Research Publications (Health Sciences)

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Reducing the alloy thickness of base metal ceramic restorations
(Dental Technicians Association of South Africa, 2009) Le Roux, Andre Rayne
Reduction in base metal alloy thickness will permit additional porcelain depth and improved aesthetics but unfortunately little information exists regarding the thickness to which base metal alloys may be reduced in comparison to noble metal alloys for metal ceramic restorations. Even with comparison of noble metal alloys the aesthetic benefits are restricted to improving aesthetics in base metal restoration further, since noble metal alloys are generally regarded as providing superior aesthetics to base metal restorative alloys. Purpose: The objective of this study was to determine whether a significant reduction in thickness could be achieved using a base metal alloy as compared to a noble metal alloy and the thickness to which base metal alloy substructures could safely be reduced while still providing the same resistance to fracture of the porcelain. Material and methods: Tensile strength tests (N) of the modulus of rupture of the porcelain were performed on 40 base metal alloy (Wiron 99, Bego, Germany) and 12 noble metal alloy rectangular specimens (5.8 mm wide and 15.0 mm long) bonded to a standardized 1.0 mm thickness of dentine Creation porcelain. The base metal alloy thickness varied in 0.1mm increments from 0.1 to 0.4 mm. The results were compared to 12 noble metal alloy (Bio Y 81, Argen, South Africa) specimens of recommended minimum thickness (0.3 mm). Data for the results was obtained using a universal tensile testing instrument, which was set to operate at a cross head speed of 0.5mm (Instron Mini 44, Instron corporation U.S.A). The applied force (N) that measured the modulus of rupture of each specimen was printed from a computer connected to the Instron Mini 44 that operated on a 95% level of confidence. Instron Agents (Durban, South Africa) performed the calibration and setting up of the machine prior to testing the specimens. Results: The results indicated a permissible 33.33% reduction in the base metal alloy specimens as compared to the noble metal alloy control specimens. This was deduced from the reduction in alloy thickness of up to 0.2 mm for base metal alloy specimens as compared to the 0.3 mm noble metal alloy specimens. The recommended thickness to which the base metal alloys could be reduced without distortion of the alloy was also 0.2 mm. The one-way ANOVA showed a level of significance of (α=05).
Flexibility of experimental alumina/feldspar and SR ADORO dental composites
(South African Dental Association, 2010) Le Roux, Andre Rayne; Lachman, Nirusha
Introduction: Flexure of a dental composite can be detrimental to the success of a restoration. Flexibility considerations are thus important when comparing dental materials to optimize the success of resin restorations. Aims and objectives: Flexibility of 5.6 x 18.0 x 2.0 mm3 experimental alumina/feldspar and SR ADORO® dental composites specimens were compared. It was hypothesized that alumina/ feldspar composites would be less flexible under a load than SR ADORO® composites and that the flexibility would decrease significantly as the feldspar content was increased. Methods: Alumina was chemically sintered or bonded with 40%, 50% and 60% feldspar mass, silanized and infiltrated with urethane dimethacrylate (UDMA) to prepare the alumina/feldspar dental restorative composite specimens. Three point bending tests were performed in the Instron 44® machine for flexural comparison to SR ADORO®. Results and conclusions: The alumina/feldspar specimens showed lower flexibility (mm displacement) than SR ADORO® (p<0.05). Accurate flexibility comparisons were performed with 5.6 x 18.0 x 2.0 mm3 specimens. Flexibility comparisons performed with 5.6 x 18.0 x 2.0 mm3 specimens indicated that experimental alumina/ feldspar dental composites may provide added marginal seal benefit. However confirmation via in vivo function of alumina/ feldspar dental composites is recommended.
Wear and flexural strength comparisons of alumina/feldspar resin infiltrated dental composites
(South African Dental Association, 2008) Le Roux, Andre Rayne; Lachman, Nirusha; Walker, Mark; Botha, T.
