An exploratory study of the challenges experienced by single mother university students
- Authors: Mapasa, Yolisa Yvonne
- Date: 2013
- Subjects: Teenage mothers -- South Africa , Women college students -- South Africa.
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9962 , http://hdl.handle.net/10948/d1020170
- Description: This treatise reports on a qualitative exploratory study that was aimed at identifying and describing the challenges experienced by single mothers who were students at a South African university. The researcher is of the view that single parenthood is a global challenge but very little has been done to explore this phenomenon in South Africa. A purposive convenience sample of four voluntary full time registered single mother students at a university in the Western Cape Province was utilised in the study. The participants ranged in age between eighteen and twenty three years and were English second language speakers. In-depth individual interviews were conducted with the four participants and the data were analysed into qualitative themes. The following main challenges for the sample of single mother university students emerged from the data: (i) Financial challenges. (ii) Concern for the general wellbeing of children. (iii) Difficulties regarding the separation of mother and child. (iv) The importance of tertiary education in finding future employment. (v) Dual role stress. Sub-themes within these main themes were also identified and discussed. Recommendations for future research, based on the findings of this study, are also offered.
- Full Text:
- Date Issued: 2013
- Authors: Mapasa, Yolisa Yvonne
- Date: 2013
- Subjects: Teenage mothers -- South Africa , Women college students -- South Africa.
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9962 , http://hdl.handle.net/10948/d1020170
- Description: This treatise reports on a qualitative exploratory study that was aimed at identifying and describing the challenges experienced by single mothers who were students at a South African university. The researcher is of the view that single parenthood is a global challenge but very little has been done to explore this phenomenon in South Africa. A purposive convenience sample of four voluntary full time registered single mother students at a university in the Western Cape Province was utilised in the study. The participants ranged in age between eighteen and twenty three years and were English second language speakers. In-depth individual interviews were conducted with the four participants and the data were analysed into qualitative themes. The following main challenges for the sample of single mother university students emerged from the data: (i) Financial challenges. (ii) Concern for the general wellbeing of children. (iii) Difficulties regarding the separation of mother and child. (iv) The importance of tertiary education in finding future employment. (v) Dual role stress. Sub-themes within these main themes were also identified and discussed. Recommendations for future research, based on the findings of this study, are also offered.
- Full Text:
- Date Issued: 2013
An interpretive phenomenological analysis of change in attitudes and beliefs toward domestic violence and rape myths as experienced by Eastern Cape adolescents
- Authors: De Vries, Lauré
- Date: 2019
- Subjects: Violence in children -- South Africa -- Eastern Cape , Violence -- South Africa -- Eastern Cape -- Psychological aspects Women -- Violence against Children -- Attitudes
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/39436 , vital:35246
- Description: Although there is extensive research focused on decreasing the occurrence of gender-based violence (GBV) (domestic violence and rape) with a focus on underlying attitudes and beliefs, no attention is given to how these attitudes and beliefs and change therein, is experienced. This study aimed to address this gap by interviewing three adolescent learners (one female and two males aged 16 to 18) who formed part of a community-based rape prevention project at their school in Motherwell (Eastern Cape). By utilizing Interpretive Phenomenological Analysis (IPA), the researcher explored and described lived experiences in terms of change in attitudes toward domestic violence (objective 1) and beliefs about rape myths (objective 2). Analytic attention was not restricted to the perceived influence of the attended rape prevention project but was given to broader lived experiences. The Transtheoretical Model of Change was employed as the theoretical framework. From the findings, the researcher argues that the three participants experienced a shift from the precontemplation stage toward the action stage. Participants described change from a disengaged but concerned onlooker, to a conscious onlooker, and finally to a willing agent of change. Through the interplay of change influencers deeply embedded in their social context, participants described not only individual change, but also the awakening of an internal willingness to effect broader social change. However, participants raised concerns about their ability to do so. The results of this small study with a cohort of adolescents may have important implications for future research, as adolescents are often an untapped resource in forming part of the larger movement toward social change.
- Full Text:
- Date Issued: 2019
- Authors: De Vries, Lauré
- Date: 2019
- Subjects: Violence in children -- South Africa -- Eastern Cape , Violence -- South Africa -- Eastern Cape -- Psychological aspects Women -- Violence against Children -- Attitudes
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/39436 , vital:35246
- Description: Although there is extensive research focused on decreasing the occurrence of gender-based violence (GBV) (domestic violence and rape) with a focus on underlying attitudes and beliefs, no attention is given to how these attitudes and beliefs and change therein, is experienced. This study aimed to address this gap by interviewing three adolescent learners (one female and two males aged 16 to 18) who formed part of a community-based rape prevention project at their school in Motherwell (Eastern Cape). By utilizing Interpretive Phenomenological Analysis (IPA), the researcher explored and described lived experiences in terms of change in attitudes toward domestic violence (objective 1) and beliefs about rape myths (objective 2). Analytic attention was not restricted to the perceived influence of the attended rape prevention project but was given to broader lived experiences. The Transtheoretical Model of Change was employed as the theoretical framework. From the findings, the researcher argues that the three participants experienced a shift from the precontemplation stage toward the action stage. Participants described change from a disengaged but concerned onlooker, to a conscious onlooker, and finally to a willing agent of change. Through the interplay of change influencers deeply embedded in their social context, participants described not only individual change, but also the awakening of an internal willingness to effect broader social change. However, participants raised concerns about their ability to do so. The results of this small study with a cohort of adolescents may have important implications for future research, as adolescents are often an untapped resource in forming part of the larger movement toward social change.
- Full Text:
- Date Issued: 2019
An intervention for high-risk type 2 diabetic clients during preconception and internatal in re-engineering of primary health care
- Authors: Ngoma, Siphokazi Amanda
- Date: 2018
- Subjects: Diabetes Diabetes Mellitus, Type 2
- Language: English
- Type: Thesis , Masters , (MCur) Nursing
- Identifier: http://hdl.handle.net/10353/10199 , vital:35375
- Description: The South African disease profile has changed significantly and has increasing prevalence of overweight and obesity in relation to body mass index. Type 2 diabetes mellitus is greatly associated with increased body mass index and poses a great health concern for women of childbearing age. Complications of type 2 diabetes mellitus in pregnancy has life-threatening for the mother and baby. South African women have a tendency of avoiding and neglecting routine screening before pregnancy, that is part of preconception care or internatal care. The aim of the study sought to identify women of childbearing age with predisposing factors of type 2 diabetes, in order to intervene, using a lifestyle modification to delay and prevent the occurrence of type 2 diabetes. A quantitative intervention study using parallel group randomized control trials was used. One hundred and forty-six women of childbearing age (18-45 years) were recruited and assigned to either control (n=73 + 9) or experimental group (n=73 +9). using a computer software randomizer application to avoid bias in selection of participants by the researcher. Both groups received health education from the researcher and the dietician from hospital. The control group had no intervention done, whereas the experimental group attended physical activity sessions which were administered by a hired lay coach. The findings showed that both groups are at risk of developing type 2 diabetes although they both groups lose weight. The weight loss of the control group was owed to education during recruitment. Vegetable consumption was minimal to the younger age group than the older age groups. Waist circumference above 105cm consumed less vegetables, a higher waist circumference is associated with insulin resistance. There was also minimal exercises and knowledge about the preconception care. Diabetes prevention is vital for the women of childbearing age as it affects both mother and child. The study recommends lifestyle modification (exercise and healthy diet) to prevent and delay of type 2 diabetes and gestational diabetes mellitus. The study also recommends Preconception care and Re- engineering of Primary health care uses community health care workers for screening high risk women during home visits.
- Full Text:
- Date Issued: 2018
- Authors: Ngoma, Siphokazi Amanda
- Date: 2018
- Subjects: Diabetes Diabetes Mellitus, Type 2
- Language: English
- Type: Thesis , Masters , (MCur) Nursing
- Identifier: http://hdl.handle.net/10353/10199 , vital:35375
- Description: The South African disease profile has changed significantly and has increasing prevalence of overweight and obesity in relation to body mass index. Type 2 diabetes mellitus is greatly associated with increased body mass index and poses a great health concern for women of childbearing age. Complications of type 2 diabetes mellitus in pregnancy has life-threatening for the mother and baby. South African women have a tendency of avoiding and neglecting routine screening before pregnancy, that is part of preconception care or internatal care. The aim of the study sought to identify women of childbearing age with predisposing factors of type 2 diabetes, in order to intervene, using a lifestyle modification to delay and prevent the occurrence of type 2 diabetes. A quantitative intervention study using parallel group randomized control trials was used. One hundred and forty-six women of childbearing age (18-45 years) were recruited and assigned to either control (n=73 + 9) or experimental group (n=73 +9). using a computer software randomizer application to avoid bias in selection of participants by the researcher. Both groups received health education from the researcher and the dietician from hospital. The control group had no intervention done, whereas the experimental group attended physical activity sessions which were administered by a hired lay coach. The findings showed that both groups are at risk of developing type 2 diabetes although they both groups lose weight. The weight loss of the control group was owed to education during recruitment. Vegetable consumption was minimal to the younger age group than the older age groups. Waist circumference above 105cm consumed less vegetables, a higher waist circumference is associated with insulin resistance. There was also minimal exercises and knowledge about the preconception care. Diabetes prevention is vital for the women of childbearing age as it affects both mother and child. The study recommends lifestyle modification (exercise and healthy diet) to prevent and delay of type 2 diabetes and gestational diabetes mellitus. The study also recommends Preconception care and Re- engineering of Primary health care uses community health care workers for screening high risk women during home visits.
- Full Text:
- Date Issued: 2018
An intervention study for low risk pregnant women and high risk pregnant women with GDM in Buffalo City Metropolitan Municipality, Eastern Cape, South Africa
- Authors: Vellem, Nonceba Mercy
- Date: 2018
- Subjects: Diabetes in pregnancy -- South Africa Nursing services -- South Africa -- Eastern Cape -- Administration Pregnancy -- Complications
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/9723 , vital:34891
- Description: Low risk and high risk pregnant women (HRPW) with gestational diabetes mellitus (GDM) who practise sedentary life style are at risk of overweight and obesity that predispose to gestational diabetes mellitus (GDM). The purpose of the study is to describe the effectiveness of an intervention strategy of modified diet and planned physical activity implemented amongst low-risk and high-risk pregnant women with GDM in Buffalo City Metropolitan Municipality in the Eastern Cape, South Africa. Quantitative experimental intervention design and stratified random sampling was used for drawing a sample of low-risk and high risk pregnant women with GDM. A sample size 291 of LRPW and n=34 HRPW were eligible for the study. The sample frame of the study was taken from the registers of the CHCs, Frere Hospital and Cecilia Makiwane Hospital (CMH). Questionnaires were used to collect data from the low and high risk pregnant with GDM. Descriptive statistics (frequency, percentages, mean and standard deviation) were used for categorical variables. A p-value of < 0.05 was considered statistically significant. The total analysed of LRPW were n=135 and HRPW n=34 all in control group due to miscarriages, phone loss and relocation. LRPW had some risk factors of overweight (6.2 percent), obesity (15.5 percent), family history of diabetes (16.5 percent). HRPW also had overweight and obesity of (14.7 percent) and family history of (26.4 percent) as the Pvalue was statistically significant of weight was 001, MUAC Pvalue of 000 and Pvalue of BMI 000. There were alarming abnormalities of urinalysis of protein, glucose, leucocytes and blood in urine. The LRPW and HRPW had consumption of high content of carbohydrates, vegetables, fats and low in fruit, vegetables and fibre diet. Both LRPW and HRPW were also interested on the education about modified diet benefits (95.1 percent) and modified diet programs networks (87.5 percent). The barriers showed that LRPW and HRPW were low motivation (90 percent) minimal knowledge and benefits of modified diet (93 percent) and socio-cultural issues (86 percent). The majority of participants both LRPW and HRPW showed the interest in the planned physical activity benefits especially frequent education (96.9 percent) and encouragement of social support networks (90.2 percent) and convenient location (89.4 percent). But the HRPW had lower engagement than the LRPW in planned physical activity and is associated with risk of GDM. Although pregnant women were faced with fatigue and low energy (98.6 percent), as pregnancy progresses, minimum information regarding benefits of planned physical activity (87.6 percent) and the socio-cultural influence (77.8 percent). The recommendations are education on frequent use of modified diet and planned physical activity that is available, less economical and within their context. Frequent screening of all pregnant women during pregnancy of BMI, MUAC and weight and educate accordingly. The availability of dietician and physical activity speciality is needed.
