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Risk factors for fungal co-infections in critically ill COVID-19 patients, with a focus on immunosuppressants
No full textSevere cases of coronavirus disease 2019 (COVID-19) managed in the intensive care unit are prone to complications, including secondary infections with opportunistic fungal pathogens. Systemic fungal co-infections in hospitalized COVID-19 patients may exacerbate COVID-19 disease severity, hamper treatment effectiveness and increase mortality. Here, we reiterate the role of fungal co-infections in exacerbating COVID-19 disease severity as well as highlight emerging trends related to fungal disease burden in COVID-19 patients. Furthermore, we provide perspectives on the risk factors for fungal co-infections in hospitalized COVID-19 patients and highlight the potential role of prolonged immunomodulatory treatments in driving fungal co-infections, including COVID-19-associated pulmonary aspergillosis (CAPA), COVID-19-associated candidiasis (CAC) and mucormycosis. We reiterate the need for early diagnosis of suspected COVID-19-associated systemic mycoses in the hospital setting.Publisher's versio
Poor lives matter: COVID-19 and the plight of vulnerable groups with specific reference to poverty and inequality in South Africa
No full textThis article explores the impact of the COVID-19 pandemic on vulnerable people in South Africa in the specific context of poverty and inequality. It does so by first looking at the conceptual context and then highlighting the extent of the impact both from a constitutional and human rights context and from a legislative context. It uses the poor and vulnerable as a proxy to explore the impact of the pandemic (and the measures put in place to contain it) on the specific constitutional rights of vulnerable people, before suggesting a human rights-based approach to managing the pandemic. It concludes that, despite the South African government having undertaken some of the actions recommended, there remains room for improvement and scope for further research, as the pandemic is expected to continue for some time.Publisher's versio
Post-traumatic stress and coping strategies of South African nurses during the second wave of the COVID-19 pandemic
No full textPrior to the 2019 novel coronavirus (COVID-19) outbreak, the South African healthcare system was already under severe strain due to amongst others, a lack of human resources, poor governance and management, and an unequal distribution of resources among provinces and between the public and private healthcare sectors. At the center of these challenges are nurses, the backbone of the healthcare system, and the first point of call for most patients in the country. This research investigated post-traumatic stress and coping strategies of nurses during the second wave of COVID-19 in the country. A structured self-administered questionnaire captured the biographic characteristics, perceived risk factors for COVID-19, and views on infection control of 286 nurses Data were subjected to descriptive and binomial logistic regression analyses. More than four in every 10 nurses screened positive for higher levels of post-traumatic disorder (PTSD). Self-reported risk for contracting COVID-19 mainly centered on being a health worker and patients’ non-adherence to infection prevention guidelines. Unpreparedness to manage COVID-19 patients, poorer health, and avoidant coping were associated with PTSD. Nurses voiced a need for emotional support and empathy from managers. Emotional, psychological, and debriefing intervention sessions that focus on positive coping strategies to actively address stress are recommended.Publisher's versio
Economic sustainability of small mining communities: a case study of Kathu
No full textDissertation (M.Comm. (Economics))--University of the Free State, 2021With the global fluctuations in commodity prices and increasing costs, most mines go through periods of downscale and eventually close down. The closures lead to various negative socio-economic impacts such as higher unemployment, declining growth and increased poverty levels encountered by affected mining communities. This study explores the roles that mining companies and other key stakeholders should play in the development of local economies in order to bring about economic sustainability. The South African legislative and policy framework are scrutinised for their effectiveness in promoting economic sustainability. In addition, key factors limiting the effective implementation