A best-practice guideline for facilitating adherence to anti-retroviral therapy for persons attending public hospitals in Ghana
- Authors: Agyeman-Yeboah, Joana
- Date: 2017
- Subjects: HIV infections -- Treatment -- Ghana , Health services administration -- Ghana Public health -- Ghana Hospital care -- Ghana
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/13603 , vital:27256
- Description: The retention of persons on an HIV programme has been a global challenge. The success of any strategy to optimize adherence to anti-retroviral therapy (ART) depends on the intensive and effective adherence counselling and strategies. It is important to research whether persons receiving anti-retroviral therapy in public hospitals in Ghana are receiving the needed service that would optimize their adherence to the anti-retroviral therapy. Therefore, this study explored and described the experiences of healthcare professionals providing care, support and guidance to persons on ART at public hospitals in Ghana, as well as the best-practice guideline that could contribute to facilitating the ART adherence of patients. This study also explored and described the experiences of persons living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) on ART, regarding their adherence to the therapy. The study was organized into three phases. In Phase One: a qualitative, exploratory, descriptive and contextual design was employed. The research population included healthcare professionals, providing services at the HIV clinic at the public hospitals in Ghana, namely the Korle-Bu Teaching Hospital; the 37 Military Hospital and the Ridge Hospital. The healthcare professionals comprised of doctors, nurses, pharmacists and trained counsellors employed in any of the three public hospitals. Persons receiving ART at any of the three public hospitals were also part of the research population. Semi-structured interviews were conducted with healthcare professionals and persons receiving ART. Data were collected from healthcare professionals in relation to their experiences regarding the provision of ART services, their understanding of evidence-based practice and best-practice guidelines, as well as data on the experiences of persons receiving ART in relation to their adherence to the therapy. The data were analysed using Creswell’s six steps of data analysis; and the coding of the data was done according to Tesch’s eight steps of coding. Trustworthiness was ensured by using Lincoln and Guba’s framework which comprised credibility, transferability, dependability, confirmability and authenticity. Ethical principles such as beneficence and non-maleficence, respect for human dignity, justice, veracity, privacy and confidentiality were considered in the study. In phase two, the literature was searched by using an integrative literature review approach and critically appraising the methodological quality of the guidelines in order to identify the best available evidence related to adherence to ART. In Phase Three, a best-practice guideline for facilitating adherence to ART was developed for public hospitals in Ghana based on the findings of the empirical research of Phase One and the integrative literature review in Phase Two. The guideline was submitted to an expert panel for review; and it was modified, according to the recommendations of the panel.
- Full Text:
- Date Issued: 2017
- Authors: Agyeman-Yeboah, Joana
- Date: 2017
- Subjects: HIV infections -- Treatment -- Ghana , Health services administration -- Ghana Public health -- Ghana Hospital care -- Ghana
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/13603 , vital:27256
- Description: The retention of persons on an HIV programme has been a global challenge. The success of any strategy to optimize adherence to anti-retroviral therapy (ART) depends on the intensive and effective adherence counselling and strategies. It is important to research whether persons receiving anti-retroviral therapy in public hospitals in Ghana are receiving the needed service that would optimize their adherence to the anti-retroviral therapy. Therefore, this study explored and described the experiences of healthcare professionals providing care, support and guidance to persons on ART at public hospitals in Ghana, as well as the best-practice guideline that could contribute to facilitating the ART adherence of patients. This study also explored and described the experiences of persons living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) on ART, regarding their adherence to the therapy. The study was organized into three phases. In Phase One: a qualitative, exploratory, descriptive and contextual design was employed. The research population included healthcare professionals, providing services at the HIV clinic at the public hospitals in Ghana, namely the Korle-Bu Teaching Hospital; the 37 Military Hospital and the Ridge Hospital. The healthcare professionals comprised of doctors, nurses, pharmacists and trained counsellors employed in any of the three public hospitals. Persons receiving ART at any of the three public hospitals were also part of the research population. Semi-structured interviews were conducted with healthcare professionals and persons receiving ART. Data were collected from healthcare professionals in relation to their experiences regarding the provision of ART services, their understanding of evidence-based practice and best-practice guidelines, as well as data on the experiences of persons receiving ART in relation to their adherence to the therapy. The data were analysed using Creswell’s six steps of data analysis; and the coding of the data was done according to Tesch’s eight steps of coding. Trustworthiness was ensured by using Lincoln and Guba’s framework which comprised credibility, transferability, dependability, confirmability and authenticity. Ethical principles such as beneficence and non-maleficence, respect for human dignity, justice, veracity, privacy and confidentiality were considered in the study. In phase two, the literature was searched by using an integrative literature review approach and critically appraising the methodological quality of the guidelines in order to identify the best available evidence related to adherence to ART. In Phase Three, a best-practice guideline for facilitating adherence to ART was developed for public hospitals in Ghana based on the findings of the empirical research of Phase One and the integrative literature review in Phase Two. The guideline was submitted to an expert panel for review; and it was modified, according to the recommendations of the panel.
- Full Text:
- Date Issued: 2017
A normative study of the Raven's Coloured Progressive Matrices for South African children with cognitive barriers to learning
- Authors: August, Justin Oswin
- Date: 2017
- Subjects: Children -- Intelligence testing -- South Africa , Inclusive education -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19419 , vital:28869
- Description: With the changing landscape in South Africa to a full democracy, increased research has been undertaken in the psychometric field on local and national normative studies regarding various assessment measures. The Raven’s Coloured Progressive Matrices (CPM) is one of the measures that have already been extensively normed throughout the world for various population groups. In South Africa, local norms for normal populations of children have been developed by groups of researchers in the Grahamstown (Eastern Cape) as well as the Bloemfontein (Free State) areas. With a South African school educational system that focuses on Inclusive Education, there is a growing need for mainstream schools to identify learners who are at risk for learning disabilities in order to develop appropriate supportive intervention plans. The research aimed to establish psychometric normative screening data based on the Raven’s CPM, and to compare these with the established and published international and local Raven’s CPM norms. In addition, the researcher developed pilot classification scores for the early screening and detection of at risk learners in order to encourage the potential role and use of the Raven’s CPM in the identification of cognitive learning barriers. The sample consisted of 388 primary school learners identified as having cognitive barriers to learning. Archival data was used that was gathered from a Psychological clinic that provided screening services to schools in the Nelson Mandela Metropolitan area. The results of the study indicated that there was a proportional relationship between age and test performance. Gender differences were found where the males in this study outperformed the females. There was a significant difference in the Raven’s CPM test performance with respect to the grade levels of the learners. The study developed a special set of norms with cognitive classification scores that will aid in the early identification of learning disabilities.
- Full Text:
- Date Issued: 2017
- Authors: August, Justin Oswin
- Date: 2017
- Subjects: Children -- Intelligence testing -- South Africa , Inclusive education -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19419 , vital:28869
- Description: With the changing landscape in South Africa to a full democracy, increased research has been undertaken in the psychometric field on local and national normative studies regarding various assessment measures. The Raven’s Coloured Progressive Matrices (CPM) is one of the measures that have already been extensively normed throughout the world for various population groups. In South Africa, local norms for normal populations of children have been developed by groups of researchers in the Grahamstown (Eastern Cape) as well as the Bloemfontein (Free State) areas. With a South African school educational system that focuses on Inclusive Education, there is a growing need for mainstream schools to identify learners who are at risk for learning disabilities in order to develop appropriate supportive intervention plans. The research aimed to establish psychometric normative screening data based on the Raven’s CPM, and to compare these with the established and published international and local Raven’s CPM norms. In addition, the researcher developed pilot classification scores for the early screening and detection of at risk learners in order to encourage the potential role and use of the Raven’s CPM in the identification of cognitive learning barriers. The sample consisted of 388 primary school learners identified as having cognitive barriers to learning. Archival data was used that was gathered from a Psychological clinic that provided screening services to schools in the Nelson Mandela Metropolitan area. The results of the study indicated that there was a proportional relationship between age and test performance. Gender differences were found where the males in this study outperformed the females. There was a significant difference in the Raven’s CPM test performance with respect to the grade levels of the learners. The study developed a special set of norms with cognitive classification scores that will aid in the early identification of learning disabilities.
- Full Text:
- Date Issued: 2017
A phenomenological study of problematic internet use with massively multiplayer online games
- Authors: Bopp, Stacey-Lee
- Date: 2017
- Subjects: Computer games -- Psychological aspects , Internet games -- Psychological aspects Internet addiction
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/13757 , vital:27305
- Description: Massively multiplayer online games (MMOG’s) are a specific form of online computer games that allow for millions of people to simultaneously play online at any time. This form of online gaming has become a huge phenomenon worldwide both as a popular past time and a business endeavour for many individuals. There are more than 16 million people worldwide who subscribe to fantasy role-playing online games. Although such games can provide entertainment for many people, they can also lead to problematic Internet use (PIU). PIU has also been referred to as Internet addiction, and can cause significant problems in an individual’s functioning. The study aimed to enhance a greater understanding of the phenomenon of male adults’ experiences PIU with MMOG’s. More specifically the study aims to identify if PIU with MMOG’s can be considered a form of Internet addiction within South Africa. Furthermore, assisting in the further development of online addiction diagnosis and treatment strategies. The study utilised an interpretive phenomenological approach (IPA) and participants were purposively sampled. The data was collected using semi-structured individual interviews. Furthermore, Braun and Clarks thematic analysis was used during data analysis while incorporating the four major processes in phenomenological research, namely 1) epoche, 2) phenomenological reduction, 3) imaginative variation and, 4) synthesis. Themes that emerged from the analysis of the participants’ experiences included, initial description of use, motives for continued use of MMOG’s, consequences of PIU with MMOG’s, perceptions of PIU with MMOG’s, and treatment considerations. This study provided a thick description of South African and international literature and combines the literature with the themes that emerged from the participants experiences in order to produce discussions based on the findings of this qualitative study. Conclusions, recommendations, and limitations of this study informed future research on cyber citizenship by providing a detailed understanding of the context of South African male adults’ experiences of PIU with MMOG’s.
- Full Text:
- Date Issued: 2017
- Authors: Bopp, Stacey-Lee
- Date: 2017
- Subjects: Computer games -- Psychological aspects , Internet games -- Psychological aspects Internet addiction
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/13757 , vital:27305
- Description: Massively multiplayer online games (MMOG’s) are a specific form of online computer games that allow for millions of people to simultaneously play online at any time. This form of online gaming has become a huge phenomenon worldwide both as a popular past time and a business endeavour for many individuals. There are more than 16 million people worldwide who subscribe to fantasy role-playing online games. Although such games can provide entertainment for many people, they can also lead to problematic Internet use (PIU). PIU has also been referred to as Internet addiction, and can cause significant problems in an individual’s functioning. The study aimed to enhance a greater understanding of the phenomenon of male adults’ experiences PIU with MMOG’s. More specifically the study aims to identify if PIU with MMOG’s can be considered a form of Internet addiction within South Africa. Furthermore, assisting in the further development of online addiction diagnosis and treatment strategies. The study utilised an interpretive phenomenological approach (IPA) and participants were purposively sampled. The data was collected using semi-structured individual interviews. Furthermore, Braun and Clarks thematic analysis was used during data analysis while incorporating the four major processes in phenomenological research, namely 1) epoche, 2) phenomenological reduction, 3) imaginative variation and, 4) synthesis. Themes that emerged from the analysis of the participants’ experiences included, initial description of use, motives for continued use of MMOG’s, consequences of PIU with MMOG’s, perceptions of PIU with MMOG’s, and treatment considerations. This study provided a thick description of South African and international literature and combines the literature with the themes that emerged from the participants experiences in order to produce discussions based on the findings of this qualitative study. Conclusions, recommendations, and limitations of this study informed future research on cyber citizenship by providing a detailed understanding of the context of South African male adults’ experiences of PIU with MMOG’s.
