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COVID-19 home remedies and myths becoming a hazardous health infodemic?
No full textCoronavirus disease 2019 (COVID-19) brought on several social, economic, political, and environmental challenges. What was mostly questioned was the efficacy of the Disaster Management Act 57 of 2002 (As Amended 16 of 2015) (DMA), which was used to declare COVID-19 a disaster. The concern was whether the DMA is able to deal with pandemics when its focus is mostly on climate-related disasters. Most public health emergencies experience the spread of overwhelming information, some of which may be true and others may be false information. This article discusses the home remedies and myths related to COVID-19, that could impede pandemic response efforts. Subsequently, this study raises a question regarding
the effectiveness of DMA to deal with such types of compounding risks. In doing so, this research is exploratory where the DMA and the media articles on COVID-19 home remedies and myths are systematically reviewed. Coronavirus disease 2019 home remedies and myths were found to be hazardous and the DMA was found unprepared to deal with such types of compounding risks. ‘Infodemic management’ needs to be considered in the DMA in order to prepare for effective disaster response.Publisher's versio
Combat exposure as moderator between risk, protective factors and suicide ideation for South African Army Infantry soldiers
No full textThe South African National Defence Force is a recruiting, and operational organisation with the protection of the country as primary function. Ironically, this large conglomerate of men and women tasked with this ideal function has been plagued by a consistently increasing manifestation of suicide acts. This behavioural pattern has been noted on a global scale and by its very nature presents a concern to military organisations around the world. The aim of this study was to investigate the current state of suicide ideation among South African Infantry soldiers of the SANDF, by examining the contribution of risk and resource factors as well as the role of combat exposure in affecting this relationship. A total of 1475 respondents were selected from nine South African Army Infantry units in various provinces in South Africa. The study followed a quantitative and non-experimental approach using a correlational and cross-sectional survey-type research design. Gathering data proceeded by using the following self-reporting measuring instruments: a biographical questionnaire compiled by the researcher, the Scale for Suicide Ideation (SSI), the Orientation to Life Questionnaire (OLQ), the PTSD Checklist-Civilian Version (PCL-C), the Alcohol Use Disorders Identification Test (AUDIT), the Perceived Stress Scale (PSS), and the Interpersonal Support Evaluation List (ISEL). A hierarchical regression analysis was conducted to determine the influence of various risk and resource factors on suicide ideation, and a stepwise regression analysis investigated the unique contributions of risk and resource factors on suicide ideation. To determine whether combat exposure moderated or mediated the relationship between the mentioned variables, a series of subset regression analyses that investigated suicide ideation as dependent variable in relation to independent resource variables (appraisal, tangible support, belonging, comprehensibility, manageability, and meaning) and risk variables (alcohol consumption, dependence, related problems, PTSD, and perceived stress) was conducted. The findings from this study indicate that the level of suicide ideation for the sample was considerably lower when compared with other international military samples. However, participants with combat exposure were categorised as among the high-risk group for suicide ideation. In the stepwise regression analysis, it was found that risk and resource variables collectively explained 16% of the variance of suicide ideation significant on the 1% level of significance. More specifically, four risk variables, namely perceived stress, alcohol-related problems, alcohol dependence, and PTSD, contributed to the increased level of suicide ideation among active duty members of the South African Army Infantry. In addition, seven protective variables (i.e., self-esteem, appraisal, belonging, comprehensibility, manageability, meaning, and tangible support) explained a combined 0.5% of the variance of suicide ideation. Consequently, it was found that only tangible support (subscale of ISEL) had made a significant contribution; it was associated negatively with suicide ideation. Combat exposure significantly influenced the reported level of suicide ideation in risk variables (i.e., alcohol-related problems, alcohol dependence, and PTSD) and the protective variable (i.e., tangible support) for infantry soldiers. From this study, it is recommended that future research focuses on exploring the current variables from the sample of deployed and non-deployed soldiers, the sample of soldiers exposed to and not exposed to combat, as well as gender differences as factors that moderate suicide ideation. The findings of this research contain essential baseline data that will be utilised by the military organisation toward developing mechanisms that assist soldiers in dealing with the debilitating effect of combat trauma by focusing on strengthening their coping resources such as tangible support
HBV viral load and drug resistance among HIV-HBV co-infected patients: a cross-sectional study in central South Africa