of developmental strategies are also identified. Local economic development is often selected as the desired developmental strategy with the aim to create jobs, improve living standards and overall contribute to the economic sustainability of the mining locality. Kathu town, located in the Northern Cape province in South Africa, was used as a case study. Various outlooks, including legal, economic, and social perspectives on the challenges the town face were obtained through the use of interviews, document analysis and memos. Using constant comparative analysis to analyse the data obtained, themes such as a weak community involvement, lack in trust, poor collaboration, poor municipal capacity and possible legislation and policy flaws emerged. The study showed efforts towards sustainable local economic development. However, these efforts might not be sufficient for economic sustainability post mine-closure. Themes in support of this finding include: first, legislation and policy frameworks are promoting growth and not planning for decline to ensure an economically sustainable town. Second, the level of Kathu town’s dependency on the mining companies remain high and the local government is not fulfilling its roles and responsibilities optimally due to the lack of capacity and funding. Third, community members are not participating or contributing to development, however, the proposal of collaborative planning might address the issue. Last, fluctuations in commodity prices and incapacity will hamper the prospects of future development. Despite the challenges hindering the economic development of Kathu town, the mining company and local municipalities realise and acknowledge the shortcomings in their efforts towards promoting economic sustainability. The study makes recommendations about improving the legislative framework and planning arrangements, and hopes to contribute to the knowledge base from which all key stakeholders will learn.University of the Free Stat
Photosynthetic efficiency and biochemical responses of vegetable-type soybean cultivars under drought stress
No full textClimate change accelerates drought, which negatively impacts plant growth and development by altering the normal metabolic activities, resulting in poor crop yield. Soybean, (Glycine max L. Merrill), also known as edamame is native to South-East Asia and is popular in many parts of the world because of its high nutritional value, health, and economic benefits. The crop was recently introduced to South Africa because of its potential to improve food security. However, there is lack of information on its physiological and biochemical responses to drought. Previous studies on drought-stressed edamame demonstrated that some cultivars, especially the better-adapted ones, had induced accumulation of the total soluble sugars. Since the production of the sugars emanates mainly from the process of photosynthesis, this study was conducted to elucidate how edamame responds to drought stress by focusing on the photosynthetic efficiency, quantification of the non-structural (i.e., soluble sugars) and structural carbohydrates (i.e., non-soluble sugars), including lignin and total phenols. Also, it was important to determine the relationships between the photosynthetic efficiency parameters and all the carbohydrate responses. The information from this study is very crucial as it can be used to identify the physiological and biochemical markers of drought tolerance, which is critical for screening edamame cultivars for drought tolerance. Such information can ultimately be employed in the selection of cultivars to be included in the edamame drought tolerance breeding programs. The six edamame cultivars were germinated and grown in the greenhouse under controlled conditions. Drought stress was applied at the third trifoliate (V3) leaf stage by withholding irrigation to reach 30% WHC. The photosynthetic efficiency parameters such as chlorophyll fluorescence and stomatal conductance were determined using non-invasive methods. The sampling for all the physiological and biochemical parameters was done at flowering (R2) and pod filling (R4) stages. The photosynthesis pigments were quantified using a spectrophotometer. The non-structural carbohydrates (glucose, sucrose, trehalose, and starch) were quantified according to the instructions on the Megazyme kits. The structural carbohydrates were quantified using spectroscopy, Fourier-transform infrared (FTIR), and X-ray diffraction (XRD). The statistical analysis was done using Genstat software.
