Walter Sisulu University
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Clinical and demographic profile of catatonic patients who received electroconvulsive therapy in a South African setting
Get PDFTurnover of benthic macroinvertebrates along the Mthatha River, Eastern Cape, South Africa: implications for water quality bio-monitoring using indicator species
Get PDFVersions of masculinity in Zukiswa Wanners work
Get PDFTraditional notions of masculinity which give power and authority to one dominant form of masculinity in the contemporary era are under scrutiny as they are constantly being challenged through the emergence of alternative forms of masculinity. Through the use of Wanner’s novels, this work examines how South African masculinities are constructed, how they are challenged, and how alternative forms are negotiated. It unpacks Wanner’s depiction of hegemonic, thwarted, complicit and marginalised masculinities as it traces the diversity and fluidity of masculinities in these literary texts and the resultant alternative masculinities these novels propose. Furthermore, this work foregrounds the often taken-for-granted role of women and portrays it as the centre around which masculinities are constructed. This is achieved by probing deeper into the familial unit and looking at the traditional gender roles of women, taking into consideration that the South African constitution allows them either to stick to these roles or to choose from an array of career choices presented to them. It is suggested that instead of viewing masculinity as a standard uniform entity, it is profitable to perceive it as a heterogeneous entity, comprising of different versions which are determined by different factors. It is further suggested that the role of women in the construction of masculinities should be given recognition, as they seem to play a significant role in either inhibiting or promoting the transformation of masculinities through the choices they make.Thesis (M.Arts) -- Faculty of Humanities, Social Sciences and Law, 201
An Evaluation of the Role of an Intermediate Care Facility in the Continuum of Care in Western Cape, South Africa
Get PDFDeterminants of Type 2 diabetes mellitus among HIV/AIDS patients on antiretroviral drugs in the OR Tambo District, South Africa
Get PDFType 2 diabetes mellitus (DM) is a frequent adverse effect of antiretroviral drugs for those who are on ARVS. People with type 2 DM can suffer multiple complications that hinder the quality of life. In South Africa research has shown significant increase in neuropathy, heart and kidney diseases among patients living with type 2 DM and HIV/AIDS compared to DM without HIV. Accessed knowledge lacked consistency on the predictors of DM in HIV/AIDS patients with regards to the type of ARVS with higher risks of DM. Research needed to be done to find the determinants of type 2 DM in HIV/AIDS context. The purpose of this study was to describe the determinants of type 2 DM among HIV/AIDS patients on ARVS in the OR Tambo District, SA in order to develop intervention strategies to mitigate the long-term effects of type 2 DM. A quantitative research methodology using a case control retrospective study was used. A sample of 177 (33%) cases with HIV/AIDS and type 2 DM was selected using a one stage stratified sampling with allocation proportional to size of each stratum of the four sub-districts of OR Tambo District. Two non-diabetic patients with HIV/AIDS were selected as controls per case unpaired and totalled up to 354 (67%) controls. A self-administration questionnaire adopted from the WHO (2011) STEPwise surveillance tool for chronic diseases was used for data collection. Stata (standard version 13.0, Stata Corp., Lakeway Drive USA) was used for data management and analysis. Findings of the study revealed determinants of type 2 DM grouped as the socio-demographic determinants; tertiary education and marital status, levels of physical activities; lack of vigorous activity and sport, types of diets; high fruits and vegetables and healthy eating out at restaurants, arterial blood pressure; lack of routine BP check and known HPT and types of ARVS used in HIV/AIDS therapy. Compared with patients who received FDC, the risk of type 2 DM was 43 times and 22 higher when a tri-therapy regimen contained Ritonavir and Lopinavir respectively . The majority of DM patients (n=177) were diagnosed type 2 DM after ARVS at n=108 (61%). In managing the diabetic patients a shift from a single disease to multiple-chronic disease focus is required to mitigate the complex drug interactions that exist in the control of NCDs such as HIV/AIDS, DM, HPT and other long-term diseases. The HIV/AIDS and type 2 DM awareness and care intervention strategy is recommended as healthy lifestyle, monitoring of side effects and drug interactions, enhanced FDC roll out and elimination of unsafe ARVS to improve the health outcomes of type 2 DM patients in an HIV/AIDS context in OR Tambo District
