38981 research outputs found
Sort by
An analysis of the isiXhosa telephonic descriptors of cardiac arrest (ca) in a Western Cape emergency control centre
Get PDFIntroduction: Out-of-hospital cardiac Arrest (OHCA) represents a considerable public health challenge, characterised by its critical time sensitivity, high morbidity, and poor survival rates. Despite decades of low survival rates, OHCA survival has been a constant concern for healthcare systems globally. The first stage of managing OHCA is immediate recognition by bystanders and emergency control centre personnel, which rely on the descriptors that callers provide. Varying educational levels and languages make identifying such patients in the Western Cape (WC), South Africa (SA), challenging. This study aims to identify key isiXhosa speaking descriptors used telephonically in the Western Cape Department of Health and Wellness, EMS, when IsiXhosa speaking callers are requesting emergency medical care at the emergency control centre in the event of OHCA. Methodology: Data from the computer-aided dispatch (CAD) programme with a “medical” and "patient unresponsive" incident classification were collected for 12 months (January 2018, to December 2018). A collection of corresponding patient care data were collected to confirm OHCA. The original voice recordings between the caller and the emergency call taker during the emergency were transcribed verbatim. Transcriptions underwent inductive, Hseih and Shannon qualitative content analysis to the manifest level. Descriptors of OHCA in isiXhosa calls were coded, categorised, and quantified. Results: The study identified 729 confirmed OHCA cases, of which 24 (3.3%) were in isiXhosa and were eligible for analysis. Five distinctive categories were identified from the content analysis. Notable descriptors used by callers to describe OHCA were related to respiratory effort (29.4%), cardiac activity (23.5%), level of consciousness (23.5%), clinical features (11.8%) and ill health (11.8%). Conclusion: This study highlighted the descriptors used by isiXhosa-speaking callers when reporting out-of-hospital cardiac arrest telephonically in South Africa's Western Cape province. The findings underscore the importance of providing a list of phrases and words descriptors used in communication between the caller and call takers
Exploring the relationship between sexual risk behaviours and HIV Status awareness among men in South Africa: analysis of data from the 2017 South African National house-based HIV prevalence, incidence and behaviour survey
Get PDFSouth Africa has one of the highest HIV prevalence rates globally, with men being a key population at risk due to risky sexual behaviours and lower HIV status awareness compared to women. This study explored the relationships between sexual risk behaviours and HIV status awareness among 1,630 sexually active South African men (≥15 years, median age 34 years, interquartile range 24-44) using data from the 2017 South African National House-based HIV Prevalence, Incidence, and Behaviour Surveys (SABSSMV). Overall, 13.5% of men self-reported living with HIV (srHIV+) and there was high concordance between self-reported and laboratory confirmed HIV status with 92.0% (95% confidence interval [CI] 84.1% - 96.1%) and 88.0% (95% CI 85.5% - 90.2%); p<0.001, of men srHIV+ and those self-reporting not living with HIV (srHIV-) being laboratory confirmed, respectively. In total, 68.3% (95% CI 64.6% - 71.8%) of men reported casual sexual partners ( 48.2% [95% CI 39.0% - 57.5%] among men srHIV+ vs. 71.4% [95% CI 67.4% - 75.2%] among men srHIV-); p<0.001, 4.9% (95% CI 3.6% - 6.7%) reported ≥2 sexual partners (2.6% [95% CI 1.1% - 6.2%] vs. 5.3% [95% CI 3.8% - 7.4%]); p = 0.116, 26.5% (95% CI 23.4% - 29.9%) reported inconsistent condom use at last sex with all partners in the past year (23.3% [16.0% - 32.7%] vs. 27.0% [95% CI 23.6% - 30.8%]); p = 0.430, and 14.2% (95% CI 11.8% - 17.1%) reported alcohol use at last sex (16.9% [95% CI 10.9% - 25.1%] vs. 13.8% [11.3% - 16.9%]); p = 0.431, with values in brackets showing the proportion among those (srHIV+) versus (srHIV-), respectively. In logistic regression models, men (srHIV+) were less likely to report engaging in casual sex compared to men (srHIV-) ( (adjusted odds ratio 0.51 95% CI: 0.27–0.97). Variations in sexual risk behaviours were observed by demographic characteristics, and age appeared to modify the association between reported HIV status and some risk behaviours. The findings highlight the impact of HIV status on risky sexual behaviour, emphasizing the need for comprehensive HIV testing and counselling (HTC), safe sex education, and integrated behavioural and structural approaches in healthcare. Tailored interventions such as age-specific messaging, accessible educational content, ensuring condom and PrEP availability, youth-friendly tech-based solutions like online counselling or mobile apps, and public campaigns promoting safe sexual practices, will be essential to address the unique needs of different age groups, education levels, HIV statuses, and geographic settings