Drought stress increased the quantum efficiency (Fv/Fm) of AGS429 and UVE17 by 10% and 9% respectively at the pod filling stage respectively. The Performance index on absorption basis (PIabs) of AGS429 and UVE17 were also increased by 72% and 71% respectively at the pod filling stage. The overall photosynthetic performance of UVE17 was reduced by drought stress because this cultivar showed a total performance index (PItotal) decrease of about 28% at the pod filling stage. The cultivars, AGS354 and AGS429 had a 21% and 26% increase in chlorophyll b content at pod filling. The carotenoid content was significantly reduced in UVE17 at pod filling, showing that this cultivar had the least antioxidative defence against the reactive oxygen species (ROS) produced under drought stress. Carotenoids (CRDs) positively correlated with chlorophyll-a (Chl-a), PIabs, and PItotal, which could result in the protection of photosystems. Additionally, at the pod filling stage, UVE17 had a 59% reduction in the stomatal conductance, suggesting a poor rate of CO2 uptake and assimilation under drought stress. According to the studied photosynthesis parameters, UV17 is a poor-performing cultivar under drought stress. Drought stress-induced the accumulation of trehalose, sucrose, and starch at pod filling, but decreased glucose content of most cultivars, except UVE7. Starch had a significant positive correlation with Ch-a and the total seed mass per plant, showing its importance in improving yield under drought stress in edamame. The cell wall studies showed that drought stress did not have any significant effect on the total phenolic content of all cultivars. However, the acid-soluble lignin was significantly increased in most cultivars except UVE14 and UVE17. The FTIR and XRD results suggest that the UVE14 cell wall was the most intact during drought stress followed by UVE8 and AGS429. In conclusion, the CRDs, stomatal conductance, performance indexes of the photosystems, starch, hemicellulose, and lignin are essential physiological-biochemical mechanisms of drought tolerance in edamame. These parameters could be used in the edamame breeding programs for drought tolerance screening. AGS429 and UVE14 are better performing cultivars under severe drought stress and should be included in the drought tolerance breeding programs.Faculty of Natural and Agricultural Sciences - Department of Plant Science
MK as cultural phenomenon: a case study documenting the dispersion of Afrikaans alternative music during the period 2005–2013
No full textMK was a channel on the premium package of the paid Digital Satellite Television Service (DSTV) of Multichoice and kykNET in South Africa during the period 2005 to 2013. The channel broadcast music 24/7, using mostly Afrikaans as medium. Through its content and programming, the channel helped to support and build a new identity for the post-apartheid Afrikaans-speaking youth aged 13 to 25 years. While highlighting issues central to the life world of the Afrikaans youth at the time, simultaneously, MK culture set the scene for unique, dissident forms of expression in Afrikaans. A large following was amassed within its first two years of existence, which turned the channel into a cultural phenomenon. As a ‘social influencer’, MK stimulated the formation of new sub-genres in the field of Afrikaans rock and alternative music, subcultures representative of the language use and cultural or countercultural practices of the Afrikaans-speaking youth, and a new-found freedom of self by means of alternative or dissident forms of music. Despite the channel’s widespread influence on various musical, technical, and social platforms, culminating in a lifestyle channel with music videos at its core, no in-depth research on MK exists. To address this hiatus, my study’s objective was to research MK’s philosophy and its legacy regarding the expansion of marginal Afrikaans identities as constructed in alternative Afrikaans music and its subgenres, including hip-hop and rap. Based on this contextual framing, the research question underpinning the study was as follows: How was the dispersion of Afrikaans alternative music related to MK as a cultural phenomenon, and how were social themes such as identity and branding influenced by its specific mode of address, as well as its meta-textual production of discourse? The qualitative methodology of ethnographic case study was found to be a productive approach for my research, documenting MK as a distinctive, single-case cultural phenomenon. As most of the channel’s social media and internet traces have been removed indefinitely, semi-structured interviews with MK stakeholders served as the primary source for my data collection, supplemented by a study of MK archival material. Interviewees were chosen based on their involvement and field of expertise that constituted and helped shape the media image of the channel. These included v production managers, critics, journalists, band members, and managers actively involved with MK during its existence. Archival materials included all MK Awards nominees’ music videos (2007–2013) and the channel’s broadcast programmes. As my study involved a relatively wide range of data sources, thematic analysis has proven to be relevant to my work. While