Introduction: Incorporating a feldspar chemical bond between alumina filler particles is expected to increase the wear-resistant and flexural strength properties. Aims and Objectives: An investigation was carried out to evaluate the influence of the feldspar chemical bonding between alumina filler particles on wear and flexural strength of experimental alumina/feldspar dental composites. It was hypothesized that wear resistance and flexural strength would be significantly increased with increased feldspar mass. Methods: Alumina was chemically sintered and bonded with 30% and 60% feldspar mass, silanized and infiltrated with UDMA resin to prepare the dental restorative composite material. Results and conclusions: Higher wear-resistant characteristics resulted with increased feldspar mass of up to 60% (p<0.05). Higher flexural strength characteristics resulted as the feldspar mass was increased up to 60% (p>0.05). Feldspar chemical bonding between the alumina particles may improve on the wear-resistance and flexural strength of alumina/ feldspar composites.
Dental composite materials: highlighting the problem of wear for posterior restorations
(South African Dental Association, 2007) Le Roux, Andre Rayne; Lachman, Nirusha
Manufacturers of dental composites promote their products as having ideal wear resistant characteristics. Evaluation of the problems that persist with wear of dental composites is made. Recommendations for further research involving wear resistance of dental composite materials are provided. This article provides a review of English, peer-reviewed literature involving wear resistance of dental composite materials conducted through ScienceDirect and hand searched data bases between 1994 and 2006.
Are point-of-decision prompts in a sports science and medicine centre effective in changing the prevalence of stair usage? : a preliminary study
(2009) Pillay, Julian David; Kolbe-Alexander, Tracy; Achmat, Masturah; Carstens, Madelaine; Lambert, Estelle V.
Objective. To determine the impact of a signed intervention on promoting stair versus lift usage in a health and fitness facility. Design. A 3-week observational study in which a simple timeseries design of collecting data before, during and after the introduction of an intervention was used. Setting. The Sports Science Institute of South Africa (SSISA): a 5-storey building with a centrally located lift lobby and internal stairwell. Method. Observers were placed unobtrusively on the ground floor, with good visibility of lift/stairwell, to observe ascending movement of students, staff, tenants, visitors and patients 4 hours/day (07h00 - 09h00, 16h00 - 18h00), 4 days/week for 3 weeks. During week 2, motivational signs were displayed on the wall next to the lift and stairs and on the floor leading to the stairwell. In week 3, signage was removed. Factors considered in predicting stair use were gender, phase of intervention, and whether persons were staff/students or visitors. Results. A total of 4 256 person-counts were recorded. Prevalence of stair use increased from 43% before the intervention to 53% during the intervention to 50% after the intervention. Odds of using the stairs during the intervention increased by 45% (odds ratio (OR) 1.45, 95% confidence interval (CI) 1.25 - 1.68) (p<0.00001), were 41% higher for staff/students compared with visitors (p<0.00001) and were 55% greater for women (p<0.00001). These effects did not change significantly after the intervention and stair use remained modestly higher than before the intervention. Conclusion. Signed intervention produced significant increases in stair usage during and after the intervention. These findings support the effectiveness of point-of-decision prompts for changing behaviour, and highlight potential factors influencing the impact of such messages.
Steps that count! : The development of a pedometer-based health promotion intervention in an employed, health insured South African population
(BioMed Central, 2012-10-17) Pillay, Julian David; Kolbe-Alexander, Tracy; Mechelen, Willem; Lambert, Estelle V.
Physical activity (PA) has been identified as a central component in the promotion of health. PA programs can provide a low cost intervention opportunity, encouraging PA behavioral change while worksites have been shown to be an appropriate setting for implementing such health promotion programs. Along with these trends, there has been an emergence of the use of pedometers as a self-monitoring and motivational aid for PA. This study determines the effectiveness of a worksite health promotion program comprising of a 10-week, pedometer-based intervention (“Steps that Count!”), and individualized emailbased feedback to effect PA behavioral change.Methods The study is a randomized controlled trial in a worksite setting, using pedometers and individualized email-based feedback to increase steps per day (steps/d). Participant selection will be based on attendance at a corporate wellness event and information obtained, following the completion of a Health Risk Appraisal (HRA), in keeping with inclusion criteria for the study. All participants will, at week 1 (pre-intervention), be provided with a blinded pedometer to assess baseline levels of PA. Participants will be provided with feedback on pedometer data and identify strategies to improve daily PA towards current PA recommendations. Participants will thereafter be randomly assigned to the intervention group (INT) or control group (CTL). The INT will subsequently wear an un-blinded pedometer for 10 consecutive weeks. Individualized feedback messages based on average steps per day, derived from pedometer data (INT) and general supportive/motivational messages (INT+CTL), will be provided via bi-weekly e-mails; blinded pedometer-wear will be conducted at week 12 (post-intervention: INT+CTL). Discussion The purpose of this paper is to outline the rationale behind, and the development of, an intervention aimed at improving ambulatory PA through pedometer use, combined with regular, individualized, email-based feedback. Pedometer-measured PA and individualized feedback may be a practical and easily applied intervention.
Type 2 diabetes management : patient knowledge and health care team perceptions, South Africa
(OpenJournals, 2012-10-18) Mshunqane, Nombeko; Stewart, Aimee V.; Rothberg, Allan D.
Background: South African research indicates that the highest death rates between 2004 and 2005 were from diabetes mellitus. There is minimal research information on interactions between what patients know about their disease and what health professionals perceive that patients should know to control their disease well. Objectives: This study determined the knowledge that patients with type 2 diabetes have about the management of their disease, as well as the perceptions of the health care team about the services given to patients. Method: Qualitative data were collected using two focus groups and in-depth interviews. Patient focus group (n = 10) explored patients’ knowledge about management of type 2 diabetes. Patients were recruited from Dr George Mukhari Hospital outpatients’ diabetes clinic. Professional focus group (n = 8) explored the health care team’s experiences, barriers and facilitators in managing the disease. Professional focus group participants were recruited because of their expertise in chronic disease management, working in the community (public health) or working directly with patients with type 2 diabetes. Five health care professionals were interviewed using the same guide of questions as for the focus group. Results: Participants identified type 2 diabetes as a chronic disease that needs behaviour change for good control. Five major themes were identified: patients’ knowledge; education programmes; behaviour change; support; and a patient-centred approach. Conclusion: Management of type 2 diabetes may be enhanced by reinforcing patients’ knowledge, encouraging behaviour change whilst taking into consideration patients’ backgrounds. The health care team needs to utilise a patient-centred approach.
Two year clinical outcomes after sirolimus-eluting stent implantation for the treatment of coronary artery disease
(Medical Technology SA, 2012) Adam, Jamila Khatoon; Dyer, Robby B.; Harrypaul, Ashika; Rmaih, Wafaa
Background Coronary artery stents are known to reduce rates of restenosis after coronary stenting, but it is uncertain how long this benefit is maintained. Clinical data has raised concerns that drug-eluting stents are associated with increased rates of late stent thrombosis, death or myocardial infarction. Objectives To evaluate the safety and reliability of sirolimus-eluting stents in real-world practice out to two years. Methods From January 2008 to June 2008, 30 patients were enrolled in the study after implantation of one or more sirolimus-eluting stents. We evaluated clinical follow-up information for up to two years after the implantation of Cypher® Select stents in 30 patients with 35 lesions. Results Mean patient age was 62.33 +/- 10.99 years, 7 percent were diabetic and 30 percent presented with acute myocardial infarctions. The procedure’s success rate was 100 percent for the sirolimus-eluting stent implantation, and follow-up rates were 100 percent. Mean total stent length was 22.32 +/- 6.63 mm, with 13 percent receiving more than one stent. Two year freedom from mortality, myocardial infarction, target vessel revascularization and stent thrombosis was 100 percent. Dual antiplatelet therapy was taken by 100 percent at 1 month, 53 percent at 6 months, 40 percent at 1 year and 0 percent of patients at 2 years. The rate of survival free of myocardial infarction, bypass surgery and repeated angioplasty for stented lesions was 100% at two years. Conclusions Treatment of lesions with sirolimus-eluting stents is associated with a sustained clinical benefit two years after device implantation.
The use of probiotics and safety concerns : a review
(Academic Journals, 2012-10-27) Krishna, Suresh Babu Naidu; Adam, Jamila Khatoon; Govender, P.
Probiotics are defined as “live microorganisms which when administered in adequate amounts confer a health benefit on the host’’. Most probiotics fall into the group of organisms’ known as lactic acid-producing bacteria and are normally consumed in the form of yogurt, fermented milks, cereal or other fermented foods. Many of the products currently available in the market are not clearly tied to research documenting beneficial effects. Probiotics are regulated by FDA and several reports are available now for mislabeling the product claiming health benefits. As live microbial products, probiotics are potential sources of risk and there exists skeptical attitude among medical professionals and consumers who have less than optimal experiences with probiotics. This review outlines information regarding probiotics, overview of proposed regulatory guidelines and commercial probiotic products available in the market considered as safe for humans.
Poor academic performance : a perspective of final year diagnostic radiography students
(Elsevier, 2012-08) Gqweta, Ntokozo
Introduction A study was conducted on final year diagnostic radiography students at a University of Technology in Durban. The aim of the study was to investigate the final year diagnostic radiography students' opinions and views on academic performance in order to inform teaching and learning methods. The objectives were • To explore the students' opinions regarding poor performance. • To identify strategies to improve academic performance. Method A qualitative, interpretive approach was used to explain and understand the students' lived experiences of their academic performances. A short open ended questionnaire was administered to a cohort of final diagnostic radiography students following feedback on a written assessment. Questionnaire responses were then manually captured and analyzed. Results Five (5) themes were identified that could possibly be associated with poor academic performance. These themes were, poor preparation, lack of independent study, difficulty in understanding learning content and misinterpretation of assessment questions, inefficient studying techniques as well as perceived improvement strategies. Conclusion Students identified their inadequate preparation and the lack of dedicated independent studying as the main reasons for poor performance. Students preferred to be taught in an assessment oriented manner. However their identified improvement strategies were aligned with the learner centred approach.
Achieving prehospital analgesia
(BMJ, 2010-10-23) Castle, Nicholas; Naidoo, Raveen
An analysis of the need for accredited training on the administration of intravenous contrast media by radiographers : results of an online survey
(The South African Radiographer, 2012) Swindon, Lynda; Friedrich-Nel, Hesta; Isaacs, Ferial; Munro, Leonie
Role extension has been debated amongst South African radiographers for a number of years. However, the administration of contrast media still remains outside their scope of practice. The Society of Radiographers of South Africa (SORSA) has received anecdotal reports that radiographers are administering contrast media. This practice is a direct infringement of the rights of patients who are required to be treated and examined by health professionals who practice within their legal scope. The aim of this survey was to investigate the views and opinions of South African radiographers regarding the injecting of contrast media and the type of training needed if it were included in the scope of practice of South African radiographers. A questionnaire was sent to 845 radiographers using an online survey programme (SurveyMonkey). The questions related to biographical information, work experience, training and the medico-legal aspects of intravenous contrast media injection by radiographers. The response rate was 21% (n=177). Eighty-one percent (81%) were diagnostic radiographers. Seventy-three percent (73%) practice radiography in a major city. There was an equal representation of the public and private sector, namely 43% for both. Of those from the public sector 47% were from a tertiary healthcare facility. More than seventy-eight percent (>78%) practice radiography in a health facility that provides radiology services. Seventy-three percent (73%) were aware of mild to moderate adverse reactions to contrast media; 45% were aware of severe adverse reactions to contrast media in their workplace. Eighty-five percent (85%) thought that accredited training should include the administration of contrast media as well as resuscitation of a patient. Sixty-two percent (62%) thought the accredited training should include pharmacology and advanced resuscitation. Ninety-three percent (93%) thought the main advantage would be an increase in service delivery to patients; 85% thought the main disadvantage would be potential risk of criminal or civil litigation. Ninety-seven percent (97%) were of the opinion that radiographers who introduce contrast media to patients must have current malpractice insurance. The results of this survey provide new information on the current status of contrast media administration to the patient whose safety and rights remain at the centre of our focus. It is recommended that the statutory body, namely the professional board for radiography and clinical technology (RCT) of the Health Professions Council of South Africa (HPCSA) takes cognizance of the outcome of this study and embarks on a more extensive survey to include a larger sample which would be more representative of the South African radiography population.
Manipulative and multimodal therapy for upper extremity and temporomandibular disorders : a systematic review
(Elsevier, 2013-03) Korporaal, Charmaine Maria; Tong, Victor; Pollard, Henry; Robb, Andrew; Pribicevic, Mario; Bonnefin, Debra; Cassa, Tammy Kay; Brantingham, James W.
Objective The purpose of this study was to complete a systematic review of manual and manipulative therapy (MMT) for common upper extremity pain and disorders including the temporomandibular joint (TMJ). Methods A literature search was conducted using the Cumulative Index of Nursing Allied Health Literature, PubMed, Manual, Alternative, and Natural Therapy Index System (MANTIS), Physiotherapy Evidence Database (PEDro), Index to Chiropractic Literature, Google Scholar, and hand search inclusive of literature from January 1983 to March 5, 2012. Search limits included the English language and human studies along with MeSH terms such as manipulation, chiropractic, osteopathic, orthopedic, and physical therapies. Inclusion criteria required an extremity peripheral diagnosis (for upper extremity problems including the elbow, wrist, hand, finger and the (upper quadrant) temporomandibular joint) and MMT with or without multimodal therapy. Studies were assessed using the PEDro scale in conjunction with modified guidelines and systems. After synthesis and considered judgment scoring was complete, evidence grades of “A, B, C and I” were applied. Results Out of 764 citations reviewed, 129 studies were deemed possibly to probably useful and/or relevant to develop expert consensus. Out of 81 randomized controlled or clinical trials, 35 were included. Five controlled or clinical trials were located and 4 were included. Fifty case series, reports and/or single-group pre-test post-test prospective case series were located with 32 included. There is Fair (B) level of evidence for MMT to specific joints and the full kinetic chain combined generally with exercise and/or multimodal therapy for lateral epicondylopathy, carpal tunnel syndrome, and temporomandibular joint disorders, in the short term. Conclusion The information from this study will help guide practitioners in the use of MMT, soft tissue technique, exercise, and/or multimodal therapy for the treatment of a variety of upper extremity complaints in the context of the hierarchy of published and available evidence.
Minibus taxi drivers’ sexual beliefs and practices associated with HIV infection and AIDS in KwaZulu-Natal, South Africa
(AOSIS, 2013-01-08) Ncama, Busisiwe; Mchunu, Gugu; Naidoo, Joanne; Majeke, Sisana; Pillay, Padmini; Myeza, Thandazile; Ndebele, Thandiwe
Risky sexual behaviours in South Africa are a major contributing factor to the spread of HIV infection and AIDS. HIV infection amongst minibus taxi drivers is a concern, because these people belong to an occupational group that exhibits risky behaviours due to the demands of their work. Given the high vulnerability of minibus taxi drivers, exploring the sexual beliefs and health-related sexual practices of this group will assist in planning targeted interventions. The objectives of this study were to assess the level of knowledge, beliefs and practices regarding HIV infection and AIDS amongst minibus taxi drivers. An exploratory descriptive study was conducted using a pre-tested questionnaire to explore and describe sexual beliefs and practices associated with HIV infection and AIDS in a convenience sample of 175 minibus taxi drivers. Permission to undertake the study was obtained from the KwaZulu-Natal Taxi Alliance and individuals who participated in the study. Data analysis were analysed using the Statistical Package for Social Sciences 13.0. The study revealed that minibus taxi drivers are one of the high- risk groups in the spread of HIV infection and AIDS; they lack necessary education and need attention in relation to control and prevention of the spread of HIV and AIDS. Multiple sexual partners are relatively common amongst the minibus taxi drivers. Violence against women and even forceful sexual intercourse in the belief that women should tolerate it to keep the family together was reported. There is a need for intervention programmes with a focus on minibus taxi drivers and similar high-risk groups. Prevention activities should incorporate the distribution of condoms amongst this group and HIV prevention educational programmes, as well as creating mechanisms for accessing circumcision by the minibus taxi drivers.
Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa
(AOSIS, 2013-07-05) Sokhela, Dudu Gloria; Makhanya, Jabulile Nonhlanhla; Sibiya, Maureen Nokuthula; Nokes, Kathleen M.