- Full Text:
- Date Issued: 2018
- Authors: Vellem, Nonceba Mercy
- Date: 2018
- Subjects: Diabetes in pregnancy -- South Africa Nursing services -- South Africa -- Eastern Cape -- Administration Pregnancy -- Complications
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/9723 , vital:34891
- Description: Low risk and high risk pregnant women (HRPW) with gestational diabetes mellitus (GDM) who practise sedentary life style are at risk of overweight and obesity that predispose to gestational diabetes mellitus (GDM). The purpose of the study is to describe the effectiveness of an intervention strategy of modified diet and planned physical activity implemented amongst low-risk and high-risk pregnant women with GDM in Buffalo City Metropolitan Municipality in the Eastern Cape, South Africa. Quantitative experimental intervention design and stratified random sampling was used for drawing a sample of low-risk and high risk pregnant women with GDM. A sample size 291 of LRPW and n=34 HRPW were eligible for the study. The sample frame of the study was taken from the registers of the CHCs, Frere Hospital and Cecilia Makiwane Hospital (CMH). Questionnaires were used to collect data from the low and high risk pregnant with GDM. Descriptive statistics (frequency, percentages, mean and standard deviation) were used for categorical variables. A p-value of < 0.05 was considered statistically significant. The total analysed of LRPW were n=135 and HRPW n=34 all in control group due to miscarriages, phone loss and relocation. LRPW had some risk factors of overweight (6.2 percent), obesity (15.5 percent), family history of diabetes (16.5 percent). HRPW also had overweight and obesity of (14.7 percent) and family history of (26.4 percent) as the Pvalue was statistically significant of weight was 001, MUAC Pvalue of 000 and Pvalue of BMI 000. There were alarming abnormalities of urinalysis of protein, glucose, leucocytes and blood in urine. The LRPW and HRPW had consumption of high content of carbohydrates, vegetables, fats and low in fruit, vegetables and fibre diet. Both LRPW and HRPW were also interested on the education about modified diet benefits (95.1 percent) and modified diet programs networks (87.5 percent). The barriers showed that LRPW and HRPW were low motivation (90 percent) minimal knowledge and benefits of modified diet (93 percent) and socio-cultural issues (86 percent). The majority of participants both LRPW and HRPW showed the interest in the planned physical activity benefits especially frequent education (96.9 percent) and encouragement of social support networks (90.2 percent) and convenient location (89.4 percent). But the HRPW had lower engagement than the LRPW in planned physical activity and is associated with risk of GDM. Although pregnant women were faced with fatigue and low energy (98.6 percent), as pregnancy progresses, minimum information regarding benefits of planned physical activity (87.6 percent) and the socio-cultural influence (77.8 percent). The recommendations are education on frequent use of modified diet and planned physical activity that is available, less economical and within their context. Frequent screening of all pregnant women during pregnancy of BMI, MUAC and weight and educate accordingly. The availability of dietician and physical activity speciality is needed.
- Full Text:
- Date Issued: 2018
An intervention study to develop a male circumcision health promotion programme at Libode Rural Communities in the Eastern Cape Province, South Africa
- Authors: Douglas, Mbuyiselo
- Date: 2013
- Subjects: Circumcision Health promotion Penis surgery South Africa -- Libode
- Language: English
- Type: Thesis , Doctoral , Ph D
- Identifier: vital:18476 , http://hdl.handle.net/11260/d1007187
- Description: The purpose of this study was to develop an intervention health promotion programme to prevent circumcision related health problem such as sepsis, botched circumcision, dehydration, penile amputation and reduce the number of deaths. The intervention programme was aimed at promoting a safe male circumcision practice affecting boys aged 12-18 years at Libode rural communities in Eastern Cape Province of South Africa. This was achieved through a mixed method design using both quantitative and qualitative approaches utilizing sequential transformative strategy to allow for the convergence of multiple perspectives of the traditional male circumcision in Libode. The study was conducted in 22 schools of the rural communities of Libode because most of the participants are still attending school. Frequencies and percentages were used to analyse the quantitative data, utilizing the Statistical Package for Social Sciences (SPSS). A total of 1036 participants, AmaXhosa circumcised young men (abafana) and uncircumcised boys (amakhwenkwe) participated in the cross-sectional survey, quantitative phase of the study. Qualitative phase of this study was composed of 7 focus group discussions with a total of 84 circumcised and uncircumcised male participants and 10 key informants’ interviews were conducted. In analysis qualitative data, the researcher found the most descriptive words for each topic and turned them into categories or sub-themes. Topics that related to each other were then grouped in order to reduce the number of categories and to create themes. The similar categories of data were grouped and analysed using Tesch’s method. Findings indicated that traditional circumcision is performed during winter and summer holidays in order to cater for the boys who are attending schools. The circumcision age at Libode ranges from 12 and 18 years of age which is against the Health Standards in Traditional Circumcision Act (Act No. 6 of 2001). Although the participants were aware of the complications of male circumcision in Libode, there was a high preference for traditional circumcision (92.3% of participants) to hospital circumcision. The participants were of the view that the benefits of traditional circumcision outweigh the complications or challenges related to traditional circumcision. They wanted to be socially accepted and wanted to learn about manhood values in the traditional circumcision which are values that cannot be achieved through the hospital based circumcision. As male circumcision initiation is seasonal and the intervention programme needed to be approved by different stakeholders, the testing of intervention programme could not happen before the programme was approved by all the stakeholders.
- Full Text:
- Date Issued: 2013
- Authors: Douglas, Mbuyiselo
- Date: 2013
- Subjects: Circumcision Health promotion Penis surgery South Africa -- Libode
- Language: English
- Type: Thesis , Doctoral , Ph D
- Identifier: vital:18476 , http://hdl.handle.net/11260/d1007187
- Description: The purpose of this study was to develop an intervention health promotion programme to prevent circumcision related health problem such as sepsis, botched circumcision, dehydration, penile amputation and reduce the number of deaths. The intervention programme was aimed at promoting a safe male circumcision practice affecting boys aged 12-18 years at Libode rural communities in Eastern Cape Province of South Africa. This was achieved through a mixed method design using both quantitative and qualitative approaches utilizing sequential transformative strategy to allow for the convergence of multiple perspectives of the traditional male circumcision in Libode. The study was conducted in 22 schools of the rural communities of Libode because most of the participants are still attending school. Frequencies and percentages were used to analyse the quantitative data, utilizing the Statistical Package for Social Sciences (SPSS). A total of 1036 participants, AmaXhosa circumcised young men (abafana) and uncircumcised boys (amakhwenkwe) participated in the cross-sectional survey, quantitative phase of the study. Qualitative phase of this study was composed of 7 focus group discussions with a total of 84 circumcised and uncircumcised male participants and 10 key informants’ interviews were conducted. In analysis qualitative data, the researcher found the most descriptive words for each topic and turned them into categories or sub-themes. Topics that related to each other were then grouped in order to reduce the number of categories and to create themes. The similar categories of data were grouped and analysed using Tesch’s method. Findings indicated that traditional circumcision is performed during winter and summer holidays in order to cater for the boys who are attending schools. The circumcision age at Libode ranges from 12 and 18 years of age which is against the Health Standards in Traditional Circumcision Act (Act No. 6 of 2001). Although the participants were aware of the complications of male circumcision in Libode, there was a high preference for traditional circumcision (92.3% of participants) to hospital circumcision. The participants were of the view that the benefits of traditional circumcision outweigh the complications or challenges related to traditional circumcision. They wanted to be socially accepted and wanted to learn about manhood values in the traditional circumcision which are values that cannot be achieved through the hospital based circumcision. As male circumcision initiation is seasonal and the intervention programme needed to be approved by different stakeholders, the testing of intervention programme could not happen before the programme was approved by all the stakeholders.
- Full Text:
- Date Issued: 2013
An investigation into births before arrival in healthcare facilities in uThungulu Health District during a period of 1 April 2014 to 31 March 2015
- Mkhwanazi, Cynthia Nqobile Nokuthula
- Authors: Mkhwanazi, Cynthia Nqobile Nokuthula
- Date: 2018
- Subjects: Childbirth Childbirth at home
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11161 , vital:37198
- Description: Births Before Arrival (BBAs) in healthcare facilities is a worldwide health challenge. These births results with diverse obstetric and neonatal complications which could be avoided should delivery took place in an accredited environment. Delivery in health facility rate and Births Before Arrival is one of the vital measures used to monitor access as well as quality of Maternal and Child health services. A birth before arrival in health institutions happens accidentally and unattended by skilled health professionals outside the healthcare facilities (Lazic & Takač, 2011). It is found in both developed and developing countries with various adverse outcomes ranging from haemorrhage to death. Important strides had been taken to improve maternal and child health globally but the healthcare facilities are still experiencing an overwhelming number of births before arrival in healthcare facilities. This is a public health concern. The purpose of the study was to identify factors associated with Births before Arrival in UThungulu Health District facilities and determine the prevalence of BBAs and the neonatal and maternal morbidity and mortality associated with it. A retrospective quantitative research design was used. Maternity clinical records Reviews of 238 Births Before Arrival (BBA) in healthcare facilities that occurred between 1 April 2014 to 31 March 2015 were conducted in the six hospitals in UThungulu Health District. The births before arrival data was analysed using SPSS (Statistical Package for Social Science) version 23, for Windows and used for descriptive and inferential analysis. The reasons for BBA included poor ante natal education of mothers on early signs of labour, lack of transport, poor use of maternity waiting areas and some clinics do not conduct deliveries. The majority of study participants were single (unmarried) and this accentuates the importance of strengthening family planning coverage in this area. Poor reporting of early neonatal deaths and stillbirths was one of the significant observations made during the study. Deceased babies were left at home and buried without being registered at home affairs. Taking cognizance of diverse risks and health needs of expectant women would assist the Health department in planning for adequate coverage for provision of suitable pregnancy care that would improve the health of women and their babies.
