Theses and dissertations (Health Sciences)

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Access and utilisation of antenatal care services in a rural community of eThekwini District in KwaZulu-Natal
(2016) Bhengu, Thandeka Jacqueline; Sibiya, Maureen Nokuthula; Ngxongo, Thembelihle Sylvia Patience
Introduction Although the South African Government adopted a primary health care approach to health care service provision in order to ensure equitable access to and utilization of health care services to all communities, the country continues to face challenges regarding access and utilisation of health care services especially in the rural communities. Antenatal care which is mostly provided at primary health care level is regarded as the cornerstone for the success of the maternal and child health care programme. Therefore, poor access to and under-utilisation of health care services could potentially influence the success of this programme and pregnancy outcomes. Aim of the study The aim of the study was to determine whether pregnant women from KwaMkhizwana rural community had access to and were utilising antenatal care services. Methodology A qualitative, exploratory, descriptive and contextual study was conducted guided by Thaddeus and Maine’s three delays model. Purposive sampling of the pregnant women and all categories of nurses who were employed in the three health care facilities in the area was done. Data was collected in two phases through in-depth semi-structured interviews with both the pregnant women and the nurses respectively between February and March 2016. The sample size was guided by data saturation. All data were analysed using the Tesch’s method of data analysis. Study findings Six major themes and several sub-themes emerged from the interviews with both Phase 1 and Phase 2 participants. The major themes included: 1) access to health care and emergency services, 2) availability of human and material resources, 3) social and cultural beliefs, 4) past pregnancy experiences, 5) communication and transparency regarding health care service delivery and 6) quality of antenatal care services. Summary of the findings The pregnant women encountered several challenges which led to delays in seeking, reaching and receiving antenatal care. Most of the pregnant women participants related limited access to health care, with under-utilisation of antenatal services. They were unhappy about the antenatal care services they received in the three available health care facilities in the area, which made these facilities to be inaccessible and underutilised. The nurse participants recognised the challenges facing the pregnant women regarding the access and utilisation of antenatal care services, together with the challenges faced by the nurses while working in the three available health care facilities in the area. Recommendations The recommendations that were made included: to consider building a centrally located fixed primary health care clinic that would ensure equal access to health care services, strengthening the implementation of policies regarding the referral system and ambulance services, ensuring sustainable availability of human and material resources, developing strategies to ensure that the antenatal care services are delivered in line with the South African Department of Health policies and guidelines and strengthening community education. A further study on provision of antenatal care services in the area is also recommended.
Achievement of clinical learning objectives by midwifery nursing students : an appreciative inquiry
(2020-06-19) Ngcobo, Ntombifuthi Pearl; Sokhela, Dudu Gloria
INTRODUCTION ABSTRACT Clinical practice in nursing education is vital as it provides a platform for nursing students to correlate what they have been taught in the classroom during a theory session and apply it in the real-life situation. There are specific objectives which midwifery nursing students must achieve in order to meet the required competency levels as prescribed by the South African nursing education regulating body the South African Nursing Council (SANC) (South Africa 2005: 5). Some of the learning objectives that have to be achieved by midwifery students are: demonstrate competency in the assessment, planning and implementation and evaluation of nursing care for a woman with an uncomplicated and complicated pregnancy, labour puerperium and normal new born baby. The country has embarked on an endeavour to improve maternal and child health as expressed in the Sustainable Development Goals (SDGs) (United Nations 2015: 3). Goal number 3 of the 17 SDGs is to ensure healthy lives and promote well-being for all at all ages. This goal is relevant to this study as competent midwives are the foundation for maintaining mother and child well- being during pregnancy, labour, delivery and post-delivery, yielding healthy families, communities and the nation. AIM OF THE STUDY The purpose of the study was to describe how an Appreciative inquiry (AI) was used to determine strategies used towards achievement of the midwifery clinical learning objectives. METHODOLOGY An AI approach with a qualitative descriptive research design was used to determine the strategies used by the lecturer and midwifery clinical instructors and students in the University of Technology (UoT) selected for this study and students towards achievement of their clinical learning outcomes. Purposive sampling was used to select the lecturer, midwifery clinical instructors in the UoT, hospital midwifery clinical instructors and students. Six professional nurses from the clinical facilities, one lecturer from the UoT, seven clinical instructors from the UoT and eleven midwifery nursing students were purposively sampled and interviewed. RESULTS The results of the study revealed that there were several factors that assisted students to achieve their midwifery clinical learning objectives. These included supervision by clinical instructors who modelled good behaviour, had no favouritism and were always willing to teach students. Collegiality and co-operation between lecturers, clinical instructors in the UoT and facility clinical instructors assisted in bridging the gap between theory and practice resulting in students achieving their midwifery clinical learning objectives. Staff development was cited as a key factor in ensuring that students are taught relevant and up-to-date knowledge. CONCLUSION Collaboration of all stakeholders in coordinating and planning student training is essential for the production of well-rounded, competent and confident students. In this collaboration, it is imperative to acknowledge that everyone’s contribution is equally important for good outcomes of students.
Alcohol use amongst students in a university of technology in Kwazulu-Natal, South Africa
(2023-05-31) Ntombela, Florence Buzani; Sokhela, Dudu Gloria; Mahlanze, Hazel Thokozani
BACKGROUND Alcohol use among students in universities is becoming a major problem worldwide and has the potential of adversely affecting students’ performance academically, including in South Africa. Peer group influence in higher education institutions is more significant than parental or religious upbringing because students are away from home, not under their parents’ direction anymore and are free to do as they please. Therefore, peer group pressure plays a large role in the socialization of university students and in introducing alcohol as an acceptable culture of tertiary educational institutions. Aim The aim of this study was to determine the extent of alcohol use and drinking patterns among university students in a university of technology in KwaZulu-Natal, South Africa, and the relationship of these elements to their academic performance. Methods This was a quantitative, non-experimental, cross sectional descriptive study. A structured questionnaire was used for data collection were collected from a purposive sample of 349 undergraduate students in a university of technology in KwaZulu-Natal, South Africa. SPSS 26.0 was used for the statistical analysis of data. Results A significant number (67.0%) of respondents were in the age group of 20-24 years. Only 34% of the total number of undergraduate students attested to drinking alcohol, with 29.9% (n=35) drinking 3 to 4 standard drinks on one occasion and 5.1% (n=6) drinking up to 9 or more drinks per sitting. About 25.8% of respondents reported drinking monthly and 1.7% indicated weekly. About 5% of the sampled respondents were problematic alcohol users of which 2% had medium level problems and 1% had high-level problems. Conclusion Problematic alcohol use among students in a university of technology was associated with challenges like bunking classes, poor academic achievement, and peer pressure. This study recommends employing joint strategies including faculty, lecturers, and community leaders to reduce problematic alcohol use among students. The existing efforts can be strengthened through awareness campaigns and information given to all levels of undergraduates, starting in orientation week for the first years, a period where students are first acquainted into a new values and society.