No full textIn South Africa, human immunodeficiency virus (HIV) infected individuals co-infected with hepatitis B virus (HBV) do not routinely undergo HBV viral load (VL) testing when on antiretroviral therapy in the public sector treatment programme. We set out to explore whether HIV VL can be used as a proxy for HBV treatment response, since HIV VL testing is routinely performed in HIV/HBV co-infected patients. The clinical utility of HIV VL testing in this context may be impacted by the slower rate of viral decay which has been described for HBV as compared to HIV. In total, 224 patient samples were tested for HBV VL to determine the relatedness between HIV VL and HBV VL results. Samples with detectable HBV VL were sequenced to identify HBV associated drug mutations, hepatitis B surface antigen (HBsAg) mutations and genotype. Chi-square test for independence (χ2) was used to determine the relatedness between the viral loads, which indicated that the two viral loads are related (p-value2000 IU/mL which has previously been linked to an increased risk of HBV related complications. Sequencing results showed that 10 samples had lamivudine resistance, however, no tenofovir resistance was detected. Three samples had immune escape mutations, two caused by the HBsAg mutations E164D and I195M and one by the immune-associated escape mutations N131T and D144A. The results from the study show that patients with HIV/HBV co-infection need to be monitored more closely in South Africa regarding HBV treatment response. The extensive use of lamivudine for HIV treatment in South Africa can be a driver of immune escape and further research needs to be done to determine the possible public health impact.National Health Laboratory Service Research Trus
National profile of the characteristics of patients treated for TTP an extension of the study: the characteristics of patients with TTP at the Universitas Haematology Department from 2010-2017 (HSD2018/0114)
No full textThrombotic thrombocytopenic purpura (TTP) is a rare life-threatening haematological disorder. It is caused by a deficiency in ADAMTS13. ADAMTS13 is a zinc-containing
Metalloprotease enzyme that cleaves Von Willebrand factor (VWF). The deficiency of ADAMTS13 results in VWF accumulation and causes platelet rich thrombi, resulting in haemolytic anaemia and thrombocytopenia. There is an increased risk of TTP among female patients, patients from black races and patients with blood group O, based on previous studies. It is also most commonly seen among patients with HIV. The mainstay of treatment is plasma exchange and fresh frozen plasma. A retrospective study aimed
At describing the national characteristics of TTP from 2010 to 2017 was done. Permission to conduct the study was obtained from the Health Sciences Research Ethics Committee of the University of the Free State (HSREC), Western Cape Blood Service (WCBS) ethics committee and South African National Blood Service (SANBS). The described characteristics are the age, gender, blood group and the blood products given to the patients
Early language intervention in deaf children of hearing parents
No full textLanguage development is often hampered by the fact that 90 per cent of deaf children are born into hearing families who do not know Sign language (SL) or haven't had any previous contact with the deaf world. Such parents often use only spoken language to communicate with the child, which results in no or very little language exposure. Many deaf children only start to learn a language, signed or spoken, when they start attending school, usually between the ages of three and seven. As a result, the deaf child has a delay in cognitive and language development and finds it hard to learn a SL, like South African Sign Language (SASL), as well as a written language (e.g., English). This late exposure to SL proves to be a serious cognitive problem for deaf children when compared to those children who acquired language from birth.This problem led to the research question namely, whether deaf children’s language and cognition can still develop to the required level for school readiness if early language intervention (ELI) takes place within the critical period of language acquisition. To answer the question, a case study was done at a school for the deaf and blind with a small group of deaf learners in the foundation phase. The results show that the little language exposure these children received in only one year of school already made a huge difference to their language and cognitive development. This article also makes recommendations to the various stakeholders in deaf education.Publisher's versio
Breeding of maize for fall armyworm resistance in southern Africa
No full textIn 2016 sub-Saharan Africa (SSA) was invaded by the transboundary maize-eating pest, fall armyworm [Spodoptera frugiperda (J.E. Smith); FAW]. The pest has threatened food security and livelihoods of the majority of smallholder farmers in the region. The main aim of this study was to investigate the potential of breeding maize with resistance to FAW in southern Africa. The first study aimed to assess the breeding potential of introduced exotic FAW resistant trait donor maize lines with southern Africa germplasm. Thirteen mid-altitude adapted inbred lines were crossed with seven FAW-resistant exotic donor lines, in a line x tester mating scheme that produced 84 F1s which were evaluated together with checks at four locations under natural FAW infestation. The best exotic donor lines with low and negative general combining ability (GCA) effects for foliar FAW damage (FFAWD) resistance scores and good grain yield (GYD) per se performance were CML139, CML67, CML121 and CML345. Local lines that showed similar good attributes were CimExp1, CimExp4, CimExp5, CimExp8 and CimExp10. The best crosses were CimExp1/CML331, CimExp1/CML345, CimExp10/CML331 CimExp5/CML331 and CimExp5/CML345. In the second study, two sets of germplasm (hybrids/OPVs and inbred lines) were evaluated for FAW resistance under managed and natural FAW infestation. The objective was to evaluate commercial and experimental maize hybrids and parental lines cultivated in southern Africa for resistance to FAW. Commercial cultivars were significantly more affected by FAW infestation than experimental hybrids. The introduced FAW-resistant donor lines (CML338, CML67, CML121 and CML334) showed better resistance to FAW damage, individually and in hybrid combinations. Local inbreds, SV1P, CML491 and CML539, also showed good FAW resistance. Husk cover, ear rot, anthesis date and plant height were correlated