- Full Text:
- Date Issued: 2018
- Authors: Mkhwanazi, Cynthia Nqobile Nokuthula
- Date: 2018
- Subjects: Childbirth Childbirth at home
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11161 , vital:37198
- Description: Births Before Arrival (BBAs) in healthcare facilities is a worldwide health challenge. These births results with diverse obstetric and neonatal complications which could be avoided should delivery took place in an accredited environment. Delivery in health facility rate and Births Before Arrival is one of the vital measures used to monitor access as well as quality of Maternal and Child health services. A birth before arrival in health institutions happens accidentally and unattended by skilled health professionals outside the healthcare facilities (Lazic & Takač, 2011). It is found in both developed and developing countries with various adverse outcomes ranging from haemorrhage to death. Important strides had been taken to improve maternal and child health globally but the healthcare facilities are still experiencing an overwhelming number of births before arrival in healthcare facilities. This is a public health concern. The purpose of the study was to identify factors associated with Births before Arrival in UThungulu Health District facilities and determine the prevalence of BBAs and the neonatal and maternal morbidity and mortality associated with it. A retrospective quantitative research design was used. Maternity clinical records Reviews of 238 Births Before Arrival (BBA) in healthcare facilities that occurred between 1 April 2014 to 31 March 2015 were conducted in the six hospitals in UThungulu Health District. The births before arrival data was analysed using SPSS (Statistical Package for Social Science) version 23, for Windows and used for descriptive and inferential analysis. The reasons for BBA included poor ante natal education of mothers on early signs of labour, lack of transport, poor use of maternity waiting areas and some clinics do not conduct deliveries. The majority of study participants were single (unmarried) and this accentuates the importance of strengthening family planning coverage in this area. Poor reporting of early neonatal deaths and stillbirths was one of the significant observations made during the study. Deceased babies were left at home and buried without being registered at home affairs. Taking cognizance of diverse risks and health needs of expectant women would assist the Health department in planning for adequate coverage for provision of suitable pregnancy care that would improve the health of women and their babies.
- Full Text:
- Date Issued: 2018
An investigation into development of a stable aqeous suspension of Metronidazole Benzoate for oral use
- Authors: Zietsman, Sharon Lynne
- Date: 2005
- Subjects: Metronidazole -- Testing , Excipients -- South Africa -- Testing , Rheology -- South Africa
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10158 , http://hdl.handle.net/10948/456 , Metronidazole -- Testing , Excipients -- South Africa -- Testing , Rheology -- South Africa
- Description: Metronidazole is a synthetic, nitroimidazole-derivative antibacterial and antiprotozoal agent (ed. McEvoy, 2001). It has been reported that crystallization occurs in aqueous suspensions of metronidazole benzoate, a bland-tasting prodrug of metronidazole, as a result of conversion from the anhydrous to the monohydrate form, thereby compromising the stability and clinical efficacy of the substance due to the particle size growth (Hoelgaard & Moller, 1983). A generic South African based pharmaceutical company commenced formulation of an aqueous metronidazole benzoate suspension and experienced problems with crystallization that occurred in products stored at 2 to 8 °C. This study aimed to continue development of the product in order to identify a formulation that prevents formation of the hydrate form of metronidazole benzoate and the accompanying crystal growth. A variety of metronidazole benzoate suspensions were manufactured on a laboratory scale using a number of natural and synthetic suspending agents, including magnesium aluminium silicate, povidone K90, xanthan gum and Avicel® RC-591 (microcrystalline cellulose and carboxymethylcellulose sodium), over a range of concentrations. Analytical quantification methods were developed and validated, and the physicochemical properties of the raw material and finished products were fully characterized. Rheological tests were performed in order to characterize the suspension flow properties. Real-time and accelerated stability studies and a temperature cycle study were conducted in accordance with the International Conference on Harmonization (ICH) guidelines. Conversion of metronidazole benzoate to the monohydrate form took place in suspensions containing xanthan gum 0.65 percent m/v under real-time and accelerated storage conditions. The suspensions containing Avicel® RC-591 were found to be physically and chemically stable after the temperature cycle and over the 12-week period whilst stored at 25 ºC / 60 percent RH and 5 ºC. The suspensions were chemically stable whilst stored at 40 ºC / 75 percent RH but showed sedimentation at this accelerated condition. The metronidazole benzoate contained in these products remained in the anhydrous state under all storage conditions and were consequently concluded to be the most stable formulations out of all the products analyzed in the current study. The suspending agent system consisting of microcrystalline cellulose and carboxymethylcellulose sodium thus shows promise in preventing the conversion of metronidazole benzoate from the anhydrate to the monohydrate form, thereby inhibited the subsequent increase in particle size due to crystal growth.
- Full Text:
- Date Issued: 2005
- Authors: Zietsman, Sharon Lynne
- Date: 2005
- Subjects: Metronidazole -- Testing , Excipients -- South Africa -- Testing , Rheology -- South Africa
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10158 , http://hdl.handle.net/10948/456 , Metronidazole -- Testing , Excipients -- South Africa -- Testing , Rheology -- South Africa
- Description: Metronidazole is a synthetic, nitroimidazole-derivative antibacterial and antiprotozoal agent (ed. McEvoy, 2001). It has been reported that crystallization occurs in aqueous suspensions of metronidazole benzoate, a bland-tasting prodrug of metronidazole, as a result of conversion from the anhydrous to the monohydrate form, thereby compromising the stability and clinical efficacy of the substance due to the particle size growth (Hoelgaard & Moller, 1983). A generic South African based pharmaceutical company commenced formulation of an aqueous metronidazole benzoate suspension and experienced problems with crystallization that occurred in products stored at 2 to 8 °C. This study aimed to continue development of the product in order to identify a formulation that prevents formation of the hydrate form of metronidazole benzoate and the accompanying crystal growth. A variety of metronidazole benzoate suspensions were manufactured on a laboratory scale using a number of natural and synthetic suspending agents, including magnesium aluminium silicate, povidone K90, xanthan gum and Avicel® RC-591 (microcrystalline cellulose and carboxymethylcellulose sodium), over a range of concentrations. Analytical quantification methods were developed and validated, and the physicochemical properties of the raw material and finished products were fully characterized. Rheological tests were performed in order to characterize the suspension flow properties. Real-time and accelerated stability studies and a temperature cycle study were conducted in accordance with the International Conference on Harmonization (ICH) guidelines. Conversion of metronidazole benzoate to the monohydrate form took place in suspensions containing xanthan gum 0.65 percent m/v under real-time and accelerated storage conditions. The suspensions containing Avicel® RC-591 were found to be physically and chemically stable after the temperature cycle and over the 12-week period whilst stored at 25 ºC / 60 percent RH and 5 ºC. The suspensions were chemically stable whilst stored at 40 ºC / 75 percent RH but showed sedimentation at this accelerated condition. The metronidazole benzoate contained in these products remained in the anhydrous state under all storage conditions and were consequently concluded to be the most stable formulations out of all the products analyzed in the current study. The suspending agent system consisting of microcrystalline cellulose and carboxymethylcellulose sodium thus shows promise in preventing the conversion of metronidazole benzoate from the anhydrate to the monohydrate form, thereby inhibited the subsequent increase in particle size due to crystal growth.
- Full Text:
- Date Issued: 2005
An investigation into factors influencing lack of improvement towards achieving compliance with the quality national core standards in KSD clinics, O.R. Tambo District
- Authors: Mnyamana, Tozama Nobom
- Date: 2018
- Subjects: Health facilities--Standards , Health facilities--South Africa , Medical care--South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19498 , vital:43133
- Description: The purpose of this study was to explore factors associated with lack of improvement in the health care provided towards achieving compliance with the National Core Standards (NCS) in King Sabata Dalindyebo (KSD) sub-district clinics, in OR Tambo District in the Eastern Cape. A quantitative design was seen as the most suitable for this study. This method was chosen as the one that would best assist the researcher to meet the objectives of the study. A purposive sampling method was chosen, according to which the researcher selected five sites; all clinics that had been previously inspected for quality standards by the Office of Health Standards Compliance at least once. Participants for the study were all employees of those clinics and one representative of the governing structure of each. Twenty-eight participants in total formed part of the study as two did not return their responses. For collecting data from the participants, self-administered questionnaires were used. Throughout the data collection process, ethical standards of nursing research regarding anonymity, confidentiality and privacy were adhered to. Collected data were analysed using the Statistical Package for the Social Sciences (SPSS) computer software. The distribution of results is presented in tables and bar graphs. The results of the study reveal that a quality-oriented culture is lacking in our clinics with poor participation of clinics teams in quality improvement processes. Leadership and management at clinic level need strengthening. It was also found that there is insufficient capacitation of departmental strategic shift innovations, revealed in the complete absence of information sharing and feedback regarding previous assessments. In addition, there is a shortage of resources including basic equipment in clinics. , Thesis (MPH) -- University of Fort Hare, 2018
- Full Text:
- Date Issued: 2018
- Authors: Mnyamana, Tozama Nobom
- Date: 2018
- Subjects: Health facilities--Standards , Health facilities--South Africa , Medical care--South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19498 , vital:43133
- Description: The purpose of this study was to explore factors associated with lack of improvement in the health care provided towards achieving compliance with the National Core Standards (NCS) in King Sabata Dalindyebo (KSD) sub-district clinics, in OR Tambo District in the Eastern Cape. A quantitative design was seen as the most suitable for this study. This method was chosen as the one that would best assist the researcher to meet the objectives of the study. A purposive sampling method was chosen, according to which the researcher selected five sites; all clinics that had been previously inspected for quality standards by the Office of Health Standards Compliance at least once. Participants for the study were all employees of those clinics and one representative of the governing structure of each. Twenty-eight participants in total formed part of the study as two did not return their responses. For collecting data from the participants, self-administered questionnaires were used. Throughout the data collection process, ethical standards of nursing research regarding anonymity, confidentiality and privacy were adhered to. Collected data were analysed using the Statistical Package for the Social Sciences (SPSS) computer software. The distribution of results is presented in tables and bar graphs. The results of the study reveal that a quality-oriented culture is lacking in our clinics with poor participation of clinics teams in quality improvement processes. Leadership and management at clinic level need strengthening. It was also found that there is insufficient capacitation of departmental strategic shift innovations, revealed in the complete absence of information sharing and feedback regarding previous assessments. In addition, there is a shortage of resources including basic equipment in clinics. , Thesis (MPH) -- University of Fort Hare, 2018
- Full Text:
- Date Issued: 2018
An investigation into the antibacterial activities of medicinial plants traditionally used in the Eastern Cape to treat secondary skin infections associated with burn wounds
- Authors: Weideman, Liezel
- Date: 2005
- Subjects: Materia medica, Vegetable -- South Africa -- Eastern Cape , Burns and scalds -- Alternative treatment , Skin -- Infections
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10116 , http://hdl.handle.net/10948/172 , Materia medica, Vegetable -- South Africa -- Eastern Cape , Burns and scalds -- Alternative treatment , Skin -- Infections
- Description: Traditional medicine has a long history of being used for treating various ailments ranging in severity. Although traditional medicine has typically been the health care for the poorest levels of society, there is a worldwide growth in popularity. The growing popularity of traditional medicine, termed the green boom, may be ascribed to people taking a more holistic approach to maintain their health. Traditional medicine is widely used on a regular basis by 70% of South Africans. Various indigenous medicinal plants are used for the preparation of traditional herbal medicine. These plants are mostly indigenous to the regions were it is used. In this study four medicinal plants (Bulbine frutescens, Leonotis leounurus, Melianthus major & Zantedecshia aethiopica) that are traditionally used in the Eastern Cape region for treating burn wound infections, were collected for investigation. The in vitro antibacterial activity of these plants was tested against different bacterial strains of eight different bacteria. The bacteria used in this investigation included bacterial strains of four Gram-positive bacteria, S. aureus, methicillin-resistant S. aureus (MRSA), E. feacalis, S. pyogenes and four Gramnegative bacteria, P. aeruginosa, A. baumanii, K. pneumoniae and P. mirabilis. Traditional preparations as well as three different extracts (methanol, aqueous & acetone) of the plants were used for in vitro antibacterial activity testing. The microtitre plate assay and agar dilution assay were used for determining the antibacterial activity of the traditional preparations and plant extracts against the different bacterial strains. In the microtitre plate assay the antibacterial activity was tested using the bacterial growth indicator, INT and a microtitre plate spectrophotometer to determine the minimal inhibitory concentrations of the plant extracts and traditional preparations. The microtitre plate assay was used for testing the antibacterial activity of the plants against the bacterial strains of five bacteria, S. aureus, MRSA, P. aeruginosa, A. baumanii and K. pneumoniae. The bacterial strains of the three bacteria, S. pyogenes, E. feacalis and P. mirabilis were not compatible with the microtitre plate assay using INT and spectrophotometric readings to determine bacterial inhibition. Therefore the agar dilution assay were used as an alternative method for determining the MIC’s of the plant extracts against the bacterial strains of these bacteria. The initial plant extract concentration in the microtitre plate assay differed with the different plant extracts in the microtitre plate assay. Acetone followed by methanol extracted the highest plant extract concentrations with the different medicinal plants. M. major followed by L. leonurus produced the highest plant extract concentrations following extraction with the different extraction solvents. Consequently the acetone extract of M. major had the highest plant extract concentration before serial dilution in the microtitre plate assay. Uniform plant extract concentrations were tested in the agar dilution assay. The methanol extract followed by the acetone extract of the plants gave the highest antibacterial activity against the different bacterial strains. The extracts of M. major followed by L. leonurus inhibited the highest number of bacterial strains in the microtitre plate assay and the extracts of B. frutescens inhibited the lowest number of bacterial strains. The acetone and methanol extracts of M. major were the only extracts that displayed antibacterial activity in the agar dilution assay. The bacterial strains of P. mirabilis were the only bacteria that were inhibited using this method. The bacterial strains of S. pyogenes and E. feacalis were not inhibited at any of the plant extract concentrations in the agar dilution assay.