Vulnerabilities of Coastal Tourism destinations to climate change related incidents: a case study selected holiday resorts along the wildcoast, Eastern Cape, South Africa
Get PDFClimate change is a global phenomenon with major impacts on coastlines, leaving coastal areas vulnerable to conditions such as sea level rise, flooding as well as storm surges, which results in increased damage to or loss of coastal property and infrastructure. The study examined the vulnerability of the Eastern Cape’s Wild Coast resorts to climate change related impacts. Both qualitative and quantitative methods aided by questionnaires and GIS mapping were used to identify vulnerable settlements as well as their impacts. A meta analysis of the identified vulnerabilities was studied and strategies employed to reduce the impacts was also done. Results indicated that almost 80% of the Wild Coast resorts occur within the low-lying areas of the coast and these areas were mostly affected by impacts such as sea level rise, heavy rainfall and floods accompanied by storm surges. Another alarming challenge faced by the King Sabata Dalindyebo Municipality was controlling unplanned developments within these low-lying zones of the coast. Therefore, it is recommended that relevant departments provide awareness through various platforms such as workshops, programmes and campaigns to ensure that people understand the risk of climate change on low-lying areas as well as mainstreaming climate change in long term development planning. This study highlights a need for monitoring of coastal environments vulnerable to the impact of climate change along a South African coastline
Barriers to Collaborative Culture of Teaching and Learning in Selected High Schools of Libode In O.R. Tambo Coastal Education District
Get PDFThe purpose of this study was to investigate the barriers to collaborative culture of teaching and learning in selected high schools in Libode, O.R Tambo Coastal Education District. The literature review looked into each of the following aspects of teacher collaborative culture of teaching and learning in schools: theoretical framework, significance of changing the culture of teaching and learning and in schools, the nature of teacher resistance in collaborative teaching and learning in schools, the nature of teacher collaborative professional development activities in schools, the existence of collaborative learning culture in schools, leadership in collaborative culture of teaching and learning. This study was qualitative in nature and employed case study as the research design. The convenient sampling strategy was used to select three (3) high schools in Circuit 9 and 10 in Libode, O.R Tambo Coastal Education District. Four (4) teachers and one (1) principal were purposefully selected from each school the 3 schools and this made a total of fifteen (15) participants. Face-to-face individual interviews were conducted to gather data about the view points and opinions of the participants concerning the barriers to collaborative culture of teaching and learning in selected high schools of Libode, O.R Tambo Coastal Education District. Data collected was analyzed using the interpretational analytical strategies. Themes were drawn from the responses of the participants and analyzed. Some of the findings were that: There was inadequacy of positive attitudes towards collaboration with other teachers in the process of teaching and learning, teacher resistances was a barrier to collaboration in schools, there were inadequate collaborative strategies to provide the social, emotional, and intellectual engagement among teachers, knowledge sharing among teachers was limited, there was prevalence of teachers who work in isolation and strongly protect their individualism without professional collaboration and school managers played inadequate role in maintaining a collaborative learning environment among teachers. The researcher made some recommendations towards ensuring effective and efficient teacher collaboration in the high schools of Libode, O.R Tambo Coastal Education District.Thesis (M.Ed) -- Faculty of Education Sciences, 201
Factors affecting adherence to antiretroviral therapy among pregnant women in theEastern Cape, South Africa
Get PDFBackground:Context-specific factors influence adherence to antiretroviral therapy (ART) among pregnant womenliving with HIV. Gaps exist in the understanding of the reasons for the variable outcomes of the prevention ofmother-to-child transmission (PMTCT) programme at the health facility level in South Africa. This study examinedadherence levels and reasons for non-adherence during pregnancy in a cohort of parturient women enrolled in thePMTCT programme in the Eastern Cape, South Africa.Methods:This was a mixed-methods study involving 1709 parturient women in the Eastern Cape, South Africa. Weconducted a multi-centre retrospective analysis of the mother-infant pair in the PMTCT electronic database in 2016.Semi-structured interviews of purposively selected parturient women with self-reported poor adherence (n= 177)were conducted to gain understanding of the main barriers to adherence. Binary logistic regression was used todetermine the independent predictors of ART non-adherence.Results:A high proportion (69.0%) of women reported perfect adherence. In the logistic regression analysis, afteradjusting for confounding factors, marital status, cigarette smoking, alcohol use and non-disclosure to a family memberwere the independent predictors of non-adherence. Analysis of the qualitative data revealed that drug-related side-effects, being away from home, forgetfulness, non-disclosure, stigma and work-related demand were among the mainreasons for non-adherence to ART.Conclusions:Non-adherence to the antiretroviral therapy among pregnant women in this setting is associated withlifestyle behaviours, HIV-related stigma and ART side-effects. In order to eliminate mother-to-child transmission of HIV,clinicians need to screen for these factors at every antenatal clinic visit.Keywords:Adherence, Non-adherence, HIV, Antiretroviral therapy, Elimination of mother-to-child transmission,Prevention of mother-to-child transmission, Stigma, South Afric
Perceptions and Attitudes of Health Care Professionals Regarding the Role of Clinical Associates in District Hospitals in the Eastern Cape Province, South Africa
Get PDFABSTRACT Introduction National Department of Health of South Africa introduced clinical associates in 2002 to work under the supervision of medical doctors in district hospitals. The first cohort of clinical associates was trained at Walter Sisulu Universty, Eastern Cape in 2008. However, there is no information about the attitudes and how other healthcare professionals within the health team and health setting perceive them. Aim The study assessed the knowledge, perceptions and attitudes of other health care professionals towards the clinical associates’ role. Methods This was a cross-sectional survey with attitudes and perceptions as dependent variables and role of clinical associates as independent variable. This study was carried out in four district hospitals in the Eastern Cape Province, South Africa, namely, Mthatha General, St Barnabas, Madwaleni and All Saints hospitals. Quantitative and qualitative approaches were used for this study. The study population included other healthcare professionals working within the study setting. A simple random sampling procedure was utilized to recruit doctors and nurses in the four district hospitals. Associations between dependent variables (inhibiting factors of effectiveness, scope of practice, benefits from clinical associates to health care, place and overall acceptance of clinical associates (CAS) in district hospitals, personnel monitoring CAS, concerns for diagnosis and management of patients, concerns about performing clinical procedures) and independent and explanatory variables (age, gender, occupation, ethnic group, qualifications, religion, inhibiting factors of effectiveness) were presented using Chi- square test. Student t- test and analysis of variance (ANOVA) were used to compare means between two groups and ≥3 groups, respectively. P-value < 0.05 was significant for differences.ii Results The participants were characterized by male predominance (28 male professionals vs 9 female professionals), mean age of 59.5 % married, 54 % Christians, 86.5 % Blacks, 78.4 % doctors vs 21.6 % nurses, duration for clinical associates ≥ 1 year by 71.1 % participants, clinical associates supervision in the department by 51.4 % participants. The perceptions were positive about clinical associates on scope of practice (as assistant doctors) in 73 %, Benefits to healthcare in 86.5 %, no concerns on diagnosis and management of patients in 83.8 % and positive relevance in 73.3 %. The magnitude of barriers to positive perceptions about CAS was in non-acceptance by doctors in 67.6 %, concerns about performing clinical procedures in 94.6 %, and knowledge in 94.6 %. For attitudes, personnel monitoring of CAS was positive in 81.1 %, and appointment of more number of CAS was also positive in 83.3 %, need of CAS in district hospitals was expressed in 81.1 %. Respondents with positive perceptions of CAS considered as assistant doctors were older (age = 42.7 ± 16.3 years: P = 0.039) than those with negative perceptions (age = 31 ± 8.7 years). Respondents with negative perceptions from CAS were younger (age = 25.6 ± 5.3: P = 0.028) than those with positive perceptions (age = 41.7 ± 15.4 years). Female gender, Blacks, Christian religion, lowest qualifications of respondents were significantly associated with positive perceptions. There was agreement between quantitative approach and qualitative approach according perceptions and attitudes on the role of CAS. Conclusion These findings demonstrated excellent levels of social accountability for the role of clinical associates in the healthcare system and delivery of patient care. However, recommendations are necessary to minimize few barriers to integration of CAS in the healthcare system