with FAW resistance. The third study aimed to investigate the stability of grain yield performance and resistance to FAW of resistant maize lines, cultivars and experimental hybrids under natural FAW infestation. The hybrids Mutsa-MN521 and CimExp55/CML334 were the most preferred, combining FAW resistance, adaptation and stability across FAW infested environments. Other acceptable hybrids were 113WH330, Manjanja-MN421, CML338/CML334 and PAN53. The local inbred lines SV1P and CML491 combined adaptability and stable FFAWD resistance across environments. The best exotic donor lines exhibiting stable FAW resistance were CML67, CML346, CML121 and CML338. Harare and Gwebi were identified as the most discriminating sites for GYD performance in hybrids, while Kadoma and Rattray-Arnold Research Stations were the most discriminating environments for FFAWD among inbred lines. The fourth study explored the opportunity of using mutation breeding in maize crop improvement with the intention to enhance genetic diversity and trait performance to combat emerging threats such as FAW. The study determined optimum gamma irradiation doses to use in maize mutation breeding. Doses in the range of 160 gy - 250 gy were recommended for maize inbred lines while 200 - 275 gy were recommended for OPVs. Overall, the study concluded that effective FAW resistance can be attained in southern Africa using local and exotic genetic resources. The study recommends the use of gamma irradiation to broaden genetic diversity for effective selection. Furthermore, doubled haploid technology and the development and validation of markers will hasten genetic gains, increase selection accuracy and reduce linkage drag in breeding for FAW resistance in southern Africa
Soil fertilization synergistically enhances the impact of pollination services in increasing seed yield of sunflower under dryland conditions
No full textTo exploit the potential of ecological intensification during sunflower cropping, it is crucial to understand the potential synergies between crop management and ecosystem services. We therefore examined the effect of pollination intensification on sunflower yield and productivity under various levels of soil fertilization over two seasons in the eastern Free State, South Africa. We manipulated soil fertility with fertilizer applications and pollination with exclusion bags. We found a synergetic effect between pollination and soil fertilization whereby increasing pollination intensity led to a far higher impact on sunflower yield when the soil had been fertilized. Specifically, the intensification of insect pollination increased seed yield by approximately 0.4 ton/ha on nutrient poor soil and by approximately 1.7 ton/ha on moderately fertilized soil. Our findings suggest that sunflower crops on adequate balanced soil fertility will receive abundant insect pollination and may gain more from both synergies than crops grown in areas with degraded soil fertility.Publisher's versio
The distinctive attributes of registered nurses in a South African military context
No full textRegistered nurses who work in the military have the dual role of being both a soldier and a nurse. This unique situation has prompted research about the attributes necessary for them to fulfil their roles. Besides providing general day-to-day nursing care, the reality of unrest in South Africa, terrorism, natural and human-made disasters, and deployment has led to the question of whether South African military nurses have the attributes to manage these added demanding and stressful situations. The differences between the uniqueness of military nursing in relation to civilian counterparts in South Africa are not well reflected in literature. The question was thus posed: “What are the distinctive attributes of registered nurses in a South African military context?” Since little is known or understood about the distinctive attributes of military nurses, the researcher selected a qualitative research approach through which data could be obtained from registered nurses who experience the challenges of working in the South African military context on a daily basis. The study was conducted at one specific military healthcare institute. The accessible population included 90 registered nurses at the specific military healthcare institute. The researcher used the nominal group technique (NGT) to obtain nominal and descriptive data about the distinctive attributes of registered nurses within the South African military context. The inclusion criteria for the groups were as follows: • Being a professional nurse registered with the South African Nursing Council; • Having two or more years’ experience of working within the South African military context; and • Being available to participate in the study; e.g., not being deployed during the period of data collection. To gather sufficient and relevant data, two NGT discussions were conducted. The researcher analysed the various sets of data by using six of the seven steps to analyse the data from multiple nominal groups as described by Van Breda (2005:4-12). The results of this research study indicate that the general characteristics of military nurses can be categorised as multi-skilled, military discipline, resilience, physical fitness, occupational respect, compliance, and military etiquette. Fostering and cultivating these attributes among registered nurses in the South African military healthcare context is important to ensure that the calibre of nurses meets the required standard in order to achieve the organisation’s goals.University of the Free State (UFS
Construct validity and reliability of the generalised anxiety disorder-7 scale in a sample of tuberculosis patients in the Free State Province, South Africa
No full textBackground: Generalised anxiety disorder (GAD) frequently occurs amongst patients with tuberculosis (TB) and contributes to poor quality of life and treatment outcomes. This study evaluated the construct validity and reliability of the GAD-7 scale in a sample of patients with TB in the Free State Province.