Background: Comprehensive Primary Health Care (PHC), based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans. Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service. Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed. Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources. Conclusion: Effective health communication strategies contribute to positive experiences by health care users and these can be effected by: (1) involvement of health care providers in planning the construction of health facilities to give input about patient flow, infection prevention and control and provision of privacy, (2) effective complaints mechanisms for users to ensure that complaints are followed up and (3)encouraging users to arrive at the facility throughout the day, rather than the present practice where all users arrive at the clinic early in the morning.
Correlation between glutathione S-transferase Mu 1 (GSTM1) and glutathione S-transferase pi gene (GSTP1) polymorphisms and markers of inflammatory stress in pregnant females
(Academic Journals, 2013-03) Reddy, Poovendhree; Naidoo, Rajen N.; Chuturgoon, Anil A.; Asharam, Kareshma; Naidoo, Dhaneshree; Phulukdaree, Alisa; Gounden, Shivona
The Mother and Child Environmental Cohort (MACE) study piloted in South Africa in 2010 to 2011, collected genetic, biochemical and clinical data from pregnant females residing in south and north Durban. We evaluated birth outcomes and the influence of GSTM1pos→GSTM1null and the GSTP1 (Ile105Val; AA→AG/GG) polymorphisms on the extent of DNA damage and with biomarkers [glutathione (GSH) and malondialdehyde (MDA)] related to oxidative stress in mothers with different levels of pollutant exposure. There was no significant difference in adverse birth outcomes or genotype distribution between mothers from the exposed and lower exposed areas. Mean GSH and comet tail length did not differ significantly between GSTM1pos and GSTM1null genotypes. When stratified by genotype, mean MDA levels was higher among GSTM1 null mothers compared to the GSTM1pos mothers (p = 0.01). When each of the genotypes was stratified by exposure, mean GSH concentration was significantly higher in north Durban for the GSTM1pos, GSTM1null and GSTP1AG+GG genotypes (p < 0.05), and mean comet tail length was significantly increased in south Durban among participants with the GSTM1pos, GSTM1null, and the GSTP1AG+GG genotypes. The expression of GSTM1 and GSTP1 polymorphic genotypes may lead to varying susceptibility to the adverse effects of pollutants by modifying the response to oxidative stress.
Variations in housing satisfaction and health status in four lower socio-economic housing typologies in the eThekwini Municipality in KwaZulu-Natal
(Taylor and Francis, 2013-07-26) Narsai, Prishah; Taylor, Myra; Jinabhai, Champaklal C.; Stevens, Fred
A study was done in the Durban Area, South Africa amongst residents (n = 300) of four lower socio-economic housing typologies: Reconstruction and Development Programme (RDP) houses, informal settlements (IS), traditional rural houses (TR) and inner-city apartments (IC). Respondents living in IC were most satisfied with their dwellings, those living in RDP houses and in IS were the least satisfied. People living in the IC perceived their health best, while those living in IS perceived it as worst. Major reasons for dissatisfaction with housing were pest infestation in their dwelling in the past 12 months, inadequate toilet facilities, high temperature, unclean neighbourhood, poor ventilation and dust. Pest infestation and poor ventilation were mentioned most frequently by flat dwellers whilst RDP, IS and TR households complained about inadequate toilet facilities. For many people living in low socio-economic housing, both housing and service provision remain inadequate.
Spirituality in social work in South Africa : insights from a survey with academics
(Sage Publications, 2013-05) Bhagwan, Raisuyah
Historically, spirituality has shared a tenuous position with social work. Scholarship underpinning its relevance to client well-being and anti-oppressive practice has proliferated, entrenching its niche in education. In South Africa, very little empirical work exists except for a survey with final year social work students. This article presents findings made with a national survey of academics: 66 educators from 16 universities participated indicating positive views on spirituality in education and practice in South Africa.