- Full Text:
- Date Issued: 2017
A psychobiographical study of Robert Nesta “Bob” Marley
- Authors: Willis, Lynn Sherri
- Date: 2017
- Subjects: Developmental psychology , Life cycle, Human -- Psychological aspects Marley, Bob , Psychology -- Biographical methods
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/13480 , vital:27209
- Description: Psychobiography is a qualitative research design used to explore and understand the life story of an individual through the lens of psychological theory. The application of theory is typically done to finished lives of well-known or enigmatic people, and covers the person’s entire lifespan. The aim of the study was to explore and describe the personality development of the Rastafarian reggae musician Bob Marley.To meet this aim the study created a comprehensive picture of Marley’s life within the particular social, economic and historical context in which he lived. Marley’s work was considered influential both during and after his life. His music is listened to by diverse groups of people, and is known internationally. Marley’s personality was explored by applying Eric Berne’s theory of Transactional Analysis (TA) to his life story. Data was collected and analyzed using a strategy consisting of three steps, namely, data reduction, data display, and conclusion drawing and verification. Results of the study indicated that TA is a suitable theory for creating insight into the life of this historical figure, and has led to an increased understanding of the application of this psychological theory. Lastly, the study has contributed towards increasing the number of psychobiographical studies conducted in the South African context.
- Full Text:
- Date Issued: 2017
- Authors: Willis, Lynn Sherri
- Date: 2017
- Subjects: Developmental psychology , Life cycle, Human -- Psychological aspects Marley, Bob , Psychology -- Biographical methods
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/13480 , vital:27209
- Description: Psychobiography is a qualitative research design used to explore and understand the life story of an individual through the lens of psychological theory. The application of theory is typically done to finished lives of well-known or enigmatic people, and covers the person’s entire lifespan. The aim of the study was to explore and describe the personality development of the Rastafarian reggae musician Bob Marley.To meet this aim the study created a comprehensive picture of Marley’s life within the particular social, economic and historical context in which he lived. Marley’s work was considered influential both during and after his life. His music is listened to by diverse groups of people, and is known internationally. Marley’s personality was explored by applying Eric Berne’s theory of Transactional Analysis (TA) to his life story. Data was collected and analyzed using a strategy consisting of three steps, namely, data reduction, data display, and conclusion drawing and verification. Results of the study indicated that TA is a suitable theory for creating insight into the life of this historical figure, and has led to an increased understanding of the application of this psychological theory. Lastly, the study has contributed towards increasing the number of psychobiographical studies conducted in the South African context.
- Full Text:
- Date Issued: 2017
A systematic review of online child sexual abuse: victim risk and offender profile and methodologies
- Authors: Sleeman, Ananda
- Date: 2017
- Subjects: Child sexual abuse , Child pornography , Sexually abused children , Online sexual predators
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/10761 , vital:26821
- Description: The purpose of this treatise was to synthesize the current research, nationally and internationally, both qualitative and quantitative, concerning online child sexual abuse. The study focused on crimes of a sexual nature perpetrated against children, with or without consent, in an online environment. The aim was to clearly articulate the characteristics of victims, including both their vulnerabilities and their protective factors and to provide offender profiles, including their methodologies. Method: A systematic search for peer reviewed articles published between 2000 and 2006 was conducted. The final sample included 73 articles, which were arranged in order of publication, and the top and bottom interquartile range was selected for review and coding. Results: 36 articles were thematically coded in order to identify the most prominent themes in the articles. The result of this review was a typology of victims and offenders, as well as offender methodologies that reflects an aggregation of the most prominent research on the subject of online child sexual abuse. Conclusion: Much of the common knowledge concerning online child sexual offenders and their victims is incorrect. The typologies identified in this review show a much more diverse picture of both offenders and victims than is held in popular knowledge. This research has identified the damage that misinformation can do, and has highlighted the need for accurate, empirically sound information to be made available to parents, teachers, health care professionals and youth.
- Full Text:
- Date Issued: 2017
A systematic review of online child sexual abuse: victim risk and offender profile and methodologies
- Authors: Sleeman, Ananda
- Date: 2017
- Subjects: Child sexual abuse , Child pornography , Sexually abused children , Online sexual predators
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/10761 , vital:26821
- Description: The purpose of this treatise was to synthesize the current research, nationally and internationally, both qualitative and quantitative, concerning online child sexual abuse. The study focused on crimes of a sexual nature perpetrated against children, with or without consent, in an online environment. The aim was to clearly articulate the characteristics of victims, including both their vulnerabilities and their protective factors and to provide offender profiles, including their methodologies. Method: A systematic search for peer reviewed articles published between 2000 and 2006 was conducted. The final sample included 73 articles, which were arranged in order of publication, and the top and bottom interquartile range was selected for review and coding. Results: 36 articles were thematically coded in order to identify the most prominent themes in the articles. The result of this review was a typology of victims and offenders, as well as offender methodologies that reflects an aggregation of the most prominent research on the subject of online child sexual abuse. Conclusion: Much of the common knowledge concerning online child sexual offenders and their victims is incorrect. The typologies identified in this review show a much more diverse picture of both offenders and victims than is held in popular knowledge. This research has identified the damage that misinformation can do, and has highlighted the need for accurate, empirically sound information to be made available to parents, teachers, health care professionals and youth.
- Full Text:
- Date Issued: 2017
Activities, functions and structure of public sector pharmaceutical and therapeutics committees in the Eastern Cape Province, South Africa
- Authors: Henge-Daweti, Vatiswa
- Date: 2017
- Subjects: Medical ethics committees -- South Africa -- Eastern Cape Pharmaceutical policy -- South Africa -- Eastern Cape , Pharmaceutical services -- South Africa -- Eastern Cape Pharmaceutical ethics -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/15945 , vital:28293
- Description: The Council of Australian Therapeutic Advisory Groups (CATAG) (2013) define a Pharmaceutical and Therapeutics Committee (PTC) as a ‘multi-disciplinary team committee with a commitment to the overall governance of the medicines management system in health service organizations to ensure the judicious, appropriate, safe, effective and cost-effective use of medicines’. The multi-disciplinary team includes the health care providers, who are actively participating in the health care systems, such as doctors, pharmacists, nurses, administrators, finance officers, quality improvement managers and other staff members who participate in the medicine use processes according to their knowledge and skills. The major role of this committee is to evaluate and promote rational drug use by health care providers and consumers. In addition, this committee is responsible for developing systems and strategies to prevent adverse medicine reactions and medication errors, enhance rational prescribing and dispensing, provide educational activities and ensure the use of quality and cost-effective medicines. This is a cross-sectional study that was aimed at exploring the structure, activities and functions of public sector institutional Pharmaceutical and Therapeutics Committees (PTC) in the Eastern Cape (EC) Province in South Africa (SA). The primary objectives of the study were to (i) investigate and describe the structure, functions and the activities of the institutional PTCs, and (ii) explore and describe the perception of PTC secretariats on the functionality of the institutional PTCs. A purpose-designed questionnaire including both quantitative and qualitative aspects adapted from other international studies was piloted prior to being used for data collection. The secretariats of the institutional PTCs were requested to complete the questionnaire. Data were analysed using descriptive statistics for the quantitative aspects and thematic analysis for the qualitative component of the questionnaire. Data collection commenced after approval by the relevant ethics committees had been granted. The findings of the study reflected that the majority of the PTCs in the EC province, SA are district/sub-district PTCs which are a cluster of a number of health care institutions in close proximity. The PTC members were appointed by the executive authority as recommended by the literature and other guiding documents. As expected the nurses were dominant as the members of the PTCs in these district/sub-district PTCs. The secretariats were the pharmacists where pharmacists were available and chairperson were doctors. These findings correspond to the recommendations by the National Department of Health PTC policy (2015) and the studies conducted in other countries. A number of PTCs had sub-committees formed e.g. ABC analysis review committee, medicine utilization evaluation (MUE) committee and pharmacovigilance committee to optimise their functionality. Out of 15 PTCs only five PTCs with sub-committees reported functions and interventions, establishment of policies and SOPs. The rest had no outcomes or interventions reported. Poor production of policies and SOPs was observed which differs from other countries’ PTCs. The focus of sub-committees in other countries is the development of formulary and policies related to medicine use. These findings pose a question regarding the functionality and effectiveness of the existing institutional PTCs in the province. In addition, the basic documents that are required to run the PTC were unavailable in a number of PTCs. Barriers to the functionality of PTCs were reported i) Lack of pharmacists and training in PTCs. ii) The rural nature of the EC province and iii) Unavailability of resources including lack of re-imbursement of personal costs. These findings reveal that budget allocation for institutional PTCs is crucial for their functionality. It can be concluded that in the EC province the institutional PTCs which are active and effective are low in number and do not cover all geographical areas. Secondly there is a need for training and educating the PTC members on the role of the PTC members, role of sub-committees, development of policies, SOPs and the basic documents for the functionality of the committee. It is also important that during training the monitoring and evaluation of the effectiveness of the committee is emphasised. Therefore, the choice of the PTC objectives should be measurable as they can assist as indicators of effectiveness. Support by the executive authority has been observed.