- Full Text:
- Date Issued: 2005
- Authors: Weideman, Liezel
- Date: 2005
- Subjects: Materia medica, Vegetable -- South Africa -- Eastern Cape , Burns and scalds -- Alternative treatment , Skin -- Infections
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10116 , http://hdl.handle.net/10948/172 , Materia medica, Vegetable -- South Africa -- Eastern Cape , Burns and scalds -- Alternative treatment , Skin -- Infections
- Description: Traditional medicine has a long history of being used for treating various ailments ranging in severity. Although traditional medicine has typically been the health care for the poorest levels of society, there is a worldwide growth in popularity. The growing popularity of traditional medicine, termed the green boom, may be ascribed to people taking a more holistic approach to maintain their health. Traditional medicine is widely used on a regular basis by 70% of South Africans. Various indigenous medicinal plants are used for the preparation of traditional herbal medicine. These plants are mostly indigenous to the regions were it is used. In this study four medicinal plants (Bulbine frutescens, Leonotis leounurus, Melianthus major & Zantedecshia aethiopica) that are traditionally used in the Eastern Cape region for treating burn wound infections, were collected for investigation. The in vitro antibacterial activity of these plants was tested against different bacterial strains of eight different bacteria. The bacteria used in this investigation included bacterial strains of four Gram-positive bacteria, S. aureus, methicillin-resistant S. aureus (MRSA), E. feacalis, S. pyogenes and four Gramnegative bacteria, P. aeruginosa, A. baumanii, K. pneumoniae and P. mirabilis. Traditional preparations as well as three different extracts (methanol, aqueous & acetone) of the plants were used for in vitro antibacterial activity testing. The microtitre plate assay and agar dilution assay were used for determining the antibacterial activity of the traditional preparations and plant extracts against the different bacterial strains. In the microtitre plate assay the antibacterial activity was tested using the bacterial growth indicator, INT and a microtitre plate spectrophotometer to determine the minimal inhibitory concentrations of the plant extracts and traditional preparations. The microtitre plate assay was used for testing the antibacterial activity of the plants against the bacterial strains of five bacteria, S. aureus, MRSA, P. aeruginosa, A. baumanii and K. pneumoniae. The bacterial strains of the three bacteria, S. pyogenes, E. feacalis and P. mirabilis were not compatible with the microtitre plate assay using INT and spectrophotometric readings to determine bacterial inhibition. Therefore the agar dilution assay were used as an alternative method for determining the MIC’s of the plant extracts against the bacterial strains of these bacteria. The initial plant extract concentration in the microtitre plate assay differed with the different plant extracts in the microtitre plate assay. Acetone followed by methanol extracted the highest plant extract concentrations with the different medicinal plants. M. major followed by L. leonurus produced the highest plant extract concentrations following extraction with the different extraction solvents. Consequently the acetone extract of M. major had the highest plant extract concentration before serial dilution in the microtitre plate assay. Uniform plant extract concentrations were tested in the agar dilution assay. The methanol extract followed by the acetone extract of the plants gave the highest antibacterial activity against the different bacterial strains. The extracts of M. major followed by L. leonurus inhibited the highest number of bacterial strains in the microtitre plate assay and the extracts of B. frutescens inhibited the lowest number of bacterial strains. The acetone and methanol extracts of M. major were the only extracts that displayed antibacterial activity in the agar dilution assay. The bacterial strains of P. mirabilis were the only bacteria that were inhibited using this method. The bacterial strains of S. pyogenes and E. feacalis were not inhibited at any of the plant extract concentrations in the agar dilution assay.
- Full Text:
- Date Issued: 2005
An investigation into the antimicrobial and anticancer activities of Geranium incanum, Artemisia afra and Artemisia absinthium
- Authors: Freidberg, Ryno
- Date: 2009
- Subjects: Medicinal plants -- South Africa , Cancer -- Alternative treatment -- South Africa , Anti-infective agents
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10122 , http://hdl.handle.net/10948/1045 , Medicinal plants -- South Africa , Cancer -- Alternative treatment -- South Africa , Anti-infective agents
- Description: It has been estimated that between 3000 and 4000 plant species are used for their medicinal properties throughout South Africa, with approximately 27 million South Africans making use of traditional medicines. Of this 27 million, 3 million South Africans rely on traditional medicine as their primary source of health care. Of the 250 000 to 500 000 known plant species, very few have been investigated for their pharmacological qualities, and compounds of significant medicinal value may still remain undiscovered in many plant species. The aims of this study included investigating the antimicrobial properties of Geranium incanum and Artemisia afra, both plants traditionally used for their medicinal properties, and comparing the antimicrobial activity of the latter to that of Artemisia absinthium, as well as investigating the anticancer properties of G. incanum and A. afra, and comparing the anticancer activity of the latter to that of A. absinthium. Infusions, aqueous-, methanol- and acetone extracts of the three plants were prepared and used for anticancer and antimicrobial screening. Plant specimens used to prepare extracts for antimicrobial activity were collected and extracted over three seasons, while extracts used for anticancer screening were prepared from plants collected during the summer only. Considerable variation existed in the percentage crude extract yields obtained when different extractants were used, while the season in which the plants were harvested and extracted also appeared to play a significant role in the amount of extract obtained. The plant extracts were screened for antimicrobial activity against various strains of Candida albicans, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococcus aureus and Bacillus cereus, using an agar dilution method. G. incanum and A. afra possessed activity for C. albicans, while all three plants showed activity for S. aureus and B. cereus. Activity was largely dependent on the extraction method used. iii The 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay was used to screen for anticancer activity of the respective extracts, at varying concentrations, against MCF-7 (human breast adenocarcinoma) cells, HT-29 (human colonic adenocarcinoma) cells and HeLa (human cervical cancer) cells. All of the extracts showed cytotoxic activity in all three cell lines to varying extents, depending on the extract used and cell line screened. The acetone extract of A. afra proved to be the most effective inhibitor with the lowest IC50 (2.65 ± 1.05 μg/ml) having been shown in MCF-7 cells. A. afra and A. absinthium showed similar inhibitory patterns, with the methanol- and acetone extracts having been the most potent inhibitors of each of the respective cell lines in general. Fluorescence microscopy employing 4',6-diamidino-2-phenylindole dihydrochloride (DAPI) and propidium iodide (PI) staining indicated that the acetone extract of A. afra induces apoptosis in MCF-7 cells as apposed to necrosis, and the results were comparable to those obtained for cells exposed to cisplatin. Screening of the A. afra acetone extract for toxicity in normal human cells using the CellTiter-Blue® assay indicated the extract to be toxic to peripheral blood mononuclear cells (PBMC’s) at concentrations comparable to that for MCF-7 cells, while cell cycle analysis of MCF-7 cells exposed to the A. afra acetone extract indicated the extract’s ability to induce apoptosis comparable to that of cisplatin, with the extract exerting its activity at a point during or just prior to the S phase of the cell cycle.
- Full Text:
- Date Issued: 2009
- Authors: Freidberg, Ryno
- Date: 2009
- Subjects: Medicinal plants -- South Africa , Cancer -- Alternative treatment -- South Africa , Anti-infective agents
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10122 , http://hdl.handle.net/10948/1045 , Medicinal plants -- South Africa , Cancer -- Alternative treatment -- South Africa , Anti-infective agents
- Description: It has been estimated that between 3000 and 4000 plant species are used for their medicinal properties throughout South Africa, with approximately 27 million South Africans making use of traditional medicines. Of this 27 million, 3 million South Africans rely on traditional medicine as their primary source of health care. Of the 250 000 to 500 000 known plant species, very few have been investigated for their pharmacological qualities, and compounds of significant medicinal value may still remain undiscovered in many plant species. The aims of this study included investigating the antimicrobial properties of Geranium incanum and Artemisia afra, both plants traditionally used for their medicinal properties, and comparing the antimicrobial activity of the latter to that of Artemisia absinthium, as well as investigating the anticancer properties of G. incanum and A. afra, and comparing the anticancer activity of the latter to that of A. absinthium. Infusions, aqueous-, methanol- and acetone extracts of the three plants were prepared and used for anticancer and antimicrobial screening. Plant specimens used to prepare extracts for antimicrobial activity were collected and extracted over three seasons, while extracts used for anticancer screening were prepared from plants collected during the summer only. Considerable variation existed in the percentage crude extract yields obtained when different extractants were used, while the season in which the plants were harvested and extracted also appeared to play a significant role in the amount of extract obtained. The plant extracts were screened for antimicrobial activity against various strains of Candida albicans, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococcus aureus and Bacillus cereus, using an agar dilution method. G. incanum and A. afra possessed activity for C. albicans, while all three plants showed activity for S. aureus and B. cereus. Activity was largely dependent on the extraction method used. iii The 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay was used to screen for anticancer activity of the respective extracts, at varying concentrations, against MCF-7 (human breast adenocarcinoma) cells, HT-29 (human colonic adenocarcinoma) cells and HeLa (human cervical cancer) cells. All of the extracts showed cytotoxic activity in all three cell lines to varying extents, depending on the extract used and cell line screened. The acetone extract of A. afra proved to be the most effective inhibitor with the lowest IC50 (2.65 ± 1.05 μg/ml) having been shown in MCF-7 cells. A. afra and A. absinthium showed similar inhibitory patterns, with the methanol- and acetone extracts having been the most potent inhibitors of each of the respective cell lines in general. Fluorescence microscopy employing 4',6-diamidino-2-phenylindole dihydrochloride (DAPI) and propidium iodide (PI) staining indicated that the acetone extract of A. afra induces apoptosis in MCF-7 cells as apposed to necrosis, and the results were comparable to those obtained for cells exposed to cisplatin. Screening of the A. afra acetone extract for toxicity in normal human cells using the CellTiter-Blue® assay indicated the extract to be toxic to peripheral blood mononuclear cells (PBMC’s) at concentrations comparable to that for MCF-7 cells, while cell cycle analysis of MCF-7 cells exposed to the A. afra acetone extract indicated the extract’s ability to induce apoptosis comparable to that of cisplatin, with the extract exerting its activity at a point during or just prior to the S phase of the cell cycle.