Assessing infection control knowledge and compliance in theatre at a private hospital in KwaZulu-Natal, South Africa
(2022-09-29) Naidoo, Elizabeth Laura; Adam, Jamila Khatoon
Infections acquired in a hospital (HAI) often referred to as nosocomial infections are related with increasing morbidity and death among patients that are hospitalised and are predisposed to an elevated risk of infection by health workers (HCWs). The need to maintain an effective infection prevention and control program is therefore essential for quality health care. This study sought to assess the knowledge and compliance of infection control practices of Cardiovascular Perfusionists in theatre at a private healthcare facility in KwaZulu-Natal (KZN) in the city of Durban. A qualitative, research design was used to explore the knowledge and compliance of infection control practices of Cardiovascular Perfusionists by conducting online semi structured interviews. The interviews were conducted online due to the current pandemic of COVID-19, where much consideration was given to social distancing and modes of virus transmission. Duration of the interviews lasted no more than 20 minutes. Prior to conducting the main study, a pilot study was pursued in order to ensure that the interview questions were relevant and that the participants had clear engagement with the questions and no modification nor questions were added to the interview guide. The researcher found that the actual description of the professions differed in the procedures carried out, however, the theatre environment is the same, and only a few questions pertaining to the difference in practice of the participants had to be slightly rephrased in order to be more applicable to the main study. The study was conducted by means of a purposive sample of Cardiovascular Perfusionists. The interviews conducted were limited to only those that practice in the private sector. Participants were chosen based on their ability to provide the necessary information. The interviews were transcribed and then coded by a statistician. The rationale for selecting this strategy was that the researcher was seeking knowledge about the factors that influence the knowledge and compliance of Cardiovascular Perfusionists in the private sector regarding infection prevention and control techniques. Subsequently, these participants would be therefore able to contribute valuable information. The major themes which emerged where namely., infection control and prevention, knowledge of healthcare associated infections, awareness of healthcare acquired infections, cardiovascular perfusionists procedures and precautions followed in cardiovascular surgery. The study found that there is a need for Clinical Technologist specialising in Cardiovascular Perfusion to undergo training in infection control and prevention practices at the higher education and training level. Subsequently, the study reveals that Cardiovascular Perfusionists have a good overall understanding of pathogens and the implications thereof. The study also notes that there is considerable compliance to infection control practices in theatre irrespective of the knowledge pertaining to infection control and prevention policies.
An assessment of the Somatology extended curriculum programme at the Durban University of Technology
(2019-09-05) Makgobole, Mokgadi Ursula; Bass, Gregory Hylton; Puckree, Lina
Since the beginning of democracy in South Africa post 1994, the debate in South African Higher Education has progressed from, initially, increasing disadvantaged student access to higher education to improving student success and improving throughout rates and high attrition amongst the previously disadvantaged students. In order to increase access of students from disadvantaged educational backgrounds and improve success in higher education, institutions have introduced additional programmes such as Extended Curriculum Programmes (ECP). The ECP is an alternative curriculum structure that creates the space needed to equip underprepared students with skills to assist them to succeed in higher education. The Somatology programme at the Durban University of Technology (DUT) introduced the ECP in 2005. However, there is limited published research on the impact of the ECP in the Somatology programme since its inception. Using a mixed convergent parallel design, and following a post-positivist paradigm, this dissertation aimed to assess the impact of the Somatology ECP on students’ throughput, success and dropout rates and to understand the general satisfaction of the students placed in the ECP with being placed in the ECP. In order to establish quantitative data, a retrospective analysis of the student records of all students that had been registered at the Somatology programme at the Durban University of Technology for the period 2005 to 2013 was sourced from DUT’s Institutional Management Information System (MIS). The throughput and dropout rates were analysed using descriptive statistics, ANOVA, and t-test. The data obtained is valid as access to the MIS system is restricted and only authorised DUT staff have access to MIS data. In contrast, the qualitative phase prospectively focus on students who graduated from the Somatology programme via the ECP. A simple random sampling technique was used to select a total of 15 participants who were interviewed using semi-structured interviews. The qualitative data generated was analysed using thematic content analysis. The quantitative analysis found that there was a marked improvement in the throughput rate of students who enrolled via the ECP programme. However, no significant difference was recorded in the throughput (P>0.05) and dropout rates (P>0.05) of the ECP when compared with the mainstream cohort (P>0.05) over the period under study. In addition, the overall success rate of the ECP cohort were comparable to that of the mainstream (P>0.05) showing that the interventions delivered on the ECP were successful for students entering the Somatology programme considered underprepared for higher education. In probing the factors that had influenced the improved throughput rate, a key finding from the qualitative analyses was that participating students attributed their ultimate success to the additional interventions given in the ECP. The ECP students felt they were at an advantage when it came to assessments compared to mainstream. In light of the study findings, this dissertation found that the Somatology ECP was a successful programme as there was an improvement in the academic success of the students in terms of their throughput and dropout rates of the cohort studied.
The association between acute childhood diarrhoea and diarrhoeagenic E.coli present in contaminated soil in informal settlements in Durban
(2016) Ramlal, Preshod Sewnand; Kistnasamy, Emilie J.; Olaniran, Ade O.