Methods: A pilot study was conducted amongst a convenience sample of 208 adult patients newly diagnosed with drug-susceptible TB attending primary healthcare (PHC) facilities in the Lejweleputswa District in the Free State. A structured interviewer-administered questionnaire comprising social demographic questions and the GAD-7 scale was used. Confirmatory factor analysis was used to investigate the construct validity of the GAD-7 scale. The reliability of the scale was assessed by calculating Cronbach’s α.
Results: The analysis showed that a modified two-factor (somatic symptoms and cognitive-emotional symptoms) model, in which the items ‘Not being able to stop or control worrying’ and ‘Worrying too much about different things’ were allowed to covary (Comparative Fit Index: 0.996, Tucker–Lewis Index: 0.993, Root Mean Square Error of Approximation: 0.070, 90% confidence interval: 0.032–0.089), fitted the data better than a unidimensional (generalised anxiety) or an unmodified two-factor model. The indicators all showed significant positive factor loadings, with standardised coefficients ranging from 0.719 to 0.873. The Cronbach’s alpha of the scale was 0.86.
Conclusion: The modified two-factor structure and high internal consistency respectively provide evidence for construct validity and reliability of the GAD-7 scale for assessing GAD amongst patients with TB. Studies are necessary to assess the performance of this brief scale under routine TB programme conditions in the Free State.Publisher's versio
Investigating curriculum based training on patient handover within higher education institutions
No full textBackground: Communication between healthcare providers (HCPs) is crucial for holistic patient care and conformance to the continuum of care. Patient handover is viewed as an essential element for aligning this continuum of care in the healthcare environment. The education of HCPs notoriously neglects the topic of patient handover through various healthcare programmes with minimal interprofessional education taking place. The South African Qualifications Authority (SAQA) and quality councils (Council on Higher Education, Umalusi, and Quality Council of Trades and Occupations), guided by the various professional healthcare boards, which provides the benchmark for healthcare education outcomes, fails to incorporate patient handover as a topic of interest into most healthcare programmes curricula. Programme-specific outcomes appear not to reflect patient handover as a priority in healthcare. Poor interprofessional communication is linked to one-quarter of all adverse medical events and prolonged patient admission, with massive cost implications related to the duplication of diagnostic testing. Interprofessional power gradients have been indicated to directly influence how patient handover is conducted. Aims and objectives: The aim of this study was to investigate the current status of patient handover from a theoretical and practical perspective. The objectives followed to achieve the aim included reviewing the curricula of healthcare programmes published by SAQA. A rapid literature review was conducted to ascertain what national and international recommendations can be made regarding patient handover protocols. An HCP questionnaire was constructed and disseminated to hospital healthcare providers (H-HCPs) and prehospital healthcare providers (P-HCPs) to determine their perceptions of current standards related to patient handover. Methodology: A sequential mixed-methods design was employed, following a more qualitative approach to data collection. Methods: A curriculum content review was conducted on the SAQA-published healthcare programme curricula, followed by a rapid literature review. The data from these phases were utilised to construct an HCP questionnaire, to incorporate both H-HCPs’ and P-HCPs’ responses. Results: The various methods in this study indicated that patient handover is minimally implemented throughout the various healthcare programmes’ curricula. Simulation-based medical education (SBME) was highlighted as the best method to incorporate patient handover education and to assess the topic. The various healthcare programmes indicated minimal structure during theoretical education, with emphasis on informal learning by higher education institutions (HEIs). P-HCPs indicated the most experience with internationally recognised handover acronyms, while H-HCPs indicated minimal experience on the same topic. There appears to be a large gap between what H-HCPs deem important information during patient handover and the information that P-HCPs hand over. None of the HCPs indicated satisfaction with how current handover practices are done, but most HCPs felt confident with handing over a patient holistically. Conclusions: The World Health Organization’s recommendation to incorporate patient handover into all HCP programmes is highly neglected. Even though patient handover is superficially covered in theory lectures, educational limitations still exist regarding how to incorporate patient handover into teaching and learning. Informal education forms a significant part of this academic topic, with no standard approach adopted in current healthcare systems by either H-HCPs or P-HCPs. Formal assessment on patient handover is not incorporated. SBME encourages the ideal platform for educating, assessing, and providing constructive feedback on patient handover. The theory-practice gap between HEIs and healthcare facilities expands daily. Little interprofessional education is incorporated into healthcare, which directly influences the gap between a unified healthcare system. The less time that is spent on interprofessional education, the greater this gap becomes. Recommendations: Interprofessional collaboration is required between the various healthcare programmes. Educational institution and HCP collaboration is necessary to increase healthcare programme curricula, while simultaneously adapting to both industry and patient needs