CARE) intervention through an integration of the Enneagram personality typology with current models of the CAR, and then to evaluate the impact of the CARE intervention on CAR quality. Sixty-two university-level athletes and their nine coaches participated in the study. Quantitative and qualitative results indicate that the CARE intervention significantly enhanced CAR quality, including direct and meta-perceptions of closeness, commitment and complementarity, as well as co-orientation. Intervention outcomes included enhanced mutual understanding in the CAR, enhanced self-awareness, enhanced team relationships, and adaptive interpersonal behaviour change. These outcomes were associated with a shared awareness between coaches and athletes of their Enneagram personality type traits and motivations. Coach-athlete relationship quality was further enhanced by re-constructing coaches’ and athletes’ personal narratives based on self-descriptions of Enneagram type strengths, and a redefinition of individuals’ core motivations to incorporate adaptive interpersonal behaviour change.
- Full Text:
- Date Issued: 2018
Development of a community pharmacy experiential learning programme in a South African context: a design research approach
- Kritiotis, Lia Costas, Thesis Advisor
- Authors: Kritiotis, Lia Costas , Thesis Advisor
- Date: 2018
- Subjects: Pharmacists -- Training of , Experintial training , Community development -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/17481 , vital:28353
- Description: Application of the design research approach to devise, develop and optimise an experiential learning programme and adaptation of the Volunteer Functions Inventory (VFI) to understand community pharmacists’ motives, are unique contributions to the global pharmacy education setting. This study generated new theory, in the form of substantive and procedural claims (design principles) regarding experiential learning programmes and preceptor and student motivation in a South African pharmacy educational context, which can be added to the existing international landscape and more importantly, plant the foundational seeds of insight that can be utilised as guiding tools by other South African pharmacy faculties.
- Full Text:
- Date Issued: 2018
- Authors: Kritiotis, Lia Costas , Thesis Advisor
- Date: 2018
- Subjects: Pharmacists -- Training of , Experintial training , Community development -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/17481 , vital:28353
- Description: Application of the design research approach to devise, develop and optimise an experiential learning programme and adaptation of the Volunteer Functions Inventory (VFI) to understand community pharmacists’ motives, are unique contributions to the global pharmacy education setting. This study generated new theory, in the form of substantive and procedural claims (design principles) regarding experiential learning programmes and preceptor and student motivation in a South African pharmacy educational context, which can be added to the existing international landscape and more importantly, plant the foundational seeds of insight that can be utilised as guiding tools by other South African pharmacy faculties.
- Full Text:
- Date Issued: 2018
Development of a paediatric-friendly formulation intended for the treatment of multi-drug resistant tuberculosis
- Authors: Nkomo, Jethro
- Date: 2018
- Subjects: Drugs -- Dosage , Pediatrics -- Formulae, receipts, prescriptions Multidrug-resistant tuberculosis -- South Africa Primary health care -- South Africa
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/33660 , vital:32962
- Description: Children suffering from multidrug-resistant tuberculosis (MDR-TB) are treated with at least four drugs a day for at least twenty-four months. Approximately 25 000 - 32 000 children worldwide become infected with MDR-TB each year, yet there is a lack of adequate paediatric MDR-TB options for child-friendly dosage forms for the treatment of the condition. The available options are limited to manipulating different dosage forms intended for adults by means of breaking the tablets or otherwise, to deliver the drugs to children. This challenge that is faced by both health care professionals and caregivers subsequently poses drug quality, efficacy, and safety concerns to children being treated for MDR-TB. The objective of this study was to formulate a paediatric-friendly dosage form for the treatment of MDR-TB in children below the age of eight years. A fixed-dose combination (FDC) in form of a dispersible-tablet that contains two core drugs used in treatment of MDR-TB; levofloxacin and pyrazinamide, was developed. Quality by design principles was employed in developing the product. The systematic procedure ensures that quality is built into the product throughout the manufacturing process. It allows for identification of the critical quality attributes and modification of critical process parameters to lie within desired ranges. Preformulation studies were conducted on the active ingredients to investigate potential interactions and compatibility. Some of the analytical techniques employed in the process included an HPLC assay method that was developed to simultaneously separate levofloxacin and pyrazinamide, differential scanning calorimetry (DSC), infrared spectroscopy (IR), thermogravimetric analysis (TGA), and powder density studies. A direct compression tableting process was selected as the method of choice for product formulation. Active ingredients were blended with the excipients and compressed using tableting equipment to successfully produce FDC fast-disintegrating tablets containing 150 mg of levofloxacin and 300 mg pyrazinamide. The product quality was analysed and optimised using mathematical and statistical techniques such as response surface methodology (RSM) and ANOVA, to meet the required standards recommended by the United States Pharmacopoeia. The FDC dispersible tablet containing levofloxacin and pyrazinamide in the potential treatment of MDR-TB in children was successfully formulated, manufactured and evaluated. The tablet dosage form passed all the relevant quality criteria that governed the scope of this study and disintegrate in approximately 37 seconds when placed in water. It is generally a sizeable challenge to manufacture fixed-dose combination drug products due to physicochemical differences of various drugs, however, with adequate resources researchers may still find a way to formulate more child-friendly dosage forms for MDR-TB. This may lead to improved drug efficacy, reduced safety risks and decreased burden on caregivers and healthcare workers who must administer the treatment.