In South Africa, under-five childhood morbidity and mortality rates have increased due to diarrhoea with acute diarrhoea posing a major public health threat especially, in informal settlements. Therefore this study sought to, a) investigate community knowledge, attitudes, behaviour and practices (KABP) regarding domestic waste and childhood diarrhoeal management, b) to enumerate and identify diarrhoeagenic E.coli species from soil samples extracted from open waste dump sites and c) to investigate any association(s) with diarrhoeagenic E.coli and potential risk of contracting diarrhoea. This two-phased cross-sectional study in six informal settlements in the greater Durban area constituted, respectively, of the administering of questionnaires to 360 primary caregivers and; sampling the prevalence of diarrhoeagenic E.coli (DEC) in waste dumps using quantitative polymerase chain reaction methodologies. Relationships between socio-demographic and educational status to determine potential household risk factors towards under-five diarrhoea prevalence were assessed. The KABP results identified domestic waste and greywater disposal, mother and child method of sanitation, personal and domestic hygiene practices and mechanical vectors as significant contributory risk factors. Of concern is that more than 80% of under-five children played in or near faecally-contaminated waste dump sites. The recovery of four DEC pathotypes including enterohaemorrhagic E.coli, enteropathogenic E.coli, enterotoxigenic E.coli and enteroaggregative E.coli suggest that its persistence in waste-dump soil has the ability to cause under-five diarrhoea in both sporadic and endemic settings. This commonly transmitted hand-to-mouth illness will necessitate and place huge demands on the primary catalysts of change i.e. local governmental role players and caregivers. These change agents have to ensure highly consistent levels of domestic and personal hygiene and implement feasible reduction strategies to waste-dump exposure of diarrhoeal-causing pathogens, particularly among under-five children living in Durban’s informal settlements.
Back pain and its relationship to socio-demographic and psycho-social factors in a cohort of pregnant women attending a primary health care clinic in the eThekwini municipality
(2019) Hawker, Carmen; O'Connor, Laura
Background: The prevalence of back pain and general discomfort is not uncommon in pregnant women, often being under-reported until it affects their daily routine. South Africa, a third world developing country has unique risk factors and demographic profile. Although many studies have previously studied the various factors relating to back pain in pregnancy, this topic is far from being exhausted as a research area. Specifically, new studies should be conducted on the prevalence of back pain in pregnancy to analyse the impact it has on women worldwide. Little research has been conducted on rural communities in Africa especially in South Africa, to assess the risk of pregnancy-related back pain. Therefore, the information obtained from this study will provide a better understanding of the demographics, physical demands and psycho-social stresses experienced by pregnant women in this understudied population. Back pain and general discomfort is not uncommon in pregnant women, but it is often under- reported and can be disabling. International studies report a high prevalence especially in the last trimester. Little is known about the prevalence of and risk factors for back pain in South African pregnant women. Thus, this study aimed to determine the relationship between socio-demographic and psychosocial factors in a cohort of pregnant women attending a primary health care clinic in the eThekwini municipality of the province of KwaZulu-Natal, South Africa. Method: A retrospective descriptive cohort design was utilized whereby 382 participants’ files were assessed for eligibility. The files consisted of a socio-demographic questionnaire, a chart review and two epidemiological questionnaires that were administered to the participants during the first and third trimester. Permission to access these files was obtained from the principle investigator of the MRC/DUT project. All participants signed consent forms for research purposes. The data relevant to this study was extracted and analysed using Statistical Package for the Social Science version 24.0 (IMB Analytics). Descriptive statistics were used to describe the data in terms of means and standard deviations or frequencies and count where appropriate. Inferential statistics allowed for relationships between the variables to be assessed. A p - value of less than 0.05 was used to indicate statistical significance. Results: The total of 303 files were included. Participants were Black Africans, mostly single (81.2%, n=229) with a mean age of 25.84 (±SD 6.04). There was a high unemployment rate (70.8%, n=199), with most having obtained a secondary education (77.1%, n=213), and 44.1% (n=122) residing in squatter camps. There was a high human immunodeficiency infection rate (40.5%, n=94). Of the 303 participant files eligible for the study only 46 returned for the third trimester follow up. The prevalence of BP in the first trimester was 12.4% (n=35) and 10.9% (n=5) in the third trimester. LBP was the most (8.5%, n=24) in the first and 10.9% (n=5) in the third trimester, followed by UBP and NP. The incidence of back pain over the duration of pregnancy was zero. Being single (p = 0.03), reporting no stress (p = 0.04), not using pain killers (p = 0.01), and no alcohol consumption in the current pregnancy (p = 0.03) were associated with a decreased risk of back pain. There were no relationships found between the variables and back pain prevalence in the third trimester. Conclusion: The women attending this primary health care clinic are relatively young, come from a low socio-economic area with low reported levels of stress and substance abuse. They reported low levels of back pain. The follow up rate at the third trimester was low and this may skew the results of this study. Further research is needed in this community and South Africa to appreciate the prevalence and impact of back pain in pregnancy.
