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Alcohol use among women attending antenatal care in Buffalo City, Eastern Cape

- Bredenkamp, Petrus Johannes

Authors: Bredenkamp, Petrus Johannes
Date: 2022-04-07
Subjects: Uncatalogued
Language: English
Type: Master's thesis , text
Identifier: http://hdl.handle.net/10962/234358 , vital:50188
Description: Alcohol use during pregnancy is known to cause neurodevelopmental disorders in offspring, known as Fetal Alcohol Spectrum Disorders (FASD). High prevalence of FASD has been observed in certain parts South Africa, but many areas of the country remain unstudied, and factors contributing to drinking among pregnant women are poorly understood. This study surveyed 1099 women attending antenatal care at public primary healthcare facilities in the Buffalo City Metropolitan Area in the Eastern Cape. Data was collected using the Alcohol Use Identification Test, a 10-item self-report measure of drinking behaviour in isiXhosa, English, and Afrikaans. Factors associated with alcohol use, risky drinking, binge drinking, and hazardous/harmful drinking were identified using logistic regression. A minority of the sample reported alcohol use (64%). Among those reporting alcohol use, most reported occasional binge drinking (63%) and met criteria for risky drinking (59%) and hazardous/harmful drinking (52%). Living with a regular drinker was significantly associated with alcohol use (OR 1.98, 95% CI 1.51 – 2.58), risky drinking (OR 2.03, 95% CI 1.49 – 2.76), binge drinking (OR 2.21, 95% CI 1.64 – 2.97), and hazardous/harmful drinking (OR 2.0, 95% CI 1.41 – 2.99). However, women who were married/cohabiting were less likely to report alcohol use (OR .71, 95% CI .53 - .95). Experiencing intimate partner violence during the current pregnancy was associated with alcohol use (OR 2.42, 95% CI 1.38 – 4.27) and hazardous/harmful drinking (OR 2.62, 95% CI 1.32 – 5.22). In this study, women who identified as Coloured were more likely to report alcohol use than Women who identified as African (OR 2.74, 95% CI 1.4 – 5.36). These findings simultaneously provide evidence of problematic drinking among pregnant women in a previously understudied area and show that external factors affect women’s drinking behaviour during pregnancy. Interventions aimed at reducing the incidence of FASD should consider alcohol use by pregnant women in the context of their lived experiences. , Thesis (MA) -- Faculty of Humanities, Psychology, 2022
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Date Issued: 2022-04-07

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Design of Immunobiosensors for Detection of Tumor-Associated Anti-P53 Autoantibodies: Method Development

- Adeniyi, Omotayo Kayode

Authors: Adeniyi, Omotayo Kayode
Date: 2020
Subjects: Uncatalogued
Language: English
Type: thesis , text , Doctoral , PhD
Identifier: http://hdl.handle.net/10962/162988 , vital:41002 , 10.21504/10962/162988
Description: Introduction -- Experimental -- Label-Free Impedimetric Sensing of Anti-P53ab... -- Fluorescent detection of Anti-P53ab -- Peroxidase-like activity of Fe3O4@SiNP-APTES-Au@Pd... -- Colorimetric detection of Anti-P53ab , Thesis (PhD)--Rhodes University, Science Faculty, Department of Chemistry, 2020. , Detection and profiling of circulating tumor-associated autoantibodies (TAAbs) are useful for screening and early-stage diagnosis of asymptomatic lung cancer. Immunobiosensor technologies aimed to accomplish the highly sensitive, rapid and low-cost detection of TAAbs can improve the early-stage detection of lung cancer. Immunobiosensors for the detection of anti-P53-tumour associated autoantibodies have been developed in this work. The design of sensing interfaces with immobilized P53 protein (P53ag) as a sensing element layer on a solid interface was investigated. Several methods of detecting anti-P53-antibodies (anti-P53ab) were investigated. These methods are label-free detection using electrochemical impedance spectroscopy (EIS) and two label techniques. The label-free electrochemical techniques utilize gold electrode pre-modified with a conducting layer of electrochemically grafted phenylethylamine for covalent immobilization of P53ag. The limit of anti-P53ab detection with the label-free EIS was 103.0 pg.ml-1. The labeled technique developed utilizes fluorescent, and peroxidase-like nanomaterial labeled antibody as a detection probe. For the fluorescence detection, fluorescent silica nanoparticles were synthesized by overloading FITC into the silica matrix and conjugated to detection antibody (anti-IgG). The detection of the anti-P53ab was based on the dissolution of the silica nanoparticles to release the loaded dye as a signal amplification strategy. The fluorescence detection was carried out on a microplate, and magnetic bead modified P53-antigen platforms and limit of detection (LoD) were 42.0 fg.ml-1 and 3.3 fg.ml-1 for anti-P53ab; respectively. Fe3O4@SiNP-APTES-Au@Pd hybrid nanoparticles were synthesized, and their peroxidase-like activity and colorimetric detection were evaluated. The Fe3O4@SiNP-APTES-Au@Pd exhibited comparable activity to HRP. The Fe3O4@SiNP-APTES-Au@Pd was conjugated to protein-G-anti-IgG for the detection of anti-P53ab on a microplate and cellulose paper platforms. The LoD was 20.0 fg.ml-1 and 63.0 fg.ml-1 for the microplate and cellulose paper platform; respectively. The potential application of the designed immunobiosensor was evaluated in simulated serum samples. The developed sensors showed higher detection sensitivity, stability and had a lower detection limit for anti-P53ab when compared with the ELISA based detection. The results have provided alternative and effective quantification approaches to ELISA and a promising future for multiplexed detection of tumor-associated autoantibodies. The developed methodologies in this thesis could be applied for the detection of other autoantibodies in other cancer types and auto-immune diseases.
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Date Issued: 2020

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NUMSA Members: Support the dismissed 270 Karl Schmidt workers

- Congress of South African Trade Unions

Authors: Congress of South African Trade Unions
Date: 1990-06
Subjects: Uncatalogued
Language: English
Type: text
Identifier: http://hdl.handle.net/10962/106000 , vital:32592
Description: The German multi-national Karl Schmidt 1 dismissed 270 NUMSA members on 22nd July 1987. During May, three shop stewards were dismissed for calling a meeting on company premises. This meeting was held to get workers’ views on the 5-6 may stayaway called by progressive organisations in protest against the ‘white’ elections and the killings of SARHWU workers. After dismissing the shop stewards the company refused to reinstate them or agree to the arbitration of the dispute. The company refused NUMSA access to ballot its members for a legal strike after the expiry of the dispute resolving 30-day period. Instead, when workers elected a delegation to see management on 20 July 1987 to enquire about the situation, the company: 1. Brought the delegation before disciplinary hearings; 2. Fired a worker without a hearing on 21 July 1987; 3. Suspended a shop steward on the night- shift for six months on 21 July 1987; 4. Dismissed the entire nightshift on 21 July 1987 wh:(e workers were waiting in the canteen for management to address them; 5. Dismissed the entire dayshift on 22 July 1987 while workers were waiting for a report on the dismissal of the nightshift from the company. Karl Schmidt have always displayed racist, anti-union attitudes. Shop stewards have always been a particular target. During 1986 workers had to strike to get a shop steward reinstated after he was dismissed without a hearing
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Date Issued: 1990-06

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The design and evaluation of targeted patient-centred health information to improve knowledge and behavioural outcomes in tuberculosis patients with limited literacy

- Patel, Sonal

Authors: Patel, Sonal
Date: 2015
Subjects: Uncatalogued
Language: English
Type: Doctoral theses , text
Identifier: http://hdl.handle.net/10962/194071 , vital:45420 , DOI 10.21504/10962/194071
Description: South Africa carries a significant TB burden as evidenced in the 2013 statistics which report 450 000 new active TB cases and 890 000 TB-related mortalities. For successful treatment outcomes, 90% adherence is necessary, but many patients prematurely discontinue treatment due to poor knowledge and understanding of their complex TB medicines. Patient education is pivotal in improving knowledge, health literacy and behavioural outcomes such as health information seeking, self-efficacy and adherence. In the under-resourced South African healthcare system, time and capacity to adequately counsel patients are limited. The value of written medicine information (WMI) to supplement the verbal information provided by healthcare professionals (HCPs) has been widely investigated but minimal South African research is available. Current WMI distributed in South Africa is mainly generated by pharmaceutical manufacturers and is complex, incomprehensible and undesirable to patients. TB-related WMI focuses mainly on the disease, with little information relating to TB medicines and their use. The overall aim of this project was to improve patient knowledge about their TB medicines through the use of a simple illustrated patient information leaflet (PIL). Objectives to achieve this aim included: investigation of the medicine information seeking behaviour (MISB) of long term patients attending public health sector facilities; the development and validation of a medicine literacy test (MLT) to identify patients with limited health literacy requiring additional support and counselling; the development and evaluation of a patient-centred illustrated PIL for first-line TB treatment; the assessment of self-efficacy and adherence using modified versions of the HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES) and Morisky 8-item Medicine Adherence Scale (MMAS-8), respectively, and the investigation of the impact of the PIL on patient knowledge and these health-related behaviours. Six focus group discussions (FGDs) conducted in 34 isiXhosa-speaking patients with limited formal education taking long-term treatment explored themes related to information needs, information-seeking practices and awareness of and ability to utilize information sources. Codes were analysed and potential themes and subthemes were identified and refined. The findings of this study reflected a passive, disempowered patient due to both patient-related and systemic healthcare factors. Poor awareness of information sources, lack of health-related knowledge, stigma and lack of awareness of the importance of appropriate medicine-related knowledge contributed to a lack of information-seeking practice. Patients neither asked questions nor were encouraged to do so. All expressed an unmet need for information and a desire for receiving relevant, appropriate, written medicine-related information. Feedback from this phase of the study was used to inform the development of the targeted patientcentred PIL. A double-sided A4 PIL containing information about TB medicines was designed giving careful consideration to content, format and layout features. Twenty five pictograms were designed through a rigorous, iterative design process and were included in the PIL that was evaluated in a randomised control trial (RCT) conducted amongst 120 TB patients attending a high burden TB clinic in South Africa. Interviews were conducted in either isiXhosa or Afrikaans via a trained interpreter. Patients were randomly allocated to either a control (standard care) or an experimental group (standard care plus brief counselling using the PIL). Two interviews were conducted using a prepared questionnaire; one at baseline followed by a 4-week follow-up. Baseline data included demographics, medicine literacy test, health information sources, knowledge of TB medicines, self-reported adherence and self-efficacy. Data collected at the 4-week follow-up interview included TB knowledge, self-reported adherence, self-efficacy, opinion of TB medicine information and interpretation of pictograms. Data were analysed using t-test, correlations, chi-square and ANOVA tests at a 0.05 level of significance. The PIL was successful in improving patient knowledge of the disease, TB medicine-taking, side effects, drug-resistant TB and HIV and TB co-infection. At baseline, there was no significant difference in the overall mean percentage knowledge score between the control and experimental groups (p=0.074). At follow-up, the percentage knowledge score for the experimental group increased significantly from 59.0% to 84.6% (p<0.001) and showed a significantly higher score than the control group (p<0.001), displaying evidence of the impact of the PIL as a counselling tool on patient knowledge. The PIL generated a highly positive response in the experimental group who indicated that they had referred to the leaflet over the last month and that it had played an important role in improving their TB medicine-related knowledge. This was reflected in the experimental group knowledge score of greater than 80% for almost three quarters of the patients whereas only 14% in the control group achieved this score. Patients appreciated the inclusion of pictograms and strongly felt that they helped them to recall and understand the textual PIL content. The study found that patients want side effect information and, interestingly, did not perceive the presentation of side effects in pictorial form to constitute a risk factor for nonadherence. Use of the illustrated PIL (experimental group) resulted in a significant improvement in patient self-efficacy (p=0.002), but showed no effect on self-reported adherence (p=0.563). Neither self-efficacy nor adherence was influenced by gender, age or education. An education effect on knowledge was only observed in the control group at baseline. The newly developed MLT was shown to be a valid and reliable tool and a moderate, positive and significant correlation was noted between the MLT score and baseline TB medicine-related knowledge in both the control and experimental groups. As there is a paucity of studies investigating the influence of take-home written leaflets on TB medicine knowledge and on patient behaviour, this study represents a significant knowledge contribution. It is the first study to report the development and evaluation of a patient-centred PIL to address the dearth of available TB medicine information. The use of targeted user-friendly, illustrated information leaflets can be a valuable counselling aid to improve patient knowledge and self-efficacy, particularly among patients with limited literacy. However, careful consideration of the design and content, with input from the endusers at all stages of the process, will optimise its effectiveness. The proposed framework for the development and implementation of patient-centred health and medicines information in a developing country context presented in this thesis could be used as a theoretical basis for informing the development of effective information materials targeting other disease states. Local patients taking TB medicines identified nurses, WMI and media as their current sources of information but they expressed a strong desire to know more about their treatment. Targeted public health interventions that focus on medicine-taking information and behaviours and encourage patients to adopt a more active, questioning role in health consultations could improve health literacy and empower patients in their medicine-taking practices. , Thesis (PhD) -- Faculty of Pharmacy, Pharmacy, 2015
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Date Issued: 2015

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