- Full Text:
- Date Issued: 2017
- Authors: Henge-Daweti, Vatiswa
- Date: 2017
- Subjects: Medical ethics committees -- South Africa -- Eastern Cape Pharmaceutical policy -- South Africa -- Eastern Cape , Pharmaceutical services -- South Africa -- Eastern Cape Pharmaceutical ethics -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/15945 , vital:28293
- Description: The Council of Australian Therapeutic Advisory Groups (CATAG) (2013) define a Pharmaceutical and Therapeutics Committee (PTC) as a ‘multi-disciplinary team committee with a commitment to the overall governance of the medicines management system in health service organizations to ensure the judicious, appropriate, safe, effective and cost-effective use of medicines’. The multi-disciplinary team includes the health care providers, who are actively participating in the health care systems, such as doctors, pharmacists, nurses, administrators, finance officers, quality improvement managers and other staff members who participate in the medicine use processes according to their knowledge and skills. The major role of this committee is to evaluate and promote rational drug use by health care providers and consumers. In addition, this committee is responsible for developing systems and strategies to prevent adverse medicine reactions and medication errors, enhance rational prescribing and dispensing, provide educational activities and ensure the use of quality and cost-effective medicines. This is a cross-sectional study that was aimed at exploring the structure, activities and functions of public sector institutional Pharmaceutical and Therapeutics Committees (PTC) in the Eastern Cape (EC) Province in South Africa (SA). The primary objectives of the study were to (i) investigate and describe the structure, functions and the activities of the institutional PTCs, and (ii) explore and describe the perception of PTC secretariats on the functionality of the institutional PTCs. A purpose-designed questionnaire including both quantitative and qualitative aspects adapted from other international studies was piloted prior to being used for data collection. The secretariats of the institutional PTCs were requested to complete the questionnaire. Data were analysed using descriptive statistics for the quantitative aspects and thematic analysis for the qualitative component of the questionnaire. Data collection commenced after approval by the relevant ethics committees had been granted. The findings of the study reflected that the majority of the PTCs in the EC province, SA are district/sub-district PTCs which are a cluster of a number of health care institutions in close proximity. The PTC members were appointed by the executive authority as recommended by the literature and other guiding documents. As expected the nurses were dominant as the members of the PTCs in these district/sub-district PTCs. The secretariats were the pharmacists where pharmacists were available and chairperson were doctors. These findings correspond to the recommendations by the National Department of Health PTC policy (2015) and the studies conducted in other countries. A number of PTCs had sub-committees formed e.g. ABC analysis review committee, medicine utilization evaluation (MUE) committee and pharmacovigilance committee to optimise their functionality. Out of 15 PTCs only five PTCs with sub-committees reported functions and interventions, establishment of policies and SOPs. The rest had no outcomes or interventions reported. Poor production of policies and SOPs was observed which differs from other countries’ PTCs. The focus of sub-committees in other countries is the development of formulary and policies related to medicine use. These findings pose a question regarding the functionality and effectiveness of the existing institutional PTCs in the province. In addition, the basic documents that are required to run the PTC were unavailable in a number of PTCs. Barriers to the functionality of PTCs were reported i) Lack of pharmacists and training in PTCs. ii) The rural nature of the EC province and iii) Unavailability of resources including lack of re-imbursement of personal costs. These findings reveal that budget allocation for institutional PTCs is crucial for their functionality. It can be concluded that in the EC province the institutional PTCs which are active and effective are low in number and do not cover all geographical areas. Secondly there is a need for training and educating the PTC members on the role of the PTC members, role of sub-committees, development of policies, SOPs and the basic documents for the functionality of the committee. It is also important that during training the monitoring and evaluation of the effectiveness of the committee is emphasised. Therefore, the choice of the PTC objectives should be measurable as they can assist as indicators of effectiveness. Support by the executive authority has been observed.
- Full Text:
- Date Issued: 2017
Adolescent mothers’ breastfeeding experiences in Nelson Mandela Bay health district
- Authors: Fordjour Afriyie, Vera
- Date: 2017
- Subjects: Breastfeeding -- South Africa -- Eastern Cape , Children -- Nutrition -- South Africa -- Port Elizabeth , Teenage mothers -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/13879 , vital:27316
- Description: Rationale: There is limited research available in South Africa that explores the breastfeeding experience among adolescent mothers; most of the studies were conducted in developed countries. One such study relating to the above mentioned developed countries stated that social and commitment factors influence the decision to breastfeed by adolescents. Furthermore, while adolescent mothers appreciate the benefits of breastfeeding, pain, public exposure and perceived complexities related to breastfeeding create barriers for them. The researcher was unable to ascertain if similar ambiguities exist among adolescent mothers in South Africa, and in the Eastern Cape (EC) in particular with its high rates of adolescent pregnancy. In order to attempt to develop age appropriate recommendations to assist adolescent mothers with their breastfeeding journey, the researcher undertook this research study to answer the following question: What are the breastfeeding experiences of adolescent mothers in the Nelson Mandela Bay Heath District (NMBHD)? Aim: The research aim was to determine the experiences of adolescent mothers regarding breastfeeding in NMBHD. Methods: The study implemented a qualitative research approach. To enhance the design, the researcher utilised an explorative, descriptive and contextual research design. The ethical principles that guided this study were autonomy, nonmaleficence, beneficence and justice. Fourteen adolescent mothers, attending PHC facilities in the NMBHD participated in the study. Participants were chosen from a purposive sampling technique and data were collected from semi-structured interviews, compromising of individual interviews. The researcher analysed the data using the using the eight steps of the Tesch analysis technique. Data was also analysed by an independent coder. Results obtained from the Tesch approach were compared to that of the independent coder results. Thereafter, the major themes and sub-themes that related to the study objectives were identified. Results: Three themes and 10 sub-themes were identified. Lack of knowledge and poor adherence to EBF, perceived breastmilk insufficiency, as well as incorrect infant feeding advice given by maternal mothers and grandmothers were associated with early introduction of complementary feeding. Most participants were motivated to breastfeed due to its economic and bonding benefits, as well as seeing their infant‟s progress in growth. Challenges of breastfeeding mentioned by the participants include: lack of support from the fathers of their infants and from health care providers, breast milk leakage, and the foul smell associated with the leaking of breast milk. The participants of the study also had suggestions to help improve the support given to adolescent mothers by health care providers in PHC facilities. Conclusions and recommendations: In conclusion, this study‟s findings revealed that adolescent mothers may need extra age appropriate education and support to assist them in breastfeeding successfully at PHC facilities, the community and schools. Maternal mothers and grandmothers were found to be the primary source of a support network for most adolescent mothers as opposed to health care providers who were categorised as being the secondary source of support. Thus, breastfeeding promotion tailored at maternal mothers and grandmothers would be beneficial in improving their knowledge about the recommended infant feeding practices and consequently aid in providing appropriate support and advice to adolescent mothers. Additionally, training and attitude modification of health care providers is needed to provide adolescent mothers with age-appropriate, effective and sensitive care and counselling.
- Full Text:
- Date Issued: 2017
- Authors: Fordjour Afriyie, Vera
- Date: 2017
- Subjects: Breastfeeding -- South Africa -- Eastern Cape , Children -- Nutrition -- South Africa -- Port Elizabeth , Teenage mothers -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/13879 , vital:27316
- Description: Rationale: There is limited research available in South Africa that explores the breastfeeding experience among adolescent mothers; most of the studies were conducted in developed countries. One such study relating to the above mentioned developed countries stated that social and commitment factors influence the decision to breastfeed by adolescents. Furthermore, while adolescent mothers appreciate the benefits of breastfeeding, pain, public exposure and perceived complexities related to breastfeeding create barriers for them. The researcher was unable to ascertain if similar ambiguities exist among adolescent mothers in South Africa, and in the Eastern Cape (EC) in particular with its high rates of adolescent pregnancy. In order to attempt to develop age appropriate recommendations to assist adolescent mothers with their breastfeeding journey, the researcher undertook this research study to answer the following question: What are the breastfeeding experiences of adolescent mothers in the Nelson Mandela Bay Heath District (NMBHD)? Aim: The research aim was to determine the experiences of adolescent mothers regarding breastfeeding in NMBHD. Methods: The study implemented a qualitative research approach. To enhance the design, the researcher utilised an explorative, descriptive and contextual research design. The ethical principles that guided this study were autonomy, nonmaleficence, beneficence and justice. Fourteen adolescent mothers, attending PHC facilities in the NMBHD participated in the study. Participants were chosen from a purposive sampling technique and data were collected from semi-structured interviews, compromising of individual interviews. The researcher analysed the data using the using the eight steps of the Tesch analysis technique. Data was also analysed by an independent coder. Results obtained from the Tesch approach were compared to that of the independent coder results. Thereafter, the major themes and sub-themes that related to the study objectives were identified. Results: Three themes and 10 sub-themes were identified. Lack of knowledge and poor adherence to EBF, perceived breastmilk insufficiency, as well as incorrect infant feeding advice given by maternal mothers and grandmothers were associated with early introduction of complementary feeding. Most participants were motivated to breastfeed due to its economic and bonding benefits, as well as seeing their infant‟s progress in growth. Challenges of breastfeeding mentioned by the participants include: lack of support from the fathers of their infants and from health care providers, breast milk leakage, and the foul smell associated with the leaking of breast milk. The participants of the study also had suggestions to help improve the support given to adolescent mothers by health care providers in PHC facilities. Conclusions and recommendations: In conclusion, this study‟s findings revealed that adolescent mothers may need extra age appropriate education and support to assist them in breastfeeding successfully at PHC facilities, the community and schools. Maternal mothers and grandmothers were found to be the primary source of a support network for most adolescent mothers as opposed to health care providers who were categorised as being the secondary source of support. Thus, breastfeeding promotion tailored at maternal mothers and grandmothers would be beneficial in improving their knowledge about the recommended infant feeding practices and consequently aid in providing appropriate support and advice to adolescent mothers. Additionally, training and attitude modification of health care providers is needed to provide adolescent mothers with age-appropriate, effective and sensitive care and counselling.
- Full Text:
- Date Issued: 2017
An exploratory study of female South African university students’ knowledge and perceptions of subdermal contraceptive implants
- Kalla, Sikander Abdul Razaak
- Authors: Kalla, Sikander Abdul Razaak
- Date: 2017
- Subjects: Contraceptives -- South Africa -- Psychological aspects , Birth control -- South Africa -- Students Contraception -- South Africa -- Psychological aspects
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/17691 , vital:28437
- Description: South Africa‟s recent efforts to improve contraceptive uptake include the public launch of the subdermal contraceptive implant (branded Implanon NXT®). The launch of this modern contraceptive was welcomed as an initiative that holds promise in addressing elevated unintended pregnancy rates in the country. However, a paucity of research regarding the uptake of this contraceptive exists. This study sought to narrow this research gap by exploring the knowledge and perceptions that young female South African university students have of contraceptive implants, as well as investigate how these views may shape the willingness for these females to incorporate contraceptive implants into their birth control regimen. Semi-structured interviews were conducted with young female students enrolled at Nelson Mandela University and data from these interviews was analysed using thematic analysis. Findings were examined through a lens of social constructionism and critical psychology. Analysis revealed the following key findings: the function, suitability, and negative perceptions, of a particular contraceptive are notable considerations taken into account by young female university students when investigating contraceptives; psychosocial challenges are prominent in the arena of contraception; contraceptive implants possess the potential to reduce stigmatisation and empower women; however, participants asserted that there are significant psychosocial and structural barriers to the uptake of this contraceptive. These findings highlighted that contraceptive knowledge and perceptions are influenced by an interplay of psychosocial and structural factors. These factors were ultimately noted to influence young female South African university students‟ willingness to incorporate contraceptive implants into their birth control regimen.