- Full Text:
- Date Issued: 2018
- Authors: Nkomo, Jethro
- Date: 2018
- Subjects: Drugs -- Dosage , Pediatrics -- Formulae, receipts, prescriptions Multidrug-resistant tuberculosis -- South Africa Primary health care -- South Africa
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/33660 , vital:32962
- Description: Children suffering from multidrug-resistant tuberculosis (MDR-TB) are treated with at least four drugs a day for at least twenty-four months. Approximately 25 000 - 32 000 children worldwide become infected with MDR-TB each year, yet there is a lack of adequate paediatric MDR-TB options for child-friendly dosage forms for the treatment of the condition. The available options are limited to manipulating different dosage forms intended for adults by means of breaking the tablets or otherwise, to deliver the drugs to children. This challenge that is faced by both health care professionals and caregivers subsequently poses drug quality, efficacy, and safety concerns to children being treated for MDR-TB. The objective of this study was to formulate a paediatric-friendly dosage form for the treatment of MDR-TB in children below the age of eight years. A fixed-dose combination (FDC) in form of a dispersible-tablet that contains two core drugs used in treatment of MDR-TB; levofloxacin and pyrazinamide, was developed. Quality by design principles was employed in developing the product. The systematic procedure ensures that quality is built into the product throughout the manufacturing process. It allows for identification of the critical quality attributes and modification of critical process parameters to lie within desired ranges. Preformulation studies were conducted on the active ingredients to investigate potential interactions and compatibility. Some of the analytical techniques employed in the process included an HPLC assay method that was developed to simultaneously separate levofloxacin and pyrazinamide, differential scanning calorimetry (DSC), infrared spectroscopy (IR), thermogravimetric analysis (TGA), and powder density studies. A direct compression tableting process was selected as the method of choice for product formulation. Active ingredients were blended with the excipients and compressed using tableting equipment to successfully produce FDC fast-disintegrating tablets containing 150 mg of levofloxacin and 300 mg pyrazinamide. The product quality was analysed and optimised using mathematical and statistical techniques such as response surface methodology (RSM) and ANOVA, to meet the required standards recommended by the United States Pharmacopoeia. The FDC dispersible tablet containing levofloxacin and pyrazinamide in the potential treatment of MDR-TB in children was successfully formulated, manufactured and evaluated. The tablet dosage form passed all the relevant quality criteria that governed the scope of this study and disintegrate in approximately 37 seconds when placed in water. It is generally a sizeable challenge to manufacture fixed-dose combination drug products due to physicochemical differences of various drugs, however, with adequate resources researchers may still find a way to formulate more child-friendly dosage forms for MDR-TB. This may lead to improved drug efficacy, reduced safety risks and decreased burden on caregivers and healthcare workers who must administer the treatment.
