Faculty of Health Sciences
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Item Exploring the interrelationships between physical function, functional exercise capacity, and exercise self-efficacy in persons living with HIV(SAGE Publications, 2024) Nokes, Kathleen M.; Sokhela, Dudu G.; Orton, Penelope Margaret; Samuels, William Ellery; Phillips, J. Craig; Tufts, Kimberly Adams; Perazzo, Joseph D.; Chaiphibalsarisdi, Puangtip; Portillo, Carmen; Schnall, Rebecca; Hamilton, Mary Jane; Dawson-Rose, Carol; Webel, Allison R.While physical activity can mitigate the metabolic effects of HIV disease and HIV medications, many HIV-infected persons report low levels of physical activity. Purpose: To determine if there were differences between the subjective and objective assessments of physical activity while controlling for sociodemographic, anthropometric, and clinical characteristics. Setting/sample: A total of 810 participants across eight sites located in three countries. Measures: Subjective instruments were the two subscales of Self-efficacy for Exercise Behaviors Scale: Making Time for Exercise and Resisting Relapse and Patient-Reported Outcomes Measurement Information System, which measured physical function. The objective measure of functional exercise capacity was the 6-minute Walk Test. Analysis: Both univariate and multivariant analyses were used. Results: Physical function was significantly associated with Making Time for Exercise (β = 1.76, p = .039) but not with Resisting Relapse (β = 1.16, p = .168). Age (β = −1.88, p = .001), being employed (β = 16.19, p < .001) and race (βs = 13.84–31.98, p < .001), hip–waist ratio (β = −2.18, p < .001), and comorbidities (β = 7.31, p < .001) were significant predictors of physical functioning. The model predicting physical function accounted for a large amount of variance (adjusted R2 = .938). The patterns of results predicting functional exercise capacity were similar. Making Time for Exercise self-efficacy scores significantly predicted functional exercise capacity (β = 0.14, p = .029), and Resisting Relapse scores again did not (β = −0.10, p = .120). Among the covariates, age (β = −0.16, p < .001), gender (β = −0.43, p < .001), education (β = 0.08, p = .026), and hip–waist ratio (β = 0.09, p = .034) were significant. This model did not account for much of the overall variance in the data (adjusted R2 = .081). We found a modest significant relationship between physical function and functional exercise capacity ( r = 0.27). Conclusions: Making Time for Exercise Self-efficacy was more significant than Resisting Relapse for both physical function and functional exercise capacity. Interventions to promote achievement of physical activity need to use multiple measurement strategies.Item COIL4COIL : building expertise and capacity in faculty at Durban University of Technology, South Africa(Erasmus+ National Agency for EU Higher Education Cooperation, DAAD, 2020-05) Orton, Penelope Margaret; Cooke, Lesley Anne; Morton, JoelDurban University of Technology (DUT) has, as two of its strategic objectives, internationalisation of the curriculum and e learning. In pursuit of these two strategic objectives, DUT became the first African university to join the State University of New York (SUNY) Collaborative Online International Learning (COIL) global network in 2016. At DUT, the graduate attributes include critical and creative thinkers who work independently and collaboratively, knowledgeable practitioners, effective communicators, culturally, environmentally and socially aware within a local and global context and active and reflective learners. COIL/Virtual Engagement (VE) offers opportunities to develop these attributes in students and enhances their soft skills, which are so necessary in the workplace. COIL/VE has allowed students and academic staff from DUT to engage in collaborative learning experiences using technology and to date we have had approximately 20 projects across different departments and collaborating with programmes in New York State, Mexico, Brazil and the Netherlands. DUT is currently, expanding their international partnering network beyond the SUNY COIL network. When new ideas and ways of doing things, changes are introduced it is suggested that the innovators, those who jump on board first, are approximately 2.5% of the staff, then the early adopters are approximately 13.5% of the staff and the early majority 34%. This is an indication of work that needs to be done, in the University to get academic staff to embrace the concept of COIL/VE and introduce projects into their programmes and modules. In an effort to roll out COIL/VE to the academic fraternity at DUT, we have adopted a number of initiatives with mixed success. A COIL Clinic is held every week which is a “drop in” opportunity where academic staff can drop in to have a chat about COIL/VE – partnering, instructional design, ideas they may have or just an opportunity to explore the concept a little more. Varieties of workshops are held where the concept of COIL/VE is explained, some ideas of the use of technology are shared and participants have time to discuss and conceptualise a project for themselves. In some workshops, academic staff who have had successful projects are invited to share their experience with participants. There are occasions where the COIL/VE project has resulted in inbound mobility of an international partner and their expertise and/or experience is shared with DUT academic staff. In order to develop academic staff capacity a blended short course was developed to run over 5 weeks but was not a great success and this needs to be reconsidered and redesigned. A face-to-face session was held which was well attended but the online component was not well “attended.” Following this and in discussion with a European colleague an activity was offered once off between a European university, one in the United States and DUT. Academic staff were invited to a virtual meeting on Zoom and they had a short introduction to COIL/VE and then went into “breakout rooms” to discuss with international colleagues ideas for possible projects. Following which they all came back together and shared some of the discussions. From this exercise academic staff were encouraging the formation of a community of practice which would meet regularly. One of the constraints with the North South partnerships is the semester differences. In the Northern Hemisphere the 1st semester is from September through to about March/April. In the Southern Hemisphere the 1st semester is from February to June. This means that the first half of the year is a better time to collaborate North South with project development happening in the second half of the year for Implementation in the next year. This is true for the collaboration on staff development too where from June to September staff are away on vacation at various times during those 3 months. The last activity, which we have suggested as a strategy, to develop academic staff capacity is a journal club. This activity would help engage academic staff in the pedagogy and scholarship of COIL/VE and would go some way to developing the scholarship opportunities emanating out of COIL/VE projects. DUT COIL/VE is supported by an Educational Technologist who is able to assist academic staff with technology that assists with academic development in the use of technology in teaching. Durban University of Technology is in the initial stages of its COIL/VE trajectory and has so far, tapped into the 2.5% of teaching innovators and now needs to move the initiative into developing the next level of academic staff who, could be considered, early adopters. The opportunities to develop a community of practice and a community of enquiry, to progress the use of models and frameworks to teach with technology and to develop the scholarship of teaching and learning in COIL/VE are exciting.Item Exploring intersectionality and HIV stigma in persons receiving HIV care in nurse-led public clinics in Durban, South Africa(Elsevier BV, 2023) Sokhela, Dudu Gloria; Orton, Penelope Margaret; Nokes, Kathleen M.; Samuels, William E.Background: Although stigma associated with South African people living with HIV has declined since the 1980s when HIV/AIDS was first identified, it still persists. Stigma is associated with poor health outcomes and avoidance of interactions with healthcare systems. The HIV stigma framework distinguishes three HIV-related self-stigma mechanisms. Aims: The aims of this study were to explore intersectionality between HIV-stigma mechanisms and selected sociodemographic as well as HIV factors, and interrelationships between three HIV-related self-stigma mechanisms. Setting and method: This study was a secondary analysis of data collected from a cross-sectional sample of people receiving HIV-related primary health care at different municipal clinics in Durban, South Africa (N = 100). Results: The average participant was Black African, female, unemployed, with a monthly income below R2 500, most had completed primary school. No sociodemographic or HIV-related factors were significantly related to total or subscale HIV stigma scores. Respondents reported experiencing (enacted) no stigmatization, did not expect to experience (anticipated) much stigmatization from their social interactions with family, community, healthcareworkers, and reported no strong stigmatizing beliefs about themselves (internalized). Conclusion: Intersectionality did not identify any particular socio-demographic or HIV-related factor associated with greater HIV stigma. Participants reported low HIV stigma arising from interactions with healthcare and social service providers or families. Although no socio-demographic or HIV-related factors were significantly associated with HIV stigma mechanisms in this relatively homogeneous sample, being marginalized can nevertheless result from living with other differences compared to societal norms and result in particular vulnerability when living with HIV/AIDS.Item Factors related to functional exercise capacity amongst people with HIV in Durban, South Africa(AOSIS, 2021-04-29) Orton, Penelope Margaret; Sokhela, Dudu Gloria; Nokes, Kathleen M.; Perazzo, Joseph D.; Webel, Allison R.BackgroundPeople with HIV (PWH), who engage in regular physical activity, have improved fitness, muscular strength, body composition, health-related quality of life and mental health symptoms, but PWH have amongst the lowest physical activity levels of those with any chronic health condition. Furthermore, there is scant evidence examining these relationships in PWH in Africa.Aim
To address these critical gaps, this cross-sectional descriptive research study examined the relationships between demographic, HIV-related, anthropometric factors, neighbourhood walkability and physical activity, amongst PWH in Durban, South Africa.Setting
Respondents (N = 100) were receiving primary healthcare in six eThekwini nurse-run municipal clinics.Methods
Self-reported socio-demographic data were collected, and HIV-related medical data were extracted from respondent's medical charts. Height and weight were measured to calculate the body mass index (BMI, kg/m2); neighbourhood walkability was measured on the Neighbourhood Environment scale; and physical activity, specifically functional exercise capacity, was measured by the 6-min walk test (6MWT).Results
On average, respondents were black African, female, approximately 38 years old and unemployed; men were of normal weight whilst women were overweight. Only 65% of the respondents reached the age- and sex-predicted distance during the 6MWT. Correlational analyses did not reveal any significant relationships between the functional exercise capacity and socio-demographic, HIV-related factors or anthropometric measures.Conclusion
South African PWH do not reach their predicated walking distance on the 6MWT. Engaging community agencies to promote walking as both a means of transportation and leisure physical activity may decrease the risks of a sedentary lifestyle and improve progression towards recommended physical activity targets.Item Creating an instrument to measure perceptions about access to health-related higher education programmes in South Africa(Stellenbosch University, 2020-12-04) Orton, Penelope Margaret; Essack, Sabhia; Nokes, Kathleen M.; Brysiewicz, PetraBackground: The South African government has created countless policies that support the need to admit and graduate students who had been excluded from health-science programmes in higher education settings during the apartheid era. Objective: to develop a questionnaire that could be used by various stakeholders to obtain their perceptions about access to health sciences education in higher education settings. Method: A mixed methods design was used; the qualitative stage allowed for the identification of themes while the quantitative stage used measurement theory, to develop an instrument based on those themes. Results: The overarching theme was Achieving equity of access for success is multi-factorial and has diverse & complex challenges and eight sub-themes emerged which were used to create a 17-item questionnaire that has good content validity and reliability (Cronbach alpha=.767). Conclusion: Further psychometric testing with larger, more diverse samples will result in a refined instrument that can be administered to various stakeholder groups, such as current and potential health sciences students and faculties, and used in programme evaluation. Health science programmes can use the instrument to measure access within different disciplines and possible changes over time as innovations are piloted. Different health sciences programmes can be compared and contrasted and objective data can be used to make systematic organizational changes.