Comparative assessment of absolute cardiovascular disease risk characterization from non-laboratory- based risk assessment in South African populations
(BioMed Central, 2013-07-24) Gaziano, Thomas A.; Pandya, Ankur; Steyn, Krisela; Levitt, Naomi; Mollentze, Willie; Joubert, Gina; Walsh, Corinna M; Motala, Ayesha A.; Kruger, Annamarie; Schutte, Aletta E.; Naidoo, Datshana Prakash; Prakaschandra, Dorcas Rosaley; Laubscher, Ria
Background All rigorous primary cardiovascular disease (CVD) prevention guidelines recommend absolute CVD risk scores to identify high- and low-risk patients, but laboratory testing can be impractical in low- and middle-income countries. The purpose of this study was to compare the ranking performance of a simple, non-laboratory-based risk score to laboratory-based scores in various South African populations. Methods We calculated and compared 10-year CVD (or coronary heart disease (CHD)) risk for 14,772 adults from thirteen cross-sectional South African populations (data collected from 1987 to 2009). Risk characterization performance for the non-laboratory-based score was assessed by comparing rankings of risk with six laboratory-based scores (three versions of Framingham risk, SCORE for high- and low-risk countries, and CUORE) using Spearman rank correlation and percent of population equivalently characterized as ‘high’ or ‘low’ risk. Total 10-year non-laboratory-based risk of CVD death was also calculated for a representative cross-section from the 1998 South African Demographic Health Survey (DHS, n = 9,379) to estimate the national burden of CVD mortality risk. Results Spearman correlation coefficients for the non-laboratory-based score with the laboratory-based scores ranged from 0.88 to 0.986. Using conventional thresholds for CVD risk (10% to 20% 10-year CVD risk), 90% to 92% of men and 94% to 97% of women were equivalently characterized as ‘high’ or ‘low’ risk using the non-laboratory-based and Framingham (2008) CVD risk score. These results were robust across the six risk scores evaluated and the thirteen cross-sectional datasets, with few exceptions (lower agreement between the non-laboratory-based and Framingham (1991) CHD risk scores). Approximately 18% of adults in the DHS population were characterized as ‘high CVD risk’ (10-year CVD death risk >20%) using the non-laboratory-based score. Conclusions We found a high level of correlation between a simple, non-laboratory-based CVD risk score and commonly-used laboratory-based risk scores. The burden of CVD mortality risk was high for men and women in South Africa. The policy and clinical implications are that fast, low-cost screening tools can lead to similar risk assessment results compared to time- and resource-intensive approaches. Until setting-specific cohort studies can derive and validate country-specific risk scores, non-laboratory-based CVD risk assessment could be an effective and efficient primary CVD screening approach in South Africa.
Effects of resource limitation on habitat usage by the browser guild in Hluhluwe-iMfolozi Park, South Africa
(Cambridge University Press, 2013-01) O'Kane, Christopher A. J.; Page, Bruce R.; Macdonald, David W.; Duffy, Kevin Jan
Resource depletion and associated increases in interspeciﬁc competition are likely to inﬂuence differential habitat usage amongst a guild. We tested some prominent theoretical concepts using observed differences in seasonal habitat use amongst the savanna browser guild (elephant, giraffe, impala, kudu and nyala) in Hluhluwe-iMfolozi Park, South Africa. Herbivore locations (n = 3108) were recorded over 2 y using repeated road transects and, for elephant, GPS collars (187 254 downloads). Densities were calculated using a novel GIS approach designed to be a cost-effective method for annual censuses, but also able to cope with abrupt changes in visibility. Selectivity for (Manly’s α) vegetation types, and overlap (Schoener’s index) in vegetation type usage were calculated. Resource depletion in the dry season resulted in all members of the guild increasing selectivity for vegetation types (sum of absolute values away from the neutral value for Manly’s alpha for the guild: dry seasons 3.97, 5.16; corresponding wet seasons 3.12, 3.68), but decreasing interspeciﬁc overlap (80% of Schoener’s indices lower in dry season versus wet season). These effects were more marked over the second, more severe, dry season. We found support for the niche overlap hypothesis and the niche compression hypothesis. The Jarman–Bell principle was generally supported, although unexpectedly during the severe dry season elephant showed the most selectivity for vegetation type. The greater the resource depletion, the more relevant interspeciﬁc differences in habitat usage become in relation to the differential impacts of guild members.