- Full Text:
- Date Issued: 2018
Development of health promotion guidelines for weight management among primary health care nurses in the Eastern Cape Province, South Africa
- Authors: Monakali, Sizeka
- Date: 2018
- Subjects: Health promotion Body weight -- Regulation Obesity -- prevention and control
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10006 , vital:35285
- Description: Overweight and obesity have become significant public health threats both globally and in South Africa. PHC professional nurses are first contact to patients and the community as well as key stakeholders in the management and education of obese patients. However, anecdotal evidence seems to question their suitability as good models of the advocated healthy lifestyle behaviours and weight management, as overweight and obesity is also prevalent among the professional nurses. This study examines the prevalence and determinants of overweight and obesity among PHC professional nurses in the Eastern Cape (EC) Province of South Africa. This was a workplace, cross-sectional study involving 203 PHC professional nurses conveniently selected across 41 PHC facilities in EC, South Africa. A WHO STEP wise questionnaire was used to collect demographic and behavioural data. Anthropometric (weight, height and waist circumference [WC]) measurements were taken following a standard protocol. Overweight and obesity was defined as a BMI of 25-29.9kgm-2, and BMI ≥ 30kgm-2, respectively. Seventy six percent of the nurses were obese. An additional 18 percent were overweight. Age, gender, marital status, duration of practice, alcohol use and smoking were significantly associated with obesity. There was no association between physical activity and obesity. After adjusting for confounders, only age more than 30 years (OR=5.2, 95 percentCI=1.6-16.4) and not using alcohol (OR= 4.0 95 percentCI= 1.7-9.1) were significant and independent predictors of obesity among the nurses. In conclusion is an alarmingly high prevalence of obesity among primary healthcare professional nurses in Eastern Cape, South Africa. This shows that PHC professional nurses in EC are not good models of the healthy behaviours, judge be BMI indicator, if they do advocates for healthy weight management to patients. This constitutes a future risk for an increased prevalence of chronic diseases and a handicapped healthcare workforce. There is a need to implement measures to promote healthy lifestyle behaviour and weight management among professional nurses in this setting.
- Full Text:
- Date Issued: 2018
- Authors: Monakali, Sizeka
- Date: 2018
- Subjects: Health promotion Body weight -- Regulation Obesity -- prevention and control
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10006 , vital:35285
- Description: Overweight and obesity have become significant public health threats both globally and in South Africa. PHC professional nurses are first contact to patients and the community as well as key stakeholders in the management and education of obese patients. However, anecdotal evidence seems to question their suitability as good models of the advocated healthy lifestyle behaviours and weight management, as overweight and obesity is also prevalent among the professional nurses. This study examines the prevalence and determinants of overweight and obesity among PHC professional nurses in the Eastern Cape (EC) Province of South Africa. This was a workplace, cross-sectional study involving 203 PHC professional nurses conveniently selected across 41 PHC facilities in EC, South Africa. A WHO STEP wise questionnaire was used to collect demographic and behavioural data. Anthropometric (weight, height and waist circumference [WC]) measurements were taken following a standard protocol. Overweight and obesity was defined as a BMI of 25-29.9kgm-2, and BMI ≥ 30kgm-2, respectively. Seventy six percent of the nurses were obese. An additional 18 percent were overweight. Age, gender, marital status, duration of practice, alcohol use and smoking were significantly associated with obesity. There was no association between physical activity and obesity. After adjusting for confounders, only age more than 30 years (OR=5.2, 95 percentCI=1.6-16.4) and not using alcohol (OR= 4.0 95 percentCI= 1.7-9.1) were significant and independent predictors of obesity among the nurses. In conclusion is an alarmingly high prevalence of obesity among primary healthcare professional nurses in Eastern Cape, South Africa. This shows that PHC professional nurses in EC are not good models of the healthy behaviours, judge be BMI indicator, if they do advocates for healthy weight management to patients. This constitutes a future risk for an increased prevalence of chronic diseases and a handicapped healthcare workforce. There is a need to implement measures to promote healthy lifestyle behaviour and weight management among professional nurses in this setting.
- Full Text:
- Date Issued: 2018
Digital storytelling as a teaching and learning strategy: experiences of student nurses
- Authors: Espach, Juanita
- Date: 2018
- Subjects: Nursing -- Study and teaching -- South Africa , Nursing students -- South Africa Storytelling -- South Africa -- Computer network resources College teaching -- South Africa Competency-based education
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/21549 , vital:29552
- Description: The ever changing landscape of technology influences every aspect of modern society, also education. Within recent years, technological advancements and inventive educators have transformed traditional teaching and learning strategies to innovative technology infused strategies. These strategies could potentially meet the learning style of the millennial student. One such strategy is described as digital storytelling, during which student groups create a three to five minute multimedia video, utilizing a combination of digital elements such as a narrative voice recording, music, pictures, video and animation. After creating the digital story, the end product is shared with peers. Paucity in research regarding the use of digital storytelling in the context of nursing education in the Republic of South Africa was found. Thus the aim of the study was to explore and describe the experiences of student nurses during the use of digital storytelling as a teaching and learning strategy at a private Nursing Education Institution in Port Elizabeth. The researcher conducted an exploratory, descriptive, contextual and qualitative study which utilized a connectivism framework as the paradigm. Digital storytelling was used as a teaching and learning strategy in the researcher’s own class. A convenience sampling method was therefore employed to select participants. Data was gathered through documenting observational notes during the process of utilizing digital storytelling in the classroom. After the student nurses had utilized digital storytelling, five focus group interviews with twenty four research participants were conducted, which provided data saturation. The data was transcribed and analysed utilizing Tesch’s thematic analysis method and three themes emerged from the data. The benefits of digital storytelling were voiced by the participants since digital storytelling gave them a means to express themselves and they gained new skills while collaborating with others and improving their learning. There was a negative side to it as well, during which research participants experienced negative emotions, lacked the necessary technological skills and found peer teaching an obstacle to their own learning. The participants also provided suggestions to improve the use of digital storytelling during teaching and learning. A thick description of the data with a literature control was provided. The researcher utilized the findings of this study to develop guidelines for Nurse Educators in order to optimize the use of digital storytelling as a teaching and learning strategy. Rigour and trustworthiness were ensured by utilizing Guba and Lincoln’s four criteria. In this study the researcher adhered to the ethical principles as described by the Belmont Report and paid specific attention to the application of these ethical principles in the context of conducting research on one’s own teaching practices. The limitations of this study were that data was collected from only one group of student nurses at one private NEI, after the student nurses’ utilized digital storytelling for the first time in their training. The findings of this study can be used by Nurse Educators to optimize the use of digital storytelling as a teaching and learning strategy. The recommendations of this study include the implementation of the guidelines developed for Nurse Educators.