Clinical experiences of first-time registered Master's chiropractic students during their clinical practicum
(2017) Ganesh, Nivida; Varatharajullu, Desiree; Sibiya, Maureen Nokuthula
Background The imperative of clinical education in chiropractic is to endow students with the clinical competencies and professional attributes necessary for independent practice. The clinical practicum exposes chiropractic students to the realities, demands and expectations of patient care through immersion into the clinical learning environment. Various authors emphasise the importance of obtaining a student’s perspective of their experiences within this environment as it is essential to curriculum development and improvement, delivery of quality clinical education, and student satisfaction with their standard of education. Interestingly, unlike in other health professions’ disciplines, the clinical experiences of chiropractic students who have commenced their clinical practicum have scarcely been described in international literature. This study is the first of its kind to record the clinical experiences of chiropractic students during their clinical practicum in South Africa. Aim The aim of this study was to explore and describe the clinical experiences of first-time registered Master’s chiropractic students during their clinical practicum component at the Durban University of Technology Chiropractic Day Clinic in 2016. Method A qualitative, exploratory, descriptive approach was utilised. A purposive sample of 15 first-time registered Master’s chiropractic students was interviewed. Their clinical experiences during the clinical practicum were obtained through semi-structured interviews. Seven key questions, each relating to a specific aspect of the clinical practicum, were used to stimulate discussion. The data were recorded electronically and thereafter transcribed. Thematic analysis was used to interpret the data. Results Four main themes were identified, viz. undergraduate education and pre-clinical preparation; experiences within the clinical learning environment; inter-personal relationships in a clinical learning environment, and appraisal of the clinical practicum. Participants reported that the undergraduate and pre-clinical preparatory phase needed to be more practically orientated in order to provide relevance and cohesion to clinical learning. Significant experiences in the clinical learning environment included personal and professional growth and development, perceptions of preparedness for independent practice, perceptions of patient responses to chiropractic care, administrative duties and clinic infrastructure. The interpersonal relationships that contributed to the overall clinical experience were between students and their clinical supervisors, and students and the administrative staff. The appraisal of the clinical practicum included highlights and positive aspects that shaped the attitudes, values and philosophies of students, as well as the challenges and obstacles they encountered within the clinical learning environment. Conclusion This is the first South African study to document the clinical experiences of first-time registered Master’s chiropractic students. These clinical experiences were based on a variety of organisational and curriculum-orientated factors, as well as interpersonal dynamics. While students acknowledged and appreciated the critical importance of clinical education, and valued the learning opportunities within the clinical setting, they also provided constructive feedback on matters needing improvement to enhance the overall clinical experience. The lack of exposure to patient care prior to the commencement of the clinical practicum negatively impacted the clinical experiences. It is recommended that the findings of this study be utilised by the key stakeholders within chiropractic education to enhance chiropractic clinical education in South Africa.
Clinical instructor's experiences of clinical education at a chiropractic teaching clinic in KwaZulu-Natal
(2018) Vogl, Enya Elizabeth; Orton, Penelope Margaret
INTRODUCTION: This dissertation provides insight into the status of the clinical instructor’s experience of clinical education at a chiropractic teaching clinic in KwaZulu-Natal and aims to equip the profession to understand better how clinical instructors perceive their role in the clinical education of chiropractic students. AIMS AND OBJECTIVES: The primary objective of this study was to explore and describe the experiences of the clinical instructors at the Durban University of Technology (DUT) Chiropractic Day Clinic (CDC) as perceived by themselves. This study contributes to knowledge of the clinical education experience of clinical instructors at the DUT CDC. This information can assist the institution to better equip the clinical instructors for clinical learning, thus improving the educational experience of the students, and accomplishing the departmental and institutional vision and mission. RESEARCH DESIGN: This study was conducted within a constructivist paradigm using a qualitative, exploratory, descriptive design to explore the experiences of clinical instructors at the DUT CDC with regards to the clinical education setting. The constructivist paradigm as an epistemological position takes the view that knowledge of how things are is a product of how we come to understand them. This design concentrates on understanding and exploring meaning and the way people make meaning rather than proving a theory. RESEARCH METHODOLOGY: Semi-structured interviews were conducted with chiropractic clinical instructors so as to explore their clinical education experience within the DUT CDC, until saturation was met. A total of 14 interviews were conducted and analysed. The data was transcribed and coded by the researcher as well as the research supervisor. Content was analysed using the Graneheim and Lundman (2004) framework. RESULTS: The research question was answered and three primary themes that encompassed the experience of the chiropractic clinical instructors were identified. These were: clinical instruction and the role of the clinical instructor; interpersonal relationships in the clinical education setting; and the clinical education environment experience.
Clinical learning environment and supervision of student nurses' in a private nursing college : a cross sectional study
(2021-05-27) Mbonambi, Maureen Phindile; Orton, Penelope Margaret; Radana, Nolundi (Jevu)
ABSTRACT BACKGROUND: it is in my view that nursing education relates to the process of teaching and learning, given by nurse educators and clinical facilitators to nursing students. The teaching and learning process is conducted in a special Clinical Environment (CLE) entailing theoretical and practical learning. In addition to the teaching personnel, the clinical facilitators are responsible for placement of students in positive learning facilities for practical orientation in the clinical learning outcomes. It is these interactive processes that determine the state of readiness of the students in regards to their suitable attitudes required to provide nursing care. AIM OF THE STUDY: The purpose of this study is to describe nursing students’ experiences of clinical learning and clinical supervision at a private nursing college in eThekwini, in order to achieve improvements. METHODOLOGY: This study is influenced and guided by the quantitative, descriptive cross-sectional survey. It was done among student nurses (n = 120) at a private nursing college in eThekwini which offers the bridging course leading to registration as a Registered Nurse (R683) (South African Nursing Council 2006). In this study, data was gathered using the Clinical Learning Environment and Supervision (CLES) questionnaire developed by Mikko Saarikoski (2002), and it was analyzed by means of IBM SPSS statistics version 21. RESULTS: According to the study a general consensus has provided meaningful situations in the clinical learning environment. The clinical managers should give feedback to student nurses as it enhances their learning process. DISCUSSIONS: Findings in this study revealed that most participants were motivated and optimistic, and according to them, there was a positive clinical atmosphere; which is the most important features of a good clinical environment. RECOMMENDATIONS: It is encouraged that the clinical facilitators make more visits to the wards where the students are allocated for greater learning ability by the students. Professional nurses in the wards are to create a positive learning environment and use the presence of the students to maintain trust and prevent confusion.
