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Faculty of Health Sciences

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    Experiences of midwives regarding nursing practice breakdown in maternity units at a selected public hospital in KwaZulu Natal
    (UNISA Press, 2016) Mhlongo, Ndumiso Mbonisi; Sibiya, Maureen Nokuthula; Miya, Respect M.
    Pregnant women have certain expectations about the midwife and their skills. If such expectations are not met, substandard care occurs. Such substandard care has a negative impact on both the pregnant women and the Department of Health. The aim of the study was to explore and describe the experiences of midwives regarding practice breakdown in maternity units at a public hospital in KwaZulu-Natal in order to improve the quality of care in maternity units. A qualitative research study that was exploratory, descriptive and contextual in nature was conducted. Semi-structured interviews were conducted with 13 midwives. Data was transcribed verbatim, then organised into codes. The study revealed that the majority of the participants faced practice breakdown, which mostly starts during ante-natal care visits. Midwives who attended to pregnant women during ante-natal care did not follow set protocols and guidelines and this resulted in complications during delivery. Midwives were of the opinion that the management did not care about their challenges and did not attempt to resolve the challenges. Therefore, strategies of retaining midwives must be put in place by the Department of Health. Midwives must be relieved in all nonnursing- related matters to allow them to focus on the pregnant women.
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    Spirituality and spiritual care in the context of nursing education in South Africa
    (AOSIS, 2015-12-17) Chandramohan, Sandhya; Bhagwan, Raisuyah
    In order for nursing education to prepare nurses for holistic patient care, it is critical that educators become more aware of the religious and spiritual dimensions in patient care and be able to provide adequate knowledge and skills for nurses to offer spiritually-based care in an ethical way. Furthermore, spiritual care is an essential component in the nursing context, as nurses have to care for patients who may often turn to the spiritual dimension to cope and heal. These aspects are important issues to be considered in planning what should be taught as part of spiritual care. OBJECTIVES: This paper presents findings from a study on nursing practitioners' views on the role of spiritual care in nursing practice and whether current nursing education has integrated this dimension into teaching. METHOD: A descriptive survey using a cross-sectional design with 385 nurses was conducted between December 2012 and February 2013. Participants were recruited through multistage random sampling. Data analysis was undertaken using SSPS 0.20. RESULTS: All the participants (n = 385) concurred that spiritual care was a salient component of holistic patient care. They however stated that the primary barriers to providing spiritual care related to uncertainty on how to provide this type of care, and a lack of educational preparedness for this role. CONCLUSION: The study found that nurses were very accepting of the need for spiritual care as part of their nursing role but that nursing education had not paid adequate attention to integrating this dimension into the nursing curriculum.
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    African leafy vegetables as bio-factories for silver nanoparticles : a case study on Amaranthus dubius C Mart. Ex Thell
    (Elsevier, 2016) Sigamoney, M.; Shaik, S.; Govender, P.; Krishna, Suresh Babu Naidu
    Nanoparticles are used across many scientific and pharmaceutical fields and are found in products that come into close contact with the human body. There is a growing need for ‘green synthesis’ of silver (Ag) nanoparticles and plant-mediated synthesis is becoming increasingly popular. The current study aimed to firstly synthesise Ag nanoparticles using fresh and freeze-dried leaves, stems and roots of the African leafy vegetable, Amaranthus dubius. The synthesised Ag nanoparticles were subsequently characterised using UV–visible spectroscopy, scan-ning electron microscopy (SEM), transmission electron microscopy (TEM), energy-dispersive X-ray (EDX) anal-ysis and Fourier transform infrared (FTIR) spectral analysis. The bioactivity (antibacterial and antifungal) of the synthesised Ag nanoparticles was also assessed using the minimum inhibition concentration (MIC) method. The results suggest that A. dubius plant extracts can serve as environmentally benign bio-factories for the synthe-sis of bioactive Ag nanoparticles. However, the characteristics of these nanoparticles differed based on the organ used to prepare the extract and whether the plant material was fresh or freeze-dried. Silver nanoparticle yield was greatest in the freeze-dried and fresh leaf extracts of A. dubius. However, EDX analysis revealed nanoparticles produced using freeze-dried and fresh stem extracts to contain the most elemental Ag. Silver nanoparticles syn-thesised from the different plant organs all displayed a spherical shape; however, Ag nanoparticles synthesised from the stem extracts (30–35 nm) were significantly larger than those synthesised from leaf and root extracts (18–21 nm). FTIR analysis confirmed the presence of carbonyl groups, proteins and aldehydes on nanoparticles produced using all extract types. The Ag nanoparticles synthesised from fresh stem extracts displayed the highest antimicrobial activity compared with those synthesised from the other plant organs. Fresh stem extracts of A. dubius appear to be most suitable for biosynthesis of Ag nanoparticles, yielding the largest nanoparticles, with the highest elemental Ag content, and greatest inhibition of microbial growth.