- Full Text:
- Date Issued: 2018
- Authors: Espach, Juanita
- Date: 2018
- Subjects: Nursing -- Study and teaching -- South Africa , Nursing students -- South Africa Storytelling -- South Africa -- Computer network resources College teaching -- South Africa Competency-based education
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/21549 , vital:29552
- Description: The ever changing landscape of technology influences every aspect of modern society, also education. Within recent years, technological advancements and inventive educators have transformed traditional teaching and learning strategies to innovative technology infused strategies. These strategies could potentially meet the learning style of the millennial student. One such strategy is described as digital storytelling, during which student groups create a three to five minute multimedia video, utilizing a combination of digital elements such as a narrative voice recording, music, pictures, video and animation. After creating the digital story, the end product is shared with peers. Paucity in research regarding the use of digital storytelling in the context of nursing education in the Republic of South Africa was found. Thus the aim of the study was to explore and describe the experiences of student nurses during the use of digital storytelling as a teaching and learning strategy at a private Nursing Education Institution in Port Elizabeth. The researcher conducted an exploratory, descriptive, contextual and qualitative study which utilized a connectivism framework as the paradigm. Digital storytelling was used as a teaching and learning strategy in the researcher’s own class. A convenience sampling method was therefore employed to select participants. Data was gathered through documenting observational notes during the process of utilizing digital storytelling in the classroom. After the student nurses had utilized digital storytelling, five focus group interviews with twenty four research participants were conducted, which provided data saturation. The data was transcribed and analysed utilizing Tesch’s thematic analysis method and three themes emerged from the data. The benefits of digital storytelling were voiced by the participants since digital storytelling gave them a means to express themselves and they gained new skills while collaborating with others and improving their learning. There was a negative side to it as well, during which research participants experienced negative emotions, lacked the necessary technological skills and found peer teaching an obstacle to their own learning. The participants also provided suggestions to improve the use of digital storytelling during teaching and learning. A thick description of the data with a literature control was provided. The researcher utilized the findings of this study to develop guidelines for Nurse Educators in order to optimize the use of digital storytelling as a teaching and learning strategy. Rigour and trustworthiness were ensured by utilizing Guba and Lincoln’s four criteria. In this study the researcher adhered to the ethical principles as described by the Belmont Report and paid specific attention to the application of these ethical principles in the context of conducting research on one’s own teaching practices. The limitations of this study were that data was collected from only one group of student nurses at one private NEI, after the student nurses’ utilized digital storytelling for the first time in their training. The findings of this study can be used by Nurse Educators to optimize the use of digital storytelling as a teaching and learning strategy. The recommendations of this study include the implementation of the guidelines developed for Nurse Educators.
