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An investigation into structured postgraduate programmes for emergency care practitioners in South Africa
No full textWith this study, the researcher pursued an investigation into the perceived need for structured postgraduate programmes for emergency care practitioners (ECPs) in South Africa. In 2017, South Africa terminated the vocational education and training route that was historically used by the prehospital emergency medical care (EMC) profession. Prehospital EMC education and training now conform to various legislative requirements that inform higher education. In accordance with the adopted Emergency Care Qualifications Framework, the professional registration of ECPs (four-year-degree graduates) is the highest clinical (professional) registration that can be obtained in the profession of prehospital EMC, which is achieved with a four-year qualification. The current academic framework allows for vertical articulation; however, the currently offered master’s and doctorate programmes are solely research based, which limits the professional registration, pathways, and clinical abilities of practitioners. The researcher suggests that this may further contribute to a silo-based healthcare system. There is no professional recognition (Health Professions Council of South Africa) of postgraduate programmes pursued within the metier of prehospital EMC. The research was guided by its aim, research question, and objectives. The holistic aim of this study, with which the research question and objectives were aligned, was to determine the potential need for structured postgraduate programmes that would enhance clinical ability and professional roles and titles (professional registration), allow for further clinical career pathways, and equip graduates with the necessary knowledge and skills to complement a system-based, interdisciplinary, and multi-skilled healthcare system and workforce with the adoption of National Health Insurance by 2030. The researcher embarked on this study with a pragmatic worldview, and adopted a qualitative research methodology with an interactive research design. Two methods were utilised to obtain the necessary data that would address the research question and objectives. Firstly, a literature study was employed to determine the current body of knowledge and practices in the international and South African settings. In the South African setting, it is evident that minimal literature exists when compared to international research findings. Secondly, the researcher conducted semi-structured interviews with the goal of producing rich, contextual, and conceptual knowledge relating to the research aim, question, and objectives. The research findings are presented in Chapter 2 as a publishable, original research article (the article was drafted in accordance with the Australasian Journal of Paramedicine’s author guidelines). The thematic coding of the semi-structured interview transcripts produced six dominant themes, namely “undergraduate education and training”, “postgraduate education and training”, “prehospital EMC shortfalls”, “professional positioning with the adoption of the National Health Insurance”, “professional recognition”, and “the need for structured postgraduate study programmes”. In the presence of an ailing national healthcare system, reform should know no limits, and the ability to multi-skill healthcare professionals, enhance versatility and roles within the healthcare system, and adopt a proactive/preventative approach to healthcare is critical to future success and sustainability. ECPs are in a unique, versatile, and dynamic position to complement the national healthcare system. This study concluded by suggesting that there is a perceived need (professional and healthcare system related) in the South African setting for the development of structured postgraduate programmes that would promote a clinical career within the emerging profession of prehospital EMC. Due to the complex nature of healthcare and educational systems, the researcher provides numerous recommendations to achieve the implementation of the findings (related to the need for structured postgraduate programmes) and to address additional themes that emerged from the primary data
Enhancing the therapeutic role of registered nurses in a care-and-rehabilitation facility
No full textDissertation (MSoc.Sc.(Nursing))--University of the Free State, 2021Registered nurses, as frontline health care providers, render nursing care to people with intellectual disabilities in care-and-rehabilitation facilities. It is their responsibility to deliver therapeutic nursing care by creating a therapeutic milieu for people with intellectual disabilities in long-term wards. They are however challenged by various difficulties addressing these needs in unconducive environments. The purpose of this study was to explore and describe the recommendations of registered nurses to enhance their therapeutic role in care-and- rehabilitation facilities. The study followed a qualitative, explorative and descriptive research design. A purposive selection of participants (n=22), consisting of registered nurses working in a care-and-rehabilitation facility at the Free State Psychiatric Complex, was conducted. Nominal group discussions were administered by an experienced facilitator that explored the registered nurses' recommendations on their therapeutic role in a careand-rehabilitation facility. Four nominal group discussions were held with 22 registered nurses that produced 66 statements. Van Breda’s multiple group data analysis steps were followed to analyse the data collected. Themes and sub-themes were identified from data gathered during the nominal group discussions. Seven themes emerged, namely communication, staff support, healthcare environment, care delivery, education, legislative and policy framework as well as resources. Each theme produced relevant sub-themes. The findings led to specific recommendations related to the themes and sub-themes. These could guide the various stakeholders to assist registered nurses to render competent and comprehensive therapeutic nursing care for people with intellectual disabilities in care-and-rehabilitation facilities
Repetitive negative thinking as a mediator between experiential avoidance and emotional distress amongst students at a South African university
No full textUniversity students appear to report greater emotional distress than the general population. Experiential avoidance has been found to contribute to the development and exacerbation of emotional distress. Moreover, repetitive negative thinking may influence the relationship between experiential avoidance and emotional distress. However, no study has investigated the interaction of these variables amongst South African students. The current study thus sought to investigate (i) whether repetitive negative thinking mediates the relationship between experiential avoidance and emotional distress, and (ii) whether gender differences and/or educational status impact this interaction. Participants were 419 undergraduate students at a large public university in South Africa (Female=75.2%, First-generation students=37.5%). Participants completed measures of experiential avoidance, emotional distress, rumination, and worry. No significant differences were found with respect to emotional distress, experiential avoidance, or repetitive negative thinking across gender or educational status. Experiential avoidance and repetitive negative thinking accounted for 60.8% of the variance in emotional distress. Rumination emerged as the strongest predictor of experiential avoidance. Repetitive negative thinking partially mediated the relationship between experiential avoidance and emotional distress. Implications of these findings for mental health are discussed and areas for future research are identified
A social constructivist approach to enhance the literacy skills of English as Second Language pre-service students
No full textThis study was undertaken with the primary aim to provide language practitioners, particularly literacy educators and teachers with a theory-driven pedagogical framework that could be used to teach literacy using emerging technologies. This undertaking was motivated by the realization that literacy pedagogy in many educational institutions in Uganda is gradually becoming obsolete, as it is no longer adequate to address the contemporary needs of learners in the 21st century classrooms. The challenge is attributed to the way literacy is taught using predominantly behaviourist pedagogies which significantly reduce active learner engagement and have little connection with the way today’s students’ process information. Vygotsky’s sociocultural theory has been employed to advocate for social interactions and dialogical conversations between educators and students in constructing meanings in writing of English as Second Language (ESL) texts, mediated by emerging technologies, particularly the Wikis. Thus, the study has been guided by three research questions: first, to what extent does the Wiki intervention foster social interactions and collaborative dialogues among ESL pre-service students? Second, how do social interactions and collaborative dialogues mediated by the Wiki intervention impact on ESL pre-service students’ literacy skills? Third, what design principles will guide the pedagogical framework for enhancing ESL pre-service students’ literacy skills? The study has been framed within the four-phased Design Based Research (DBR) approach by Reeves (2006). This approach allows for iterative testing and refining of the Wiki design solution as well as the development of a new set of design principles to guide the teaching of literacy mediated by the Wiki technology. Data from observations, interviews, researcher’s field notes and students’ reflections and Wiki artifacts have been analyzed through a sociocultural theory-driven analytical framework during the third phase of DBR. Key findings indicate that the Wiki intervention largely fosters social interactions and dialogical engagements between students, peers, and educators. Meanings of the Wiki-generated artifacts were specifically obtained through collaborative exchanges of ideas, negotiations and shared understandings on the Wiki online platform. The contribution of this study is two-fold, namely, the practical and theoretical contribution. The practical contribution is reflected in the creation of new design principles including: supporting online presence, building online cultural experiences, validating information, promoting dialogue in literacy pedagogy, and applying literacy. This has led to a pedagogical framework that could be used to support students’ literacy mediated by technologies. The theoretical contribution of this study, on the other hand, is in the approach of utilizing Design Based Research methodology to implement the sociocultural theoretical aspects, such as social interactions, dialogue and collaboration. These were tested and refined through two cycles of implementation at an authentic language education context in Uganda
Democratisation and state-building in Lusophone African states: the cases of Cape Verde and Mozambique
No full textDespite promising prospects to political transition towards a democracy, over the last 25 years, Lusophone African states, achieved very different political and economic outcomes in relation to democratization and human development. This thesis investigates the cases of Cape Verde and Mozambique to explore the political transition and democratization processes in both countries to determine what factors support and/or undermine democratization, development, and political stability. The focus of the study is within the institutionalist scholarly tradition, thus considering the correlation between political institutionalism and economic and human development. While Cape Verde has consolidated democratic rule, Mozambique embraces authoritarian rule and became increasingly undemocratic, thus consolidating a form of political hybridity. Drawing on institutionalist and structuralist theories, this study engages quality of democratic institutions and socio-economic indicators in Cape Verde and Mozambique. The research demonstrates that for an effective transition and consolidation of democracy, institutions matter; and they shape the procedural and substantive elements of deepening democracy as well as quality of governance; which are seen as critical elements of economic and human development and quality of governance. In Mozambique, with strong Marxist ideology and military influence the ruling elite captured the state, controlled political and economic power and maintained authoritarian rules that undermine state-building in the democratic tradition and democratic transition. In Cape Verde, political institutions were more inclusive, allowing for greater voice, accountability and control of corruption and consequently democratic consolidation
Exploring the literacy leadership challenges in secondary schools
No full textThis dissertation explored the literacy leadership challenges in secondary schools. The challenges educators, departmental heads, deputy principals and principals experienced were illustrated in the research study, as well as the aspects of literacy leadership affecting literacy. This research study is based on a theoretical framework with the focus on distributed leadership and instructional leadership. This research study was conducted at three secondary schools in the Republic of South Africa, Free State Province, Motheo District (Bloemfontein). This study is grounded in the qualitative research method. Data were collected utilizing semi-structured individual interviews with all the members of the SMT (principal, deputy principal, departmental heads) and the literacy educators. Interviews with three principals, three deputy principals, six language departmental heads and six literacy educators were conducted. In addition, a documentary analysis was done in each of the three secondary schools. From the data collected at each of these respective secondary schools, various categories and themes were identified. These categories and themes were centred on the literacy leadership challenges literacy leaders experience and how instructional and distributed leadership may assist in addressing these literacy leadership challenges in the senior phase. The majority of the findings suggest that there are literacy leadership challenges in the senior phase in managing and leading the literacy curriculum at secondary schools. Additionally, the findings suggest that those SMT members who lack knowledge and skills will be unsuccessful in providing instructional leadership, which hampers literacy educators in promoting literacy in their classrooms. Thus, principals, deputy principals and departmental heads must take account for the literacy curriculum, support and enhance professional development, supervise the literacy instructional program and establish a positive literacy environment when monitoring educators. The study also revealed that parents does not fulfil their role when literacy challenges occur and this makes it challenging for SMT members to address literacy leadership challenges experienced in schools. It is therefore recommended that literacy leaders (principals) need insight and must comprehend the literacy curriculum in the senior phase to address literacy leadership challenges
Assessing adherence to recommended HIV Post Exposure Prophylaxis regimens prescribed to doctors working at the Free State Academic Complex in Bloemfontein, South Africa
No full textBackground: The prevalence of HIV infection in South Africa is one of the highest in the world and healthcare workers in this setting are particularly at risk of being infected through occupational exposures. All high-risk exposures to infective bodily fluids are considered as important, warranting the use of post exposure prophylaxis (PEP). This study determined adherence to PEP in doctors, regardless of specialty and rank. Methods: A cross sectional study was conducted by distributing a structured anonymous questionnaire to doctors working in 3 teaching hospitals in central South Africa. Results: A total of 233 of 400 distributed questionnaires were completed (response rate 58,2%) from 543 employed doctors across 3 different hospitals and over 16 specialties (coverage 42.9%). Almost all the respondents (84,7%) had at least one high risk exposure, with an average of 2,3 exposures per respondent. Most (49%) of the respondents were exposed when performing venesection. Majority (58%) thought that the exposure could have been avoided. Of those exposed, 83% used PEP at least once. Of those who took PEP, 56% stopped prematurely with 71% of them citing adverse side effects as the main reason. Workload impacted adherence negatively in at least 50% of respondents. Conclusion: Majority of doctors had more than two occupational exposures. Adherence to PEP is generally poor. This is mainly due to the side effect profile of PEP regimens used at the time of the study. The recent widespread availability of better tolerated ART drugs and more tolerable regimens for PEP, may improve adherence
Mine closure narratives in Blyvooruitzicht Gold Mine in West Rand, South Africa
No full textMine downscaling and closure have been common in the South African mining industry in the past two decades. Like in other countries, the downscaling and closure of mines has a severe impact on the lives of the mineworkers, local communities and the country’s economy. This study investigates the life experiences of former mineworkers after job loss due to mine closure. Semi-structured interviews were conducted telephonically with former mineworkers from the Blyvooruitzicht Gold Mine in the West Rand, South Africa. Interviewees were recruited through snowball sampling and were asked to tell their life stories about their mine employment and adjustment after the mine’s closure. The study reiterated that local economic activity in mining communities mainly results from mining activities. The study shows that since mine closure also threatened the livelihood of former mineworkers and local communities, mine closure contributed to psychological distress, loss of severance packages, dysfunctional families, corruption, lawlessness, crime, relying mainly on grants for survival and other related social problems. The study recommends intervention through psychosocial support by the government, the mining company and other stakeholders. Capacity-building and quality skills need to be provided to allow labour mobility beyond mining. The profiling of individual families of the former mineworkers to collectively plan and respond appropriately to the needs of individual households in mining areas should be prioritised
Assessment of time management practices of small medium sized contractors in project delivery in the Eastern Cape Province, South Africa
No full textThe purpose of this article is to assess the effective time-management practices adopted by construction SMEs to enhance successful construction project delivery. A mixed methods approach, consisting of both quantitative and qualitative research methods was adopted. A questionnaire was distributed to Small and Medium Enterprises (SMEs) management team purposively selected from CIDB Grades 1 to 4 registered contractors under the general building category. The quantitative data were analysed, using descriptive statistics. To validate quantitative findings, semi structured interviews were conducted with randomly selected respondents who were part of the survey study where content analysis was adopted. The findings revealed that the most adopted effective time-management practices to enhance the sustainable success rate of construction SMEs in South Africa included progress meeting with consultants to ensure regular monitoring of the work progress, strategic planning to recover time lost, effective management of subcontractors, and allocation of tasks to workers according to their skills and expertise. It should be noted that the quantitative findings were consistent with the qualitative findings, and revealed that effective project planning, periodic progress meetings and labour production contribute to the sustainable success rate of SMEs. The results obtained from this article could be adopted as SMEs’ effective time-management practices to enhance sustainable construction project delivery.Publisher's versio
Quantification accuracy for I-123 SPECT/CT studies using LEHR and me collimators: a Monte Carlo study
No full textDissertation (MMed.Sc.(Medical Physics))--University of the Free State, 2021The accurate quantification of Nuclear Medicine single photon emission tomography (SPECT) plays an important part in radiopharmaceutical therapy. Accurately quantifying SPECT images of a diagnostic radionuclide such as I-123 is desirable, although not a straightforward process as it is hindered by the complex decay scheme. I-123 has low-energy primary emissions of 159 keV, and performing acquisitions with a low-energy resolution (LEHR) collimator result in images with high resolution. However, I-123 also has high-energy photon emissions which degrade image contrast and quantification accuracy. This degradation can be reduced by using medium-energy collimators (ME); however, at the expense of spatial resolution. Most clinical facilities have access to LEHR collimators, but not necessarily ME collimators. The aim of this study was to evaluate the quantification accuracy of I-123 LEHR and ME collimated SPECT images when an optimised OSEM reconstruction protocol is applied. To accomplish the aim three objectives were identified: 1) validation of a SIMIND modelled gamma camera fitted with LEHR and ME collimators, 2) optimisation of the iterative reconstruction algorithm in terms of equivalent iterations and SPECT corrections, and based on these results, 3) evaluation of the quantification accuracy of I-123 LEHR and ME SPECT images. The first objective of this study, to validate the SIMIND modelled gamma camera fitted with LEHR and ME collimators for I-123, involved comparing measured and simulated I-123 data. Results of measured and simulated planar performance tests (system energy resolution, system spatial resolution, and system sensitivity) were compared for both collimators. The validation included a visual comparison of reconstructed SPECT images of a quality control phantom in terms of uniformity, cold contrast, resolution, and linearity. The measured and simulated planar results for system energy resolution, system spatial resolution and system sensitivity differed by 3.4%, 6.4% and 5.3%, respectively. The visual comparison performed on the reconstructed SPECT images showed good agreement between the measured and simulated data. The second objective was to optimise the OSEM iterative reconstruction algorithm concerning the number of iterations and SPECT corrections. SPECT images of voxel-based phantoms of spherical objects and image quality phantoms were simulated and reconstructed with different numbers of effective iterations. The count density recovery, image noise, contrast and resolution were evaluated. The image quality phantom was also reconstructed with different corrections (attenuation, scatter and collimator-detector response (CDR)) and compared. The optimal number of equivalent iterations was selected as 64 and the contribution of the different corrections was appreciated. When septal penetration and scatter was compensated for as part of the CDR correction, the LEHR collimator results were comparable to that obtained with the ME collimator. This led to the aim of the final objective: to determine the quantification accuracy of I-123 SPECT studies in patient phantoms acquired with LEHR and ME collimators. Using voxel based patient phantoms, the quantification accuracy was assessed for LEHR and ME SPECT images of spherical objects. Quantification errors smaller than 3.8% were recorded for both the LEHR and ME collimators when attenuation, scatter and CDR (including septal penetration and scatter) corrections were applied. Therefore, to conclude, when appropriate SPECT corrections were applied during the reconstruction of I 123 LEHR and ME SPECT images, the image quality between the collimators were comparable and quantification accuracy of up to 3.8% was achievable