- Full Text:
- Date Issued: 2017
- Authors: Kalla, Sikander Abdul Razaak
- Date: 2017
- Subjects: Contraceptives -- South Africa -- Psychological aspects , Birth control -- South Africa -- Students Contraception -- South Africa -- Psychological aspects
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/17691 , vital:28437
- Description: South Africa‟s recent efforts to improve contraceptive uptake include the public launch of the subdermal contraceptive implant (branded Implanon NXT®). The launch of this modern contraceptive was welcomed as an initiative that holds promise in addressing elevated unintended pregnancy rates in the country. However, a paucity of research regarding the uptake of this contraceptive exists. This study sought to narrow this research gap by exploring the knowledge and perceptions that young female South African university students have of contraceptive implants, as well as investigate how these views may shape the willingness for these females to incorporate contraceptive implants into their birth control regimen. Semi-structured interviews were conducted with young female students enrolled at Nelson Mandela University and data from these interviews was analysed using thematic analysis. Findings were examined through a lens of social constructionism and critical psychology. Analysis revealed the following key findings: the function, suitability, and negative perceptions, of a particular contraceptive are notable considerations taken into account by young female university students when investigating contraceptives; psychosocial challenges are prominent in the arena of contraception; contraceptive implants possess the potential to reduce stigmatisation and empower women; however, participants asserted that there are significant psychosocial and structural barriers to the uptake of this contraceptive. These findings highlighted that contraceptive knowledge and perceptions are influenced by an interplay of psychosocial and structural factors. These factors were ultimately noted to influence young female South African university students‟ willingness to incorporate contraceptive implants into their birth control regimen.
- Full Text:
- Date Issued: 2017
Antibacterial activities of both combined and individual medicinal plants extracts traditionally used to treat pneumonia
- Authors: Mhango, Immaculate
- Date: 2017
- Subjects: Antibacterial agents , Pneumonia -- Treatment
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19762 , vital:28959
- Description: Pneumonia is one of the five major leading causes of death in children under-fives years and the elderly worldwide. Antibiotics used for its treatment are less potent due to bacteria development of bacteria resistant to antibiotics. This has led to a surge in search of novel drugs. There are already some drugs in clinical use that have natural products and derivatives such as quinine, morphine, vincristine, and taxol among others. The healing value of medicinal plants has been well accepted since Stone Age across the globe. This plant therapy has been prescribed and prepared independently or in combination. The following plants: Terminalia sericea, Warburgia salutaris, Dodonea angustofolia, Eucalyptus camaldulensis, Ballota africana, Kigelia africana and Acorus gramineus. These plants are most commonly used for treatment of pneumonia and other ailment, were studied to validate their antimicrobial activity based on scientific determination. The primary aim of this study was to evaluate the efficacy of these plants against bacteria pneumonia pathogens. Seven medicinal plants, independently and in combinations were relatively analysed for their antimicrobial activity against Staphylococcus aureus, Streptococcus pyogenes, and Klebsiella pneumoniae. Ground plant material of roots, bark and leafs were prepared with acetone, ethanol and distilled water. Dimethyl sulfoxide (10 &100%) was used as a reconstitution solvent and ciprofloxacin (10 %) as a positive control. The antimicrobial efficacy was determined using agar well diffusion and microtiter plate methods. Interaction between plants was evaluated by calculating fraction inhibitory concentration index (ΣFIC). Noteworthy activity for individual studies with all test organisms was observed with T. sericea. However, highest ZOI (30 mm) was observed for B. africana ethanol extract for S. pyogenes. Weak microbial activity was noted in W. salutaris and D. angustofolia extracts with all test organisms. Good antimicrobial activity was observed in combination studies with all organisms. The potency of different plant combinations varied with highest ZOI observed with B. africana and W. salutaris ranging from 33-35 mm, conversely ZOI of 35 mm was also noted for S. aureus in B. africana and E. camaldulensis ethanol extract. Noteworthy antimicrobial activity was observed in T. sericea and D. angustofolia against all test pathogens. weak antimicrobial activity with highest MICs was observed in combinations where W. salutaris was involved. After calculating ΣFICs, strongest synergistic effect was displayed for W. salutaris and D. angustofolia against all test organisms (lowest ΣFICs 0.0491). Most plant extract combinations, displayed either synergistic, additive or indifferent effect, with few demonstrating antagonistic interactions. Significant antagonism effect was noted for S. pyogenes with T. sericea ethanol extract ΣFIC value of 15.51. Based on results of this study use of plants in combination increase antimicrobial efficacy. The antimicrobial activities; synergistic and additive effects observed adds credibility in the use of plant combination for therapeutic value in treatment of pneumonia. Future studies are recommended to identify and isolate specific active compounds involved in plant combination interactions. The importance of combination studies for possible development of new antimicrobials that can succumb bacterial resistance need to be highlighted.
- Full Text:
- Date Issued: 2017
- Authors: Mhango, Immaculate
- Date: 2017
- Subjects: Antibacterial agents , Pneumonia -- Treatment
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19762 , vital:28959
- Description: Pneumonia is one of the five major leading causes of death in children under-fives years and the elderly worldwide. Antibiotics used for its treatment are less potent due to bacteria development of bacteria resistant to antibiotics. This has led to a surge in search of novel drugs. There are already some drugs in clinical use that have natural products and derivatives such as quinine, morphine, vincristine, and taxol among others. The healing value of medicinal plants has been well accepted since Stone Age across the globe. This plant therapy has been prescribed and prepared independently or in combination. The following plants: Terminalia sericea, Warburgia salutaris, Dodonea angustofolia, Eucalyptus camaldulensis, Ballota africana, Kigelia africana and Acorus gramineus. These plants are most commonly used for treatment of pneumonia and other ailment, were studied to validate their antimicrobial activity based on scientific determination. The primary aim of this study was to evaluate the efficacy of these plants against bacteria pneumonia pathogens. Seven medicinal plants, independently and in combinations were relatively analysed for their antimicrobial activity against Staphylococcus aureus, Streptococcus pyogenes, and Klebsiella pneumoniae. Ground plant material of roots, bark and leafs were prepared with acetone, ethanol and distilled water. Dimethyl sulfoxide (10 &100%) was used as a reconstitution solvent and ciprofloxacin (10 %) as a positive control. The antimicrobial efficacy was determined using agar well diffusion and microtiter plate methods. Interaction between plants was evaluated by calculating fraction inhibitory concentration index (ΣFIC). Noteworthy activity for individual studies with all test organisms was observed with T. sericea. However, highest ZOI (30 mm) was observed for B. africana ethanol extract for S. pyogenes. Weak microbial activity was noted in W. salutaris and D. angustofolia extracts with all test organisms. Good antimicrobial activity was observed in combination studies with all organisms. The potency of different plant combinations varied with highest ZOI observed with B. africana and W. salutaris ranging from 33-35 mm, conversely ZOI of 35 mm was also noted for S. aureus in B. africana and E. camaldulensis ethanol extract. Noteworthy antimicrobial activity was observed in T. sericea and D. angustofolia against all test pathogens. weak antimicrobial activity with highest MICs was observed in combinations where W. salutaris was involved. After calculating ΣFICs, strongest synergistic effect was displayed for W. salutaris and D. angustofolia against all test organisms (lowest ΣFICs 0.0491). Most plant extract combinations, displayed either synergistic, additive or indifferent effect, with few demonstrating antagonistic interactions. Significant antagonism effect was noted for S. pyogenes with T. sericea ethanol extract ΣFIC value of 15.51. Based on results of this study use of plants in combination increase antimicrobial efficacy. The antimicrobial activities; synergistic and additive effects observed adds credibility in the use of plant combination for therapeutic value in treatment of pneumonia. Future studies are recommended to identify and isolate specific active compounds involved in plant combination interactions. The importance of combination studies for possible development of new antimicrobials that can succumb bacterial resistance need to be highlighted.
- Full Text:
- Date Issued: 2017
Antimicrobial activity of selected plants and their combined preparations against pathogens causing respiratory infections
- Authors: Onyebuchi, Ukwuoma Collins
- Date: 2017
- Subjects: Anti-infective agents , Respiratory infections -- Alternative treatment
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/21197 , vital:29455
- Description: Bacterial infection of the respiratory system is one of the leading causes of death in the world’s population, killing over four million people annually. Treatment of respiratory infections is usually by antibiotics administration. The emergence of multi-drug-resistant pathogens has led to the search for more effective therapeutic agents especially from medicinal plants, as compounds from plants have been shown to possess some therapeutic potential. The aim of this study is to determine the antimicrobial activity of three plants, Tetradenia riparia, Leonotis leonurus and Salvia africana-lutea and the activity of their various combined preparations against 27 pathogens usually associated with respiratory ailments. Various solvents were used for extraction of the dried powdered plant materials. The agar disc diffusion antimicrobial assay and the micro-dilution assay methods were used to determine the inhibitory activity and the minimum inhibitory concentration of the plant extracts. The nature of phytochemicals present in the extracts was determined by thin layer chromatography. The results obtained in this study, showed that ethanol produced the highest average extract yield in both the individual and combined plant preparations. A two-way analysis of variance for the disc diffusion assay showed no significant difference in the inhibition zones (Appendix 1 and 2). MIC of 0.8 mg/ml was obtained with S. africana-lutea against S. pneumoniae ATCC 49619 and B. cereus ATCC 10976 strains, indicating a strong antibacterial activity. Synergistic interaction (FIC index ranging from 0.20 – 0.50) and a strong antimicrobial activity (MIC values ranging from 0.4 – 0.8 mg/ml), was obtained with the acetone extract of the 1:1 combination of L. leonurus with S. africana-lutea. The XEA and CEF solvent systems eluted the most number of compound spots and produced the best separations. The results obtained in this study validate the traditional use of these plants and their combinations for the treatment of respiratory ailments.
- Full Text:
- Date Issued: 2017
- Authors: Onyebuchi, Ukwuoma Collins
- Date: 2017
- Subjects: Anti-infective agents , Respiratory infections -- Alternative treatment
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/21197 , vital:29455
- Description: Bacterial infection of the respiratory system is one of the leading causes of death in the world’s population, killing over four million people annually. Treatment of respiratory infections is usually by antibiotics administration. The emergence of multi-drug-resistant pathogens has led to the search for more effective therapeutic agents especially from medicinal plants, as compounds from plants have been shown to possess some therapeutic potential. The aim of this study is to determine the antimicrobial activity of three plants, Tetradenia riparia, Leonotis leonurus and Salvia africana-lutea and the activity of their various combined preparations against 27 pathogens usually associated with respiratory ailments. Various solvents were used for extraction of the dried powdered plant materials. The agar disc diffusion antimicrobial assay and the micro-dilution assay methods were used to determine the inhibitory activity and the minimum inhibitory concentration of the plant extracts. The nature of phytochemicals present in the extracts was determined by thin layer chromatography. The results obtained in this study, showed that ethanol produced the highest average extract yield in both the individual and combined plant preparations. A two-way analysis of variance for the disc diffusion assay showed no significant difference in the inhibition zones (Appendix 1 and 2). MIC of 0.8 mg/ml was obtained with S. africana-lutea against S. pneumoniae ATCC 49619 and B. cereus ATCC 10976 strains, indicating a strong antibacterial activity. Synergistic interaction (FIC index ranging from 0.20 – 0.50) and a strong antimicrobial activity (MIC values ranging from 0.4 – 0.8 mg/ml), was obtained with the acetone extract of the 1:1 combination of L. leonurus with S. africana-lutea. The XEA and CEF solvent systems eluted the most number of compound spots and produced the best separations. The results obtained in this study validate the traditional use of these plants and their combinations for the treatment of respiratory ailments.