- Full Text:
- Date Issued: 2018
Discrepancy in conventional microscopic manual differential counts of band neutrophils among microscopists
- Godson-Katchew, Chesna Terry-Lee
- Authors: Godson-Katchew, Chesna Terry-Lee
- Date: 2018
- Subjects: Neutrophils , Hematology Medical statistics -- Research
- Language: English
- Type: Thesis , Masters , MHSc
- Identifier: http://hdl.handle.net/10948/30127 , vital:30830
- Description: The interpretation of the band neutrophil count on manual differential counts performed amongst microscopists can vary greatly. The band neutrophil is an immature granulocyte, maturing towards a segmented neutrophil. There are varying degrees of misconception of the band neutrophil identification, as the band neutrophil closely resembles the maturing segmented neutrophil. Although there are guidelines for the identification of band neutrophils, many laboratories incorporate their own “standard” as to what a band neutrophil should look like. Even when a standard exists for the identification of band neutrophils, many microscopists still have difficulty identifying these cells, making it difficult to accurately perform, interpret and report a manual differential count. Due to the controversy it is thus necessary to identify whether the problem lies with the identification of the band neutrophil itself, or the individual microscopist’s perception of differentiation between the band neutrophil and a maturing segmented neutrophil. The purpose of this study was to establish the accuracy by which microscopists distinguish band neutrophils from mature segmented neutrophils, the extent of discrepancies in the band neutrophil count amongst microscopists, to establish whether microscopists required re-training and to establish meaningful recommendations for microscopists to aid in the accurate identification of band neutrophils. The researcher thus made use of a self-administered picture diagram, distributed among microscopists to assess the accuracy of the band neutrophil counts prior to training. Participants counted an average of 61.47% neutrophils and 38.53% band neutrophils. Coefficient of variation (CV) for neutrophils and band neutrophils were calculated and yielded a CV of 22.48 and 35.87 respectively. Due to the high CV calculated, suggesting a greater level of dispersion around the mean, the researcher investigated individual responses from the picture-diagram. With the findings of the individual picture-diagram results, the researcher developed an impression that there was a large variation in counts for both neutrophils and band cells. Training was then given to participants arranged by the researcher, for accurate band neutrophil identification. Following training a second survey was conducted in order to assess the variation in counts among microscopists. 1 The peripheral blood smear was then provided and used to perform a manual differential count by conventional light microscopy, in order to compare results. Similarly, results obtained by the microscopists was compared to the verified manual differential count performed by a Haematologist; to improve the accuracy of results reported routinely. With the findings of the individual manual differential count results the researcher observed, that there was indeed a discrepancy in the manual differential counts performed by microscopists.
- Full Text:
- Date Issued: 2018
- Authors: Godson-Katchew, Chesna Terry-Lee
- Date: 2018
- Subjects: Neutrophils , Hematology Medical statistics -- Research
- Language: English
- Type: Thesis , Masters , MHSc
- Identifier: http://hdl.handle.net/10948/30127 , vital:30830
- Description: The interpretation of the band neutrophil count on manual differential counts performed amongst microscopists can vary greatly. The band neutrophil is an immature granulocyte, maturing towards a segmented neutrophil. There are varying degrees of misconception of the band neutrophil identification, as the band neutrophil closely resembles the maturing segmented neutrophil. Although there are guidelines for the identification of band neutrophils, many laboratories incorporate their own “standard” as to what a band neutrophil should look like. Even when a standard exists for the identification of band neutrophils, many microscopists still have difficulty identifying these cells, making it difficult to accurately perform, interpret and report a manual differential count. Due to the controversy it is thus necessary to identify whether the problem lies with the identification of the band neutrophil itself, or the individual microscopist’s perception of differentiation between the band neutrophil and a maturing segmented neutrophil. The purpose of this study was to establish the accuracy by which microscopists distinguish band neutrophils from mature segmented neutrophils, the extent of discrepancies in the band neutrophil count amongst microscopists, to establish whether microscopists required re-training and to establish meaningful recommendations for microscopists to aid in the accurate identification of band neutrophils. The researcher thus made use of a self-administered picture diagram, distributed among microscopists to assess the accuracy of the band neutrophil counts prior to training. Participants counted an average of 61.47% neutrophils and 38.53% band neutrophils. Coefficient of variation (CV) for neutrophils and band neutrophils were calculated and yielded a CV of 22.48 and 35.87 respectively. Due to the high CV calculated, suggesting a greater level of dispersion around the mean, the researcher investigated individual responses from the picture-diagram. With the findings of the individual picture-diagram results, the researcher developed an impression that there was a large variation in counts for both neutrophils and band cells. Training was then given to participants arranged by the researcher, for accurate band neutrophil identification. Following training a second survey was conducted in order to assess the variation in counts among microscopists. 1 The peripheral blood smear was then provided and used to perform a manual differential count by conventional light microscopy, in order to compare results. Similarly, results obtained by the microscopists was compared to the verified manual differential count performed by a Haematologist; to improve the accuracy of results reported routinely. With the findings of the individual manual differential count results the researcher observed, that there was indeed a discrepancy in the manual differential counts performed by microscopists.
- Full Text:
- Date Issued: 2018