- Full Text:
- Date Issued: 2009
An investigation into the challenges faced by children as victims of HIV/AIDS with reference to the Nyandeni area in the Eastern Cape
- Authors: Kanyemba, Patricia
- Date: 2012
- Subjects: HIV -- Positive children
- Language: English
- Type: Thesis , Masters , M Sw
- Identifier: vital:18477 , http://hdl.handle.net/11260/d1007756
- Description: The aim of the study was to delineate, discuss and analyze major challenges that affect children between the ages of 13 and 18 in the Nyandeni area due to HIV/AIDS. This exploratory study was also performed to identify the categories of children made vulnerable by HIV/AIDS. One of the objectives was to provide a descriptive and analytical interpretation of the day to day experiences of children affected by HIV/AIDS. In shaping the sample size, 50 respondents were selected from three wards (2, 3 and 16) of the Nyandeni Local Municipality in the Nyandeni area in the Eastern Cape.The researcher made use of the interview technique to collect data from the respondents. In analysing data, the researcher made use of the quantitative and qualitative measures.The outcome of the study points out that HIV/AIDS is the major threat to children and that there is a significant increase in number of child headed families as a result of HIV/AIDS.
- Full Text:
- Date Issued: 2012
- Authors: Kanyemba, Patricia
- Date: 2012
- Subjects: HIV -- Positive children
- Language: English
- Type: Thesis , Masters , M Sw
- Identifier: vital:18477 , http://hdl.handle.net/11260/d1007756
- Description: The aim of the study was to delineate, discuss and analyze major challenges that affect children between the ages of 13 and 18 in the Nyandeni area due to HIV/AIDS. This exploratory study was also performed to identify the categories of children made vulnerable by HIV/AIDS. One of the objectives was to provide a descriptive and analytical interpretation of the day to day experiences of children affected by HIV/AIDS. In shaping the sample size, 50 respondents were selected from three wards (2, 3 and 16) of the Nyandeni Local Municipality in the Nyandeni area in the Eastern Cape.The researcher made use of the interview technique to collect data from the respondents. In analysing data, the researcher made use of the quantitative and qualitative measures.The outcome of the study points out that HIV/AIDS is the major threat to children and that there is a significant increase in number of child headed families as a result of HIV/AIDS.
- Full Text:
- Date Issued: 2012
An investigation into the introduction of process analytical technology, using near infrared analysis, to selected pharmaceutical processes
- Authors: Naicker, Krishnaveni
- Date: 2007
- Subjects: Near infrared spectroscopy , Pharmaceutical chemistry
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10153 , http://hdl.handle.net/10948/577 , http://hdl.handle.net/10948/d1011710 , Near infrared spectroscopy , Pharmaceutical chemistry
- Description: Introduction: Process analytical technologies are systems for the analysis and control of manufacturing processes to assure acceptable end-product quality. This is achieved by timely measurements of critical parameters and performance attributes of raw material and in-process material and processes. The introduction of process analytical technology using near infrared analysis was investigated in three areas, namely incoming raw material analysis, blend uniformity analysis and moisture determination in the fluid bed dryer. Methodology: Incoming raw material identification - The FOSS XDS rapid content analyzer was used for the development of a NIR method for the identification and material qualification of starch maize and lactose monohydrate. Blend uniformity analysis – The SP15 Laboratory Blender fitted with near infrared probe was utilized for the study. Two types of blend experiments were designed to monitor the distribution of magnesium stearate (lubricant) in the blend, namely, a powder blend utilizing lactose monohydrate and a granule blend utilizing Ridaq® granule. Software methods were developed to monitor the standard deviation of the absorbance at the wavelengths that were specific for lactose monohydrate, Ridaq® granule and magnesium stearate. To confirm the prediction of end-point using near infrared, results were verified using an atomic absorption method for magnesium stearate. The blends were sampled at the selected time intervals corresponding to three states of the blend, namely, before end-point, at end-point and after end-point using a sampling plan. An additional six blends were conducted for the granule blend and sampled when the standard deviation had reached a value below 3 x 10-6 at the magnesium stearate wavelength at four consecutive data points (standard deviation value extrapolated from blends carried out to predetermined time intervals). Moisture determination in the fluid bed dryer – Moisture values for two products (Product A and Product B) were retrospectively collected from past production batches. A process capability study was conducted on the moisture values to determine if the current process was in a state of control. Results and Discussion: Incoming raw material identification – The algorithms used for the spectral library were able to distinguish between the raw materials selected. The spectral library positively identified the starch maize and lactose monohydrate samples that were not present in the library. The negative challenge with pregelatinised starch and tablettose demonstrated that the spectral library was able to differentiate between closely related compounds. Blend uniformity analysis – Blends sampled at the predetermined time intervals demonstrated a homogeneous state when the standard deviation of the absorbance was low and a non-homogeneous state when the standard deviation of the absorbance was high, thus near infrared prediction on the state of the blend was confirmed by the standard analytical methods. The series of Ridaq® granule and magnesium stearate blends sampled when the standard deviation was below 3 x 10-6 were homogeneous with the exception of one blend that was marginally out of specification. Blend durations were significantly lower than the standard blend durations used in the facility and ranged from 112 to 198 seconds. Moisture determination in the fluid bed dryer – From the process capability study of the two products it was noted that Product A is stable but can still be optimized while Product B is at a desirable state. The statistical evaluation of the moisture values for Product A and Product B demonstrated that the use of the product temperature to monitor the moisture gave consistent results. The current process is stable and capable of producing repeatable results although near infrared provides a means for continuously monitoring the product moisture and allows one to take action to prevent over-drying or under-drying. Conclusion: From the investigations conducted, it can be seen that there is definitely a niche for process analytical technology at this pharmaceutical company. The implementation is a gradual process of change, which may take time, probably several years (Heinze & Hansen 2005).
- Full Text:
- Date Issued: 2007
- Authors: Naicker, Krishnaveni
- Date: 2007
- Subjects: Near infrared spectroscopy , Pharmaceutical chemistry
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10153 , http://hdl.handle.net/10948/577 , http://hdl.handle.net/10948/d1011710 , Near infrared spectroscopy , Pharmaceutical chemistry
- Description: Introduction: Process analytical technologies are systems for the analysis and control of manufacturing processes to assure acceptable end-product quality. This is achieved by timely measurements of critical parameters and performance attributes of raw material and in-process material and processes. The introduction of process analytical technology using near infrared analysis was investigated in three areas, namely incoming raw material analysis, blend uniformity analysis and moisture determination in the fluid bed dryer. Methodology: Incoming raw material identification - The FOSS XDS rapid content analyzer was used for the development of a NIR method for the identification and material qualification of starch maize and lactose monohydrate. Blend uniformity analysis – The SP15 Laboratory Blender fitted with near infrared probe was utilized for the study. Two types of blend experiments were designed to monitor the distribution of magnesium stearate (lubricant) in the blend, namely, a powder blend utilizing lactose monohydrate and a granule blend utilizing Ridaq® granule. Software methods were developed to monitor the standard deviation of the absorbance at the wavelengths that were specific for lactose monohydrate, Ridaq® granule and magnesium stearate. To confirm the prediction of end-point using near infrared, results were verified using an atomic absorption method for magnesium stearate. The blends were sampled at the selected time intervals corresponding to three states of the blend, namely, before end-point, at end-point and after end-point using a sampling plan. An additional six blends were conducted for the granule blend and sampled when the standard deviation had reached a value below 3 x 10-6 at the magnesium stearate wavelength at four consecutive data points (standard deviation value extrapolated from blends carried out to predetermined time intervals). Moisture determination in the fluid bed dryer – Moisture values for two products (Product A and Product B) were retrospectively collected from past production batches. A process capability study was conducted on the moisture values to determine if the current process was in a state of control. Results and Discussion: Incoming raw material identification – The algorithms used for the spectral library were able to distinguish between the raw materials selected. The spectral library positively identified the starch maize and lactose monohydrate samples that were not present in the library. The negative challenge with pregelatinised starch and tablettose demonstrated that the spectral library was able to differentiate between closely related compounds. Blend uniformity analysis – Blends sampled at the predetermined time intervals demonstrated a homogeneous state when the standard deviation of the absorbance was low and a non-homogeneous state when the standard deviation of the absorbance was high, thus near infrared prediction on the state of the blend was confirmed by the standard analytical methods. The series of Ridaq® granule and magnesium stearate blends sampled when the standard deviation was below 3 x 10-6 were homogeneous with the exception of one blend that was marginally out of specification. Blend durations were significantly lower than the standard blend durations used in the facility and ranged from 112 to 198 seconds. Moisture determination in the fluid bed dryer – From the process capability study of the two products it was noted that Product A is stable but can still be optimized while Product B is at a desirable state. The statistical evaluation of the moisture values for Product A and Product B demonstrated that the use of the product temperature to monitor the moisture gave consistent results. The current process is stable and capable of producing repeatable results although near infrared provides a means for continuously monitoring the product moisture and allows one to take action to prevent over-drying or under-drying. Conclusion: From the investigations conducted, it can be seen that there is definitely a niche for process analytical technology at this pharmaceutical company. The implementation is a gradual process of change, which may take time, probably several years (Heinze & Hansen 2005).