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    The role of trophoblast cell receptor expression in HIV-1 passage across the placenta in pre-eclampsia: an observational study
    (Wiley, 2016-10-03) Dorsamy, V.; Vallen, C.; Haffejee, Firoza; Moodley, J.; Naicker, T.
    Objective To compare expression of markers of HIV and associated receptors (p24, CD4, CCR5 and ICAM-2) in placentae and umbilical cords of HIV-associated and pre-eclamptic pregnancies to elucidate any association between these conditions in mother-to-child transmission. Design Cross-sectional immunohistochemical analysis of target receptor expression. Setting Laboratory-based study of primigravidae attending a district hospital in South Africa. Population or sample Retrospectively collected placental tissue (stratified into four groups according to HIV status of normotensive and pre-eclamptic participants (n = 20/group). Method Immunohistochemistry utilising CD4 (1:1), p24 (1:10), CCR5 (1:80) and ICAM-2 (1:100) antibodies was performed using light microscopy for image acquisition and analysis. Main outcome measures Evaluate the expression of receptors on syncytiotrophoblast involved in in utero transmission of HIV. Results Syncytiotrophoblast was immunopositive for CD4 and CCR5 antibody with greater expression of CCR5 in HIV-positive versus HIV-negative groups (F1,159 = 6.979, P = 0.009) and normotensive versus pre-eclamptic groups (F1,159 = 8.803, P = 0.003). p24 was present in both placentae and umbilical cords of babies that were HIV-negative at 6 weeks. ICAM-2 immunostaining was observed in the syncytiotrophoblast across study groups and was significantly higher in the HIV-negative pre-eclamptic group (v2 (3) = 45.3; P < 0.001). Conclusion Concurrent CD4 and CCR5 receptor expression demonstrates possible in utero viral entry routes across the placental barrier. ICAM-2 expression may influence HIV passage across the placenta or restoration of risk of pre-eclampsia in HAART-treated mothers. HIV was found in fetal circulation regardless of antiretroviral treatment. Further confirmatory ultrastructural and molecular work is warranted.
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    Placental leptin mRNA expression and serum leptin levels in pre-eclampsia associated with HIV infection
    (Taylor and Fancis Online, 2016-10-03) Haffejee, Firoza; Naicker, Thajasvarie; Singh, Moganavelli; Kharsany, Ayesha B.M.; Adhikari, Miriam; Singh, Ravesh; Maharaj, Niren; Moodley, Jagidesa
    Leptin, primarily produced by adipocytes, is implicated in the development of pre-eclampsia. This study examines placental leptin production and serum leptin levels in HIV infected and uninfected normoten-sive and pre-eclamptic pregnancies. Placental leptin production was analysed by RT-PCR and serum lep-tin levels by ELISA in normotensive (n ¼ 90) and pre-eclamptic (n ¼ 90) pregnancies which were further stratified by HIV status. Placental leptin production was higher in pre-eclampsia compared to normoten-sive pregnancies irrespective of HIV status (p ¼ .04). Serum leptin was non-significantly raised in HIV uninfected (p ¼ .42) but lower in HIV-infected (p ¼ .03) pre-eclampsia. The latter had lower BMI (p ¼ .007) and triceps skin-fold thickness (p < .001) than the HIV uninfected groups with a significant correlation between serum leptin and triceps skin-fold thickness (p < .001), indicative of less adipose tissue in HIV-infected women with consequently lower serum leptin. Thus, serum leptin levels are not indicative of increased placental production when pre-eclampsia is associated with HIV infection.
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    Reducing the surface roughness of dental acrylic resins by using an eggshell abrasive material
    (Elsevier, 2017-02) Onwubu, Stanley Chibuzor; Vahed, Anisa; Singh, Shalini; Kanny, Krishnan
    Statement of problem Excessive surface roughness of denture base resins adversely impacts oral health. Purpose The purpose of this in vitro study was to examine the abrasive potential of eggshell powder in reducing the surface roughness of denture base resins. Material and methods Thirty poly(methyl methacrylate) specimens were fabricated and polished with eggshell powders of different particle sizes and with pumice. The average surface roughness (Ra) after polishing was measured with a profilometer. Scanning electron microscope and optical electron microscope techniques were used to assess the surface roughness morphology of the specimens. ANOVA was used to analyze the Ra values. The Tukey honest significant differences and Bonferroni tests were used to identify differences between the 2 abrasive materials (α=.05). Results Significant differences in the Ra values were observed between the fine and medium eggshell powder abrasives (P<.05). Similarly, significant differences were found between pumice and the fine eggshell powder abrasives (P<.001). No significant differences were found between pumice and the medium eggshell powder abrasive (P>.05). Specimens polished with pumice had the highest Ra values, whereas specimens polished with the fine eggshell powder abrasive had the lowest Ra values. Conclusions By connecting the Ra values to the threshold limit value of 0.2 μm, eggshell powder abrasive finished denture acrylic resin surfaces better than pumice.