- Full Text:
- Date Issued: 2017
Attitudes of undergraduate psychology students towards mental illness
- Authors: Lugogwana, Pakama Linda
- Date: 2017
- Subjects: College students -- South Africa -- Attitudes , Psychology -- Study and teaching Mental illness -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/14223 , vital:27454
- Description: Negative attitudes and stigmas against those diagnosed with mental illnesses have been found to prevail in modern society, despite the availability of effective treatments and attempts to educate people about mental health. Numerous studies have been conducted on the attitudes of various groups of people and communities towards mental illness. There is, however, limited research about student populations, particularly students registered for courses in the “allied health professions”. This study aimed to explore and describe the prevailing attitudes towards mental illness of a sample of the undergraduate Psychology student population (registered between 2nd and 4th year of study) within the Faculty of Health Sciences at a South African University. The procedure followed was an electronic intranet based survey, utilising the Community Attitudes to Mental Illness (CAMI) scale. The survey was accessed via the university’s student portal and links were sent via email to students to complete. A total of n=51 student responses were recorded and analysed. Data were quantitatively analysed using t-tests and Analyses of Variance (ANOVA). No statistically significant differences on the CAMI scales were found between the students in relation to the various student demographic variables such as age, gender, race or year level, and the CAMI findings. Overall, the sample of undergraduate Psychology students were shown to have favourable attitudes towards mental illness, which is potentially accounted for by their chosen field of study of Psychology. Education and knowledge about mental health were acknowledged as being most important in reducing stigma towards mental illness.
- Full Text:
- Date Issued: 2017
- Authors: Lugogwana, Pakama Linda
- Date: 2017
- Subjects: College students -- South Africa -- Attitudes , Psychology -- Study and teaching Mental illness -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/14223 , vital:27454
- Description: Negative attitudes and stigmas against those diagnosed with mental illnesses have been found to prevail in modern society, despite the availability of effective treatments and attempts to educate people about mental health. Numerous studies have been conducted on the attitudes of various groups of people and communities towards mental illness. There is, however, limited research about student populations, particularly students registered for courses in the “allied health professions”. This study aimed to explore and describe the prevailing attitudes towards mental illness of a sample of the undergraduate Psychology student population (registered between 2nd and 4th year of study) within the Faculty of Health Sciences at a South African University. The procedure followed was an electronic intranet based survey, utilising the Community Attitudes to Mental Illness (CAMI) scale. The survey was accessed via the university’s student portal and links were sent via email to students to complete. A total of n=51 student responses were recorded and analysed. Data were quantitatively analysed using t-tests and Analyses of Variance (ANOVA). No statistically significant differences on the CAMI scales were found between the students in relation to the various student demographic variables such as age, gender, race or year level, and the CAMI findings. Overall, the sample of undergraduate Psychology students were shown to have favourable attitudes towards mental illness, which is potentially accounted for by their chosen field of study of Psychology. Education and knowledge about mental health were acknowledged as being most important in reducing stigma towards mental illness.
- Full Text:
- Date Issued: 2017
Attitutes of professional nurses towards the dimensions of quality care in the community health centres of the King Sabatha Dalindyebo sub-district, Eastern Cape
- Authors: Ntuku, Nonzukiso Sheila
- Date: 2017
- Subjects: Community health services -- South Africa -- Eastern Cape Nursing services -- South Africa-- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/13989 , vital:39737
- Description: The study focused on attitudes of professional nurses towards the dimensions of quality care. Quality care is the main focus of the Department of Health in the Republic of South Africa. The researcher believes that professional nurses form the backbone of the whole health care fraternity; hence they are central to the study of quality care dimensions. The aim of the study was to determine and describe the attitudes of professional nurses towards the dimensions of quality care in the community health centres of the KingSabatha Dalindyebo sub-district. A quantitative descriptive design was employed to meet the objectives of the study. The non-probability purposive sampling method was used to select participants to provide information on the attitudes of professional nurses towards the dimensions of quality care in the community health centres of the King Sabatha Dalindyebo sub-district, Eastern Cape. From the target of 84 professional nurses who were employed at the five community health centres of King Sabatha Dalindyebo sub-district of the O.R. Tambo District, Eastern Cape Province, 70 (83,3percent) professional nursesresponded to the questionnaires. A self-administered questionnaire written in simple English was used to collect data from the professional nurses regarding their attitudes towards dimensions of quality care. The researcher adhered to the ethical standards of nursing research as described by the Democratic Nursing Organisationof South Africa regarding anonymity, confidentiality, privacy and quality research, according to which the names of professional nurses were not recorded on the questionnaires. The data were analysed using the Statistical Package for the Social Sciences (SPSS) computer software. The distribution of the results has been presented in tables and a bar graph. The results of the study revealed that the professional nurses of these community health centres had positive attitudes towards the dimensions of quality care.
- Full Text:
- Date Issued: 2017
- Authors: Ntuku, Nonzukiso Sheila
- Date: 2017
- Subjects: Community health services -- South Africa -- Eastern Cape Nursing services -- South Africa-- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/13989 , vital:39737
- Description: The study focused on attitudes of professional nurses towards the dimensions of quality care. Quality care is the main focus of the Department of Health in the Republic of South Africa. The researcher believes that professional nurses form the backbone of the whole health care fraternity; hence they are central to the study of quality care dimensions. The aim of the study was to determine and describe the attitudes of professional nurses towards the dimensions of quality care in the community health centres of the KingSabatha Dalindyebo sub-district. A quantitative descriptive design was employed to meet the objectives of the study. The non-probability purposive sampling method was used to select participants to provide information on the attitudes of professional nurses towards the dimensions of quality care in the community health centres of the King Sabatha Dalindyebo sub-district, Eastern Cape. From the target of 84 professional nurses who were employed at the five community health centres of King Sabatha Dalindyebo sub-district of the O.R. Tambo District, Eastern Cape Province, 70 (83,3percent) professional nursesresponded to the questionnaires. A self-administered questionnaire written in simple English was used to collect data from the professional nurses regarding their attitudes towards dimensions of quality care. The researcher adhered to the ethical standards of nursing research as described by the Democratic Nursing Organisationof South Africa regarding anonymity, confidentiality, privacy and quality research, according to which the names of professional nurses were not recorded on the questionnaires. The data were analysed using the Statistical Package for the Social Sciences (SPSS) computer software. The distribution of the results has been presented in tables and a bar graph. The results of the study revealed that the professional nurses of these community health centres had positive attitudes towards the dimensions of quality care.
- Full Text:
- Date Issued: 2017
Best practice guideline for the nursing management of women with gestational diabetes mellitus in military health institutions in Ghana
- Authors: Mensah, Gwendolyn Patience
- Date: 2017
- Subjects: Diabetes in pregnancy -- Ghana , Diabetics -- Treatment -- Ghana Nursing services -- Ghana -- Administration Public health -- Ghana
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/14036 , vital:27409
- Description: Pregnancy is a normal physiological process for the majority of women. These women, their families and significant others normally expect a successful period of pregnancy, labour, delivery and arrival of a normal and healthy baby. However, some of these pregnant women may develop Gestational Diabetes Mellitus (GDM) during this period and if not managed properly, the mother and the foetus in utero are affected in a negative way: there is a likelihood of the mother and baby developing Type 2 Diabetes in the future and also, other risks such as preterm labour, and foetal macrosomia. In order to prevent such occurrences, I set out to develop a best practice guideline for the nursing management of GDM in military health institutions in Ghana in order to help enhance nursing care. The design for this research was qualitative, explorative, descriptive and contextual in nature. The research is organised in three phases: Phase one deals with the data analysis and discussion of the interviews with professional nurses and midwives and women with a history of GDM. The data collected from the interviews were transcribed, analysed and extracted with Tesch’s eight steps of coding used for the coding. The services of an independent coder were employed to assist with the coding process which led to the formulation of key themes. Semi-structured individual interviews provided a means of exploring the perceptions of professional nurses and midwives on the nursing management of GDM: in addition, women with a history of GDM were interviewed so as to elicit their views on the management they had experienced from professional nurses and midwives before and after being diagnosed with GDM. The trustworthiness of the study was ensured by conforming to Lincoln and Guba’s framework of credibility, transferability, dependability, confirmability and authenticity. An independent coder assisted with the coding process. Phase two deals with the Integrative literature review of available evidence-based clinical practice guidelines for the nursing management of GDM. Evidence-based clinical practice guidelines were searched and appraised with assistance from an independent appraiser and themes were then formulated. In Phase three, the themes from Phase one and Phase two were integrated for the development of a draft best practice guideline for the nursing management of GDM in military health institutions in Ghana. The draft guideline was given to an expert panel of reviewers for their comments and recommendations. These were considered in the development of the final best practice guideline for the nursing management of GDM.
- Full Text:
- Date Issued: 2017
- Authors: Mensah, Gwendolyn Patience
- Date: 2017
- Subjects: Diabetes in pregnancy -- Ghana , Diabetics -- Treatment -- Ghana Nursing services -- Ghana -- Administration Public health -- Ghana
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/14036 , vital:27409
- Description: Pregnancy is a normal physiological process for the majority of women. These women, their families and significant others normally expect a successful period of pregnancy, labour, delivery and arrival of a normal and healthy baby. However, some of these pregnant women may develop Gestational Diabetes Mellitus (GDM) during this period and if not managed properly, the mother and the foetus in utero are affected in a negative way: there is a likelihood of the mother and baby developing Type 2 Diabetes in the future and also, other risks such as preterm labour, and foetal macrosomia. In order to prevent such occurrences, I set out to develop a best practice guideline for the nursing management of GDM in military health institutions in Ghana in order to help enhance nursing care. The design for this research was qualitative, explorative, descriptive and contextual in nature. The research is organised in three phases: Phase one deals with the data analysis and discussion of the interviews with professional nurses and midwives and women with a history of GDM. The data collected from the interviews were transcribed, analysed and extracted with Tesch’s eight steps of coding used for the coding. The services of an independent coder were employed to assist with the coding process which led to the formulation of key themes. Semi-structured individual interviews provided a means of exploring the perceptions of professional nurses and midwives on the nursing management of GDM: in addition, women with a history of GDM were interviewed so as to elicit their views on the management they had experienced from professional nurses and midwives before and after being diagnosed with GDM. The trustworthiness of the study was ensured by conforming to Lincoln and Guba’s framework of credibility, transferability, dependability, confirmability and authenticity. An independent coder assisted with the coding process. Phase two deals with the Integrative literature review of available evidence-based clinical practice guidelines for the nursing management of GDM. Evidence-based clinical practice guidelines were searched and appraised with assistance from an independent appraiser and themes were then formulated. In Phase three, the themes from Phase one and Phase two were integrated for the development of a draft best practice guideline for the nursing management of GDM in military health institutions in Ghana. The draft guideline was given to an expert panel of reviewers for their comments and recommendations. These were considered in the development of the final best practice guideline for the nursing management of GDM.
- Full Text:
- Date Issued: 2017
Culturally informed conceptions of traumatic experience and coping strategies among the mole-dagbon of Ghana
- Authors: Thompson, Sandra
- Date: 2017
- Subjects: Cultural psychiatry -- Ghana , Post-traumatic stress disorder -- Ghana , Dagbani (African people)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/9327 , vital:26578
- Description: Culture is important to an individual’s understanding of traumatic events and the symptoms that ensue after such events. Cultural understandings also inform how individuals cope with the traumatic stress symptoms they experience. A great deal is known about the understanding of traumatic experiences and effective coping mechanisms used in Western cultures, but non-Western cultures are generally understudied. Valuable lessons are learnt from conducting studies with understudied non-Western cultures. The research sought to explore and describe the culturally informed conceptions of traumatic experience and coping strategies in one such understudied population - the Mole-Dagbon of Ghana. The research used a qualitative exploratory descriptive interpretive methodology. Purposive nonprobability sampling was used to gain access to individuals who could comment on the knowledge objectives of the study. Data was collected using focus group discussions with cultural leaders, and semi-structured interviews with traumatized individuals. All interviews were audio-recorded, transcribed, translated and analyzed using interpretive phenomenological analysis. The findings indicated that traumatic experiences and the coping strategies are influenced by a number of cultural factors. Participants’ understanding of traumatic experiences and symptoms relied heavily on normative traditional African cultural understandings, but explanations also utilized monotheistic (from Islam and Christianity) worldviews. It was also evident that not all explanations were purely spiritual and events and symptoms were also explained using a natural/scientific framework. Some aspects of this system indicated parallels with the Western cognitive understanding of traumatic stress symptoms. The Mole-Dagbon did not focus naturally on explaining the events and symptoms and in the current sample such explanations were often deferred to authoritative individuals in the society (especially the soothsayers from the Traditional African Religion). However, there was an easy focus on coping with the symptoms after a traumatic event and in this last aspect there was a great degree of agreement between participants. A clear hierarchy of coping emerged with community and family social support being considered the most important aspect. Irrespective of religious affiliation, individuals also considered a visit to the soothsayer and completing prescribed rituals as important in the process. Even where an individual did not wish to include this practice from African Traditional Religion because of religious affiliation, they acknowledged the existence and effectiveness of these practices. Finally, it was thought important that a traumatized individual consult a religious leader for counselling (again irrespective of the actual religion). While there were elements of cognitive understanding and a recognition of counselling by religious leaders, Western based treatment modalities were not mentioned as options for the treatment of the symptoms of PTSD. Practitioners that come into contact with the Mole-Dagbon may need to use collaborative treatment strategies that respects and utilizes cultural treatment strategies for PTSD. One interesting element that needs further exploration is whether the cognitive understandings of the Mole-Dagbon can be used in a cognitive therapeutic paradigm. Even though these cognitive appraisals are present in explaining symptoms, there are no direct cultural remedies that rely on them.
- Full Text:
- Date Issued: 2017
- Authors: Thompson, Sandra
- Date: 2017
- Subjects: Cultural psychiatry -- Ghana , Post-traumatic stress disorder -- Ghana , Dagbani (African people)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/9327 , vital:26578
- Description: Culture is important to an individual’s understanding of traumatic events and the symptoms that ensue after such events. Cultural understandings also inform how individuals cope with the traumatic stress symptoms they experience. A great deal is known about the understanding of traumatic experiences and effective coping mechanisms used in Western cultures, but non-Western cultures are generally understudied. Valuable lessons are learnt from conducting studies with understudied non-Western cultures. The research sought to explore and describe the culturally informed conceptions of traumatic experience and coping strategies in one such understudied population - the Mole-Dagbon of Ghana. The research used a qualitative exploratory descriptive interpretive methodology. Purposive nonprobability sampling was used to gain access to individuals who could comment on the knowledge objectives of the study. Data was collected using focus group discussions with cultural leaders, and semi-structured interviews with traumatized individuals. All interviews were audio-recorded, transcribed, translated and analyzed using interpretive phenomenological analysis. The findings indicated that traumatic experiences and the coping strategies are influenced by a number of cultural factors. Participants’ understanding of traumatic experiences and symptoms relied heavily on normative traditional African cultural understandings, but explanations also utilized monotheistic (from Islam and Christianity) worldviews. It was also evident that not all explanations were purely spiritual and events and symptoms were also explained using a natural/scientific framework. Some aspects of this system indicated parallels with the Western cognitive understanding of traumatic stress symptoms. The Mole-Dagbon did not focus naturally on explaining the events and symptoms and in the current sample such explanations were often deferred to authoritative individuals in the society (especially the soothsayers from the Traditional African Religion). However, there was an easy focus on coping with the symptoms after a traumatic event and in this last aspect there was a great degree of agreement between participants. A clear hierarchy of coping emerged with community and family social support being considered the most important aspect. Irrespective of religious affiliation, individuals also considered a visit to the soothsayer and completing prescribed rituals as important in the process. Even where an individual did not wish to include this practice from African Traditional Religion because of religious affiliation, they acknowledged the existence and effectiveness of these practices. Finally, it was thought important that a traumatized individual consult a religious leader for counselling (again irrespective of the actual religion). While there were elements of cognitive understanding and a recognition of counselling by religious leaders, Western based treatment modalities were not mentioned as options for the treatment of the symptoms of PTSD. Practitioners that come into contact with the Mole-Dagbon may need to use collaborative treatment strategies that respects and utilizes cultural treatment strategies for PTSD. One interesting element that needs further exploration is whether the cognitive understandings of the Mole-Dagbon can be used in a cognitive therapeutic paradigm. Even though these cognitive appraisals are present in explaining symptoms, there are no direct cultural remedies that rely on them.
- Full Text:
- Date Issued: 2017
Development of antibiotic loaded liposomal hydrocolloid dressings for application in wound healing
- Authors: Ntsalu, Vuyiseka
- Date: 2017
- Subjects: Wound healing -- South Africa Liposomes Hydrocolloid surgical dressings -- South Africa
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/13957 , vital:27361
- Description: Wound healing, as a normal biological process in the human body, is achieved through four precise and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. However, many factors can interfere with one or more of these phases, thus causing improper or impaired wound healing. Maintaining a moist wound environment is crucial in facilitating the wound-healing process. The beneficial effects of a moist versus a dry wound environment include re-epithelization, tissue granulation, and repair. The use of hydrocolloid occlusive dressings in maintaining a moist wound environment has proven to be a useful adjunct in facilitating wound healing. Although hydrocolloid dressings have been widely used clinically in wound management, bacterial resistance, poor solubility and sustained drug release remain to be a problem for many of the drugs used in wound therapy. In chronic wound management, where patients normally undergo long treatments and frequent dressing changes, a system that delivers drugs into a wound site in a controlled fashion can improve patient compliance and therapeutic outcomes. Liposomes are small phospholipid vesicles that have been widely investigated as drug carriers for the delivery of therapeutic agents. They are spherical lipid vesicles consisting of phospholipid bilayers that improve the efficacy of the drugs by fusing with biological membranes, and eventually releasing their entrapped content into the cells or bacteria. The aim of this study therefore, is to develop a new bacitracin-based controlled release hydrocolloid dressing, with good absorptive properties for improving the efficacy of antibiotics in wound healing. HPLC (high-pressure liquid chromatography) assay of bacitracin was performed for quantification of the drug. Liposomes were prepared using thin film hydration and extrusion methods. Liposomes were also characterized based on their ideal particle size and encapsulation efficiency, and then incorporated into the different ratios of chitosan/gelatin hydrocolloid films. The films were prepared with increase in gelatin concentration and were evaluated for folding endurance, tensile strength, water absorption capacity, morphology, drug release kinetics, antimicrobial activity and stability. The morphology of these films was found to be very smooth and homogeneous proving a good compatibility between the two polymers. With increase in gelatin concentration, folding endurance, water absorption capacity, tensile strength, drug release kinetics and antimicrobial activity were increased. The antibacterial activity against various bacterial species was improved in the bacitracin loaded hydrocolloid films as compared to the blank films. Based on the findings above, it can be concluded that chitosan/gelatin films at 1:3 proportion is a successful wound dressing for wound management with improved wound healing properties than other formulations. This formulation is a potential candidate for the development of alternative pharmaceutical dosage forms, for the treatment of bacterial infected wounds, based on the activity of the eco-friendly chitosan matrix added to the bacitracin activity. In this work, chitosan also demonstrated a great potential as a dressing for advanced wound therapy and confirmed its good biocompatibility and potential to provide, in combination with liposomes, sustained drug release which is highly beneficial for wound treatment. The addition of gelatin improved the water affinity of the films and facilitated water mediated cross-linking process.
- Full Text:
- Date Issued: 2017
- Authors: Ntsalu, Vuyiseka
- Date: 2017
- Subjects: Wound healing -- South Africa Liposomes Hydrocolloid surgical dressings -- South Africa
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/13957 , vital:27361
- Description: Wound healing, as a normal biological process in the human body, is achieved through four precise and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. However, many factors can interfere with one or more of these phases, thus causing improper or impaired wound healing. Maintaining a moist wound environment is crucial in facilitating the wound-healing process. The beneficial effects of a moist versus a dry wound environment include re-epithelization, tissue granulation, and repair. The use of hydrocolloid occlusive dressings in maintaining a moist wound environment has proven to be a useful adjunct in facilitating wound healing. Although hydrocolloid dressings have been widely used clinically in wound management, bacterial resistance, poor solubility and sustained drug release remain to be a problem for many of the drugs used in wound therapy. In chronic wound management, where patients normally undergo long treatments and frequent dressing changes, a system that delivers drugs into a wound site in a controlled fashion can improve patient compliance and therapeutic outcomes. Liposomes are small phospholipid vesicles that have been widely investigated as drug carriers for the delivery of therapeutic agents. They are spherical lipid vesicles consisting of phospholipid bilayers that improve the efficacy of the drugs by fusing with biological membranes, and eventually releasing their entrapped content into the cells or bacteria. The aim of this study therefore, is to develop a new bacitracin-based controlled release hydrocolloid dressing, with good absorptive properties for improving the efficacy of antibiotics in wound healing. HPLC (high-pressure liquid chromatography) assay of bacitracin was performed for quantification of the drug. Liposomes were prepared using thin film hydration and extrusion methods. Liposomes were also characterized based on their ideal particle size and encapsulation efficiency, and then incorporated into the different ratios of chitosan/gelatin hydrocolloid films. The films were prepared with increase in gelatin concentration and were evaluated for folding endurance, tensile strength, water absorption capacity, morphology, drug release kinetics, antimicrobial activity and stability. The morphology of these films was found to be very smooth and homogeneous proving a good compatibility between the two polymers. With increase in gelatin concentration, folding endurance, water absorption capacity, tensile strength, drug release kinetics and antimicrobial activity were increased. The antibacterial activity against various bacterial species was improved in the bacitracin loaded hydrocolloid films as compared to the blank films. Based on the findings above, it can be concluded that chitosan/gelatin films at 1:3 proportion is a successful wound dressing for wound management with improved wound healing properties than other formulations. This formulation is a potential candidate for the development of alternative pharmaceutical dosage forms, for the treatment of bacterial infected wounds, based on the activity of the eco-friendly chitosan matrix added to the bacitracin activity. In this work, chitosan also demonstrated a great potential as a dressing for advanced wound therapy and confirmed its good biocompatibility and potential to provide, in combination with liposomes, sustained drug release which is highly beneficial for wound treatment. The addition of gelatin improved the water affinity of the films and facilitated water mediated cross-linking process.
- Full Text:
- Date Issued: 2017
Dietary diversity amongst adults who buy at shopping malls in the Nelson Mandela Bay area
- Authors: De Bruin, Eunice Mari
- Date: 2017
- Subjects: Nutrition -- South Africa -- Port Elizabeth , Older people -- Nutrition Diet Food security -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/15027 , vital:28114
- Description: Background: Assessing the level of dietary diversity and contributing factors that influence the level of dietary diversity amongst adults can highlight gaps in nutrition interventions, policies and programmes, which aim at combating the double burden of malnutrition. Aim: The aim of this study was to determine which factors and relationships affect the level of dietary diversity of adults in the Nelson Mandela Bay area. Design: An exploratory comparative, cross-sectional, quantitative study design with a qualitative component that was utilised. Both interviewer- and participantadministered questionnaire sections were applied. Data were analysed using IBM SPSS Statistics, Statistica Version 12, Microsoft Office Excel 2007, Spearman rho correlation co-efficient and Pearson’s chi-square test (p-value <0.05). Participants and setting: A convenience-stratified sample (n=480) was used, consisting of adults who reside and shop at shopping centres in the Nelson Mandela area, after obtaining informed consent. Results: The findings indicated that adults in the Nelson Mandela Bay area who shopped at shopping malls had a medium level of dietary diversity. The dietary patterns found were not in line with the South African Food Based Dietary Guidelines. The most consumed food items were ‘cereals' (95%), 'sweetening agents and sweets' (89%) and ‘spices, condiments and beverages’ (87%). Fruit (45,2%) and vegetables (64,8%) were generally poorly consumed. Significance was shown as having an effect on the level of dietary diversity for factors such as ethnicity, level of education, amount of money spent on food purchase per month, distance travelled to purchase food, and nutrition knowledge. Conclusion: The study suggests that adults living in the Nelson Mandela Bay area have a medium level of dietary diversity, with practices that are not in line with the recommended South African Food Based Dietary Guidelines. Strategies, including nutrition education promotion and the implementation of current policies, programmes and interventions, should be implemented and/or strengthened to encourage behaviour change.
- Full Text:
- Date Issued: 2017
- Authors: De Bruin, Eunice Mari
- Date: 2017
- Subjects: Nutrition -- South Africa -- Port Elizabeth , Older people -- Nutrition Diet Food security -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/15027 , vital:28114
- Description: Background: Assessing the level of dietary diversity and contributing factors that influence the level of dietary diversity amongst adults can highlight gaps in nutrition interventions, policies and programmes, which aim at combating the double burden of malnutrition. Aim: The aim of this study was to determine which factors and relationships affect the level of dietary diversity of adults in the Nelson Mandela Bay area. Design: An exploratory comparative, cross-sectional, quantitative study design with a qualitative component that was utilised. Both interviewer- and participantadministered questionnaire sections were applied. Data were analysed using IBM SPSS Statistics, Statistica Version 12, Microsoft Office Excel 2007, Spearman rho correlation co-efficient and Pearson’s chi-square test (p-value <0.05). Participants and setting: A convenience-stratified sample (n=480) was used, consisting of adults who reside and shop at shopping centres in the Nelson Mandela area, after obtaining informed consent. Results: The findings indicated that adults in the Nelson Mandela Bay area who shopped at shopping malls had a medium level of dietary diversity. The dietary patterns found were not in line with the South African Food Based Dietary Guidelines. The most consumed food items were ‘cereals' (95%), 'sweetening agents and sweets' (89%) and ‘spices, condiments and beverages’ (87%). Fruit (45,2%) and vegetables (64,8%) were generally poorly consumed. Significance was shown as having an effect on the level of dietary diversity for factors such as ethnicity, level of education, amount of money spent on food purchase per month, distance travelled to purchase food, and nutrition knowledge. Conclusion: The study suggests that adults living in the Nelson Mandela Bay area have a medium level of dietary diversity, with practices that are not in line with the recommended South African Food Based Dietary Guidelines. Strategies, including nutrition education promotion and the implementation of current policies, programmes and interventions, should be implemented and/or strengthened to encourage behaviour change.
- Full Text:
- Date Issued: 2017
Discovering the root of obesity through the symbology of food: a historical and cultural exploration
- Authors: Jacobs, Nadine
- Date: 2017
- Subjects: Obesity -- Psychological aspects , Obesity -- Research Behavior modification Psychophysiology
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/17569 , vital:28379
- Description: Obesity is fast becoming a worldwide issue with detrimental health consequences. The increasing availability of effective nutritional strategies, physical exercise regimes and behaviour modification approaches to weight loss do not offer a satisfactory explanation as to why only two to five percent of people who have lost weight successfully manage to retain the weight loss over the long term. By referring to several concepts on how the symbols of food originate in the unconscious and end up becoming the unconscious impetus for conscious thought and dietary behaviours relating to food, the complexity of food pathologies, with specific reference to obesity is explored. The study presents a narrative review of the available literature on symbols in a variety of cultural-historical contexts through the theoretical lens of the psychoanalytic framework. The study contributed to the current treatment approaches to obesity, by highlighting how the unconscious content of the psyche serve to compromise conscious efforts to address the problem of obesity. Also, the need for further research into the development of a model that, by incorporating the psychoanalytic approach to obesity, will support the long-term success of weight loss intervention by addressing the underlying issues, is emphasised.
- Full Text:
- Date Issued: 2017
Discovering the root of obesity through the symbology of food: a historical and cultural exploration
- Authors: Jacobs, Nadine
- Date: 2017
- Subjects: Obesity -- Psychological aspects , Obesity -- Research Behavior modification Psychophysiology
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/17569 , vital:28379
- Description: Obesity is fast becoming a worldwide issue with detrimental health consequences. The increasing availability of effective nutritional strategies, physical exercise regimes and behaviour modification approaches to weight loss do not offer a satisfactory explanation as to why only two to five percent of people who have lost weight successfully manage to retain the weight loss over the long term. By referring to several concepts on how the symbols of food originate in the unconscious and end up becoming the unconscious impetus for conscious thought and dietary behaviours relating to food, the complexity of food pathologies, with specific reference to obesity is explored. The study presents a narrative review of the available literature on symbols in a variety of cultural-historical contexts through the theoretical lens of the psychoanalytic framework. The study contributed to the current treatment approaches to obesity, by highlighting how the unconscious content of the psyche serve to compromise conscious efforts to address the problem of obesity. Also, the need for further research into the development of a model that, by incorporating the psychoanalytic approach to obesity, will support the long-term success of weight loss intervention by addressing the underlying issues, is emphasised.
- Full Text:
- Date Issued: 2017
Employee Assistance Program (EAP) as a context for social work practice placement
- Authors: Cummings, Nicki
- Date: 2017
- Subjects: Social service -- Fieldwork -- South Africa Social work education -- South Africa , Employee assistance programs -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/15314 , vital:28218
- Description: The Bachelor of Social Work degree is a four year course consisting of classroom and field practicum training. In 2013, the Automotive Information and Development Centre (AIDC) and Nelson Mandela Metropolitan University agreed upon placing fourth year social work students within the Employee Assistance Programs affiliated with the AIDC. The research goal of this study is to enhance an understanding of Employee Assistance Programs (EAP) as a context for practicum training for (4th) fourth year social work students by exploring and describing the perceptions and experiences of students, campus supervisors and EAP company representatives. In this respect, the study seeks to determine whether EAP provides the opportunity to meet the Exit Level Outcomes for the Bachelor of Social Work degree. This study is focussed on the practical application of social work knowledge and skills; it is framed within the principles of the Outcomes Based Educational Approach to Education. It was thus considered relevant to introduce a literature review on this particular approach with the focus on the achievement of outcomes. In order to understand whether EAP is an effective learning context the researcher needed to understand how students apply the experience and bridge the gap between theory and practice to gain meaning and understanding and, essentially, learn from the practicum training experience thus further enhancing the framework. The experiential learning cycle presented by Kolb (1984) extended the framework to provide an appropriate model for facilitating learning by linking practice to theory and knowledge. Kolb’s experiential learning cycle was thus explored. The study utilised an exploratory, descriptive, qualitative approach, which is contextual in nature. Non-probability, purposive sampling was utilised to select fourth year social work students, supervisors and company representatives who were involved with EAPs and fourth year social work students at their company. Data collection incorporated semi-structured interviews. Data analysis resulted in themes, sub-themes, categories and sub-categories emerging. Upon analysis of these themes, it was clear that with the appropriate support and creativity, students were able to meet the required Exit Level Outcomes of the Bachelor of Social Work degree. The study concludes that the overall the experience of fourth year social work students placed at EAP companies has been a positive one, with students meeting the Exit Level Outcomes for the Bachelor of Social Work degree. Although this was a positive experience, greater preparation is required and communication between the relevant parties needs to be improved.
- Full Text:
- Date Issued: 2017
- Authors: Cummings, Nicki
- Date: 2017
- Subjects: Social service -- Fieldwork -- South Africa Social work education -- South Africa , Employee assistance programs -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/15314 , vital:28218
- Description: The Bachelor of Social Work degree is a four year course consisting of classroom and field practicum training. In 2013, the Automotive Information and Development Centre (AIDC) and Nelson Mandela Metropolitan University agreed upon placing fourth year social work students within the Employee Assistance Programs affiliated with the AIDC. The research goal of this study is to enhance an understanding of Employee Assistance Programs (EAP) as a context for practicum training for (4th) fourth year social work students by exploring and describing the perceptions and experiences of students, campus supervisors and EAP company representatives. In this respect, the study seeks to determine whether EAP provides the opportunity to meet the Exit Level Outcomes for the Bachelor of Social Work degree. This study is focussed on the practical application of social work knowledge and skills; it is framed within the principles of the Outcomes Based Educational Approach to Education. It was thus considered relevant to introduce a literature review on this particular approach with the focus on the achievement of outcomes. In order to understand whether EAP is an effective learning context the researcher needed to understand how students apply the experience and bridge the gap between theory and practice to gain meaning and understanding and, essentially, learn from the practicum training experience thus further enhancing the framework. The experiential learning cycle presented by Kolb (1984) extended the framework to provide an appropriate model for facilitating learning by linking practice to theory and knowledge. Kolb’s experiential learning cycle was thus explored. The study utilised an exploratory, descriptive, qualitative approach, which is contextual in nature. Non-probability, purposive sampling was utilised to select fourth year social work students, supervisors and company representatives who were involved with EAPs and fourth year social work students at their company. Data collection incorporated semi-structured interviews. Data analysis resulted in themes, sub-themes, categories and sub-categories emerging. Upon analysis of these themes, it was clear that with the appropriate support and creativity, students were able to meet the required Exit Level Outcomes of the Bachelor of Social Work degree. The study concludes that the overall the experience of fourth year social work students placed at EAP companies has been a positive one, with students meeting the Exit Level Outcomes for the Bachelor of Social Work degree. Although this was a positive experience, greater preparation is required and communication between the relevant parties needs to be improved.
- Full Text:
- Date Issued: 2017
Evaluating neuropsychiatric symptomology in HIV-positive patients on efavirenz in public-sector clinics and psychiatric hospitals
- Gaida, Razia, Grobler, Christoffel
- Authors: Gaida, Razia , Grobler, Christoffel
- Date: 2017
- Subjects: Drugs -- Side effects -- South Africa , HIV (Viruses) -- Enzymes , Antiretroviral agents -- South Africa , Anti-infective agents -- Side effects -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/29772 , vital:30776
- Description: Background: South Africa has the highest number of people living with human immunodeficiency virus (HIV) infection in the world. In 2014, an estimated 10.2% of the population was HIV-positive which amounted to 5.51 million people. Efavirenz forms part of the triple therapy backbone used in South Africa and is part of the firstline treatment for HIV. Efavirenz has been strongly associated with causing neuropsychiatric side effects in at least 50.0% of patients to whom it is prescribed. These side effects cause hesitation amongst healthcare professionals to prescribe this agent to patients with active mental illnesses. Aim: The aim of the study was to evaluate the neuropsychiatric side effects of efavirenz in HIV-positive psychiatric and non-psychiatric patients and to determine whether this drug may be recommended for use in an HIV-positive psychiatric patient population. Method: The study was divided into two parts, namely a quantitative portion and a qualitative portion. The quantitative study was a prospective drug utilisation study, while the qualitative portion consisted of semi-structured interviews carried out with healthcare professionals working with people living with HIV/AIDS (PLWHA). The study included five municipal clinics in the Nelson Mandela Metropole as well as two public-sector psychiatric facilities in the Eastern Cape where medical records were reviewed to obtain the information required. Patients were followed in both instances for a period of 24 weeks with follow-up assessments carried out at two, four, 12 and 24 week intervals. In terms of the qualitative study, nurses at the clinics and doctors at the hospitals were contacted and appointments for interviews were made. The interviews were recorded using a voice recorder and were transcribed and analysed using theoretical framework analysis. Results: The review of 126 medical records at the clinics revealed that no patient had suffered from or complained of a neuropsychiatric side effect. This may indicate that patients were not suffering from clinically significant side effects, side effects were not being adequately recorded by healthcare staff, or the healthcare staff were not questioning patients regarding side effects. A total of 26 hospitalised patients were followed for 24 weeks in the psychiatric facilities. Almost half of the patients using efavirenz experienced an improvement in symptoms to the extent that they were iii discharged from the facility. The majority of patients (66.7%) not on an efavirenzcontaining regimen did not improve to the point of discharge. Healthcare staff were vague when providing a definition of neuropsychiatric side effects. There were conflicting ideas on whether or not efavirenz should be used in patients with an active psychiatric illness. Conclusions: Further studies need to be performed in public-sector institutions to obtain a clearer picture of the side effects experienced by patients using efavirenz. Healthcare staff need to be encouraged to keep complete records to allow for meaningful analysis. The further integration of mental health services into existing HIV programmes is essential for holistic treatment. Patients in psychiatric hospitals demonstrated that even patients with psychiatric disorders on efavirenz can experience positive outcomes and stabilisation of psychiatric symptoms, which may indicate that these may not have due to efavirenz use. Further elucidation concerning the use of efavirenz in patients with psychiatric disorders, a description of the neuropsychiatric side effects, as well as management strategies must be provided in subsequent HIV guidelines.
- Full Text:
- Date Issued: 2017
- Authors: Gaida, Razia , Grobler, Christoffel
- Date: 2017
- Subjects: Drugs -- Side effects -- South Africa , HIV (Viruses) -- Enzymes , Antiretroviral agents -- South Africa , Anti-infective agents -- Side effects -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/29772 , vital:30776
- Description: Background: South Africa has the highest number of people living with human immunodeficiency virus (HIV) infection in the world. In 2014, an estimated 10.2% of the population was HIV-positive which amounted to 5.51 million people. Efavirenz forms part of the triple therapy backbone used in South Africa and is part of the firstline treatment for HIV. Efavirenz has been strongly associated with causing neuropsychiatric side effects in at least 50.0% of patients to whom it is prescribed. These side effects cause hesitation amongst healthcare professionals to prescribe this agent to patients with active mental illnesses. Aim: The aim of the study was to evaluate the neuropsychiatric side effects of efavirenz in HIV-positive psychiatric and non-psychiatric patients and to determine whether this drug may be recommended for use in an HIV-positive psychiatric patient population. Method: The study was divided into two parts, namely a quantitative portion and a qualitative portion. The quantitative study was a prospective drug utilisation study, while the qualitative portion consisted of semi-structured interviews carried out with healthcare professionals working with people living with HIV/AIDS (PLWHA). The study included five municipal clinics in the Nelson Mandela Metropole as well as two public-sector psychiatric facilities in the Eastern Cape where medical records were reviewed to obtain the information required. Patients were followed in both instances for a period of 24 weeks with follow-up assessments carried out at two, four, 12 and 24 week intervals. In terms of the qualitative study, nurses at the clinics and doctors at the hospitals were contacted and appointments for interviews were made. The interviews were recorded using a voice recorder and were transcribed and analysed using theoretical framework analysis. Results: The review of 126 medical records at the clinics revealed that no patient had suffered from or complained of a neuropsychiatric side effect. This may indicate that patients were not suffering from clinically significant side effects, side effects were not being adequately recorded by healthcare staff, or the healthcare staff were not questioning patients regarding side effects. A total of 26 hospitalised patients were followed for 24 weeks in the psychiatric facilities. Almost half of the patients using efavirenz experienced an improvement in symptoms to the extent that they were iii discharged from the facility. The majority of patients (66.7%) not on an efavirenzcontaining regimen did not improve to the point of discharge. Healthcare staff were vague when providing a definition of neuropsychiatric side effects. There were conflicting ideas on whether or not efavirenz should be used in patients with an active psychiatric illness. Conclusions: Further studies need to be performed in public-sector institutions to obtain a clearer picture of the side effects experienced by patients using efavirenz. Healthcare staff need to be encouraged to keep complete records to allow for meaningful analysis. The further integration of mental health services into existing HIV programmes is essential for holistic treatment. Patients in psychiatric hospitals demonstrated that even patients with psychiatric disorders on efavirenz can experience positive outcomes and stabilisation of psychiatric symptoms, which may indicate that these may not have due to efavirenz use. Further elucidation concerning the use of efavirenz in patients with psychiatric disorders, a description of the neuropsychiatric side effects, as well as management strategies must be provided in subsequent HIV guidelines.
- Full Text:
- Date Issued: 2017
Evaluation of medicine safety reporting systems in South Africa
- Thornborrow-Geswind, Kirsten
- Authors: Thornborrow-Geswind, Kirsten
- Date: 2017
- Subjects: Drugs -- Side effects -- Research -- South Africa Pharmacoepidemiology -- Research -- South Africa , Medicine -- South Africa -- Safety measures Public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/21439 , vital:29517
- Description: Pharmacovigilance is “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem”. To date, no comprehensive study has been performed to evaluate the pharmacovigilance system in the public health sector in South Africa. The primary aim of this study was to evaluate the current status of pharmacovigilance systems within the public healthcare sector in South Africa, and the level of functioning of these systems, in order to provide relevant recommendations, where necessary, for improvement, using the Indicator-based Pharmacogivilance Assessment Tool (IPAT). National and provincial entities were deemed compulsory (n=14), while facilities were selected via random, stratified sampling to obtain a representation at each facility level (n=101). The IPAT was amended for relevance at each level of data collection. Indicators are classified as core and supplementary and compliance with core indicators shows the level of functioning National entities obtained an IPAT score of 36 out of a maximum of 72, achieving 50% compliance. Province D and Province G obtained overall IPAT scores of 29 and 12 respectively out of a maximum of 40, achieving an overall 72.5% and 30% compliance respectively Results at provincial and facility levels were not fully representative due to a limited response rate of 22.2% and 65.3% respectively. Regional/tertiary facilities and district facilities displayed increased awareness and implementation of pharmacovigilance activity than the lower levels of Community Health Centres (CHCs) and Primary Health Centres (PHCs). South Africa”s public healthcare system possesses the infrastructure for a well functioning pharmacovigilance system. However there are gaps in level of functioning at a national, provincial and facility level. Addressing these gaps would show a marked improvement in the system and go a long way towards the contribution of medicine safety information not only locally, but to aid other developing nations.
- Full Text:
- Date Issued: 2017
- Authors: Thornborrow-Geswind, Kirsten
- Date: 2017
- Subjects: Drugs -- Side effects -- Research -- South Africa Pharmacoepidemiology -- Research -- South Africa , Medicine -- South Africa -- Safety measures Public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/21439 , vital:29517
- Description: Pharmacovigilance is “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem”. To date, no comprehensive study has been performed to evaluate the pharmacovigilance system in the public health sector in South Africa. The primary aim of this study was to evaluate the current status of pharmacovigilance systems within the public healthcare sector in South Africa, and the level of functioning of these systems, in order to provide relevant recommendations, where necessary, for improvement, using the Indicator-based Pharmacogivilance Assessment Tool (IPAT). National and provincial entities were deemed compulsory (n=14), while facilities were selected via random, stratified sampling to obtain a representation at each facility level (n=101). The IPAT was amended for relevance at each level of data collection. Indicators are classified as core and supplementary and compliance with core indicators shows the level of functioning National entities obtained an IPAT score of 36 out of a maximum of 72, achieving 50% compliance. Province D and Province G obtained overall IPAT scores of 29 and 12 respectively out of a maximum of 40, achieving an overall 72.5% and 30% compliance respectively Results at provincial and facility levels were not fully representative due to a limited response rate of 22.2% and 65.3% respectively. Regional/tertiary facilities and district facilities displayed increased awareness and implementation of pharmacovigilance activity than the lower levels of Community Health Centres (CHCs) and Primary Health Centres (PHCs). South Africa”s public healthcare system possesses the infrastructure for a well functioning pharmacovigilance system. However there are gaps in level of functioning at a national, provincial and facility level. Addressing these gaps would show a marked improvement in the system and go a long way towards the contribution of medicine safety information not only locally, but to aid other developing nations.
- Full Text:
- Date Issued: 2017