- Full Text:
- Date Issued: 2007
An investigation into the psychological impact of unemployment and coping mechanisms amongst graduates in Pietermaritzburg
- Authors: Nkasa, Nonjabulo Fortunate
- Date: 2022-12
- Subjects: Unemployment -- Social aspects , Mental health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60209 , vital:63539
- Description: Graduates expect to find employment after completing their tertiary qualifications, but they often face various challenges in finding employment. These challenges may be due to a variety of factors such as the type of qualification, structural changes in the economy, lack of experience, or the lack of relevant social networks. This has the potential to affect a graduate’s psychological well-being. The current study explored the psychological impact of unemployment in 100 unemployed graduates between 21 and 35 years of age in Pietermaritzburg. The study was quantitative and used two questionnaires, the GHQ-12 and a self-designed questionnaire, to collect data. Purposive sampling was used to obtain research participants. The Excel spreadsheet and a statistical software package called JASP (2020, version 0.12) was used to analyse data. The findings revealed that unemployment had a negative impact on the participants’ psychological well-being. Participants experienced feelings of high anxiety and depression, and felt stigmatised. Participants also felt shame and experienced lower self-esteem. Unemployment had a financial impact on participants, including financial dependency on family and friends. Some participants blamed themselves, the government system, and the education system for their unemployment. Participants reported to have a positive attitude towards employment, including remaining optimistic about their chances of finding employment. Participants used adaptive coping mechanisms, such as keeping a positive attitude, and maladaptive coping mechanisms, such as hiding their feelings. Further research needs to focus on psychological services that could assist unemployed graduates to find employment through building and maintaining their self-esteem and confidence which are key factors when initially seeking and obtaining work. Unemployment and its impact on psychological well-being has been shown to be to be a complex subject that requires intervention from different parties such as employers and health-care workers, as well as the education system. Keywords: Coping, graduates, psychological impact and unemployment , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Nkasa, Nonjabulo Fortunate
- Date: 2022-12
- Subjects: Unemployment -- Social aspects , Mental health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60209 , vital:63539
- Description: Graduates expect to find employment after completing their tertiary qualifications, but they often face various challenges in finding employment. These challenges may be due to a variety of factors such as the type of qualification, structural changes in the economy, lack of experience, or the lack of relevant social networks. This has the potential to affect a graduate’s psychological well-being. The current study explored the psychological impact of unemployment in 100 unemployed graduates between 21 and 35 years of age in Pietermaritzburg. The study was quantitative and used two questionnaires, the GHQ-12 and a self-designed questionnaire, to collect data. Purposive sampling was used to obtain research participants. The Excel spreadsheet and a statistical software package called JASP (2020, version 0.12) was used to analyse data. The findings revealed that unemployment had a negative impact on the participants’ psychological well-being. Participants experienced feelings of high anxiety and depression, and felt stigmatised. Participants also felt shame and experienced lower self-esteem. Unemployment had a financial impact on participants, including financial dependency on family and friends. Some participants blamed themselves, the government system, and the education system for their unemployment. Participants reported to have a positive attitude towards employment, including remaining optimistic about their chances of finding employment. Participants used adaptive coping mechanisms, such as keeping a positive attitude, and maladaptive coping mechanisms, such as hiding their feelings. Further research needs to focus on psychological services that could assist unemployed graduates to find employment through building and maintaining their self-esteem and confidence which are key factors when initially seeking and obtaining work. Unemployment and its impact on psychological well-being has been shown to be to be a complex subject that requires intervention from different parties such as employers and health-care workers, as well as the education system. Keywords: Coping, graduates, psychological impact and unemployment , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
An investigation of indoor air quality assessment in office buildings
- Janse van Rensburg, Francois
- Authors: Janse van Rensburg, Francois
- Date: 2007
- Subjects: Indoor air pollution , Air quality management , Air quality -- Measurement
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10824 , http://hdl.handle.net/10948/32 , Indoor air pollution , Air quality management , Air quality -- Measurement
- Description: Over the last several years studies have shown that the quality of indoor air may be worse than outdoor air. People spend as much as 90% of their time indoors, therefor, the associated health risk due to indoor air pollution may be greater than the risk due to outdoor air pollution. Building designs have altered dramatically over the last two decades resulted in "tighter" buildings that rely on sophisticated mechanical systems to provide for the quantity of air required throughout the building. These changes over the years could result in an increased number of complaints received regarding Sick Building Syndrome symptoms. The World Health Organization (WHO) estimates that up to 30% of office buildings world-wide may have significant problems regarding poor indoor air quality (IAQ). This study involves a literature study of the major indoor air pollutants regarding the source of the pollutant, the associated health effects, the measuring techniques available and the results of previous studies conducted on the specific pollutant. Measurements will be taken in two sealed buildings, one an old and the other a new building to identify the major pollutants. A questionnaire was compiled specifically for building occupants and completed by the occupants of both buildings. From the results obtained a step-by-step method for solving indoor air quality (IAQ) problems was proposed. The method was applied and evaluated in a case study of a problem building where indoor air quality related problems were experienced. The results of the study revealed that the major indoor air pollutants are present in old as well as new buildings. The study also revealed that some office workers might be more susceptible than others to the medical reactions cause to human beings by these pollutants. Some concentrations are higher in new buildings than in old buildings. The responses from the questionnaire was evaluated against the results obtained from the measurement study. The step-by-step method in the case study provided a more systematic approach at solving IAQ problems at buildings. Solving indoor air quality problems is a very practical issue and does not necessarily require an investment of expensive high technology equipment, but might merely require a practical approach. Environmental Health Officers can play a major role in providing expert advice when scrutinizing building plans. Environmental Health Officers should empower themselves with the knowledge to do inspections or investigations in office buildings by using the step-by-step method for investigating indoor air quality problems. By addressing indoor air quality problems in buildings, the workers in healthy buildings can increase their productivity with lasting effects on a company’s bottom line.
- Full Text:
- Date Issued: 2007
- Authors: Janse van Rensburg, Francois
- Date: 2007
- Subjects: Indoor air pollution , Air quality management , Air quality -- Measurement
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10824 , http://hdl.handle.net/10948/32 , Indoor air pollution , Air quality management , Air quality -- Measurement
- Description: Over the last several years studies have shown that the quality of indoor air may be worse than outdoor air. People spend as much as 90% of their time indoors, therefor, the associated health risk due to indoor air pollution may be greater than the risk due to outdoor air pollution. Building designs have altered dramatically over the last two decades resulted in "tighter" buildings that rely on sophisticated mechanical systems to provide for the quantity of air required throughout the building. These changes over the years could result in an increased number of complaints received regarding Sick Building Syndrome symptoms. The World Health Organization (WHO) estimates that up to 30% of office buildings world-wide may have significant problems regarding poor indoor air quality (IAQ). This study involves a literature study of the major indoor air pollutants regarding the source of the pollutant, the associated health effects, the measuring techniques available and the results of previous studies conducted on the specific pollutant. Measurements will be taken in two sealed buildings, one an old and the other a new building to identify the major pollutants. A questionnaire was compiled specifically for building occupants and completed by the occupants of both buildings. From the results obtained a step-by-step method for solving indoor air quality (IAQ) problems was proposed. The method was applied and evaluated in a case study of a problem building where indoor air quality related problems were experienced. The results of the study revealed that the major indoor air pollutants are present in old as well as new buildings. The study also revealed that some office workers might be more susceptible than others to the medical reactions cause to human beings by these pollutants. Some concentrations are higher in new buildings than in old buildings. The responses from the questionnaire was evaluated against the results obtained from the measurement study. The step-by-step method in the case study provided a more systematic approach at solving IAQ problems at buildings. Solving indoor air quality problems is a very practical issue and does not necessarily require an investment of expensive high technology equipment, but might merely require a practical approach. Environmental Health Officers can play a major role in providing expert advice when scrutinizing building plans. Environmental Health Officers should empower themselves with the knowledge to do inspections or investigations in office buildings by using the step-by-step method for investigating indoor air quality problems. By addressing indoor air quality problems in buildings, the workers in healthy buildings can increase their productivity with lasting effects on a company’s bottom line.
- Full Text:
- Date Issued: 2007
An investigation of specific contributing factors affecting quality assurance in the diagnosis of conventional cervical smears
- Authors: Jordaan, Suzette Mirietta
- Date: 2005
- Subjects: Cervix uteri -- Cancer -- Cytodiagnosis -- Quality control , Vaginal smears -- Quality control , Pap test -- Quality control
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10117 , http://hdl.handle.net/10948/173 , Cervix uteri -- Cancer -- Cytodiagnosis -- Quality control , Vaginal smears -- Quality control , Pap test -- Quality control
- Description: The purpose of this study is to investigate specific contributing factors affecting quality assurance in the diagnosis of conventional cervical smears. More than half of South- African women fail to have one cervical smear in their lifetime and +/- 50 percent of those who do have cervical smears taken, are lost to follow-up. Since cervical cancer is the most common malignancy amongst women in developing countries, the medical profession will have to endeavor to screen a higher rate of women and ensure a 100 percent quality assurance with every patient treated in order to reduce the unacceptable high incidence of cervical carcinoma. At this stage it seems like an impossible task to screen all women in South Africa, due to far-off rural areas, shortage of medical professionals and the lack of knowledge of some women of the necessity of cervical smears. Many newly qualified South-African doctors leave the country to go and work elsewhere. South Africa then in turn has to recruit doctors from other countries to staff the State hospitals and clinics. Some areas have one doctor to thousands of patients, insufficient nursing personnel and inadequate equipment. Doctors in some areas cannot cope with the volume of work and the long hours. One has to accept that the quality of the management of some patients is affected negatively. There are a number of medico-legal issues (world wide) in relation to aspects of cervical cancer prevention practices which are controversial and are of particular concern to all of those involved in cervical cancer prevention. Various countries have therefore formed different national organizations to address the medico-legal issues in screening for the prevention of cancer. These organizations monitors procedures, internal quality control as well as external quality control. In South Africa, medico-legal cases are not so prevalent, but may become so shortly. The South-African medical professionals therefore have to ensure that their quality of work conforms to accepted good practice in all circumstances. State hospitals serve thousands of patients per month and it is an every day occurrence to see long queues of patients sitting waiting for doctors and who often have to come back the following day. The situation appears to be much improved in private practice and since patients have medical cover and accessible medical facilities. Since cervical cancer is the most common malignancy amongst women in developing countries, the medical profession will have to endeavor to screen a higher rate of women and ensure a 100 percent quality assurance with every patient treated in order to reduce the unacceptable high incidence of cervical carcinoma. At this stage it seems like an impossible task to screen 100 percent of women in South Africa, due to far-off rural areas, the shortage of medical professionals and ignorance of patients. Quality assurance is therefore of paramount importance to every medical professional for every patient treated. Laboratories all worldwide have been, or are in the process of being accredited by their specific accreditation authorities. The main reason for this is improvement of quality control and therefore quality assurance. The South African National Accreditation Society (SANAS) now accredits various laboratories in South Africa with the view of accreditting all laboratories within a certain time limit. The Ampath laboratory Port Elizabeth was successfully accredited during 2001. Accredited laboratories have to uphold a very high degree of quality to remain accredited. A team of professionals inspects the laboratory every 2 years and other quality assurance staff inspects the laboratories every few months. All aspects of the laboratory are checked, e.g. the qualification of staff, their registration with the Health Professions Council of South Africa (HPCSA), their curriculum vitaes, equipment, safety of the laboratory etc. Since the laboratory chosen for this study, is accredited, the author evaluated every cervical smear that was received in the laboratory since the year 2000, with the following objectives in mind: · Whether the presence or absence of an endocervical component has an effect on the adequacy of cervical smears · To determine the effect of using smaller coverslips on quality assurance in the cytology laboratory · Evaluate the effect that manual re-screening of smears has on quality assurance in the cytology laboratory. As there is a shortage of cytotechnologists and pathologists worldwide, several countries make use of automated screening devices as primary screening or secondary screening for quality assurance. These devices were tested in some laboratories in South Africa but were found to be very expensive and sensitivity and specificity were not up to standard. Sensitivity is a measure of the ability of a test to detect the abnormal - Sensitivity is the ratio of true positives to true positives + false negatives. Specificity is a measure of the ability of a test to correctly identify the negative - Specificity is the ratio of true negative to true negatives + false positives. The automated screening machines failed to identify abnormal cells amongst inflammatory cells, as well as in very blood stained smears. Several other problems also occurred and an increasing number of smears had to be manually rescreened, thus making this exercise costly and not helpful as a quality assurance instrument. The slides used for this thesis, have been retrieved from the archives of the Ampath laboratory in Port Elizabeth. Fourteen specific contributing factors affecting quality assurance in the diagnosis of cervical smears are also discussed and conclusions and recommendations given.