A comparative study of a novel and school issued backpack on high school adolescent posture at the New Forest High School in the eThekwini district of KwaZulu-Natal
(2015) Reddy, Kimera; Kretzmann, Heidi; Maharaj, Praveena
Research has shown that more than 90% of the scholars, use backpacks, worldwide. The backpack has the ability to transport books, sports equipment and clothing between school and home, climaxing in a capacity that may affect posture. Therefore, it is noted that a backpack, which is not carried correctly, fitted improperly and/or over packed may pose a threat to the scholar’s posture Aim: To determine the effect between a novel and school-issued backpack in terms of postural symmetry measurements (photographic measurements), when compared to no backpack, on high school adolescent standing posture. Method: This research was a quantitative descriptive cross sectional experimental design. Each participating scholar underwent a BMI, height and weight screening, prior to inclusion into the data collection process. One hundred asymptomatic scholars, aged between 12 to 14 years, were recruited using convenience sampling. Thereafter, digital photographic images of each scholar was taken in 3 groups, i.e. no Backpack, with a school-issued backpack (Backpack A) and a novel backpack (Backpack B). These digital photographic images were then uploaded, by the researcher, onto the Posturepro 8 Computer Postural Software System. The objective measurement tool (Posturepro 8 Computer Postural Software System) calculated, in degrees, the postural measurements of the scholars’ neck, shoulder and pelvis, by manually constructing lines (horizontal and vertical) between the anatomical landmarks (bilaterally). IBM SPSS version 21 was used to analyse the data. A two-tailed p value of <0.05 was considered as statistically significant. Parametric summary statistics such as mean and standard deviations were used to describe the outcomes in each group. Postural measurements were compared between the pairs (i.e. no Backpack versus Backpack A, no Backpack versus Backpack B and Backpack A versus Backpack B) using paired sample t-tests. A one sample t-test was used to compare the symmetry measurements to a null hypothesis value of 0. Results: The mean age of the one hundred scholars was 13.5 (± 0.6 SD) years. The age of the scholars ranged between 12 and 14 years. This research was performed to determine which backpack (A or B) performed better in maintaining the scholar’s posture (with no backpack). A direct comparison was performed with no Backpack to that of Backpack A and Backpack B. The comparison for each of the differences closest to zero (‘0’) in the no Backpack, Backpack A and Backpack B groups was performed using a one sample t-test. The values closer to zero (‘0’) indicated a normal postural symmetry. None of the postural symmetry measurements were significantly different from zero in all 3 groups as the mean differences were very close to zero. Therefore, when comparing Backpack A to Backpack B, this research showed that there was no significant differences between the two backpacks when looking at postural symmetry (p=0.05). Conclusion: The trends observed in this study partly supported the claims by the company (‘Improved Postural Alignment for You’) of the novel backpack. The novel backpack (Backpack B) showed significant differences in some instances when assessing other outcome measurements, but showed no significant difference when comparing postural symmetry between the two backpacks. Further studies need to be done incorporating all aspects of postural analysis, and not just postural symmetry measurements.
A comparison of attitudes towards and practices of waste management in three different socio-economic residential areas of Umtata
(2001) Poswa, Tobius Thobile; Combrink, Jane
The purpose of this study was twofold. Firstly, the effect of the social dimensions of households on solid waste practice was investigated in order to examine relationships between socio-economic status and current solid waste practices. Current perceptions and solid. waste practices of households with different socio-economic backgrounds were assessed and compared to explain the influence of socio-economic factors in the planning and operation of a solid waste management system in developing urban areas. Secondly, a waste stream assessment was carried out to examine waste generation and composition trends among different social status residential urban areas. The generally poor state of solid waste services in most developing urban areas in South Africa and the chronic absence of data on domestic solid waste practice in the study area prompted this research initiative. A case study in Umtata involving three residential areas with different socio-economic status was used to assess and explain trends in solid waste practice and contributory factors to variations between different households amongst developing communities from a socio-economic perspective. Data were collected by a waste stream assessment survey involving measuring waste generated from the selected households and analysis of its composition. The waste stream assessment was complemented by a descriptive survey questionnaire, administered by means of personal interviews to each householder or resident in randomly selected households situated in the study area. The survey provided baseline information on solid waste practices and showed that local conditions were unique and thus require a local solution to the solid waste problems. The study showed that the understanding of the relations within households is vital for planning appropriate, effective and sustainable solid waste service programmes /systems. Gender relations, age, educational status and income are significant factors to be considered in planning and effectively operating solid waste management plans.
A demographic and descriptive survey of chiropractic patients at the chiropractic clinic at Kimberly [i.e. Kimberley] Public Hospital Complex
(2009) Higgs, Madelaine; Lakhani, Ekta; Jacobs, Ronel C.
Objective: The majority of information available on chiropractic patients originates from private practices in developed countries. However, recently reports describing chiropractic patients in South Africa have emerged, reporting on private practices and teaching clinics. Therefore, the overall purpose of this study was to determine the characteristics of patients presenting to a public chiropractic facility at the Kimberley Hospital Complex (KHC) in South Africa; and compare to the local and international private practices and teaching clinics. Methods: The period prevalence was three months in which information was extrapolated from patient files of the patients that presented to the KHC Chiropractic Clinic (KHCCC). Information that was collected included demographic data, common presenting complaints, patient history and common management protocols. Results: Data for 157 patients were recorded. The mean age of patients was 47.5 years, majority of the patients were female (70%), comprised of coloured and black patients (85%), where the greater part had a primary education level. Less than half the patients were employed in manual type of occupation, whilst almost one quarter of the patients were pensioners. By far, the greatest reason that patients visited chiropractors within the public health care sector at the KHCCC in South Africa was for chronic musculoskeletal complaints (68%). Majority presented with spinal complaints of the lower back (n=144), the most common diagnosis made was sacroiliac syndrome (48%). X-rays were the most common special investigation requested by KHCCC. The most common co-morbidities reported were hypertension, followed by diabetes and allergies. More than half the sample had undergone previous surgery. Thirty seven percent of patients received treatment for fewer than six visits. Contraindications to chiropractic treatment were indicated in only three patients. The treatment protocols that were predominantly used at the KHCCC were joint manipulation, followed by dry needling, kinesiotape and soft tissue therapy. Two thirds of all patients that were referred to the KHCCC were referred from within the medical profession. With regards to the chiropractic patients globally, similarities respect to patients in the public sector in South Africa to all sectors both locally and internationally, include factors such as majority female patients, top five anatomical locations of complaint, common usage of x-rays as a special investigation, similarities with co-morbidities including cardiovascular and endocrine, the repeated number of visits for the same complaint and manipulation remained treatment of choice. Conclusion: Although this was purely a demographic and descriptive study in nature, it gave a better understanding of patients that presented to a public hospital in a developing country like South Africa. With this demographic and descriptive information obtained in this study, it confirmed that although there is a unique population utilising chiropractic services within the public sector of South Africa, meaningful similarities have been found between patients in the different sectors in South Africa and internationally.
A description of pedagogical practices and student nurses’ critical thinking in a private nursing education institution in Pietermaritzburg, KwaZulu-Natal : a case study
(2020-11-30) Bridgelall, Nisha; Orton, Penelope Margaret; Coopasami, M.
Health care in South Africa has steadily evolved into a dynamic and complex environment coupled with the added burden of severely constrained resources. At the same time nurse practitioners are challenged daily, to provide safe, comprehensive and quality patient care. Clinical practice in nursing requires nurse graduates who are adequately trained in critical thinking skills (CTS). However, empirical evidence has highlighted that there is a lack of nurse graduates with this competency in the work environment. Consequently, the demand to produce self-directed, autonomous nurse professionals who are critical thinkers, has become a vital criterion in student nurse training. Therefore, it is incumbent that nurse educators integrate the development of CTS into their teaching strategies. Since critical thinking is an on-going process in using theory to guide clinical practice, it is imperative that nurses’ critical thinking abilities in clinical practice be measured. This will ensure the graduation of qualified nurse professionals who will deliver safe, qualitative, optimal and comprehensive nursing care with positive outcomes. Previous studies concur that it is the nurse educator who is responsible for inculcating this fundamental concept in student nurses however, finding methods for teaching the process of critical thinking has been a challenge for nurse educators that has spanned many decades. Now more than ever before there is a need for nurses who possess high-level CTS as a key competency, who can make effective clinical decisions, solve complex clinical problems, and provide quality patient care. This study focused on measuring student nurses’ critical thinking abilities in clinical practice and describes current instructional practices of nurse educators at the selected nursing educational institution (NEI). Alfaro-LeFevre’s (2016) theoretical model offers a definition of critical thinking (CT) as applied in the context of clinical practice. It describes the construct of CT as the integration of four components. For each of the components, Alfaro-LeFevre proposes a series of indicators of CT, called critical thinking indicators (CTIs). The CTIs are descriptions of behaviors that demonstrate the knowledge, attitudes, and skills that stimulate critical thinking in clinical practice (AlfaroLeFevre 2016). Aim The aim of this study was to measure the CTS of student nurses in the clinical setting and to describe the pedagogical practices of nurse educators at a selected NEI in Pietermaritzburg, KwaZulu-Natal. The findings of this study will contribute to CT development of nurses which is a fundamental skill for success within the rapidly changing healthcare arena of contemporary society. Methodology A descriptive, qualitative case study design using a multi-method approach to collecting data within a post positivist paradigm was adopted. The population comprised nurse educators and nursing students in a nursing college. The Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice) developed by Zuriguel‐Pérez et al. (2017) was chosen as the most appropriate instrument to assess student nurses’ critical thinking in practice. A sample of 120 student nurses completed this selfadministered quantitative data tool. Concurrently, qualitative focus group discussions were held to explore the pedagogic practices of nurse educators at the selected NEI. Results Qualitative and quantitative evidence in this study revealed that CTS were not being developed, initiated or supported both in the classroom and in the clinical environment. The relationship between socio-demographic factors such as age, language barriers, selection criteria, low motivation and negative attitudinal dispositions in students appeared to be major obstacles and inhibiting factors in critical thinking development. There was a lack of the use of creative and innovative pedagogic methods by nurse educators and the predominant practice was the lecture-method. The clinical setting presented further obstacles such as staff shortages, lack of clinical support, poor role modelling, lack of learning opportunities and lack of equipment and supplies. Conclusions The healthcare environment is dynamic and complex in and of itself, but the complexity is magnified by numerous further obstacles that exist as enumerated above. Critical thinking skills development is being severely compromised due to these issues. This has further widened the theory-to-practice gap which is a major concern in providing safe and beneficial patient outcomes. Now more than ever before, there is an urgent need for nurses who possess high-level CTS for effective clinical decision-making, problem-solving and the provision of quality patient care. Concerted efforts must be made to transform the classroom environment with creative and innovative teaching methodologies. Nurse educators lack adequate resources and must be equipped on how to teach for critical thinking development. Pedagogic practices must accommodate the millennial cohort who make up the majority of the nursing students. English comprehension as a compulsory subject in the beginning of the nurse training must be added to nursing curriculums. The effectiveness of teaching strategies must be measured for critical thinking development to demonstrate change over time. A clarion call is made for all stakeholders, the nursing faculty, nurse leaders in the clinical environment, professional bodies and legislature to come together and redesign the nursing curriculum to address the diversity of issues that infiltrate and impact the nursing profession. Recommendations It is recommended that further research be conducted on CTS measurement in multiple private and public NEIs and that the clinical settings be varied so as to ascertain a more comprehensive outcome. Given that personal characteristics function as an activating element in thinking ability, it is recommended that further studies be conducted to explore the demographic determinants of students such as selection criteria, age, language, diverse learning needs and backgrounds. Further research is recommended to explore the correlation between the clinical experience of nurses and the acquisition of CTS in the South African context. The addition of English language modules for students challenged in this regard should be considered. Alternative approaches in educational design in order to maximize learning for millennial students is recommended. Further studies to ascertain whether nurse educators are adequately equipped to teach for CTS development will add to the body of knowledge. This is the first study of this nature with this specific instrument to measure CTS that has been conducted in South Africa and the findings may therefore serve as baseline data for further research in this area.
The development of an eco-justice model to guide community engagement in Health Sciences
(2020-11-30) Chandramohan, Sandhya; Bhagwan, Raisuyah; Sibiya, Nokuthula
Humanity is facing massive health problems, physical pathologies and ecological damage that cannot be ignored. This escalating destruction of all forms of life on earth is a consequence of human action. Such destruction is reinforced by a worldview that denies nonhuman nature any value, respect or justice. Although the South African Department of Education developed the White paper on the Transformation of Higher Education (Department of Education 1997: 10), which committed universities to policies and programmes for community development, as part of the universities mandate there is no educational model that guides community engagement with regard to eco-issues. This study focused on developing a model to guide community engagement in Health Sciences through a qualitative approach. A developmental research paradigm was used as the research design. This paradigm allowed for the use of a qualitative research approach to design the new model. Data was collected from academics and students from Health Sciences, and faith-based leaders; through interviews and focus group discussions. Qualitative data analysis using thematic data analysis was utilized to transform the data into findings. The findings of the study confirm the ongoing damage to the eco-systems and how such environmental damage contributes negatively on health. These finding recommend that higher education embrace community engagement as a tool to create community awareness on eco-justice issues. For this to be successful it is recommended that community engagement be incorporated into Health Science modules in order to transform the Health Science curriculum. The developed eco-justice model for Health Sciences can serve as a guide for academics and students as they work in collaboration with their communities on eco-justice issues to reduce the resultant negative impact on health.
The efficacy of a homoeopathic complex (Kalium bromatum 9CH, Natrum muriaticum 9CH, Selenium 9CH, Sulphur 9CH and Thuja occidentalis 9CH) in the treatment of acne vulgaris
(2014-06-12) Ally, Sameer; Steele, Richard
Introduction Acne vulgaris is a common skin condition (disorder of the pilosebaceous duct) which is universal in adolescence. Acne vulgaris can persist into adulthood, with 1% of males and 5% of females requiring treatment until 40 years of age. Aim The aim of this study was to determine the efficacy of a homoeopathic complex (Kalium bromatum 9CH, Natrum muriaticum 9CH, Selenium 9CH, Sulphur 9CH and Thuja occidentalis 9CH), compared to placebo, in the treatment of acne vulgaris. Methodology A total of 37 participants between the ages of 18 and 31 were recruited from the Greater Durban area by means of poster advertisements placed on notice boards in shops, pharmacies, health shops, hospitals, schools, tertiary institutions including Durban University of Technology, and other public areas. Handouts were also left at these areas for people to take home. The final sample consisted of 34 participants due to the drop out of 3 participants. After participants read an information letter (English or Zulu), fulfilled the inclusion and exclusion criteria of the research, were diagnosed as having acne vulgaris by the researcher and completed an informed consent form (English or Zulu) and confidential patient information form (English or Zulu), they were randomly assigned to an experimental (homoeopathic complex) group and a control (placebo) group. In the final sample, the experimental (homoeopathic complex) group consisted of 7 males and 10 females, and the control (placebo) group consisted of 9 males and 8 females. Consultations took place at the Durban University of Technology Homoeopathic Day Clinic, and consisted of 3 consultations, an initial consultation followed by 2 follow-up consultations at 3 weekly intervals. The treatment period for each participant was therefore 6 weeks. A case history was taken and a complete physical examination was performed for all participants. The Leeds counting technique was used to assess and measure the response to treatment. The lesions assessed were the non-inflamed lesions (blackheads and whiteheads), inflamed lesions (papules, pustules, nodules, cysts and deep pustules) and the total number of acne lesions (number of non-inflamed and inflamed lesions combined). The response to treatment was measured in terms of a reduction in the number of non-inflamed, number of inflamed and total number of acne lesions, on the face, over the 6 weeks. SPSS version 20 was used to analyse the data. A p value of < 0.05 was considered as statistically significant. Non-parametric tests were used to analyse the data. The number of non-inflamed, number of inflamed and total number of acne lesions were compared within groups using the Friedman test and between groups using the Mann-Whitney U test. The number of lesions was compared separately for males and females, and also without gender classification. Results In females, the control (placebo) group showed a statistically significant reduction in the total number of acne lesions when compared to the experimental group (p = 0.034). However, as a whole, it was concluded from the results of this study that there was no significant difference in the number of non-inflamed (p = 0.193), number of inflamed (p = 0.290), and total number of acne lesions (p = 0.193) between the experimental (homoeopathic complex) and control (placebo) groups. Both groups showed a similar reduction when compared to each other. Conclusion It was concluded that the homoeopathic complex was not effective in the treatment of acne vulgaris.
The efficacy of an instructional model on the quality of teaching and learning using assessment
(2017) Mohapi, Mogapi Jeremia; Adam, Jamila Khatoon; Ngwenya, Thengamehlo Harold
The key aim of this study was to investigate the efficacy of the student-centric Integrated Teaching and Learning Model Using Assessment (ITLMUA) to enhance the effectiveness, efficiency and quality of student learning and teaching in a Clinical Technology programme. The ITLMUA provides a pragmatic theoretical framework for developing and enhancing perceptions and conceptions of pedagogics and associated educational and psychological theories, particulary assessment information to review, reflect and improve educational constructs of teaching, learning, assessment and educational research. The efficacy of ITLMUA uses effectiveness, usability and participants’ satisfaction as the key criteria in evaluating the impact of ITLMUA on the quality of student learning. The ITLMUA’s efficacy is judged in terms of participants finding it academically beneficial, valuable, suitable, useful and meaningful to instructional strategies and practices in higher education (HE). The motivation for the study is premise on lecturers’ adherence to conventional instructional strategies and practices and lack of instructional model that guides and measures the effectiveness and the quality of student learning and teaching. Increased workloads and superfluity of academic gatherings are some of the factors that exacerbate adherence to conventional instructional practices, including lack of academic qualification to understand the princples of educational practice in HE. This study promote and encourage integrated, authentic, dynamic and innovative instructional practices that demonstrate theoretical interest and practical relevance, such as active learning (AL) that is underpinned by learning theories and pedagogical principles. Furthermore, the study analyzed and identified some of the implementation challenges in introducing the integrated instructional model in a conventional learning environment in order to justify how and why it is imperative to adopt an integrated performance-based instructional model in the face-to-face (F2F) learning environment. The study proposed to provide an instrument that can be utilized to enhance the quality of student learning and teaching. The integrated instructional model can assist lecturers to reflect on their pedagogical practices with the intention of enhancing their subsequent pedagogical practices and strategies. The theoretical and conceptual framework of ITLMUA offered the lecturers an opportunity to integrate conventional and contemporary instructional practices. These frameworks have previously been underpinned by learning theories and pedagogical principles to enhance the quality of learning and teaching. Design-based research (DBR) methodology was utilized as it offered a systematic, flexible methodology that is theory-driven, and involves contextually-sensitive design principles and theories of the learning environment. It also offers the opportunity to review and redesign the ITLMUA as the research process develops, and new theoretical and conceptual framework information emerges. In addition, the DBR integrates research, design and practice into a single useful process which results into a usable product that is supported by a theoretical framework. Active learning is one of the teaching strategies that is supported and promoted by this study to improve quality learning and teaching in order for students to comply with and satisfy the academic quality standards and learning outcomes expected of them. This is can be achieved through meaningful engagement and active involvement in academic activities that promote critical analytical skills and competencies through collaborative and cooperative learning, and within a structured, supportive and facilitated learning environment. The learning environment should be characterized by student-centered and lecturer-facilitated instructional practices such as active learning teaching strategies. To enhance the quality of learning and teaching, lecturers attempt to match and modify their teaching strategies to accommodate the wide range of students in their classes, all of whom have different needs and expectations. Qualitative and quantitative research methods were used to gather data. Data analysis techniques included content analysis, the constant comparative method, factor analysis (FA) to reduce data in order to correlate and relate variables to components. Cronbach’s alpha was used to determine reliability of items. The study has demonstrated the utility, usability and efficacy of the ITLMUA as indicated, in the main, by participants’ satisfaction with the instructional model. The study reports on some of the enablers and barriers in the implementation and evaluation of the integrated instructional model and articulated the lessons that have been learned in this academic journey.