The prevalence of psychoactive substance use amongst undergraduate students at a medical school in South Africa
Get PDFBackground: Substance use and its associated problems are a global public health concern. Factors that can influence trends in substance use include the characteristics of the substance itself as well as those related to the individual and their environment (including availability and implementation of national and local policy and service delivery). Students entering a tertiary education facility show a marked increase in substance use compared to those that live at home or seek employment following graduation from high school. Several risk factors for substance use are specific to this population, including an affiliation with fraternity or sorority life, perception of high academic pressure and peer pressure. Substance use disorders develop over time following repeated episodes of misuse. It may therefore be possible to identify emerging risky substance use and to potentially arrest the development of more problematic substance use and addiction. Aim: To determine the prevalence of substance use in a sample of undergraduate students at a medical school in South Africa. Methods: This was a descriptive cross-sectional study conducted at the University of Cape Town's (UCT) medical campus. The study population included all undergraduate medical students in years one through to six who consented to participate. As this was a descriptive study no set recommendations were given regarding appropriate sample size. Data was collected using an online version of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). This tool was developed as a Web App version for this study by the UCT Department of Psychiatry and Mental Health and allowed for completion of an auto-scoring version of the ASSIST. To maintain anonymity the system assigned a random identity token which was not linked to any identifying data. Screening risk scores and brief intervention outcomes, including information for inward referral for assessment and care, were shared with the participant onscreen at the end of the screening process. The anonymized data was analysed using the R statistical software package. Descriptive statistics was used to summarize the data. Results: 444 ASSIST tools were completed with signed consent and therefore appropriate for the data analysis; this equated to a response rate of 32,2%. Across all demographics, 83.1% (369 respondents) reported substance use. Alcohol (88,1%) followed by cannabis (53,8%) and tobacco (43,1%) were the most commonly used substances by our student population. Overall, our study found that the prevalence of substance use at UCT medical school is higher in females, Caucasian individuals and students in the later years of study. The vast majority of the students, 359 out of 369 (97,3%), fall into the low-risk category for substance use. Conclusion: From this study we see that the prevalence of substance use amongst undergraduate medical students at UCT is high (83,1%). However, in this study calculated risk was shown to be low. Whilst risk might be low, we know that substance use disorders develop over time with repeated episodes of misuse. Given the devastating sequelae of substance use disorders, early identification, primary prevention and intervention is needed. Further studies building on this one would be useful particularly in exploring cause and effect of substance use. It would be interesting to see whether, as seen in international literature, difficulty in social integration as well as academic pressure from increased work load could be contributing to the high prevalence of substance use that we have seen in this population. These findings might assist in streamlining and optimising the support services that the university is able to offer this student group
Factors affecting public trust in government digital services in developing countries: a case of South Africa
Get PDFProblem Statement: The government in developing countries has been grappling with poor service delivery often evidenced by perpetual destructive service delivery protests. Slow economic growth has further eroded the government capacity to deliver public services effectively and efficiently. The advent of government digital services was intended to address these challenges, hence substantial investment in such initiatives. However, the return on such investment is low due to low uptake of digital services in developing countries. Public trust is the most cited reason for the low uptake of Government digital services. The personal, institutional and technological contextual factors play a pivotal role in building public trust in government digital services. Objective: The objective of the study was to examine and explain how contextual factors affect public trust in Government digital services in developing countries. To achieve this objective, the study analysed how personal, institutional, and technological factors influence public trust in government digital services. Methods This study was of qualitative nature and adopted an interpretive philosophy, a descriptive purpose, and a deductive approach. A conceptual framework was developed based on the literature review. A single case study was adopted. Data were collected through semi-structured interviews. Purposive and snowball sampling techniques were used to select participants. Thematic analysis was used to analyse data. Findings The results of this study show that personal, institutional, and technological contextual factors affect public trust in government digital services. People with low socio-economic status and limited digital efficacy often struggle to access and use these services. Government digital services that are deployed by institutions that lack transparency, accountability and good governance tend to be mistrusted by the public. Additionally, digital services that are not user-friendly, with poor quality of information, and lack adequate data security and privacy further erode public trust. Originality/Contribution: This study made a practical contribution by providing the government with research-based findings that can be used as input in legislation and policies aimed at improving public trust in government digital services. This study also made a theoretical contribution by providing an in-depth analysis of how personal, institutional and technological factors affect public trust in government digital services in developing countries
Gravity assisted continuous flow peritoneal dialysis (CFPD) in children with acute kidney injury
Get PDFBackground: Peritoneal dialysis (PD) has long been a mainstay of acute kidney injury (AKI) management in children of all ages, and it remains the most commonly used modality in low-income regions, where continuous kidney replacement therapy (CKRT) is not widely available. Compared to extracorporeal therapies, PD has lower clearance as well as lower and less precise fluid removal. We previously demonstrated increased ultrafiltration and clearances using continuous flow peritoneal dialysis (CFPD) in children with AKI, however the technique described required expensive high-volume CKRT pumps to circulate fluid, as well as high level technical expertise, limiting its utility in resource-constrained settings. Identifying safe, effective and low-cost techniques for CFPD may improve access to dialysis for children with AKI in low-resource settings
Bridging the education gap: an exploratory study of education in low-income rural and informal settlements in Namibia
No full textThis qualitative study explores educational challenges and opportunities in low-income communities in northern Namibia and informal settlements in central Namibia. Recognising education as a key driver of national development, the research identifies significant misalignments between the educational expectations of these communities and the priorities set by the Namibian government, highlighting systemic challenges that hinder inclusive education for marginalised populations. The study is framed using the Heneveld and Craig (1995) Framework as further highlighted, tailored for sub-Saharan Africa. This framework evaluates how national education policies translate into school practices, emphasizing the importance of socio-economic and cultural factors. The research employs an exploratory qualitative design, utilizing purposive and convenience sampling to capture the experiences of teachers, education officials, parents, and community members through interviews, focus groups, policy document reviews, and field observations. Findings reveal a disconnect between government policies and community expectations, with communities dissatisfied by top-down approaches to education reform. Socio-economic challenges, local traditions, and cultural factors shape community expectations but are often overlooked in policy design and implementation. Bureaucratic inefficiencies were also cited as barriers to effective policy execution, and resource gaps, particularly inadequate teacher training and underfunded school infrastructure, further aggravated these challenges. The study advocates for community-centric education models that incorporate local traditions and practical knowledge into curricula, fostering relevance and inclusivity. Strengthening collaboration among the Ministry of Education, schools, and communities is crucial for more effective education reforms. Additionally, the research highlights the need for capacity-building initiatives to enhance teachers' cultural competence and teaching skills. Contributing to the academic discourse on education in sub-Saharan Africa, this study emphasises the need for context-specific interventions that align educational policies with socio-economic realities, cultural identities, and community aspirations. Future research is encouraged to explore the role of local traditions, bureaucratic impacts, and private school models in improving education quality and equity
Challenges of maintaining highly specialised infrastructure facilities at an institution of higher learning in South Africa
Get PDFFacilities management (FM) plays a crucial role in the success of higher education institutions. This study explores the challenges that facilities managers encounter in performing routine maintenance work and the impact of inadequate maintenance on highly specialised facilities at a South African higher education institution. The primary aim of this study was to understand the challenges associated with maintaining highly specialised infrastructure such as biosafety containment laboratories, pre-clinical laboratories, and research clean rooms. The objectives include investigating the reason senior academics are reluctant about routine maintenance, challenges experienced by the facility managers when conducting maintenance, assessing the impact of these challenges on academic activities, identifying key factors that contribute to maintenance difficulties, and to make recommendations towards improving infrastructure management. The study employed an interpretivist paradigm with an accompanying qualitative research approach. A single case study of a higher education institution in South Africa was utilised. Data was collected via semi-structured interviews with facilities managers, maintenance personnel, contractors as well as senior academics managing or using these highly specialised facilities at the selected higher education institution. A total of 22 interviews were undertaken and the data analysed using thematic analysis. The study found that the primary reasons for senior academics' resistance to routine maintenance include disruptions to ongoing academic activities, lack of communication and stakeholder engagement, and concerns about expertise and safety, and their limited knowledge on the facility maintenance requirements. Facilities managers face significant challenges due to administrative bottlenecks, insufficient support from higher management, and ineffective project governance, including lack of formalised contractual agreements and regulatory frameworks. Budget constraints, communication barriers, fragmented communication systems, a lack of a centralised communication mechanism further exacerbate these issues as these impede the efficient dissemination of maintenance information to the relevant stakeholder(s). Furthermore, old infrastructure and a reactive maintenance culture led to frequent breakdowns. In addition, rapid technological advancements result in frequent equipment obsolescence and high maintenance costs resulting to further disruptions. To address these challenges enhanced stakeholder engagement and involvement is needed together with improved communication channels and the establishment of robust governance frameworks to ensure timely and effective maintenance of highly specialised facilities. Recommendations emanating from this study include: adopting proactive maintenance strategies to prevent equipment failures before they occur; enhancing training for technical staff to ensure they are equipped to maintain specialised equipment; improving monitoring systems to better predict maintenance needs; securing sustainable funding models to support ongoing maintenance and equipment upgrades; and lastly, involving the facility managers in the design phase of the infrastructure and in the planning of the academic calendar. These strategies aim to promote timely implementation and completion of maintenance projects, reduce costs, and ensure sustainable maintenance practices in higher education institutions. This research provided valuable insights and a framework for other institutions facing similar challenges, contributing to the broader field of infrastructure management in higher education
Development and optimisation of pre-treatment procedures to enhance total haemoglobin for carboxyhaemoglobin analysis in diluted blood samples
Get PDFCarbon monoxide (CO) is a toxic gas that is typically unnoticed due to its lack of colour, taste and odour. When CO is inhaled, it binds to haemoglobin in red blood cells and forms carboxyhaemoglobin (COHb). Used as a biomarker to investigate CO exposure, COHb can be determined in blood using a spectrophotometry-based technique called CO-oximetry. One of the challenges with certain CO-oximetric instruments is the requirement for total haemoglobin (tHb) to be above a specific concentration (1.61g/dL for the Radiometer ABL825 FLEX Blood Gas Analyser) for COHb determination in blood to be successful. Due to the nature of post-mortem forensic casework, sometimes the blood specimens sampled for COHb analysis are dilute, with tHb falling below the stated threshold. The purpose of this study was to assess and optimise two pre-treatment procedures to effectively increase tHb in excessively dilute blood samples, thereby enabling the determination of COHb using CO-oximetry. For the first procedure, ABL Radiometer AutoCheck5+ Level 2 quality controls and blank postmortem blood were spiked into diluted specimens to supplement the blood tHb. For the second procedure, a centrifugal evaporator (MiVac Quattro system) was used to concentrate the blood. The addition of the quality control and postmortem blank blood increased tHb in dilute specimens, however, no valid COHb results could be obtained. The application of evaporation on dilute samples increased tHb, and valid COHb results were obtained. The procedure showed at 30°C for 30 minutes requiring 500 μL, within-run and between-run imprecision values <5%, and bias within ± 20% for all samples. However, the results indicated a negative bias for all concentration levels, showing that the application of the procedure resulted in a slight (-5.9 to -15.0) underestimation of COHb. The stability of diluted samples, where water was added to blood, was also assessed, with the results showing instability (bias above the acceptable threshold of ± 20%) for the tested samples when stored at 4°C for one month. To test the application of the evaporation procedure, previous case samples that initially yielded no COHb results due to low tHb levels were processed using the validated procedure and analysed on the ABL825 FLEX Blood Gas Analyser. Of the 12 samples analysed, COHb results were successfully obtained for six, demonstrating the procedure's effectiveness in obtaining valid COHb results in samples with low tHb
Sleep under stress: the complex web of fear, hypervigilance and mental health in a low socioeconomic status community in South Africa
Get PDFIntroduction: There is a well-established bidirectional relationship between sleep and mental health. Furthermore, low socioeconomic status (SES) environments have been linked to both poorer sleep and mental health, at leastin part due to a lack of perceived safety. Specifically, individuals who feel unsafe or vulnerable in their neighbourhoods may either delay sleep in favour of remaining alert to potential threats or experience hypervigilance throughout the night. This state of hypervigilance is typically characterized by heightened sympathetic nervous system activity and reduced parasympathetic tone, which can be quantified through measures of autonomic nervous system function, such as heart rate variability. Heart rate variability (HRV) is a non-invasive measure of autonomic regulation of the heart which can be divided into time and frequency domain variables. Frequency domain variables are derived from the spectral power of the electrocardiography signal and include very low, low and high frequency power measures (VLF, LF and HF power, respectively). VLF and HF power reflect sympathetic withdrawal and parasympathetic input, respectively while LF is understood to reflect a combination of sympathetic and parasympathetic input. Lower HRV has previously been linked to various mental disorders, including depression and anxiety, and has been included as a contributing factor in the hyperarousal model of insomnia
Capital structure and company performance: Did the COVID-19 pandemic matter?
Get PDFPURPOSE The aim of this study is to measure the significance of the relationship between leverage and the financial performance of 137 non-financial companies from 2016 to 2023. This study also aims to draw comparisons between this relationship during the pre-COVID-19 Pandemic of 2016 to 2019, over the full period of 2016 to 2023, and post the start of the COVID-19 Pandemic, 2020 to 2023. METHODOLOGY A two-step least squares Generalised Method of Moments panel regression model using a forward orthogonal deviation to measure the significance of the relationship was utilised. This was accompanied by model robustness checks: Breusch-Godfrey Pagan, Lagrange-Multiplier, Durbin-Watson and Arellano and Bond Serial Correlation tests. FINDINGS This study identified multiple negative relationships that were statistically significant across the periods that were analysed. This includes total liabilities and return on equity (ROE) for the pre-COVID-19, COVID-19, and full periods. Non-current liabilities and ROE in the pandemic and full periods but not in the pre-pandemic periods. Current Liabilities and ROE for the pre-COVID-19 period and full period but were insignificant for the COVID-19 period. Total liabilities and return on assets (ROA) were found for the full period, but insignificant for the pre-COVID-19 and COVID-19 periods. Non current liabilities and ROA for the pre-COVID-19, COVID-19 and full periods. Current liabilities did not exhibit any statistically significant relationships with ROA for all three periods. From the findings of this study, we can conclude that companies should exercise caution when deciding to utilise leverage during crisis and non-crisis periods as it can harm financial performance. It therefore highlights the importance of financing strategies during periods of low economic activity. ORIGINALITY This study provides new evidence on the relationship between leverage and financial performance from a South African context. Additionally, it compares the relationships between the COVID-19 Pandemic and pre-COVID-19 periods, determining if the pandemic had any impact on the relationship. Three leverage variables are used: total, non-current- and current liabilities to evaluate the relationship of each type of leverage measure with financial performance