- Full Text:
- Date Issued: 2005
- Authors: Jordaan, Suzette Mirietta
- Date: 2005
- Subjects: Cervix uteri -- Cancer -- Cytodiagnosis -- Quality control , Vaginal smears -- Quality control , Pap test -- Quality control
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10117 , http://hdl.handle.net/10948/173 , Cervix uteri -- Cancer -- Cytodiagnosis -- Quality control , Vaginal smears -- Quality control , Pap test -- Quality control
- Description: The purpose of this study is to investigate specific contributing factors affecting quality assurance in the diagnosis of conventional cervical smears. More than half of South- African women fail to have one cervical smear in their lifetime and +/- 50 percent of those who do have cervical smears taken, are lost to follow-up. Since cervical cancer is the most common malignancy amongst women in developing countries, the medical profession will have to endeavor to screen a higher rate of women and ensure a 100 percent quality assurance with every patient treated in order to reduce the unacceptable high incidence of cervical carcinoma. At this stage it seems like an impossible task to screen all women in South Africa, due to far-off rural areas, shortage of medical professionals and the lack of knowledge of some women of the necessity of cervical smears. Many newly qualified South-African doctors leave the country to go and work elsewhere. South Africa then in turn has to recruit doctors from other countries to staff the State hospitals and clinics. Some areas have one doctor to thousands of patients, insufficient nursing personnel and inadequate equipment. Doctors in some areas cannot cope with the volume of work and the long hours. One has to accept that the quality of the management of some patients is affected negatively. There are a number of medico-legal issues (world wide) in relation to aspects of cervical cancer prevention practices which are controversial and are of particular concern to all of those involved in cervical cancer prevention. Various countries have therefore formed different national organizations to address the medico-legal issues in screening for the prevention of cancer. These organizations monitors procedures, internal quality control as well as external quality control. In South Africa, medico-legal cases are not so prevalent, but may become so shortly. The South-African medical professionals therefore have to ensure that their quality of work conforms to accepted good practice in all circumstances. State hospitals serve thousands of patients per month and it is an every day occurrence to see long queues of patients sitting waiting for doctors and who often have to come back the following day. The situation appears to be much improved in private practice and since patients have medical cover and accessible medical facilities. Since cervical cancer is the most common malignancy amongst women in developing countries, the medical profession will have to endeavor to screen a higher rate of women and ensure a 100 percent quality assurance with every patient treated in order to reduce the unacceptable high incidence of cervical carcinoma. At this stage it seems like an impossible task to screen 100 percent of women in South Africa, due to far-off rural areas, the shortage of medical professionals and ignorance of patients. Quality assurance is therefore of paramount importance to every medical professional for every patient treated. Laboratories all worldwide have been, or are in the process of being accredited by their specific accreditation authorities. The main reason for this is improvement of quality control and therefore quality assurance. The South African National Accreditation Society (SANAS) now accredits various laboratories in South Africa with the view of accreditting all laboratories within a certain time limit. The Ampath laboratory Port Elizabeth was successfully accredited during 2001. Accredited laboratories have to uphold a very high degree of quality to remain accredited. A team of professionals inspects the laboratory every 2 years and other quality assurance staff inspects the laboratories every few months. All aspects of the laboratory are checked, e.g. the qualification of staff, their registration with the Health Professions Council of South Africa (HPCSA), their curriculum vitaes, equipment, safety of the laboratory etc. Since the laboratory chosen for this study, is accredited, the author evaluated every cervical smear that was received in the laboratory since the year 2000, with the following objectives in mind: · Whether the presence or absence of an endocervical component has an effect on the adequacy of cervical smears · To determine the effect of using smaller coverslips on quality assurance in the cytology laboratory · Evaluate the effect that manual re-screening of smears has on quality assurance in the cytology laboratory. As there is a shortage of cytotechnologists and pathologists worldwide, several countries make use of automated screening devices as primary screening or secondary screening for quality assurance. These devices were tested in some laboratories in South Africa but were found to be very expensive and sensitivity and specificity were not up to standard. Sensitivity is a measure of the ability of a test to detect the abnormal - Sensitivity is the ratio of true positives to true positives + false negatives. Specificity is a measure of the ability of a test to correctly identify the negative - Specificity is the ratio of true negative to true negatives + false positives. The automated screening machines failed to identify abnormal cells amongst inflammatory cells, as well as in very blood stained smears. Several other problems also occurred and an increasing number of smears had to be manually rescreened, thus making this exercise costly and not helpful as a quality assurance instrument. The slides used for this thesis, have been retrieved from the archives of the Ampath laboratory in Port Elizabeth. Fourteen specific contributing factors affecting quality assurance in the diagnosis of cervical smears are also discussed and conclusions and recommendations given.
- Full Text:
- Date Issued: 2005
An Investigation on the Clinical Experiences of Newly Qualified Professional Nurses in Hospital Facilities of the Alfred Nzo District Municipality in the Eastern Cape
- Authors: Hloba, Siyathemba Prince
- Date: 2021-00
- Subjects: Nurse practitioners
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/7942 , vital:55856
- Description: The study aimed to explore and describe the clinical experiences of newly qualified professional nurses in hospital facilities of the Alfred Nzo District Municipality in the Eastern Cape. The newly qualified professional nurses may face difficulties in the hospital facilities when it comes to the execution of duties. The newly qualified professional nurses are expected to display knowledge, skills and to have a positive effect on patients, the relatives of patients and their colleagues to alleviate diseases. This challenge may create emotional distress if newly qualified professional nurses receive inadequate guidance from the senior staff members of the hospital facility. The objectives of this study were to explore and describe the clinical experiences of newly qualified professional nurses, to explore how the newly qualified professional nurses were affected emotionally by clinical experiences and to explore the support system to enhance the performance of the newly qualified professional nurses. A qualitative, explorative, descriptive and contextual design was used to explore and describe the experiences of the newly qualified professional nurses in hospital facilities of the Alfred Nzo District Municipality in the Eastern Cape. A purposive sampling of newly qualified professional nurses, with less than two years of experience after completing the community service in the clinical practice, was used. The data were collected through face-to-face and semi-structured interviews. The interviews were conducted until the data were saturated. A pilot study was done before the main study to prove the adequacy and suitability of the methods to conduct the main study. The participants‟ interviews and results of the pilot study were incorporated into the interviews and results of the main study. Tesch‟s method of thematic analysis and an independent coder were used to analyse the data and to draw meaning from the content. The study used Guba and Lincoln‟s criteria of measures to ensure trustworthiness, which included credibility, confirmability, dependability and transferability. Ethical standards were maintained throughout the study as the researcher complied with ethical principles, namely, respect for persons, beneficence, justice and autonomy. The key considerations to curb the spread of the Covid-19 pandemic, as stipulated by the World Health Organisation, were followed during the data collection. On data interpretation, three themes were developed with eight subthemes on the first theme, two subthemes on the second theme and three subthemes on the third theme. The research findings revealed that the participants experienced negative attitudes from colleagues and multidisciplinary team members. The shortage of staff and resources made participants feel ineffective in their work environment. Clinical exposure to different units and procedures in various units added value to the development of the participants. The recommendations were made with regards to three divisions. They were the hospital facilities‟ personnel, future nursing research personnel and nursing schools personnel. In hospital facilities, the recommendations included that all novice professional nurses should be made aware of the emotional impact at work. An annual plan for workshops and in-service training should be implemented. Professional counselling is required for the novice professionals who were exposed to Covid-19 isolation units. A need to increase staff coverage in the clinical units was identified as the workload is too big. Management is encouraged to be more sensitive about the newly employed nurses‟ challenges in their facilities and the most experienced nurses are encouraged to mentor and coach the novice nurses. In the future nursing research, recommendations included that more studies need to be conducted in South Africa and the Eastern Cape province to verify the findings of this research. A specific research study that will focus on the supportive needs of nurses in clinical facilities should be done institutionally to provide evidence-based practice. The research culture on the nurses‟ experiences in clinical facilities needs to become a norm. In nursing schools, the recommendations motivated that the nursing students should be exposed to all clinical units before completing the training xiv course. Further studies need to be conducted to evaluate the balance between theory and clinical learning on duly performance. The nursing education institutions should use quality improvement suggestion boxes for students to consider their experiences and opinions about their learning. Key words : clinical experiences, newly qualified professional nurses, Alfred Nzo district municipalities , Thesis (Masters) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-00
- Authors: Hloba, Siyathemba Prince
- Date: 2021-00
- Subjects: Nurse practitioners
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/7942 , vital:55856
- Description: The study aimed to explore and describe the clinical experiences of newly qualified professional nurses in hospital facilities of the Alfred Nzo District Municipality in the Eastern Cape. The newly qualified professional nurses may face difficulties in the hospital facilities when it comes to the execution of duties. The newly qualified professional nurses are expected to display knowledge, skills and to have a positive effect on patients, the relatives of patients and their colleagues to alleviate diseases. This challenge may create emotional distress if newly qualified professional nurses receive inadequate guidance from the senior staff members of the hospital facility. The objectives of this study were to explore and describe the clinical experiences of newly qualified professional nurses, to explore how the newly qualified professional nurses were affected emotionally by clinical experiences and to explore the support system to enhance the performance of the newly qualified professional nurses. A qualitative, explorative, descriptive and contextual design was used to explore and describe the experiences of the newly qualified professional nurses in hospital facilities of the Alfred Nzo District Municipality in the Eastern Cape. A purposive sampling of newly qualified professional nurses, with less than two years of experience after completing the community service in the clinical practice, was used. The data were collected through face-to-face and semi-structured interviews. The interviews were conducted until the data were saturated. A pilot study was done before the main study to prove the adequacy and suitability of the methods to conduct the main study. The participants‟ interviews and results of the pilot study were incorporated into the interviews and results of the main study. Tesch‟s method of thematic analysis and an independent coder were used to analyse the data and to draw meaning from the content. The study used Guba and Lincoln‟s criteria of measures to ensure trustworthiness, which included credibility, confirmability, dependability and transferability. Ethical standards were maintained throughout the study as the researcher complied with ethical principles, namely, respect for persons, beneficence, justice and autonomy. The key considerations to curb the spread of the Covid-19 pandemic, as stipulated by the World Health Organisation, were followed during the data collection. On data interpretation, three themes were developed with eight subthemes on the first theme, two subthemes on the second theme and three subthemes on the third theme. The research findings revealed that the participants experienced negative attitudes from colleagues and multidisciplinary team members. The shortage of staff and resources made participants feel ineffective in their work environment. Clinical exposure to different units and procedures in various units added value to the development of the participants. The recommendations were made with regards to three divisions. They were the hospital facilities‟ personnel, future nursing research personnel and nursing schools personnel. In hospital facilities, the recommendations included that all novice professional nurses should be made aware of the emotional impact at work. An annual plan for workshops and in-service training should be implemented. Professional counselling is required for the novice professionals who were exposed to Covid-19 isolation units. A need to increase staff coverage in the clinical units was identified as the workload is too big. Management is encouraged to be more sensitive about the newly employed nurses‟ challenges in their facilities and the most experienced nurses are encouraged to mentor and coach the novice nurses. In the future nursing research, recommendations included that more studies need to be conducted in South Africa and the Eastern Cape province to verify the findings of this research. A specific research study that will focus on the supportive needs of nurses in clinical facilities should be done institutionally to provide evidence-based practice. The research culture on the nurses‟ experiences in clinical facilities needs to become a norm. In nursing schools, the recommendations motivated that the nursing students should be exposed to all clinical units before completing the training xiv course. Further studies need to be conducted to evaluate the balance between theory and clinical learning on duly performance. The nursing education institutions should use quality improvement suggestion boxes for students to consider their experiences and opinions about their learning. Key words : clinical experiences, newly qualified professional nurses, Alfred Nzo district municipalities , Thesis (Masters) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-00
Analysis of early-phase contact tracing during the coronavirus disease 2019 outbreak in Mangaung Metro, Free State
- Monyobo, Priscilla Kesaletseng
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: COVID-19 (Disease) , Contact tracing (Epidemiology) , Public health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23533 , vital:58105
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3percent), 18 in April (10.5percent), 41 in May (22.9percent), and 28 in June (15.6percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5percentby the end of June 2020. Of all the contacts traced, 7.9percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: COVID-19 (Disease) , Contact tracing (Epidemiology) , Public health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23533 , vital:58105
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3percent), 18 in April (10.5percent), 41 in May (22.9percent), and 28 in June (15.6percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5percentby the end of June 2020. Of all the contacts traced, 7.9percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
Analysis of early-phase contact tracing during the coronavirus disease 2019 outbreak in Mangaung Metro, Free State
- Monyobo, Priscilla Kesaletseng
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: Contact tracing (Epidemiology) , Health services administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27006 , vital:66215
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48 percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3 percent), 18 in April (10.5 percent), 41 in May (22.9percent), and 28 in June (15.6 percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5 percent by the end of June 2020. Of all the contacts traced, 7.9 percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: Contact tracing (Epidemiology) , Health services administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27006 , vital:66215
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48 percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3 percent), 18 in April (10.5 percent), 41 in May (22.9percent), and 28 in June (15.6 percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5 percent by the end of June 2020. Of all the contacts traced, 7.9 percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
Analysis of the role of unions in health services delivery at Uitenhage district hospital
- Authors: Tshamase, Nozibele Yvonne
- Date: 2018
- Subjects: Public health Health services accessibility Labor unions
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12348 , vital:39255
- Description: Purpose: According to Khan and Khan (2011:56), a trade union is an organization of employee tasked with activities which include negotiating on behalf of their members for “pay and conditions of employment”. Several authors have purported that these roles extend beyond ensuring not only that the rights of workers are not violated and that their working environment complies with health and safety standards, but also that unions may have an effect on management practices, generally and specifically, on efficiencies and performance (Zulu, 2009; McGuire, 2011; & Dhliwayo, 2012). Health care workers including professionals are organised by the unions in a bid to influence social and economic reforms in the South African democracy. The main aim of this study was to examine the role of public sector unions and how they exercise their functions in delivery of health services Method: A qualitative research method based on phenomenological and case approaches was applied. Semi-structured interviews with open ended questions were used to prompt discussions. Documents were used to obtain complementary data. Senior managers, middle managers, union/employee representatives and employees who are members of the unions in the district hospital of Nelson Mandela Bay health district constituted the target population. Purposive non-probability sampling, which was the preferred method for this study, yielded 16 participants. Results Analysis followed Creswell’s thematic analysis involving coding responses categorising them and identifying themes. This followed repeated and thorough listening to the recorded interviews and transcribing. Themes identified were organisational functioning in line with the service delivery context; worker’s rights protection; negotiating better service conditions; implementing legislation, policies and resolutions; union-management interaction; engaging in strikes and impact on services delivery. Conclusion and Recommendations: The study found that the presence of unions in health care services was necessary because there are various categories of employees – working class – whose interests must be served. The role of the unions leaned heavily towards protection of the rights of the workers. As far as the observation of legislation is concerned, the unions demonstrated knowledge of the legislation applicable to the health care personnel, that is, the BCEA, the LRA and the PSA. The study found that unions were a hindrance to health services delivery in their quest to exercise voice monopoly. The unions tended to exert undue influence on management resulting in lack of discipline and dereliction of duty. The strike actions compromised quality of health care and the rights of citizens to access health care. There was no active participation nor positive contributions in committees where advancement of service delivery standards were deliberated and promoted. Recommendations included training of shop stewards; capacitation and training of managers, and development and communication of departmental labour relations policies.