The efficacy of mineral therapy in the treatment of attention deficit children with hyperactivity
(1996) Muller, Nadine; Till, Hettie
The aim of the study was to evaluate the efficacy of Mineral Therapy in the treatment of Attention Deficit Disorder with Hyperactivity (ADDH) , with regard to inattention, impulsivity and hyperactivity, in order to demonstrate Mineral Therapy as an alternati ve to cerebral stimulants, such as Methylphenidate Hydrochloride (Ritalin). rt was hypothesized that the Mineral Therapy would result in a substantial improvement in all aspects of ADDH, and could consequently be used as an alternati ve treatment in a number of cases. The study was a clinical trial, in which a placebo control group was compared with two experimental groups. The study was undertaken over a period of two years. Sixty attention deficit children with hyperactivity attending Livingstone Primary School were analyzed. The children involved in the study already taking Ritalin, administered and monitored by their physicians, were randomly divided, by the participating pharmacist, into two groups: one receiving placebo and Ritalin (n = 20); the other Mineral Therapy and Ritalin (n = 20). The balance of the children, who were not taking Ritalin, was given Mineral Therapy only (n = 20). Each of the subjects was treated and observed over a period of four months for the purpose of this study. Prior to and on completion of the four-month course of Mineral Therapy each subject completed two assessment tests, namely the Children's Checking Task and the Feuerstein Test. Additionally,
An epidemiological investigation into primary headaches in an adolescent population in public high schools in the Westville Ward of the Pinetown School District
(2015-06-19) Crestani, Melissa Maria Alessandra; Varatharajullu, Desiree
AIM: The aim of the study is to determine the epidemiology of adolescents attending public high schools, in the Westville ward of the Pinetown School District, who present with a history of primary headaches. SUBJECTS: Adolescents between 14 and 19 years of age currently attending a public high school in the Westville Ward of the Pinetown School District. METHODOLOGY: Upon approval from the Department of Education (DoE) and principals of participating public high schools, an appropriate time-slot was identified in which the post-pilot questionnaire and letters of information and informed consent could be delivered to the scholars via the researcher. One class from Grade nine, Grade 10, Grade 11 and Grade 12, in each school, was randomly selected by a blind draw to participate in the study. A total of 460 completed informed consent and post-pilot questionnaires were collected and placed in separate sealed ballot boxes. All sealed ballot boxes were collected by the researcher. All post-pilot questionnaires were kept confidential and only seen by the researcher and supervisor. A code was allocated to each questionnaire before data was captured on a spreadsheet for data analysis by the chosen statistician. RESULTS: In total 460 questionnaires were utilised for statistical analysis. The results showed a high prevalence of Migraine-type headache (MTH) (17.2%) and Tension-type headache (TTH) (27.6%). However, no scholars were diagnosed with a Cluster-type headache (CTH). The majority of scholars (63.8%) did not seek medical attention or advice for their headaches. A history of experiencing headaches (p=<001), participation in sport (p=0.008), difficulty sleeping (p=<0.001) and sleep bruxism (p=0.007) were the only significant risk factors noted as statistically significant in this study. CONCLUSION: This study is consistent with previous studies on the high prevalence of primary headaches in an adolescent population. Primary headaches negatively affect the daily activities of adolescents; however, majority of adolescents do not seek medical attention or advice for their headaches.
An epidemiological study of low back pain in a student population of a South African tertiary educational institution
(2004) Smith, Craig Desmond
Epidemiological studies, conducted in various countries around the world suggest that low back pain (LBP) represents a serious health risk, affecting populations all over the world. Evidence suggests that the prevalence of LBP is relatively high among people in their 20’s and 30’s. A few epidemiological studies on student populations in other countries suggest prevalence rates of 27 to 71% (Gemmel et al. 1990, Klaber-Moffet et al. 1993, Reis et al. 1996, Lebowski 1997), however LBP among students in South Africa had not yet been investigated. This study concentrated on the prevalence of LBP among the student population of a South African tertiary institution, i.e. Durban Institute of Technology (DIT). This study also proposed to investigate the level and nature of care seeking among those people suffering from LBP. A third aim of this study was to investigate the correlation between potential risk factors and the prevalence of LBP among the student population of South Africa. These were: age, gender, race, height, weight, smoking habits, parity, physical exercise and occupation.