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Sprague, Courtenay, Abigail M. Hatcher, Nataly Woollett, and Vivian Black. "How Nurses in Johannesburg Address Intimate Partner Violence in Female Patients: Understanding IPV Responses in Low- and Middle-Income Country Health Systems." Journal of Interpersonal Violence 32, no. 11 (June 19, 2015): 1591–619. http://dx.doi.org/10.1177/0886260515589929.
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One in three women, globally, experiences intimate partner violence (IPV). Although 80% of the world’s population resides in the low- and middle-income countries (LMICs), health system responses to IPV are poorly understood. In 2013, the World Health Organization released new guidelines for IPV but universal screening was not recommended in LMICs due to perceived lack of capacity and insufficient evidence. South Africa, with IPV prevalence estimated at 31% to 55%, offers a window into LMIC health systems. South African women seek health care for partner abuse, yet no guidelines exist to direct providers. This research aimed to understand how and why nurses respond to IPV. Using a descriptive design, 25 nurses from five health facilities were interviewed, generating rich narratives of provider actions. Themes were coded and analyzed. An iterative process of constant comparison of emergent data was undertaken to verify and confirm final themes. In the absence of IPV guidelines, nurses employed interventions characterized as counseling, ascertaining abuse, and referral. Nurses’ actions were motivated by fear for patients’ survival, perceived professional obligations, patients’ expectations of receiving treatment, personal experiences of IPV, and weak police responses to IPV. Findings indicated nurses were responding to IPV in a routine manner, yet comprehensive guidelines remain essential to govern and locate their actions within the framework of a public health response. South Africa yields lessons for enhancing understanding of IPV responses in LMICs, while contributing to a slim evidence base of the “how” and “why” of provider actions toward IPV in patients.
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Chisale Mabotja, Mantwa, Jonathan Levin, and Mary Kawonga. "Beliefs and perceptions regarding cervical cancer and screening associated with Pap smear uptake in Johannesburg: A cross-sectional study." PLOS ONE 16, no. 2 (February 10, 2021): e0246574. http://dx.doi.org/10.1371/journal.pone.0246574.
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Background Cervical cancer is a major global public health concern, with 85% of cases occurring in low- and middle-income countries. In South Africa, it is the second most common cancer amongst women. Screening and treatment of cervical cancer precursor lesions is associated with a lower incidence and mortality. This research determines the associations between women’s beliefs about cervical cancer and screening and the uptake of Papanicolaou (Pap) smears in Johannesburg, where cervical screening uptake is suboptimal. Methods This research was approved by the University of Witwatersrand Human Research Ethics Committee (Medical), clearance certificate number: M170243 and the Johannesburg District Heath Research Committee prior to conducting the study. All participants signed a consent form prior to participating in this study. This cross-sectional analytical study used an interviewer-administered validated measurement scale based on the Health Belief Model (HBM) to describe health beliefs regarding cervical cancer and screening among 280 women aged 30 years and older, attending Johannesburg primary care facilities in 2017. Logistic regression models, with robust estimation of variance to account for clustering of women within clinics, were fitted to identify health beliefs (perceived susceptibility, severity, barriers and benefit, cues to action, and self-efficacy) associated with ever having had a Pap smear (screening uptake), while controlling for knowledge of screening and potential confounders. Results Of the 280 women, 177 (63.2%) had ever been screened, 180 (64.3%) were never married, 199 (71.1%) attained secondary education and 133 (47.5%) were employed full time. Women of older age (AOR = 1.6 for a 5-year increase in age; CI: 1.3–1.9; P<0.001), with higher knowledge scores (AOR = 2.5 for a 5-point increase in knowledge score; 95% CI:1.0–6.3;P = 0.051), with lower perceived barriers scores (AOR = 0.4 for a 5-point increase in barriers score; 95% CI:0.3–0.5; P<0.001) and higher perceived severity scores (AOR = 1.3 for a 5-point increase in severity score; 95% CI:1.0–1.6; P = 0.017) were more likely to have had a Pap smear. Conclusions This study shows that women who take up screening are older, more knowledgeable regarding cervical cancer and screening, less likely to perceive screening barriers, and more likely to perceive cervical cancer as a severe disease. This highlights that for public health interventions to increase screening uptake, the focus should include tailored behaviour change communication strategies that address women’s beliefs regarding screening barriers and emphasize the severity of cervical cancer.
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Firnhaber, Cynthia, Nomtha Mayisela, Lu Mao, Sophie Williams, Avril Swarts, Mark Faesen, Simon Levin, et al. "Validation of Cervical Cancer Screening Methods in HIV Positive Women from Johannesburg South Africa." PLoS ONE 8, no. 1 (January 11, 2013): e53494. http://dx.doi.org/10.1371/journal.pone.0053494.
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Ballot, Daynia E., and Gilbert Rugamba. "Exchange Transfusion for Neonatal Hyperbilirubinemia in Johannesburg, South Africa, from 2006 to 2011." International Scholarly Research Notices 2016 (February 29, 2016): 1–5. http://dx.doi.org/10.1155/2016/1268149.
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Background. Severe hyperbilirubinaemia requiring exchange transfusion has become less common in recent years; however, kernicterus still occurs. The aim of this study was to review babies undergoing exchange transfusion for severe hyperbilirubinaemia in a Johannesburg hospital. Methodology. This was a retrospective review of babies who required exchange transfusion in both the neonatal and the paediatric wards from June 1, 2006, to December 31, 2011. Results. There were 64 patients who underwent 67 exchange transfusions. Isoimmune haemolysis (both Rh and ABO incompatibility) was the cause of jaundice in 9/64 (14%). Most babies who underwent exchange transfusion were sick or preterm and were admitted in hospital after birth (38/64; 59.5%); three of these babies died, but not during the exchange transfusion (3/38; 7.9%); all three had signs suggestive of neonatal sepsis. The remaining 26 babies (40.6%) were readmitted to the paediatric wards for exchange transfusion. Six of these babies (6/26; 23.0%) had signs of kernicterus. The most significant complication of exchange transfusion was apnoea requiring mechanical ventilation in three patients (3/64; 4.6%). Conclusion. Despite a relatively low number of babies undergoing exchange transfusion, kernicterus still occurs and must be prevented. Proper protocols for screening and management of severe hyperbilirubinaemia need to be enforced.
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Rohner, Eliane, Masangu Mulongo, Tafadzwa Pasipamire, Austin M. Oberlin, Bridgette Goeieman, Sophie Williams, Mwansa K. Lubeya, Lisa Rahangdale, and Carla J. Chibwesha. "Mapping the cervical cancer screening cascade among women living with HIV in Johannesburg, South Africa a." International Journal of Gynecology & Obstetrics 152, no. 1 (December 11, 2020): 53–59. http://dx.doi.org/10.1002/ijgo.13485.
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LaVigne, A., S. Grover, and S. Rayne. "Knowledge and Screening Practices of Breast and Cervical Cancer in Rural and Urban South Africa." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 46s. http://dx.doi.org/10.1200/jgo.18.38000.
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Background: The South African government has recently released cancer policies for breast and cervical cancer—the most common types and causes of cancer-related death in South African women. Increased mortality rates and advanced disease at presentation in comparison with developed countries suggests a need for greater awareness of risk factors, screening and preventative methods individualized for the population at risk. Aim: To characterize and compare the knowledge base and perceptions of women in urban and rural settings, we assessed these factors in two different cohorts in South Africa. Methods: A cross-sectional sample was taken in South Africa of women invited to participate in a survey regarding breast and cervical cancer knowledge, and awareness of risk factors, prevention and screening. Participants were approached in shopping malls and health facilities in urban Johannesburg in 2015 (“urban”) and semirural Bushbuckridge, 450 km northeast of Johannesburg (“rural”) in 2016. Results: 600 total women were surveyed, with 300 from each cohort. 83% of the urban cohort completed matriculation or higher, versus 60% of rural participants for whom high school was their highest level of education. Both groups demonstrated comparable levels of cancer awareness, and > 70% felt that cervical cancer is preventable. While the urban cohort was more knowledgeable about Pap smears (76% vs. 66%, P = 0.004), > 75% of both cohorts were willing to get one. Although both groups were largely unfamiliar with the role of HPV in cervical cancer, rural women were more aware of HIV (38% vs. 59%, P < 0.0001), smoking (43% vs. 62%, P < 0.0001) and parity (39% vs. 54%, P = 0.00019) as risk factors. Nevertheless, urban participants were more knowledgeable about breast self exams (71% vs. 59%, P = 0.001) and mammograms (62% vs. 42%, P < 0.0001), and more likely to undergo one (79% vs. 66%, P = 0.0002). Both groups identified family history and genetics as risk factors, but rural women appeared more aware of the roles of diet (30.67% vs. 39.93%, P = .011), oral contraceptives (17.33% vs. 34.77%, P < .0001), alcohol (26.67% vs. 52.15%, P < .0001) and lack of exercise (8.67% vs. 55.12%, P < .0001). Conclusion: Overall knowledge of breast and cervical cancer did not differ between both groups, despite varying levels of education and geographic setting. Women in the rural cohort demonstrated more awareness of several oncologic risk factors. Yet, the greater familiarity with and uptake of screening methods, especially for breast cancer, among women in the urban cohort may point to the benefits of proximity to health care infrastructure, such as tertiary care centers. This data supports a need for further implementation and distribution of cancer care services within cancer policies, to capitalize on increasingly sufficient levels of awareness among South African women.
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Nyathi, T., M. L. Pule, P. Segone, D. G. Van der Merwe, and S. P. Rapoho. "A dose audit of fluoroscopy examinations at Charlotte Maxeke Johannesburg Academic Hospital: Analysis of preliminary results." South African Journal of Radiology 13, no. 2 (June 15, 2009): 24. http://dx.doi.org/10.4102/sajr.v13i2.541.
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Purpose: To retrospectively analyze the radiation doses delivered to patients undergoing fluoroscopy examinations in terms of the skin dose and the dose-area product (DAP). Materials and Methods: The subjects of this study were patients who underwent fluoroscopy examinations at Charlotte Maxeke Johannesburg Academic Hospital, South Africa during the period August 2007 to March 2008. The skin dose and dose-area product values were obtained from a built-in DAP-meter installed on a digital Philips Medical Systems MultiDiagnost Eleva fluoroscopy unit. The following cases were analyzed namely barium swallow, barium meal, barium enema, hexabrix swallow, gastrografin meal, voiding cystourethrogram, fistulogram, myelogram, nephrostomy and loopogram. Results: An analysis of three hundred and thirty one examinations is presented. From the recorded data the following quantities were deduced: the mean- and range of the skin doses and DAPs, mean screening time and mean fluoroscopy duration. An analysis of the screening time for the various examinations showed a weak correlation (r = 0.59) between skin dose and screening time, while a poor correlation (r = 0.42) was deduced between DAP reading and screening time. Conclusion: There is a wide spread in the radiation doses registered for any one given type of examination. The large variability in the radiation dose delivered proves that fluoroscopic examinations stand to gain from dose optimization. The usefulness and potential use of DAP meters with regards to dose optimization in radiology is shown. In line with efforts to optimize dose from diagnostic radiography examinations the authors recommend the establishment of diagnostic reference levels (DRLs) in South Africa for the most frequent examinations in general radiography, fluoroscopy, mammography and computed tomography. Keywords: patient dose, genetic risk, dose optimization, dose reference levels
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Lince-Deroche, Naomi, Jane Phiri, Pam Michelow, Jennifer S. Smith, and Cindy Firnhaber. "Costs and Cost Effectiveness of Three Approaches for Cervical Cancer Screening among HIV-Positive Women in Johannesburg, South Africa." PLOS ONE 10, no. 11 (November 16, 2015): e0141969. http://dx.doi.org/10.1371/journal.pone.0141969.
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Dhanpat, Nelesh, Tlou Manakana, Jessica Mbacaza, Dineo Mokone, and Busisiwe Mtongana. "Exploring retention factors and job security of nurses in Gauteng public hospitals in South Africa." African Journal of Economic and Management Studies 10, no. 1 (March 11, 2019): 57–71. http://dx.doi.org/10.1108/ajems-10-2018-0311.
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PurposeThe purpose of this paper is to investigate the relationship between employee retention and job security and the impact of retention factors on the job security of nurses in public hospitals in South Africa. The retention of nurses is essential in public hospitals in South Africa. It is therefore critical that retention strategies are primed to ensure the job security of nurses.Design/methodology/approachThe study is quantitative in nature, adopts a cross-sectional approach and is set within a positivist research paradigm. Pre-established questionnaires were used to collect data. Non-probability sampling was used to select a convenience sample. Questionnaires were distributed to three public hospitals in Johannesburg and 202 responses were received. The psychometric properties of the questionnaire were established through validity and reliability. Inferential and descriptive statistics were deployed to analyse data.FindingsThe study established that there is a relationship between retention factors and job security. The study further identified retention factors as predictors of job security and noted that training and development was the strongest predictor of job security amongst nurses. In addition, the study contributes towards research on retention practices of nurses from a South African perspective.Practical implicationsThe study recommendations are diagrammatically represented. If implemented by human resource practitioners and nursing management, they are likely to enhance job security.Originality/valueThe study provides insights on the retention of nursing professionals in public hospitals in Gauteng and identifies retention factors which contribute most towards job security.
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Bailly, C., S. Henriques, N. Tsabedze, and A. Krause. "Role of family history and clinical screening in the identification of families with idiopathic dilated cardiomyopathy in Johannesburg, South Africa." South African Medical Journal 109, no. 9 (August 28, 2019): 673. http://dx.doi.org/10.7196/samj.2019.v109i9.13936.
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Rohner, Eliane, Mazvita Sengayi, Bridgette Goeieman, Pamela Michelow, Cynthia Firnhaber, Mhairi Maskew, and Julia Bohlius. "Cervical cancer risk and impact of Pap-based screening in HIV-positive women on antiretroviral therapy in Johannesburg, South Africa." International Journal of Cancer 141, no. 3 (May 19, 2017): 488–96. http://dx.doi.org/10.1002/ijc.30749.
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Page-Shipp, L., Y. Voss de Lima, K. Clouse, J. De Vos, L. Evarts, J. Bassett, I. Sanne, and A. Van Rie. "TB/HIV integration at primary care level: A quantitative assessment at 3 clinics in Johannesburg, South Africa." Southern African Journal of HIV Medicine 13, no. 3 (August 16, 2012): 138–43. http://dx.doi.org/10.4102/sajhivmed.v13i3.127.
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Background. In 2004 the World Health Organization (WHO) released the Interim Policy on Collaborative TB/HIV activities. According to the policy, for people living with HIV (PLWH), activities include intensified case finding, isoniazid preventive therapy (IPT) and infection control. For TB patients, activities included HIV counselling and testing (HCT), prevention messages, and cotrimoxazole preventive therapy (CPT), care and support, and antiretroviral therapy (ART) for those with HIV-associated TB. While important progress has been made in implementation, targets of the WHO Global Plan to Stop TB have not been reached.
Objective. To quantify TB/HIV integration at 3 primary healthcare clinics in Johannesburg, South Africa.
Methods. Routinely collected TB and HIV data from the HCT register, TB ‘suspect’ register, TB treatment register, clinic files and HIV electronic database, collected over a 3-month period, were reviewed.
Results. Of 1 104 people receiving HCT: 306 (28%) were HIV-positive; a CD4 count was documented for 57%; and few received TB screening or IPT. In clinic encounters among PLWH, 921 (15%) had documented TB symptoms; only 10% were assessed by smear microscopy, and few asymptomatic PLWH were offered IPT. Infection control was poorly documented and implemented. HIV status was documented for 155 (75%) of the 208 TB patients; 90% were HIV-positive and 88% had a documented CD4 count. Provision of CPT and ART was poorly documented.
Conclusion. The coverage of most TB/HIV collaborative activities was below Global Plan targets. The lack of standardised recording tools and incomplete documentation impeded assessment at facility level and limited the accuracy of compiled data.
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Musakwa, Nozipho Orykah, Jacob Bor, Cornelius Nattey, Elisabet Lönnermark, Peter Nyasulu, Lawrence Long, and Denise Evans. "Perceived barriers to the uptake of health services among first-year university students in Johannesburg, South Africa." PLOS ONE 16, no. 1 (January 22, 2021): e0245427. http://dx.doi.org/10.1371/journal.pone.0245427.
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Background Young people face many barriers to accessing appropriate health care services including screening for HIV and tuberculosis (TB). The study aimed to identify perceived barriers to the uptake of health services among young adults entering the tertiary education system in South Africa. Methods We conducted a cross-sectional study among first-year students aged 18–25 years, registered at one of three universities in Johannesburg, South Africa, in 2017. Participants completed a self-administered paper-based questionnaire. We describe perceived barriers to accessing health services, stratified by gender and recent engagement in TB or HIV services, together with sources of information about HIV and TB. Results Seven hundred and ninety-two (792) students were included in the study of which 54.8% were female. Perceived barriers to accessing services included long waiting time (n = 342,43.2%), attitude of health workers (n = 263,33.2%), lack of sufficient information/poor health literacy (n = 148,18.7%), and inability to leave/stay away from studies (n = 137,17.3%). Among participants who tested for HIV in the past 6 months (n = 400, 50.5%), waiting time and attitude of health care workers were perceived as barriers to accessing services. Compared to males, females were more likely to view attitudes of health workers (40.3% vs. 25.0%; p = 0.001) and inability to leave/stay away from studies (20.5% vs.13.4%; p = 0.025) as potential barriers. While just over half of the students (50.5%; 400/792) in this study had accessed health services in the past 6 months, very few (15.0%) opted to use campus health services, and even less (5%) reported receiving information about HIV and TB from the university itself. Conclusion Despite perceived barriers to accessing HIV and TB services off campus, fewer than one in five students starting out at university opted to use campus health services. Campus health services could address many of the barriers unique to university students.
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Dadoo, Zahedah, and D. E. Ballot. "An evaluation of the screening for retinopathy of prematurity in very-low-birth-weight babies at a tertiary hospital in Johannesburg, South Africa." South African Journal of Child Health 10, no. 1 (March 29, 2016): 79. http://dx.doi.org/10.7196/sajch.2016.v10i1.1099.
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Angula, Etuhole, and Valencia Melissa Zulu. "Tackling the ‘death’ of brick-and-mortar clothing retailers through store atmospherics and customer experience." Innovative Marketing 17, no. 3 (September 21, 2021): 157–68. http://dx.doi.org/10.21511/im.17(3).2021.13.
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The threat of online shopping propels brick-and-mortar retailers to innovate and design their retail atmosphere to create unforgettable shopping experiences to compete effectively and retain customers. The study firstly identifies store atmospherics factors that enhance the shopping experience and secondly explores the hypothesized relationships between store atmospherics dimensions (lighting, music, layout, and employee interaction) and customer experience. Furthermore, the effect of customer experience and repurchase intention is also explored. A self-administered survey was used, and data were collected from 390 respondents who visit physical clothing stores regularly in the City of Johannesburg in South Africa. The survey results were analyzed using the Statistical Package for Social Sciences (SPSS) for descriptive statistics. Covariance-Based Structural Equation Modelling (CB-SEM) was utilized for the path analysis. The findings reveal that only store layout, lighting, and employee interaction are essential elements in creating pleasurable customer in-store experiences (β = 0.163, p = 0.05; β = 0.207, p = 0.01; β = 0.293, p = 0.001). It is also evident that consumers perceive music to be less effective in enhancing their shopping experiences (β = 0.048, p = ns). Moreover, the results show that enriching customer experiences stimulate repeat purchases (β = 0.745, p = 0.001). The findings demonstrate that innovating the store environment should be based on shop layout, illumination, and employee contact to create appealing experiences. This study contributes to consumer and retailing services literature. Acknowledgment This study is based on the research supported partly by the University of the Witwatersrand Chancellor’s Female Academic Leaders Fellowship.
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Adam, Sumaiya, and Paul Rheeder. "Selective Screening Strategies for Gestational Diabetes: A Prospective Cohort Observational Study." Journal of Diabetes Research 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/2849346.
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Aim. We aimed to develop a prediction model for the diagnosis of gestational diabetes and to evaluate the performance of published prediction tools on our population. Methods. We conducted a cohort study on nondiabetic women < 26 weeks gestation at a level 1 clinic in Johannesburg, South Africa. At recruitment, participants completed a questionnaire and random basal glucose and HbA1c were evaluated. A 75 g 2-hour OGTT was scheduled between 24–28 weeks gestation, as per FIGO guidelines. A score was derived using multivariate logistic regression. Published scoring systems were tested by deriving ROC curves. Results. In 554 women, RBG, BMI, and previous baby ≥ 4000 g were significant risk factors included for GDM, which were used to derive a nomogram-based score. The logistic regression model for prediction of GDM had R2 0.143, Somer’s Dxy rank correlation 0.407, and Harrell’s c-score 0.703. HbA1c did not improve predictive value of the nomogram at any threshold (e.g,. at probability > 10%, 25.6% of cases were detected without the HbA1c, and 25.8% of cases would have been detected with the HbA1c). The 9 published scoring systems performed poorly. Conclusion. We propose a nomogram-based score that can be used at first antenatal visit to identify women at high risk of GDM.
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Bode, Christiaan César, and Thomas John Sheer. "A techno-economic feasibility study on the use of distributed concentrating solar power generation in Johannesburg." Journal of Energy in Southern Africa 21, no. 2 (May 1, 2010): 2–11. http://dx.doi.org/10.17159/2413-3051/2010/v21i2a3249.
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The technical and financial feasibility of small-scale distributed Concentrating Solar Thermal Power (CSP) systems for urban areas in Johannesburg, South Africa, is investigated. The University of the Witwatersrand (Wits), located in central Johannes-burg, is used as the basis of a case study for the im-plementation of these systems. A number of proven CSP technologies were identified and a technology screening was performed to identify suitable technologies for possible implementation, for a reference output of 120 kW(e). From these, a number of systems were chosen for more detailed evaluation and the hourly energy production of these systems was analysed, using local weather data. The Compound Linear Fresnel Reflector system (CLFR) proved to be most suitable because of the space and cost benefits it offers. Systems that integrate organic Rankine cycles (ORC) as well as thermal storage and hybridisation were also investigated. The levelised cost of electricity (LEC) was predicted to be between R4.31 and R3.18 per kWh. Currently these technologies cannot compete financially with the price of local, fossil produced electricity, but with the increase in electricity tariffs and demand for clean reliable power CSP technologies, may become competitive in distributed generation systems in urban areas.
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Khumalo, Gugulethu P., Nicholas J. Sadgrove, Sandy F. Van Vuuren, and Ben-Erik Van Wyk. "South Africa’s Best BARK Medicines Prescribed at the Johannesburg Muthi Markets for Skin, Gut, and Lung Infections: MIC’s and Brine Shrimp Lethality." Antibiotics 10, no. 6 (June 7, 2021): 681. http://dx.doi.org/10.3390/antibiotics10060681.
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Indigenous trade of medicinal plants in South Africa is a multi-million-rand industry and is still highly relevant in terms of primary health care. The purpose of this study was to identify today’s most traded medicinal barks, traditionally and contemporaneously used for dermatological, gastrointestinal, and respiratory tract infections; then, to investigate the antimicrobial activity and toxicity of the respective extracts and interpret outcomes in light of pharmacokinetics. Thirty-one popularly traded medicinal barks were purchased from the Faraday and Kwa Mai-Mai markets in Johannesburg, South Africa. Information on the medicinal uses of bark-based medicines in modern commerce was recorded from randomly selected traders. The minimum inhibitory concentration (MIC) method was used for antimicrobial screening, and brine shrimp lethality was used to determine toxicity. New medicinal uses were recorded for 14 bark species. Plants demonstrating some broad-spectrum activities against tested bacteria include Elaeodendron transvaalense, Erythrina lysistemon, Garcinia livingstonei, Pterocelastrus rostratus, Rapanea melanophloeos, Schotia brachypetala, Sclerocarya birrea, and Ziziphus mucronata. The lowest MIC value of 0.004 mg/mL was observed against Staphylococcus epidermidis for a dichloromethane bark extract of E. lysistemon. The tested medicinal barks were shown to be non-toxic against the Artemia nauplii (brine shrimp) bioassay, except for a methanol extract from Trichilia emetica (69.52% mortality). Bacterial inhibition of bark extracts with minimal associated toxicity is consistent with the safety and valuable use of medicinal barks for local muthi market customers. Antimicrobial outcomes against skin and gastrointestinal pathogens are feasible because mere contact-inhibition is required in vivo; however, MIC values against respiratory pathogens require further explaining from a pharmacokinetics or pharmacodynamics perspective, particularly for ingested rather than smoked therapies.
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Nelson, Jennifer A., Shelley A. Francis, Joan Liverpool, Soji Soogun, and Nokuthula Mofammere. "Healers in a non-traditional role; a focus group study of Sangoma’s knowledge of and attitudes to cervical cancer prevention and screening in Johannesburg, South Africa." Sexual & Reproductive Healthcare 1, no. 4 (November 2010): 195–96. http://dx.doi.org/10.1016/j.srhc.2010.07.004.
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Scott, Lesley, Anura David, Lara Noble, Matilda Nduna, Pedro Da Silva, Andrew Black, Francois Venter, and Wendy Stevens. "Performance of the Abbott RealTi m e MTB and MTB RIF/INH Assays in a Setting of High Tuberculosis and HIV Coinfection in South Africa." Journal of Clinical Microbiology 55, no. 8 (June 7, 2017): 2491–501. http://dx.doi.org/10.1128/jcm.00289-17.
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ABSTRACT South Africa is a country with a high incidence of tuberculosis (TB), complicated by coinfection with human immunodeficiency virus (HIV). The Xpert MTB/RIF (Cepheid, Sunnyvale, CA, USA) is used in South Africa as the test for the initial diagnosis of TB, and other molecular platforms such as the m 2000 (Abbott Molecular, Des Plaines, IL, USA) are widely used for molecular monitoring of HIV load. The latter platform is now also equipped with the RealTi m e (RT) MTB and RealTi m e MTB RIF/INH assays for TB and first-line drug resistance screening but has not been evaluated in settings of HIV and TB coinfection. A prospective clinical validation study was conducted at a community health center in Johannesburg, South Africa, and consenting individuals with presumptive pulmonary TB were enrolled. The performance of the Abbott assays was compared with those of the Xpert MTB/RIF, liquid culture, drug susceptibility testing, and clinical case definitions. A statistical analysis was performed on 206 individuals (73% were HIV positive). The sensitivity and specificity of the RT MTB were 82.5% (confidence interval [CI], 67.2 to 92.7) and 93.1% (CI, 86.2 to 97.2) on raw sputum and 77.5% (CI, 61.5 to 89.2) and 95.1% (CI, 88.9 to 98.4) on concentrated sputum, respectively, compared with those from liquid culture. The RT MTB correctly identified 17/35 more smear-negative culture-positive specimens than the Xpert MTB/RIF. Both the RT MTB and the Xpert MTB/RIF displayed sensitivities >70% and specificities >90% in HIV-positive individuals. The available drug resistance results concurred with MTBDR plus and drug susceptibility profiles. The RT MTB assay has similar diagnostic performance to the Xpert MTB/RIF and is suited to testing presumptive TB patients coinfected with HIV. The existing laboratory information system connectivity, training, and technical support make this a viable polyvalent option to scale up TB alongside HIV laboratory testing services in South Africa.
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Yende, Nompumelelo, Annelies Van Rie, Nora S. West, Jean Bassett, and Sheree R. Schwartz. "Acceptability and Preferences among Men and Women for Male Involvement in Antenatal Care." Journal of Pregnancy 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/4758017.
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Introduction. Male involvement in antenatal care (ANC) has been associated with improved prevention of mother-to-child transmission outcomes in Sub-Saharan Africa; yet it remains uncommon. We assess acceptability of male involvement from the male and female perspectives and potential incentives for men to attend ANC. Methods. Adult pregnant women and men attending primary healthcare at Witkoppen Health and Welfare Centre in Johannesburg, South Africa, from October 2013 to January 2014, were recruited using stratified random sampling to ensure equal representation across gender and HIV status. Results. 300/332 individuals (93.8%) offered participation consented. Among the 150 women, 97% had a partner; the majority (92%) preferred partner attendance at ANC, and 14% reported partner attendance during this pregnancy. The 150 men had low knowledge of services rendered at ANC outside of pregnancy monitoring, and few (19%) had previously attended ANC. Blood pressure screening, fatherhood information, and HIV testing were identified by men as incentives for attendance. Women and men expressed high willingness to, respectively, deliver (95%) and respond (97%) to ANC letter invitations. Conclusion. Invitation letters to promote male involvement in ANC are highly acceptable to pregnant women and men. Focusing invitation messages on fatherhood and primary healthcare rather than HIV testing may provide greater motivation for male involvement.
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Milner, Karen, Roseanne da Silva, Deepak Patel, and Sulaiman Salau. "How do we measure up? A comparison of lifestyle-related health risk factors among sampled employees in South African and UK companies." Global Health Promotion 25, no. 1 (July 12, 2016): 73–81. http://dx.doi.org/10.1177/1757975916656346.
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The need to address the growing prevalence of non-communicable diseases through changing the lifestyle behaviours that contribute to them has become a global priority. Settings-based health promotion strategies such as workplace health promotion programmes are growing in an attempt to start meeting this need. In order for settings-based health promotion programmes to be successful, they need to be based on the specific risk profiles of the population for whom they are designed. Workplace health promotion programmes are becoming popular in South Africa, but there are currently few data available about the health risks and lifestyle behaviours of the South African employed population. In order to obtain such data and reward workplace health promotion initiatives, Discovery Health initiated healthy company campaigns in South Africa and the UK. These campaigns took the form of a competition to assess the healthiest companies in each country. Through these campaigns, an extensive data set was collected encompassing UK and South African employees’ lifestyle behaviours and health risks. In this article, we used these data to compare self-reported physical activity levels, self-reported fruit and vegetable consumption, calculated BMI, self-reported smoking, mental health indicators, and health screening status of the UK and South African employee samples. We found significant differences across all measures, with the exception of self-reported fruit and vegetable consumption. The findings emphasise the importance of using local data to tailor workplace health promotion programmes for the population for which the programmes have been designed.
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Wake, Rachel M., Nelesh P. Govender, Tanvier Omar, Carolina Nel, Ahmad Haeri Mazanderani, Aaron S. Karat, Nazir A. Ismail, Caroline T. Tiemessen, Joseph N. Jarvis, and Thomas S. Harrison. "Cryptococcal-related Mortality Despite Fluconazole Preemptive Treatment in a Cryptococcal Antigen Screen-and-Treat Program." Clinical Infectious Diseases 70, no. 8 (June 8, 2019): 1683–90. http://dx.doi.org/10.1093/cid/ciz485.
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Abstract Background Cryptococcal antigen (CrAg) screening and treatment with preemptive fluconazole reduces the incidence of clinically evident cryptococcal meningitis in individuals living with advanced human immunodeficiency virus (HIV) disease. However, mortality remains higher in CrAg-positive than in CrAg-negative patients with similar CD4+ T-lymphocyte counts. Methods We conducted a cohort study to investigate causes of morbidity and mortality during 6 months of follow-up among asymptomatic CrAg-positive and CrAg-negative (ratio of 1:2) patients living with HIV with CD4 counts <100 cells/µL attending 2 hospitals in Johannesburg, South Africa. When possible, minimally invasive autopsy (MIA) was performed on participants who died. Results Sixty-seven CrAg-positive and 134 CrAg-negative patients were enrolled. Death occurred in 17/67 (25%) CrAg-positive and 12/134 (9%) CrAg-negative participants (hazard ratio for death, adjusted for CD4 count, 3.0; 95% confidence interval, 1.4–6.7; P = .006). Cryptococcal disease was an immediate or contributing cause of death in 12/17 (71%) CrAg-positive participants. Postmortem cryptococcal meningitis and pulmonary cryptococcosis were identified at MIA in all 4 CrAg-positive participants, 3 of whom had negative cerebrospinal fluid CrAg tests from lumbar punctures (LPs) at the time of CrAg screening. Conclusions Cryptococcal disease was an important cause of mortality among asymptomatic CrAg-positive participants despite LPs to identify and treat those with subclinical cryptococcal meningitis and preemptive fluconazole for those without meningitis. Thorough investigation for cryptococcal disease with LPs and blood cultures, prompt ART initiation, and more intensive antifungals may reduce mortality among asymptomatic CrAg-positive patients identified through screening.
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Rautenbach, Christa. "Editorial." Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad 16, no. 4 (May 17, 2017): 1. http://dx.doi.org/10.17159/1727-3781/2013/v16i4a2427.
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This edition of PER consists of eight articles, four notes and two book reviews covering a range of topics. The first article is by Oliver Fuo, a postgraduate student of the North-West University (Potchefstroom Campus). His contribution deals with the status of executive policies and the basis for their judicial enforcement in a constitutional and socio-economic context. He demonstrates that "executive" policies may be perceived to have the force of law, especially where their enforcement may be imperative for the realisation of socio-economic rights. Secondly, Ig Rautenbach of the University of Johannesburg considers empirical data on the effectiveness of the Constitutional Court during the period 1995 to 2012. He focuses on the following three questions: "How did the cases reach the court", "why did the court refuse to consider some of them", and "how often did the court invalidate laws and actions". In the third article, Magda Slabbert and Hendrik Pienaar, follows a multi-disciplinary approach to discuss the legal position of the locum tenens that is often used by medical practitioners in private practice. They recommend that a locum tenens be appointed as an independent contractor rather than an employee, and argues that the onus to ensure that he or she is registered and fit to practice rests on the principal. The fourth article by Carika Keuler deals with the "pay now, argue later" rule in terms of the Tax Administration Act 28 of 2011. She is of the opinion that the Act fails to address the imbalance between the duties of the South African Revenue Services and the right of the taxpayer to access the courts. JC Knobel, the author of the fifth article, gives an overview of the conservation status of eagles in South Africa. He discusses the existing legal framework and makes a number of recommendations to improve their legal status. Two authors, Laurence Juma and James Tsabora, both from Rhodes University, discuss the possibility of South Africa enacting a new law regulating private military and/or security companies, which they refer to as PMSC's. The seventh article by Johan Kruger and Clarence Tshoose gives a South African perspective on the impact of the Labour Relations Act 66 of 1995 on minority trade unions. In the eight place, Dave Holness offers an analysis of compulsory "live client" clinical legal education as part of the LLB course as a means of improving access to justice for the indigent.
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Mokhele, Idah, D. Evans, K. Schnippel, A. Swarts, J. S. Smith, and C. Firnhaber. "Awareness, perceived risk and practices related to cervical cancer and Pap smear screening: A cross-sectional study among HIV-positive women attending an urban HIV clinic in Johannesburg, South Africa." South African Medical Journal 106, no. 12 (December 1, 2016): 1247. http://dx.doi.org/10.7196/samj.2016.v106.i12.11224.
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Mokhele, Idah, D. Evans, K. Schnippel, A. Swarts, J. S. Smith, and C. Firnhaber. "Awareness, perceived risk and practices related to cervical cancer and Pap smear screening: A cross-sectional study among HIV-positive women attending an urban HIV clinic in Johannesburg, South Africa." South African Medical Journal 106, no. 12 (December 1, 2016): 1247. http://dx.doi.org/10.7196/samj.2017.v106i12.11224.
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A. Johnston, Kevin, and Grandon Gill. "Standard Bank: The Agile Transformation." Journal of Information Technology Education: Discussion Cases 6 (2017): 07. http://dx.doi.org/10.28945/3923.
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South Africa’s largest bank has recently completed a transformation from traditional systems development to the scaled agile framework. The individual leading the transformation is now considering how to keep the momentum going and possible new directions. Josef Langerman, Head of IT Transformation for Standard Bank, reflected on the extraordinary transformation that his organization’s IT group had recently experienced. Over the past three years, Standard Bank’s IT group had changed from the relatively well accepted systems development lifecycle/waterfall model to a revolutionary large scale agile approach. The results had been gratifying. But it left a question unanswered. Now that things were starting to stabilize, what should be the next steps? The 154-year-old Standard Bank was the largest banking group in Africa, and the 5th largest company headquartered in South Africa. The bank offered a range of corporate, business and personal banking as well as financial services. Its 49,000 employees served over 15 million customers, in 20 countries across the continent of Africa, as well as other countries scattered around the globe. Standard Bank’s IT group, located within the company’s Johannesburg headquarters, had over 6000 employees. The group managed the bank’s technology infrastructure–including a network of nearly 10,000 ATMs, its applications development, testing, deployment, maintenance and operations. By 2014, the bank recognized that its IT performance was lagging industry benchmarks in productivity, turnaround time and employee satisfaction. Employing a “do it in-house” philosophy, it embarked on a major transformation. Abandoning traditional highly structured approaches to project management and development, it had adopted an agile philosophy that was most commonly seen in much smaller organizations and technology startups. The results had been impressive–productivity, cycle time and organizational health indicators had all risen dramatically. The group had also achieved substantial reductions in its budget. Even skeptics within the organization could not fail to be impressed. Now, however, Langerman wondered about the future. He had been cautioned by his group’s HR Culture Transformation Guide that rapid improvement could easily be followed by disillusionment. What could be done to keep the momentum going forward? Should the bank double down on the types of changes to culture, practice and training that had led to its success, or was it time to let things settle? And who should be guiding the change? Should the implementation continue entirely in-house, or should outside consultants–that were working in other areas of the bank–play a significant role? In the near future, he would need to present his recommendations to the group’s CIO.
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Lince-Deroche, Naomi, Craig Van Rensburg, Cindy Firnhaber, Carol Benn, Grace Rubin, Pam Michelow, and Sarah Rayne. "Costs of Diagnosing Breast-Related Conditions at a Large, Public Hospital in a Middle-Income Country Without Population-Level Screening." Journal of Global Oncology 3, no. 2_suppl (April 2017): 21s. http://dx.doi.org/10.1200/jgo.2017.009456.
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Abstract 42 Background: Literature regarding the costs and cost-effectiveness of diagnosing breast disease globally, including cancer, has focused on mammographic screening in high-income settings. South Africa, a middle-income country, is currently crafting its first national breast cancer policy, and information on costs and best practices for national imaging services in low- and middle-income settings is required. We undertook this work to estimate the average cost per procedure and per patient for diagnosis of breast conditions by using a large, public outpatient clinic in Johannesburg as well as to explore potential cost savings through rationing mammography for diagnosis. Methods: Results of a retrospective clinical cohort study conducted at an outpatient clinic in 2013 and 2014 were used to establish a 12-month population of clinic patients and diagnostic service statistics. We used microcosting to estimate the average cost for each diagnostic procedure from the health service perspective. An Excel-based model and scenario analysis were used to explore changes in total and per patient costs when mammography use was incrementally reduced by shifting patients to ultrasound-based services. Results: We estimated that 3,867 individuals attended the clinic over 12 months. The average cost per patient for initial consultation and/or exam was $10.14 (2015 USD). Mammography was more costly than ultrasound at $59.96 and $21.11, respectively. Procedures for pathology were the most costly diagnostic (stereotactic core needle biopsy, $330.05; ultrasound-guided core needle biopsy, $279.42; fine needle aspiration, $101.00) because of substantial laboratory charges. The average cost per patient seen was $115.96. Hypothetically, replacing mammography with ultrasound resulted in minimal decreases in the average cost per patient as a result of the high cost of the mammogram machine. Cost savings at the facility level may be achieved when mammography use is eliminated entirely. Conclusion: Per patient mammography costs are largely dependent on economies of scale. Because ultrasound can be considered as an alternative for many women without compromising imaging in nonoccult disease, diagnostic mammography should be offered in centralized locations for maximum efficiency gains. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Naomi Lince-Deroche No relationship to disclose Craig Van Rensburg No relationship to disclose Cindy Firnhaber Research Funding: Merck (Inst) Carol Benn No relationship to disclose Grace Rubin No relationship to disclose Pam Michelow No relationship to disclose Sarah Rayne Travel, Accommodations, Expenses: Novartis
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Kufe, Nyuyki Clement, Maphoko Masemola, Tinashe Chikowore, Andre Pascal Kengne, Tommy Olsson, Julia H. Goedecke, and Lisa K. Micklesfield. "Protocol for systematic review and meta-analysis of sex hormones and diabetes risk in ageing men and women of African ancestry." BMJ Open 9, no. 1 (January 2019): e024446. http://dx.doi.org/10.1136/bmjopen-2018-024446.
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AimTo present the protocol of a systematic review and meta-analysis of the available evidence examining the association between sex hormones and type 2 diabetes risk in ageing men and women of African descent.MethodsWe shall conduct a comprehensive search of published studies that examined the association between sex hormones and type 2 diabetes risk in men and women aged ≥40 years from 01/01/1980 to 31/03/2018 with no language restriction. Databases to be searched include: PubMed, Scopus, Cochrane Library, Cumulative Index to Nursing and Allied Health, ISI Web of Science, Clinical Trial registries, Google Scholar and institutional websites such as the WHO, American Diabetes Association, International Diabetes Federation, World Diabetes Foundation, European Association for the Study of Diabetes, African Journal Online and ProQuest databases. This protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. Independent screening for eligible studies using defined criteria and data extraction, will be completed in duplicate. Discrepancies will be resolved by consensus or consultation with a third researcher. Risk of bias of included studies will be assessed by the appropriate Cochrane risk of bias tool. The overall association estimates will be pooled using appropriate meta-analytic techniques. Heterogeneity will be assessed using Cochrane Q statistic and the inconsistency index (I2). The random effects model will be used to calculate a pooled estimate.Ethics and disseminationNo ethics clearance is required as no primary data will be collected. The systematic review and meta-analysis are part of a PhD project at WITS University (Johannesburg, South Africa) and results will be presented at conferences and published in a peer-review journal. The results will guide future population specific interventions.PROSPERO registration numberCRD42017074581.
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Giamporcaro, Stephanie, and David Leslie. "Responsible investment at Old Mutual: a case of institutional entrepreneurship." Emerald Emerging Markets Case Studies 8, no. 4 (December 12, 2018): 1–29. http://dx.doi.org/10.1108/eemcs-02-2018-0025.
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Learning outcomes To understand the motivations for adopting RI practices for institutional investors and asset managers; to understand the different RI strategies available to institutional investors; to understand the impediments to adoption of RI at an organisational level; to debate how financial institutions can drive the growth and adoption of RI among the investment community; and to illustrate the complexities of organisational change and the strategies that institutional entrepreneurs can use to overcome resistance to change from key stakeholders. Case overview/synopsis: The case is set in October 2017 against the backdrop of the pending unbundling of Old Mutual plc into four new independent businesses, and the subsequent relisting of Old Mutual Ltd on the Johannesburg Stock Exchange in South Africa. The head of responsible investment at Old Mutual Investment Group and the main protagonist of the case, Jon Duncan, is considering what the subsequent relisting will mean for the responsible investing programmes that he has set up over the past six years. The case goes on to describe how responsible investment principles were supported through the implementation of ESG integration and active ownership strategies. It also examines recent developments in ESG product innovations and demonstrates another technique available to responsible investment practitioners in the form of best-in-class ESG screening. The case ends with Duncan contemplating the strategic priorities of the RI team moving forward, and how the managed separation might impact on the RI agenda. It provides prompts for students to discuss and formulate a strategy for advancing the aims of responsible investing. Complexity academic level The case is aimed at postgraduate-level students enrolled in a management-related degree programme such as an MBA, and covers both sustainable and responsible finance and institutional entrepreneurship theory. Supplementary materials Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes. Subject code CSS 1: Accounting and Finance
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Bezuidenhout, Jacqueline K., Katijah Khoza-Shangase, Tim De Maayer, and Renate Strehlau. "Outcomes of newborn hearing screening at an academic secondary level hospital in Johannesburg, South Africa." South African Journal of Communication Disorders 68, no. 1 (January 27, 2021). http://dx.doi.org/10.4102/sajcd.v68i1.741.
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Venter, Willem D. F., Mohammed Majam, Godspower Akpomiemie, Natasha Arulappan, Michelle Moorhouse, Nonkululeko Mashabane, and Matthew F. Chersich. "Is laboratory screening prior to antiretroviral treatment useful in Johannesburg, South Africa? Baseline findings of a clinical trial." BMC Public Health 17, S3 (July 2017). http://dx.doi.org/10.1186/s12889-017-4353-1.
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Marsay, Carina, Lenore Manderson, and Ugasvaree Subramaney. "Validation of the Whooley questions for antenatal depression and anxiety among low-income women in urban South Africa." South African Journal of Psychiatry 23 (April 11, 2017). http://dx.doi.org/10.4102/sajpsychiatry.v23i0.1013.
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Background/objective: In South Africa, approximately 40% of women suffer from depression during pregnancy. Although perinatal depression and anxiety are significant public health problems impacting maternal and infant morbidity and mortality, no routine mental health screening programmes exist in the country. A practical, accurate screening tool is needed to identify cases in these busy, resource-scarce settings.Method: A convenience sample of 145 women between 22 and 28 weeks gestation was recruited from Rahima Moosa Hospital antenatal clinic in Johannesburg. All women completed a biographical interview, the Edinburgh Postnatal Depression Scale (EPDS), the Whooley questions and a structured clinical interview.Results: The results demonstrate the sensitivity and specificity of the Whooley questions and the EPDS in identifying depression, anxiety and stress disorders of varying severity. The importance of personal, social and cultural context in influencing the content and expression of these common perinatal conditions was also identified.Discussion and conclusion: The validity of the Whooley questions in the context of urban South Africa, and the importance of ensuring clinical interviews to supplement any screening tools, is emphasised.
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Joubert, Karin, and Aisha Casoojee. "Hearing-screening record-keeping practices at primary healthcare clinics in Gauteng." South African Journal of Communication Disorders 60, no. 1 (December 9, 2013). http://dx.doi.org/10.4102/sajcd.v60i1.7.
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Objectives: As little is known about hearing screening practices at primary healthcare (PHC) clinics in South Africa, the study aimed to describe hearing-screening and record-keeping practices of nurses during typical immunisation sessions at PHC clinics in Gauteng, South Africa.Methods: Data were obtained through observations (N2=80) and questionnaires (N1=20) which were then cross-checked with retrospective information collected from the Road-to-Health Charts and City of Johannesburg Child Health Services Blue Cards of children observed during typical immunisation sessions.Results: A key finding of this study was that PHC nurses who participated in this study do not adhere to the hearing-screening record-keeping practices as outlined by the national Department of Health.Conclusions: Poor record-keeping practices hinder the efficacy of hearing-screening programmes. Accurate record keeping is important in order to document outcomes which can be used to evaluate service delivery and the efficacy of hearing-screening programmes.
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Lince-Deroche, Naomi, Kaitlyn M. Berry, Cheryl Hendrickson, Tembeka Sineke, Sharon Kgowedi, and Masangu Mulongo. "Women’s costs for accessing comprehensive sexual and reproductive health services: findings from an observational study in Johannesburg, South Africa." Reproductive Health 16, no. 1 (December 2019). http://dx.doi.org/10.1186/s12978-019-0842-2.
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Abstract Background Evaluating progress towards the Sustainable Development Goal of universal access to sexual and reproductive (SRH) services requires an understanding of the health needs of individuals and what constitutes access to services. We explored women’s costs of accessing SRH services in Johannesburg, South Africa and contextualized costs based on estimates of household income. Methods We conducted an observational study of women aged 18–49 at a public HIV treatment site and two public primary health care facilities from June 2015 to August 2016. Interviews assessed women’s SRH needs (for contraception, fertility problems, menstrual problems, menopause symptoms, sexually transmitted infections (STI), experiences of intimate-partner violence (IPV), and cervical and breast cancer screening) and associated costs. We calculated average and total costs (including out-of-pocket spending, lost income, and estimated value of time spent) for women who incurred costs. We also estimated the total and average costs of meeting all SRH needs in a hypothetical “full needs met” year. Finally, we contextualize SRH spending against a measure of catastrophic expenditure (> 10% of household income). Results Among the 385 women who participated, 94.8% had at least one SRH need in the prior 12 months; 79.7% incurred costs for accessing care. On average, women spent $28.34 on SRH needs during the prior year. Excluding one HIV-negative woman who spent 112% of her annual income on infertility treatment, HIV-positive women spent more on average annually for SRH care than HIV-negative women. Sixty percent of women reported at least one unmet SRH need. If all participants sought care for all reported needs, their average annual cost would rise to $52.65 per woman. Only two women reported catastrophic expenditure – for managing infertility. Conclusions SRH needs are constants throughout women’s lives. Small annual costs can become large costs when considered cumulatively over time. As South Africa and other countries grapple with increasing access to SRH services under the rubric of universal access, it is important to remember that individuals incur costs despite free care at the point of service. Policies that address geographic proximity and service quality would be important for reducing costs and ensuring full access to SRH services. Plain English summary Literature on women’s financial and economic costs for accessing comprehensive sexual and reproductive health care in low- and middle-income countries is extremely limited, and existing literature often overlooks out-of-pocket costs associated with travel, child care, and time spent accessing services. Using data from a survey of 385 women from a public HIV treatment site and two public primary health care facilities in Johannesburg, we found nearly all women reported at least on sexual and reproductive health need and more than 75% of women incurred costs related to those needs. Furthermore, more than half of women surveyed reported not accessing services for their sexual and reproductive health needs, suggesting a total annual cost of more than $50 USD, on average, to access services for all reported needs. While few women spent more than 10% of their total household income on sexual and reproductive health services in the prior year, needs are constant and costs incur throughout a woman’s life suggesting accessing services to meet these needs might still result in financial burden. As South Africa grapples with increasing access to sexual and reproductive health services under the rubric of universal access, it is important to remember that individuals incur costs despite free care at the point of service. Policies that address geographic proximity and service quality would be important for reducing costs and ensuring full access to services.
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Mthombeni, Solomon, Yoga Coopoo, and Habib Noorbhai. "Physical Health Status of Emergency Care Providers in South Africa." Asian Journal of Sports Medicine 11, no. 2 (May 27, 2020). http://dx.doi.org/10.5812/asjsm.100261.
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Background: Emergency care providers (ECPs) have a physically, mentally, and emotionally demanding profession. Therefore, they are predisposed to cardiovascular and other non-communicable disease risk factors. Objectives: The objective of the study was to determine the physical health status of ECPs in the North West province of South Africa through a selected anthropometric and other health parameter test battery. Methods: Ninety-one ECPs (64 males, 27 females) took part in the study voluntarily for health screening tests including body mass index (BMI), lean body mass (LBM), resting heart rate (RHR), blood pressure (BP), skinfold measurement, waist circumference (WC), waist-to-hip ratio (WHR), fasting blood glucose (FBG), and total cholesterol (TC). The collected data were subjected to statistical analysis using the Statistical Package for Social Sciences (SPSS) version 25 (IBM). Results: The participants demonstrated a mean BMI of 28.2 ± 5.5 kg/m2, body fat of 26 ± 7.6 %, and LBM of 58.6 ± 10 kg. Significant differences were seen in height (170.5 ± 6.2 vs. 160.7 ± 5.3 cm), BF% (22.5 ± 5.3 vs. 34.2 ± 6.2 %), and LBM (62.3 ± 8 vs. 49.2 ± 8.2 kg) between males and females (P ≤ 0.05). Mean systolic BP was 122 ± 15 mmHg, and diastolic BP was 81 ± 10 mmHg. Mean WC was 90.8 ± 11.4 cm. Other health parameters included mean FBG of 5.1 ± 2.4 mmol/L and mean TC of 4.9 ± 0.7 mmol/L. Significant differences were seen in WHR (0.88 ± 0.04 vs. 0.79 ± 0.06) between males and females (P ≤ 0.05). Conclusions: A significant number of ECPs presented with cardiovascular and other NCD risk factors such as hypertension, obesity, high WC, elevated FBG, and abnormal levels of TC. This can be attributed to the nature of their occupation such as working irregular shifts leading to sleep deprivation, being exposed to psychological trauma, poor nutrition during shifts, and/or lack of exercise. Stress management is an important part of these workers’ rehabilitation program. A well-formulated employee wellness program is required to set remedial measures in place.
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Michelow, Pamela, Amanda Sherrin, Louise Rossouw, Samson Mohaleamolla, Denise Evans, Avril Swarts, Ntombiyenkosi Rakhombe, Jennifer S. Smith, and Cynthia Firnhaber. "Performance of the Cellslide® automated liquid-based cytology system amongst HIV-positive women." African Journal of Laboratory Medicine 5, no. 1 (February 1, 2016). http://dx.doi.org/10.4102/ajlm.v5i1.278.
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Background: Many women undergoing cervical screening as part of a national South African screening programme may be positive for HIV. The performance of liquid-based cytology (LBC) on samples from HIV-positive women needs to be determined.Objectives: The performance of the Cellslide® automated LBC system was evaluated as a possible alternative to conventional cytology in a national cervical cancer screening programme.Methods: Split samples from 348 HIV-positive women attending an HIV treatment clinic in Johannesburg, South Africa were examined by conventional cytology and monolayer LBC methods. All samples were stained, examined and reported in the same manner. Cytotechnologists were blinded to the conventional smear diagnosis if the LBC smear was screened and vice versa.Results: The same percentage of inadequate smears (1.4%) was obtained by conventional cytology and LBC. Atypical squamous cells of undetermined significance were observed in 5.2% of conventional smears and 4.0% of LBC smears. Low-grade squamous intraepithelial lesions were found in 35.6% of conventional smears and 32.7% of LBC smears. Only one conventional smear was categorised as atypical squamous cells – cannot exclude a high-grade lesion, whereas five such cases were identified on LBC. High-grade squamous intraepithelial lesions were seen in 21.6% of conventional smears and 23.3% LBC smears. No invasive carcinoma was identified.Conclusion: The performance of the Cellslide® LBC system was similar to that of conventional cytology in this population of high-risk HIV-positive women, indicating that it may be introduced successfully as part of a cervical cancer screening programme.
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Thomas, Teena S. M., and Adriano G. Duse. "Epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) and comparison of the phenotypic versus genotypic screening tests for the detection of carbapenemases at a tertiary level, academic hospital in Johannesburg, South Africa." Southern African Journal of Infectious Diseases 33, no. 5 (September 12, 2018). http://dx.doi.org/10.4102/sajid.v33i5.142.
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Background: Carbapenem-resistant Enterobacteriaceae (CRE) cause significant infections and pose a threat to the viability of available antibiotics. Understanding the epidemiology of these infections will assist in guiding appropriate treatment and infection prevention and control (IPC) practices in an institution. In addition, the phenotypic carbapenemase-producing Enterobacteriaceae (CPE) screening tests are widely used in South Africa. However, there is no published literature on their performance against PCR in that setting. Therefore, CRE epidemiology and performance of the Modified Hodge with Imipenem and Imipenem + EDTA combined disk tests (CDT) was evaluated at a tertiary academic hospital in Johannesburg.Method: A retrospective collection of data was performed. Data from January 2015 to December 2016 of all clinical isolates that were CRE OR carbapenem-susceptible Enterobacteriaceae with at least one positive CPE screening test were collected. Information collected included the ward areas from which samples were sent, specimen type that cultured CRE, CRE identification and carbapenem MIC results, phenotypic and genotypic CPE results.Results: Certain ward areas recurred as predominant areas with CRE infection in the two-year period. The prominent sample types that cultured CRE, the predominant Enterobacteriaceae species and carbapenemases identified corresponded with national surveillance data. The predominant carbapenemase type and level of carbapenem resistance conferred changed within one year. The Hodge test performed poorly for carbapenemase detection. The CDT detected metallo-β-lactamases adequately.Conclusion: In this study, the use of the MHT to screen for CPEs performed poorly. Continued surveillance will (i) lead to an understanding of the patient population (including infection type) affected, (ii) detect changes in the carbapenemase profiles, and (iii) inform infection prevention and control and appropriate clinical management.
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Thomas, Teena SM, and Adriano G. Duse. "Epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) and comparison of the phenotypic versus genotypic screening tests for the detection of carbapenemases at a tertiary level, academic hospital in Johannesburg, South Africa." Southern African Journal of Infectious Diseases, September 12, 2018, 1–7. http://dx.doi.org/10.1080/23120053.2018.1509184.
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Walker, Janet, Lourens Schlebusch, and Bernhard Gaede. "The impact of stress on depression, ill health and coping in family members caring for patients with acquired brain injury." South African Family Practice 62, no. 1 (October 8, 2020). http://dx.doi.org/10.4102/safp.v62i1.5149.
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Background: This study investigated the impact of stress on levels of depression and ill health as an indication of psychological coping. The research sample consisted of 80 family caregivers (who are members of Headway Gauteng, located in Johannesburg, South Africa) of patients with acquired brain injury.Methods: A mixed method design of data collection was utilised that included self-report procedures (structured questionnaires and interviews) and post-interview content analyses. In addition, two individually administered measures that have been widely used in clinical practice and research were administered (a stress symptom checklist and the Beck Depression Inventory).Results: The majority of the research participants experienced high levels of stress along with an inordinate physical and mental health impact indicating that they were not able to cope up with the ongoing chronic stress of caregiving.Conclusion: Findings provide compelling evidence of the value of psychological screening for elevated stress and poor coping in family members caring for a patient with acquired brain injury in a resource-limited healthcare society. We recommend a collaborative effort between medical and psychological health practitioners in order to ensure a holistic and inclusive approach towards treatment procedures and interventions to improve coping skills in family members caring for a patient with acquired brain injury.
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"Standard Bank: The Agile Transformation." Muma Case Review 2 (2017): 001–31. http://dx.doi.org/10.28945/3911.
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Josef Langerman, Head of IT Transformation for Standard Bank, reflected on the extraordinary transformation that his organization’s IT group had recently experienced. Over the past three years, Standard Bank’s IT group had changed from the relatively well accepted systems development lifecycle/waterfall model to a revolutionary large scale agile approach. The results had been gratifying. But it left a question unanswered. Now that things were starting to stabilize, what should be the next steps? The 154-year-old Standard Bank was the largest banking group in Africa, and the 5th largest company headquartered in South Africa. The bank offered a range of corporate, business and personal banking as well as financial services. Its 49,000 employees served over 15 million customers, in 20 countries across the continent of Africa, as well as other countries scattered around the globe. Standard Bank’s IT group, located within the company’s Johannesburg headquarters, had over 6000 employees. The group managed the bank’s technology infrastructure–including a network of nearly 10,000 ATMs, its applications development, testing, deployment, maintenance and operations. By 2014, the bank recognized that its IT performance was lagging industry benchmarks in productivity, turnaround time and employee satisfaction. Employing a “do it in-house” philosophy, it embarked on a major transformation. Abandoning traditional highly structured approaches to project management and development, it had adopted an agile philosophy that was most commonly seen in much smaller organizations and technology startups. The results had been impressive–productivity, cycle time and organizational health indicators had all risen dramatically. The group had also achieved substantial reductions in its budget. Even skeptics within the organization could not fail to be impressed. Now, however, Langerman wondered about the future. He had been cautioned by his group’s HR Culture Transformation Guide that rapid improvement could easily be followed by disillusionment. What could be done to keep the momentum going forward? Should the bank double down on the types of changes to culture, practice and training that had led to its success, or was it time to let things settle? And who should be guiding the change? Should the implementation continue entirely in-house, or should outside consultants–that were working in other areas of the bank–play a significant role? In the near future, he would need to present his recommendations to the group’s CIO.
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Pillai, Jayandiran, Pagollang Motloba, Keolebogile Shirley Caroline Motaung, Carole Wallis, Lovelyn Uzoma Ozougwu, and Debashis Basu. "Proactive Measures to Combat a SARS-CoV-2 Transmission Among High Risk Patients and Health Care Workers in an Outpatient Dialysis Facility." Frontiers in Pharmacology 11 (March 23, 2021). http://dx.doi.org/10.3389/fphar.2020.600364.
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Background: End-stage-renal-failure (ESRF) patients attending clustered out-patient dialysis are susceptible to SARS-CoV-2 infection. Comorbidities render them vulnerable to severe COVID-19. Although preventative and mitigation strategies are recommended, the effect of these are unknown. A period of “potential-high-infectivity” results if a health-care-worker (HCWs) or a patient becomes infected.Aim: We describe and analyze early, universal SARS-CoV-2 real time reverse transcription polymerase chain reaction (RT-PCR) tests, biomarker monitoring and SARS-CoV-2 preventative strategies, in a single dialysis center, after a positive patient was identified.Methodology: The setting was a single outpatient dialysis center in Johannesburg, South Africa which had already implemented preventative strategies. We describe the management of 57 patients and 11 HCWs, after one of the patients tested positive for SARS-CoV-2. All individuals were subjected to RT-PCR tests and biomarkers (Neutrophil-Lymphocyte Ratio, C-reactive protein, and D-Dimer) within 72 h (initial-tests). Individuals with initial negative RT-PCR and abnormal biomarkers (one or more) were subjected to repeat RT-PCR and biomarkers (retest subgroup) during the second week. Additional stringent measures (awareness of viral transmission, dialysis distancing and screening) were implemented during the period of “potential high infectivity.” The patient retest subgroup also underwent clustered dialysis until retest results became available.Results: A second positive-patient was identified as a result of early universal RT-PCR tests. In the two positive-patients, biomarker improvement coincided with RT-PCR negative tests. We identified 13 individuals for retesting. None of these retested individuals tested positive for SARS-CoV-2 and there was no deterioration in median biomarker values between initial and retests. Collectively, none of the negative individuals developed COVID-19 symptoms during the period “potential high infectivity.”Conclusion: A SARS-CoV-2 outbreak may necessitate additional proactive steps to counteract spread of infection. This includes early universal RT-PCR testing and creating further awareness of the risk of transmission and modifying preventative strategies. Abnormal biomarkers may be poorly predictive of SARS-CoV-2 infection in ESRF patients due to underlying illnesses. Observing dynamic changes in biomarkers in RT-PCR positive and negative-patients may provide insights into general state of health.
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Metsing, I. T., and J. T. Ferreira. "Accommodation and vergence status among the 3rd and 4th graders in a mainstream school in Gauteng*." African Vision and Eye Health 71, no. 1 (December 12, 2012). http://dx.doi.org/10.4102/aveh.v71i1.64.
Full textAbstract:
Aim: The data presented in this paper is obtained from the study on the prevalence of visual deficien-cies in mainstream and learning disabled schools which revealed no difference in the prevalence of visual deficiencies in both schools. One of the objectives of this study was to determine the visual status of each learner in each of the two groups (mainstream and learning disabled). The findings of the study revealed that both groups presented with different visual deficiencies including accommodation, vergence deficiencies and poor ocular motilities which can contribute towards influencing the children’s learning skills negatively. The visual profile on the accommodative and vergence systems of the children from the mainstream school is further analysed in this paper to determine the prevalence of deficiencies in the 8-13 year-olds, and to support inclusion of the evaluation of these visual skills in the school vision screening protocol.Method: One hundred and twelve (112) children had an expanded vision screening, with eighty (80) from the mainstream school in Johannesburg aged 8-13 years. The expanded vision screeningincluded the measurement of visual acuity (Snellen Acuity), refractive error (static retinoscopy), accommodation (accuracy, facility and amplitude), evaluation of the vergence system (accuracy, facility and amplitude) and ocular motilities (direct ob-servation). Of the 80 children from the mainstream school, only 73 children’s results were consideredlearning performance of children, especially those of school-going-age. The study therefore supports the expanded vision screening of all school-going-children in South Africa to include visual efficiency skills (accommodation and vergence systems) for appropriate and early identification of the barriers and seven subjects were excluded due to their poor responses to the tests.Kolmogorov-Smirnov test was utilized to assess the normality of distribution of accommodative and vergence status of children from the mainstream school in Gauteng. Depending on the outcome of the normality, the T-test was used to analyse the data. The distribution of accommodative and vergence status (amplitudes and facilities) were found to be different from the normal distribution due to p-values found to be less than 0.05.Results: The results indicated that 12.3% had poor accommodation facility, 10% had poor accommodation amplitude, 17% had poor convergence amplitude and 21.9% had poor vergence facility. The prevalence of poor vergence facility was found to be 21.9%, higher than all the visual efficiency skills evaluated. However, the co-existence of both accommodative and vergence dysfunctions was not found, since subjects presented with either accommodative (isolated) or vergence (isolated) dysfunctions.Conclusion: The results considered were for tests performed subjectively, and therefore that could have led to the identified statistical outliers (due to inconsistent responses) in the analysis of data for the prevalence of poor accommodative (12.3%) and vergence (21.9%) facility. The prevalence of accommodative and vergence dysfunctions although low in some instances is a concern. There is definitely a need for early identification of visual deficiencies that can impact negatively on the to learning. (S Afr Optom 2012 71(1) 22-31)