traditionally, researchers have applied the method mainly to textual data, more recently, interview transcripts, field notes, historical or site documents, digital audio files and video files are included among other viable sources of information. Concerning the study of MK as a cultural phenomenon, the method offered a systematic approach to the analysis of my data, which involved the identification of themes or patterns of cultural meaning; coding relevant data according to themes; and interpreting the resulting thematic structures by seeking out overarching patterns as structured by a conceptual framework based on recent scholarship on Afrikaans identity. My research bought to the fore that the channel had been started for a specific target market, for which branding – on TV and at live events – was a major attraction. Visual marketing (on different levels and dimensions) established MK as a brand and helped to create newly established platforms for young musicians, artists, and technicians (such as audio and visual), while simultaneously extending the brand to lifestyle choices and social causes, some of which are still operative today. The variety of programmes, aided by young and ‘funky’ presenters, mediated the many facets of being a post-apartheid Afrikaans-speaking youth, providing a cultural safe space within which to rebel and process their troubled history. It also helped them to find a way forward. On a pragmatic level, MK impacted all Afrikaans rock or alternative bands during its time of existence, leaving a legacy and platform for bands to aspire to international standards for producing music or music videos. Yet, while the success and financial viability of MK were underlined by most of my respondents, one participant intimated that the decision to establish the channel had never been inspired ideologically, but (pragmatically) amounted to a business decision. In this sense, MK’s focus on an alternative Afrikaans niche market seemed to have failed as an economic strategy and eventually led to the channel’s demise. vi Within the ideological realm, contradictions were evident as the channel was found to have brought to the fore multifarious senses of self, most strongly expressed in the opposing identity formations of nostalgia and cynicism, represented in the ‘De la Rey’ phenomenon and Zef culture, respectively. While the Afrikaans nostalgia brand foregrounded exclusivist ethnocentric tendencies associated with the De la Rey subculture, Zef culture was seen as being supportive of a subversive, heterodox Afrikaner counterculture. In propagating both nostalgia and cynicism, the former glorifying the Afrikaner past, and the latter perverting exactly those notions of race and language upheld by the apartheid regime, MK was found to have contributed to new South African discourses grappling with the formation of new identities, and a definition and redefinition of terms such as ‘other’, ‘us’, ‘self’ and ‘them’, deserving of study and analysis. Key words: MK music channel; cultural phenomenon; post-apartheid youth; Afrikaans music; branding; identity formation; Afrikaans alternative music; Afrikaans-speaking youth.University of the Free State Postgraduate Schoo
Living with a child with autism spectrum disorder: two Sotho mothers’ experiences
No full textAutism spectrum disorder (ASD) is a developmental disorder that affects individuals’ social, emotional, and communication. Raising a child with ASD is challenging for families, especially the mothers as primary caregivers. This study aimed to explore and describe two
Sotho mothers' experiences of living with a child with ASD. The study was qualitative and phenomenological in nature. Semi-structured interviews were conducted with two Sotho mothers living with an ASD-
diagnosed child. Thematic analysis was used to analyse the data collected from the interviews. A biopsychosocial-spiritual model (BPSS) was used as the underpinning theory of this study. The findings revealed both the negative and positive experiences of these two Sotho mothers. The study showed that the negative experiences of the mothers could be ascribed to a lack of knowledge and understanding
of ASD-related issues, schooling issues, the challenge of managing the child's symptoms, and poor social support. On the other hand, the
mothers' positive attitude and acceptance of the children's diagnosis positively impacted their experiences. The study also highlighted that despite the myriad of challenges with which the Sotho mothers had to cope, they continued to appreciate and support their ASD-diagnosed
children. It was evident that cultural sensitivity and the lived experiences of mothers need to be taken into account in the diagnosis and treatment of ASD. This research adds to the body of knowledge
about the experiences of mothers living with a child with ASD. There is a need for further research about the experiences of mothers and
families living with a child with ASD, especially within indigenous communities
Bad faith and underdevelopment in Africa: the case of the Democratic Republic of Congo
No full textThe main research focus of this philosophical study is to investigate Jean Paul Sartre’s philosophical concept of bad faith critically in relation to the situation of underdevelopment and development in Africa in general and, more specifically, the socio-economic situation in the Democratic Republic of the Congo as a case study. This study thus uses an existential-phenomenological interpretation of bad faith (mauvaise foi) in the African situation. It also searches (normatively) how this question can be addressed. The study starts (in Chapter 1) with some methodological and conceptual remarks that offer a preliminary basis on which the issues raised above will be addressed. These issues will be in a second step linked with an introductory definition of the concepts of underdevelopment, development and bad faith – which will be taken further in the following chapters. In Chapters 2 and 3, a more sociohistorical and empirical theoretical discussion will be provided on the concepts of underdevelopment and development. In Chapter 2, the focus is on slave trade, colonialism and corruption. Chapter 3 provides six theories of underdevelopment: imperialism theory, modernisation theory, theory of balance and unbalanced growth, the aid problem and sociopsychological theory. After these two sociohistorical and theoretical chapters, the focus shifts to an ontological interpretation of Sartre’s concept of the human being (Chapter 4) and its implications for the concept of bad faith (Chapter 5) – which in many ways is the heart of the study. In Chapter 6, the critical interpretation of Sartre's concept of bad faith is applied to the situation of underdevelopment in Africa, with specific reference to the Democratic Republic of the Congo (DRC). One of the central arguments of the study is that theories of underdevelopment and development are not the only reason for underdevelopment in Africa. The view is that the attitude of bad faith in African leaders and Africans in general is an important complementary reason of underdevelopment in Africa. The conclusion of the study (Chapter 7) revisits the argumentative path of the study and will make some recommendations for possible development in the African context
Characterisation of the fibrinolytic system and the Von Willebrand factor-Adamts13 axis in the Chacma baboon
No full textBackground: The Chacma baboon (Papio ursinus) model of acquired thrombotic thrombocytopenic purpura (aTTP) is ideally suited to investigate novel treatments with potential application in this lethal thrombotic disorder, which hinges on the dysfunction of the VWF–ADAMTS13 axis. One such modality is the thrombolytic drugs, which activate the fibrinolytic system. Our recently published pilot study demonstrated the thrombolytic drug streptokinase as ineffective in resolving aTTP in this model and highlighted the deficits in our knowledge of the Chacma baboon’s fibrinolytic system and VWFADAMTS13 axis. The present study aimed to characterise these components of the Chacma baboon’s haemostatic system to better understand the aTTP model, the effects of thrombolytics in this model, and the implications for other haemostatic disease models in this species. Materials and Methods: Forty baboons were tested using observational and experimental assays. The VWF–ADAMTS13 axis was investigated by determining ADAMTS13 antigen and activity levels, VWF:Ag, VWF:RCo, and VWF:CB levels and VWF multimer patterns. The fibrinolytic system was explored by measuring the concentrations of fibrinogen, plasminogen, tPA, PAI-1, PAP complexes, TAFI, and α2- antiplasmin, and by assessing its in vitro clot lysis ability in a modified clot lysis time assay.The plasminogen activation potentials of streptokinase and tPA were determined using concentration escalation experiments. The effect of tPA-induced plasmin activity on VWF multimer patterns when in the non-globular state was assessed in the presence of the anti-ADAMTS13 mAb 3H9. Thrombin generation, which can influence the aTTP model and its response to thrombolytics, was also evaluated, as well as the effects of sex and ABO blood group. Reference intervals and interindividual variation were calculated and compared with human values. Results and Discussion: ADAMTS13 activities were generally below (but still comparable to) human ranges. VWF:Ag and VWF:CB values tended towards the lower limit of the human reference interval, whereas VWF:RCo activities were higher. All VWF multimer patterns were essentially equivalent to normal human patterns. Fibrinogen concentrations were similar to human values, but tPA, PAP complex, PAI-1 and α2- antiplasmin concentrations all tended toward the lower human ranges. Meaningful results could not be generated for ADAMTS13 antigen, plasminogen, or TAFI, possibly due to structural differences with the human protein. Streptokinase resulted in minimal plasmin activity, but tPA led to concentration-dependent increases. All baboon samples exceeded 100% of human plasmin activity at baseline and had clot lysis times shorter than pooled normal human plasma when activated by tPA. In the absence of ADAMTS13 activity, tPA reduced the non-globular high molecular weight VWF multimers in both human and baboon samples. Baboons had greater overall endogenous thrombin potentials than humans, which was more prominent in females (p=0.0238). Except for lower fibrinogen concentrations (p=0.0134) in male baboons, and PAP complex concentrations which were higher (p=0.0188), no other sex-related differences were apparent. No baboons were typed as ABO group B or AB, and none were Rh(D) negative. Group O baboons had higher fibrinogen concentrations (p=0.0355), but all other parameters were unaffected. Fibrinogen and especially α2-antiplasmin were subject to considerable interindividual biological variation. Conclusion: The central thesis of this research is that the components of the Chacma baboon’s haemostatic system pertinent to the pathogenesis of aTTP and its treatment with thrombolytics are similar enough to their human counterparts to enable continued use of this species as a model of human haemostasis, provided quantitative results are interpreted within the context of the novel reference intervals, and the identified limitations and interspecies differences are considered. Finally, tPA should be explored further in the,Chacma baboon aTTP model in vivo to provide proof-of-concept for the use of thrombolytic drugs in the treatment of aTTP in humans
Chronic diseases of lifestyle: a risk assessment and health promotion framework for a rural and urban primary health care setting in the Free State province
No full textThesis (Ph.D. (Community Health))-University of the Free State, 2021Non-communicable diseases (NCDs), also known as chronic diseases (CD), are the leading cause of death globally. The World Health Organization (WHO) projects a significant increase in CD mortality rates, especially in developing countries. Chronic diseases of lifestyle (CDL) are chronic diseases that share similar modifiable risk factors resulting in long-term disease processes. The WHO's country-specific profile for NCDs illustrates the persistent high prevalence of modifiable risk factors in South Africa (SA) relating to CDL that place a significant burden on health systems. Shifting from an expensive hospital-centred acute-care approach to an affordable and effective primary health care (PHC) approach requires knowledge of communities' risk and disease profiles. Effective community-based PHC responses can reduce morbidity and mortality caused by CDL. However, detailed information relating to CDL and risk factors that maintain the risk cycle for CDL in rural and urban Free State (FS) communities is still limited. This study aimed to develop a framework to provide a better understanding of the CDL risk profiles and barriers and challenges experienced with regard to the effective implementation of CDL programmes in a rural and an urban PHC setting in the FS. A convergent mixed method design was applied in the study. Using the existing Assuring Health for All in the FS database, the quantitative study (PHASE I) aimed to compile a risk factor profile for the FS's rural and urban study populations. Qualitative data (PHASE II), obtained during focus group discussions, explored participants’ knowledge of CDL (patients with CDL) and related training programmes (PHC team members and medical students). Participants' attitudes and experiences of the practical implementation of CDL intervention programmes in these communities were also investigated. The quantitative part of the study found similarities and distinct differences in the CDL risk profiles between the urban and rural study communities. The qualitative part of the study provided insight into CDL-related health needs and current experiences of intervention programmes in the PHC settings. PHC team members indicated that CDL guidelines covered a range of diseases relevant to the SA context; however, several challenges and barriers to implementing the protocols and guidelines were identified. Focus group discussions with patients revealed, among others, staff shortages, high patient load leading to long waiting times, lack of supporting health care services, and transport as barriers to optimal health care at PHC facilities. Focus group discussions conducted with medical students confirmed the before-mentioned findings. In addition, medical students indicated that community-based education provided valuable opportunities to develop knowledge, skills, and attitudes relating to PHC. However, they highlighted the importance for students to have a contextualised understanding of the multi-factorial aetiology of CDL in different communities. A combination of quantitative and qualitative data was used to construct a CDL risk assessment and health promotion framework for the urban and rural settings. In Step 1 of developing the risk assessment and health promotion framework, identified CDL risk factors in each study population were prioritised to complete the risk assessment process. Step 2 identified CDL training needs for PHC teams, patient educational needs, and MBChB CDL curriculum development needs. Step 3 revealed three main barriers: resource constraints, patient noncompliance, and the lack of supporting healthcare services to the effective implementation of CDL programmes. Step 4, the final step, used the six main focus areas identified in steps 1-3 to develop a tailor-made community-based patient-centred approach to facilitate the development of focused and effective PHC programmes for CDL in these resource-constrained areas. This thesis contains details of the research study.National Research Foundation (NRF)University of the Free State (UFS