- Full Text:
- Date Issued: 2018
- Authors: Tshamase, Nozibele Yvonne
- Date: 2018
- Subjects: Public health Health services accessibility Labor unions
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12348 , vital:39255
- Description: Purpose: According to Khan and Khan (2011:56), a trade union is an organization of employee tasked with activities which include negotiating on behalf of their members for “pay and conditions of employment”. Several authors have purported that these roles extend beyond ensuring not only that the rights of workers are not violated and that their working environment complies with health and safety standards, but also that unions may have an effect on management practices, generally and specifically, on efficiencies and performance (Zulu, 2009; McGuire, 2011; & Dhliwayo, 2012). Health care workers including professionals are organised by the unions in a bid to influence social and economic reforms in the South African democracy. The main aim of this study was to examine the role of public sector unions and how they exercise their functions in delivery of health services Method: A qualitative research method based on phenomenological and case approaches was applied. Semi-structured interviews with open ended questions were used to prompt discussions. Documents were used to obtain complementary data. Senior managers, middle managers, union/employee representatives and employees who are members of the unions in the district hospital of Nelson Mandela Bay health district constituted the target population. Purposive non-probability sampling, which was the preferred method for this study, yielded 16 participants. Results Analysis followed Creswell’s thematic analysis involving coding responses categorising them and identifying themes. This followed repeated and thorough listening to the recorded interviews and transcribing. Themes identified were organisational functioning in line with the service delivery context; worker’s rights protection; negotiating better service conditions; implementing legislation, policies and resolutions; union-management interaction; engaging in strikes and impact on services delivery. Conclusion and Recommendations: The study found that the presence of unions in health care services was necessary because there are various categories of employees – working class – whose interests must be served. The role of the unions leaned heavily towards protection of the rights of the workers. As far as the observation of legislation is concerned, the unions demonstrated knowledge of the legislation applicable to the health care personnel, that is, the BCEA, the LRA and the PSA. The study found that unions were a hindrance to health services delivery in their quest to exercise voice monopoly. The unions tended to exert undue influence on management resulting in lack of discipline and dereliction of duty. The strike actions compromised quality of health care and the rights of citizens to access health care. There was no active participation nor positive contributions in committees where advancement of service delivery standards were deliberated and promoted. Recommendations included training of shop stewards; capacitation and training of managers, and development and communication of departmental labour relations policies.
- Full Text:
- Date Issued: 2018
Anthropometric indicators in identifying malnutrition risk among children younger than two years in Motherwell, Nelson Mandela Metropolitan Municipality
- Authors: McLaren, Shawn William
- Date: 2017
- Subjects: Nutrition disorders in children -- South Africa -- Nelson Mandela Bay Municipality , Malnutrition in children -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/19256 , vital:28811
- Description: Introduction: South Africa is burdened with a high prevalence of childhood malnutrition. The World Health Organisation (WHO) endorses weight for length (WFL) Z-scores and mid-upper arm circumference (MUAC) as tools for identifying children who are malnourished. The MUAC measurement offers many advantages for its use in community nutrition, and may aid in the early identification of malnourished children. More accurate and comprehensive data on child anthropometric status are needed in the Nelson Mandela Bay Health District (NMBHD), as well as assessment of the efficacy of using a simplified tool such as MUAC to screen for malnutrition. Aim: This study aimed to synthesise a profile of the nutritional status of children younger than two years old in Motherwell, Nelson Mandela Metropolitan Municipality (NMMM) to assess the value of MUAC as a predictor of malnutrition risk and develop malnutrition screening recommendations relevant to this population. Methods: This study followed a cross-sectional design using a quantitative approach. A convenience sample (n=419) of children below 24 months of age was selected from clinics and creches in Motherwell between October 2015 and February 2016 (Ethics approval: H15-HEA-DIET-002). Primary caregivers provided informed written consent for study participation. Trained fieldworkers performed anthropometric measurements according to standardised methods and completed a structured questionnaire. Data was described using means and standard deviations. Linear regression was used to assess relationships within the data. The MUAC’s ability to identify malnutrition was described using sensitivity and specificity probabilities. Results: Only 6% of the sample of children (n=23) were classified as stunted and 3% of the children (n=12) were severely stunted. The WHZ Z-score identified 0% (n=1) child with severe acute malnutrition (SAM), and 1% (n=3) children as MAM. The MUAC identified more children as SAM (2%) and MAM (3%). It was found that 16% of the children (n=65) were overweight or obese according to WHZ. It was found that there is a strong linear relationship between WHZ and MUAC (r=0.739). Using the least squares regression equation, a MUAC cut off value of 13,80cm for males and 13,5cm for females between six and 24 months old was projected. The male cut-off value has a 100% sensitivity and 94,5% specificity for MAM and SAM while the female MUAC cut off had a specificity of 96,4%. Low birth weight children had significantly (p<0.0005) lower mean WAZ and HAZ scores than normal birth weight children. Conclusions and recommendations The prevalence of overweight and obesity among children younger than two years was high in Motherwell, while stunting and wasting prevalence were lower than expected for the population. Raising the MUAC cut-off values from 12,5cm for MAM to 13,80cm for males and 13,47cm for females may increase the number of children younger than two years who are included in nutrition interventions. It is recommended that healthcare workers focus on breastfeeding and appropriate complementary feeding practices to reduce the risk of overweight in infants and young children.
- Full Text:
- Authors: McLaren, Shawn William
- Date: 2017
- Subjects: Nutrition disorders in children -- South Africa -- Nelson Mandela Bay Municipality , Malnutrition in children -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/19256 , vital:28811
- Description: Introduction: South Africa is burdened with a high prevalence of childhood malnutrition. The World Health Organisation (WHO) endorses weight for length (WFL) Z-scores and mid-upper arm circumference (MUAC) as tools for identifying children who are malnourished. The MUAC measurement offers many advantages for its use in community nutrition, and may aid in the early identification of malnourished children. More accurate and comprehensive data on child anthropometric status are needed in the Nelson Mandela Bay Health District (NMBHD), as well as assessment of the efficacy of using a simplified tool such as MUAC to screen for malnutrition. Aim: This study aimed to synthesise a profile of the nutritional status of children younger than two years old in Motherwell, Nelson Mandela Metropolitan Municipality (NMMM) to assess the value of MUAC as a predictor of malnutrition risk and develop malnutrition screening recommendations relevant to this population. Methods: This study followed a cross-sectional design using a quantitative approach. A convenience sample (n=419) of children below 24 months of age was selected from clinics and creches in Motherwell between October 2015 and February 2016 (Ethics approval: H15-HEA-DIET-002). Primary caregivers provided informed written consent for study participation. Trained fieldworkers performed anthropometric measurements according to standardised methods and completed a structured questionnaire. Data was described using means and standard deviations. Linear regression was used to assess relationships within the data. The MUAC’s ability to identify malnutrition was described using sensitivity and specificity probabilities. Results: Only 6% of the sample of children (n=23) were classified as stunted and 3% of the children (n=12) were severely stunted. The WHZ Z-score identified 0% (n=1) child with severe acute malnutrition (SAM), and 1% (n=3) children as MAM. The MUAC identified more children as SAM (2%) and MAM (3%). It was found that 16% of the children (n=65) were overweight or obese according to WHZ. It was found that there is a strong linear relationship between WHZ and MUAC (r=0.739). Using the least squares regression equation, a MUAC cut off value of 13,80cm for males and 13,5cm for females between six and 24 months old was projected. The male cut-off value has a 100% sensitivity and 94,5% specificity for MAM and SAM while the female MUAC cut off had a specificity of 96,4%. Low birth weight children had significantly (p<0.0005) lower mean WAZ and HAZ scores than normal birth weight children. Conclusions and recommendations The prevalence of overweight and obesity among children younger than two years was high in Motherwell, while stunting and wasting prevalence were lower than expected for the population. Raising the MUAC cut-off values from 12,5cm for MAM to 13,80cm for males and 13,47cm for females may increase the number of children younger than two years who are included in nutrition interventions. It is recommended that healthcare workers focus on breastfeeding and appropriate complementary feeding practices to reduce the risk of overweight in infants and young children.
- Full Text: