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A retrospective study to evaluate local control and freedom from biochemical failure in Prostate cancer treated with Hypo-fractionated split course 3D conformal radiotherapy at Universitas Academic Hospital, Bloemfontein, South Africa
No full textBackground: Prostate cancer is the most common malignancy in men and the second most common cause of death for men in South Africa and universally. Three-dimensional conformal radiotherapy (3DCRT) is a safe and efficacious method to deliver radiation for prostate malignancy patients in all risk groups with acceptable toxicity rates and adequate biochemical control. AIM: To describe local control and freedom from biochemical failure in Prostate cancer patients treated with Hypo-fractionated split course external beam radiotherapy in a specified population for a given period. Methods: A retrospective descriptive cohort was conducted. Files of 142 patients with locally confined prostate adenocarcinoma who was treated at the Universitas Annex Hospital between 2003-2013 were reviewed. Data collected included demographics, risk factors, recurrence risk stratification, Gleason score, TNM staging, and PSA levels. Results: The prevalence of disease control was 108/142=76.1% at the end of the study period (60 months). The median age of the study participants was 68 years. Of the study participants, 40.14 % were white, 54.23% were black, and 5.63% were other races. At a median follow up of 5 years, all low-risk patients that participated in this study had disease control (local and biochemical), intermediate and high-risk patients with disease control were 12.68% and 59.15% respectively. The 34(23.9%) patients that had progression of the disease, 2.11% (3) and 21.83% (31) were intermediate and high risk, respectively. Conclusion: Hypo-fractionated split course 3DCRT in patients with localized prostate cancer has a significant locoregional disease control and freedom from biochemical failure
The knowledge and attitudes of Grade R school teachers regarding the psychosocial impact of strabismus amongst school children
No full textDissertation (MOptom.(Optometry))--University of the Free State, 2020BACKGROUND: Negative social bias due to strabismus affects the self-esteem and learning process of a child. Social and educational milestones are already prioritised as early at a pre-primary school level. A Grade R teacher’s interaction with a child with strabismus can steer their functional development and influence their future quality of life. A lack of knowledge and an erroneous attitude ultimately contributes to the negative social stigma about strabismus. PURPOSE: The study aimed to determine the knowledge and attitudes of Grade R school teachers regarding the psychosocial impact of strabismus among school children. METHODS: A descriptive study was carried out from March to June 2018, through a structured questionnaire. RESULTS: Thirty-one female Grade R teachers, ages ranging between 24 and 62 years participated in the research study. The majority of the teachers (87.10%) were able to correctly identify a child with strabismus and refer them to treatment. Children with strabismus were thought of being at risk of struggling with areas of mathematics, language and life skills (64.52%). Nevertheless, the teachers had an overall positive attitude towards a photograph of a child with strabismus depicted in the questionnaire. The teachers described the strabismic child as happy, cute, healthy and intelligent. The teachers also suggested that a child with strabismus will be able to be a class representative (83.87%). The teachers were also aware that a child with strabismus may be at risk for developing a low self-esteem (identified by 83.87%) and to experience social anxiety (identified by 45.16%). CONCLUSION: The negative social biases towards strabismus are clearly defined in previous research. This study, however, contradicts previous findings. Not only did the Grade R teachers demonstrate a good understanding of the clinical aspects related to strabismus, but they also had an overall positive attitude towards strabismus in general
Identification of marketing strategies to promote tourism: the case of Soetdoring Nature Reserve in the Free State province
No full textThe purpose of this study was to investigate and identify marketing strategies to promote tourism at Soetdoring Nature Reserve located in the Free State Province. The primary question that was explored was what recommendations can be made with regard to marketing of the Soetdoring Nature Reserve. For research objectives to be achieved, an in-depth literature review was undertaken. Additionally, a survey was also conducted to determine the current status of the Soetdoring Nature Reserve and data were sourced by means of self-administered questionnaires. The hypothesis was proven to be correct by a literature review, namely that marketing plays a significant role in promoting tourism and has the potential of attracting tourists and raising revenue. The recommendations were made within the context of empirical survey findings. To improve the current marketing at the Soetdoring Nature Reserve, it has been recommended that there should be a turnaround marketing strategy and that resources in a form of funds and staff should be augmented. Furthermore, the 7Ps of marketing, which are of paramount importance, were also recommended, as well as that there more marketing should be done on social media and on the internet
NGOs interventions for rural communities resilience to climate change and variability case study: Mulanje district, southern Malawi
No full textClimate change and variability is a huge developmental challenge for Malawi as it touches on key developmental issues facing human development. Given the country’s rurality and vulnerability to climate change, communities continue to face unprecedented impacts of climate change, which in the end impacts greatly on the economic, social, political and environmental components of society. Growing recognition of the role of Non-Governmental Organizations (NGOs) in climate resilience work offers hope in the climate change response discourse. Aside from many other varied roles in climate services, NGOs have been a key player in supporting resilience building for rural communities. Despite the emergency and presence of many NGOs, the impact and effectiveness require further exploration basically due to the fact that communities continue to remain vulnerable to climate shocks despite huge financial investment in the resilience-building processes. This study attempts to underscore the role and effectiveness of NGOs' interventions in regards to climate change, with a focus on Mulanje district in Malawi as a case study. The study’s central question is what is the role of NGOs and how are the interventions implemented by NGOs contributing to communities’ climate resilience? Data collection tools involved developed questionnaire guides that were administered through Focus Group Discussions (FGD) and Key Informant Interviews (KII). A total of 88 respondents were engaged, and their views were transcribed into themes that generated results.. Using Mulanje district, in Malawi as a case study, the study discovered that indeed NGOs are a possible alternative to the government in servicing the needs of vulnerable communities in regards to climate change resilience building. This is mostly manifested in its intermediary role in providing climate services such as knowledge, skills and resilience building interventions. Conclusions are drawn from the study centered on acknowledging the role of NGOs in providing new opportunities and innovations in resilience building and further highlight the need for strengthening the capacity of NGOs to effectively deliver climate change resilience building interventions. Furthermore, the study concludes that despite the commendable role played by NGOs, there is need to address ever emerging challenges in regards to flexibility, funding gaps as well as meeting project targets
The prevalence of burnout among anaesthesiology registrars in the University of the Free State
No full textIntroduction: In January 2019 the leading health care organizations in the United States declared burnout as a “public health crisis” with an alarming figure of 78% among the nation’s physicians. Burnout is an “individual experience that is specific to the work context” which is associated with poor outcomes in job performance and health. Studies have revealed burnout ranging from 18-84% during postgraduate medical education (residency). The aim of the study was to quantify the prevalence of burnout among anaesthesiology registrars and to identify protective and aggravating factors. Method: A descriptive, prospective cross-sectional study was done in November 2018 among 23 anaesthesiology registrars using the Maslach Burnout Inventory (MBI), which is the instrument that has been validated globally to assess the dimensions of burnout: emotional exhaustion, depersonalization and a reduced sense of personal accomplishment. A self-developed questionnaire that assessed demographics, factors that contributed to and protected from burnout was also administered. Results: A prevalence of 17.4% of burnout was found with an equal distribution between males and females. The analysis of the data showed that all the participants who reported burnout were married. Difficulty in maintaining a balance between work, family and a social life was the greatest factor for reconsidering anaesthesia as a career. This was exacerbated by not having fixed working hours. The protective factors identified were: spending time with loved ones, praying, taking a break or spending time in solitude and exercise. About half (47.8 %) of the participants reported themselves as being prone to errors particularly when sleep deprived. Conclusion: The registrars in the department of anaesthesiology showed less burnout in comparison with counterparts in anaesthesiology residency training programmes within South Africa and internationally. This reinforces the findings in other studies that physicians in small urban settings show less burnout when compared with national averages. The protective factors identified in Bloemfontein can be further adopted as preventive action to further improve the wellbeing of the registrar vis-à-vis patient outcomes.Postgraduate Administration Offic
The ‘Business’ of hair: the meaning of hair for Southern African Black women
No full textHair carries different meanings all over the world and reflects our interconnected globe, as well as our regional and local histories. For many years, black people in Southern Africa have had to assimilate to dominant Eurocentric beauty standards with respect to hair. This, particularly for black women, was and continues to be a locus of social, physical and emotional oppression. Major events in history such as the Transatlantic Slave Trade, racial segregation, and apartheid have played an important role in influencing the complex relationship that black women have with their hair, in and beyond the region. As a result of this turbulent history, the Natural Hair Movement strives to fight against stereotypes about black women’s hair, including the related issues of racism and discrimination. However, the paths towards embracing natural hair are diverse and encapsulate a complexity which escapes singular and simplistic interpretations. This study explores the nuanced and diverse meanings, and practices that surround hair for black women in contemporary Namibia and South Africa. The hair journey of black women is intricate and often escapes representations that reduce hair to debates surrounding opposing labels of ‘natural’ or ‘un-natural’. Seven women participated in this ethnographic research and shared their perspectives on hair in general, and “natural hair” in particular. These women reside in Windhoek, Namibia and in Bloemfontein, South Africa. The results revealed that the relationship that black women have with natural hair is often strongly related to processes of identity formation. In some cases, these processes were shaped by women’s efforts at daily hair maintenance and socio-economic concerns. In others, they reflected black women’s deeper spiritual and metaphysical connection with natural hair. Furthermore, it is evident from the results that affinity towards natural hair can also be an important form of social activism. Therefore, regardless of whether or not black women view their hair choices politically, wearing natural hair is a stand against Eurocentric beauty standards, thus altering the relationship that black women have with hair. In essence, this thesis illustrates the importance of hair for black women in Southern Africa and the multiplicity of meanings that are attached to it. In addition, it also stresses the need to liberate and decolonise the mindset of black communities regarding hair, and to wean young black girls from the Eurocentric subliminal messages of hair care companies
Molecular characterization of rotavirus strains from pre- and post-vaccine introduction in South Africa
No full textIntroduction: Group A rotavirus (RVA) persists as the infectious etiological agent for acute gastroenteritis (AGE) in children under the age of five years globally, despite the introduction of RVA vaccines. A major concern during the post-RVA vaccination period is the potential for vaccine-induced strain changes, which may lead to putative vaccine-escape strains that may affect the efficacy of RVA vaccines in the long-term. There is a paucity of longitudinal whole-genome studies to assess the impact of RVA vaccine introduction on the circulating RVA strains in South Africa. Aim: The study aimed to elucidate the impact of RVA vaccine introduction on the whole-genome of G1P[8] and G2P[4] RVA strains that circulated in South Africa, seven years before and seven years after RVA vaccine (Rotarix®) introduction. Materials and Methods Rotavirus positive stool samples genotyped conventionally as G1P[8] (n=103) and G2P[4] (n=98) as part of the routine World Health Organization (WHO) RVA surveillance were retrieved from the archival storage of Diarrhoea Pathogens Research Unit (DPRU) based in Pretoria and Center of Enteric Diseases, National Institute for Communicable Diseases (NICD), Johannesburg, South Africa. Rotavirus dsRNA was extracted from the stool samples. cDNA was synthesized from the purified extracted RNA using the Maxima Kit. The DNA libraries were prepared using the Nextera XT Kit and paired-end sequencing for 600 cycles (301 x 2) was performed on a MiSeq Illumina® platform. Results and Discussion Firstly, the study investigated the genotype variation and relative emergence of potential vaccine-escape strains. Two atypical DS-1-like G1P[8] strains were identified. The two atypical G1P[8] strains circulated prior to vaccine introduction in South Africa compared to reports in recent studies that detected this strain during the post-vaccination period. Phylogenetic analysis showed that these atypical G1P[8] strains emerged through reassortment mechanism involving locally circulating South African G1P[8] strains and the DS-1-like backbone of G2P[6] strains. Secondly, the study investigated the evolutionary dynamics of South African pre-and post-G1P[8] and G2P[4] strains. South African G1 strains clustered in G1 lineage-I and II while majority (84.2%) of P[8] strains grouped in P[8] lineage-III, highlighting prevalent co-circulation of the G1 and P[8] strains in these lineages before and after vaccine introduction. All the South African G2 strains segregated into the predominant G2-lineage IV, while 99.7% of the P[4] strains clustered in P[4]-lineage IV, underscoring the continued prevalence of these lineages over time. Thirdly, the study investigated the genetic changes between pre and post-vaccine strains, whereby, for G1P[8] strains, we identified amino acid (aa) differences that potentially explained the yearly clustering of post-vaccine strains into sub-lineages. However, we did not observe aa differences that were consistently conserved throughout the post-vaccine period. For G2P[4] strains, we identified aa residues that were consistently prevalent and appeared at a significantly higher frequency in 60-80-% of post-vaccine strains at various sites in the gene segments compared to their negligible proportions of 1-2% during the pre-vaccine period. Fourthly, we investigated the aa profiles within the mapped antigenic regions of the neutralization proteins. The aa profile in the antigenic profiles of pre- and post-vaccine G1 and P[8] strains was nearly the same except for the N147D substitution observed in eight post-vaccine G1 strains. Similarly, the overall aa profile in G2 and P[4] antigenic domains remained mostly unchanged between pre and post-vaccine strains. Conclusion: Rotarix® did not appear to impact the antigenic and non-antigenic profile of South African post-vaccine G1P[8] and G2P[4] strains. Furthermore, the atypical DS-1-like strains identified in this study appeared to have emerged through natural RVA evolutionary processes and not necessarily vaccine-induced. Continued long-term whole-genome surveillance remains necessary to assess the impact of RVA vaccination on circulating RVA strains.Bill and Melinda Gates FoundationPoliomyelitis Research FoundationUniversity of the Free State Postgraduate bursar
The use of WhatsApp as a social communication medium in the context of ethical values in a healthcare facility business environment in the Northern Cape
No full textDissertation (MBA (Business Administration))--University of the Free State, 2020The primary research objective of the research study was to analyse ethical values
in a healthcare facility business environment with particular reference to WhatsApp
as a social communication medium in the Northern Cape. The study was guided by
the following secondary research objectives, namely:
(i) To discuss social media as a communication medium, with particular reference
to WhatsApp; (ii) To identify the current problem areas in the use of WhatsApp in the healthcare
facility in the Northern Cape; (iii) To identify the understanding of leaders in a private healthcare facility about
the optimal use of WhatsApp in a healthcare facility in the Northern Cape;
and (iv) To implement guidelines for the safe use of WhatsApp in the healthcare
facility in the Northern Cape. In order to reach the primary objective of this study, a qualitative research design
was followed. Semi-structured interviews were held with members of the healthcare
facility's Core Management Team which consist of two parts. The first part is a selfadministered
section, which consists of closed-ended questions in a Likert scale
format. The answers provided in this section allowed the researcher to ask more indepth
questions in the second part of the interview, to gain a deeper understanding
of the responses provided in the self-administered portion of the interview.
The majority of participants felt that using WhatsApp to reach a patient is acceptable
while confidential patient information should only be shared via WhatsApp with the
consent of the patient. Additionally, management also seem to understand the use of
WhatsApp as a communication tool as they felt equipped to use WhatsApp as a
social medium platform. Although a current policy at the healthcare facility addresses the use of Facebook as
a social media platform for communication, there is no official policy for the use of
WhatsApp as a social media communication tool. Recommendations for the
implementation of WhatsApp as communication tool thus included the implementation of a policy that specifically state that no personal information should
be communicated via WhatsApp. This policy should be communicated to all staff as
well as extensive training in the use of WhatsApp should be offered in an effort to
align the awareness and consistent implementation of such a policy
The importance of shepherd leadership practices on easing the textbook burden on South African university students
Get PDFThe argument advanced in this article is that excellent shepherd leadership practices serve as a condition necessary for affording South African university students easy access to the required book chapters instead of enduring the burden of having to buy the full books. In order to embellish this viewpoint, relevant data were collected through focus group interview discussion sessions (FGIDs) with a sample of 40 purposefully sampled participants from a target population of university students, lecturers and local textbooks sales personnel. These participants were first categorised into 4 focus groups of 10 members each and were
interviewed for a duration of between 40 minutes and one hour per focus group. By adopting an interpretivist paradigm, utilising a qualitative research approach and descriptive phenomenology as a strategy of enquiry (design genre), the study was able to explore the lived experiences of the participants. The two key research questions guiding the study were; how can the key university lecturers as curriculum leaders and shepherd leaders ease the textbook burden on South African university students? and What role can textbook publishing companies play towards easing the textbook burdens on university students? Deploying shepherd leadership as the theoretical lens for viewing and analysing the data through inductive and/or thematic approach, the study’s main finding was that since the biggest cost that university students have
is books and given that most of the books are only used for one semester, their exorbitant prices more often than not, lead students to resort to photocopying while publishers lose out. The study concluded that using such new platforms as E-llumin 8, can help students alleviate their textbook burden since it allows them access to specifically prescribed book chapters at a time instead of buying the full books. The chief recommendation from the study was that university lecturers need to work in cooperation with the key book publishing companies to embrace any new and innovative ways to ease the textbook burden on students whilst also ensuring that publishers do not lose out.Publisher's versio
Electrodiagnostic tests to confirm clinically suspected carpal tunnel syndrome
No full textBackground: Compression of the median nerve at the wrist is the most common entrapment neuropathy. Patients present with sensory symptoms in the median nerve distribution, pain in the hand, wrist or forearm and weakness of thumb opposition or abduction in severe cases. The value of nerve conduction studies (NCS) in the diagnosis of carpal tunnel syndrome (CTS) is not clear. There are contradicting results from different reports, other reports citing the importance of electrodiagnostic (EDX) test in the diagnosis of CTS while other reports did not establish that link. In the Free State Province, patients with CTS are mainly managed by orthopaedic surgeons. Only a small proportion of patients are managed by neurosurgeons at Universitas Academic Hospital. The diagnosis is primarily made on clinical grounds. Conservative measures are tried first, but patients who do not respond to these, undergo carpal tunnel release surgery (CTRS). Objectives: The aim was to determine which EDX tests best correlate with the clinical diagnosis and severity of CTS. The objective was to establish EDX guidelines to be used in the neurology electrophysiology unit when diagnosing CTS. Method: A cross sectional analytic study. Patients with a diagnosis of CTS based on clinical signs and symptoms were recruited into the study from January 2019 to October 2019. They were requested to complete the Boston questionnaire (BQ) which assesses symptoms severity and functional capacity. Nine NC parameters were then tested and results compared with those from the BQ to determine whether they correlate. EDX severity score for CTS was assessed and was compared to the two components of the BQ. Results: Eighty-three percent of hands had severe to very severe symptoms on Boston 1 however, only 37.5% had severe to very severe functional impairment on Boston 2. Weighted kappa of 0.19 indicating no agreement between Boston 1 and 2, severe symptoms is not associated with an increase in functional impairment. No statistically significant correlation was found between EDX severity score, symptoms and functional status with a p value of 0.44 and 0.77 respectively. Conclusion: • There was no linear relationship between symptom severity and functional impairment; the majority of patients reported severe symptoms but no disability. • Clinical and EDX tests showed a weak positive correlation which is statistically insignificant. • Symptomatology rather than functional impairment was more indicative of severity of CTS. • No correlation was found between EDX tests, Boston 1 and Boston 2. • We were unable to answer with confidence the question of whether NCS is always necessary and feel that a follow-up post-op study will provide useful insights