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    Linking the ‘know-that’ and ‘know-how’ knowledge through games : a quest to evolve the future for science and engineering education
    (Springer Science+Business Media, 2016) Vahed, Anisa; McKenna, Sioux; Singh, Shalini
    This paper responds to Muller’s notions of ‘knowing-that’ and ‘knowing how’. The paper addresses how educational interventions that are designed in line with targeted discipline-specific subjects can enhance the balance between professional practice and disciplinary knowledge in professionally accredited programmes at universities of technology. The context is a Dental Technology programme at a University of Technology in South Africa. Teaching through discipline-specific games, conceptualised from a game literacies perspective, is proposed as an engaging, interactive pedagogy for learning dis-ciplinary knowledge that potentially encourages access to a particular affinity group. The authors use concepts from Bernstein and Maton to investigate whether epistemic relations or social relations are emphasised through board and digital games designed for two Dental Technology subjects. This paper offers valuable insight into alternative pedagogies that can be adopted into science, technology, engineering, and mathematics education with the aim of paving a pathway towards Muller’s Scenario 3.
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    The operating room as a clinical learning environment : an exploratory study
    (Elsevier, 2016) Meyer, Rhoda; Van Schlkwyk, Susan C.; Prakaschandra, Dorcas Rosaley
    Students undertake their clinical placement in various clinical settings for the exposure to and acqui-sition of skills related to that particular context. The operating room is a context that offers the oppor-tunity to develop critical skills related to the perioperative care of the patient. Despite numerous studies that have been undertaken in this field, few have investigated the operating room as a clinical learning environment in the South African private healthcare context. The aim of this study was to determine nursing students' perceptions of the operating room as a clinical learning environment. An exploratory, interpretive and descriptive design generating qualitative data was utilized. Eight nursing students completed an open-ended questionnaire, and twelve nursing students participated in the focus group discussion. Four themes emerged, namely, ‘interpersonal factors’, ‘educational factors’, ‘private operating room context’, and ‘recommendations’. The opinion that the operating room offers an opportunity to gain skills unique to this context was expressed. However, despite the potential learning opportunities, the key findings of this study reveal negative perceptions of nursing students regarding learning ex-periences in the operating room. Exploration into the preparatory needs of students specific to learning outcomes before operating room placement should be considered. It will also be necessary to improve collaboration between lecturers, mentors and theatre managers.
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    The use of standard treatment guidelines and essential medicines list by professional nurses at primary healthcare clinics in the uMgungundlovu District in South Africa
    (Elsevier, 2015) Sooruth, Umritha Raj; Sibiya, Maureen Nokuthula; Sokhela, Dudu Gloria
    One of the major challenges for the Department of Health in South Africa today is inequity and the need to provide quality integrated health care for all its citizens. Primary healthcare (PHC) has been declared as the way to achieve this goal, through the District Health System. Standard Treatment Guidelines (STGs) and the Essential Medicines List (EML) have been developed and are used at PHC clinics and hospitals. This study explored the use of STGs and the EML by professional nurses at PHC clinics in the uMgungundlovu District, province of KwaZulu-Natal in South Africa. A quantitative descriptive research design was used. Questionnaires were used to collect data from respondents at the PHC clinics. The researcher also reviewed the professional nurse’s registers retrospectively on the rational use of drugs. The findings of the study revealed that the respondents had a good understanding of the use of the STGs and the EML. There was no evidence of polypharmacy, and medications were prescribed according to the STGs and the EML guidelines. Areas that were suboptimal were related to prescription writing, in writing of schedules and routes of medication as indicated in facility records. The results further showed that training on the use of the STGs and EML were inadequate, which implies the need for strengthening of training programmes.
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    Assessment of the use of the new maternity case record in improving the quality of ante natal care in eThekwini District, KwaZulu-Natal
    (Elsevier, 2015) Sibiya, Maureen Nokuthula; Cele, Reginah Jabulisile; Ngxongo, Thembelihle Sylvia Patience
    The national guidelines for maternity care in South Africa recommend that a standardised maternity case record be used by all facilities at all levels of care in order to improve the quality of care for pregnant women. This will facilitate continuity and quality of care for women during pregnancy, labour and post-partum. The aim of the study was to assess the use of the maternity case record in improving the quality of the antenatal care for pregnant women. An exploratory, descriptive study using both quantita-tive and qualitative design was used to conduct the study. Data was collected through a retrospective record review using a checklist for the quantitative strand, and from midwives using unstructured inter-views for the qualitative strand. The quantitative data set was analysed using the Statistical Package for the Social Sciences version 21.0 and the qualitative strand was analysed using the Tesch’s method of data analysis. The results of the record review revealed that although the recording was done fairly well, there were a number of activities and interventions that were recorded poorly or not recorded at all in some primary health care clinics. The midwives verbalised that many mistakes and mismanagement of ante-natal care clients emanated from the structure and the design of the new maternity case record.