Background Pulmonary tuberculosis (PTB) remains a major concern worldwide. Albeit curable, PTB continues to negatively affect patients’ health-related quality of life (HRQoL) and functioning even after cure. Objectives To describe the demographics, respiratory symptoms, pulmonary airflow patterns, HRQoL and exercise capacity of cured PTB patients, in the Breede Valley district of South Africa. Methods A cross-sectional study conducted at five primary health care facilities included adult patients diagnosed with PTB, who had completed anti-tuberculosis treatment. Post-treatment bronchodilator lung function, HRQoL and 6-min walk distance (6MWD) were measured. Results Three hundred and twenty-four patients were screened. Specific challenges resulted in 45 patients being included (male n = 25 [56%]; mean population age 39.9 [± 10.2]). HRQoL was assessed using the short-form 12v2, part of the burden of lung disease core questionnaire. In general, self-reported physical scores (physical health component summary score = 45) were higher than mental scores (mental health component summary score = 39). The mean 6MWD was 294.5 m (± 122.7) m (range 110 m – 600 m), which is well below normal reference values. Forty-eight percent (48%) of the sample presented with abnormal lung function, including obstructive ( n = 9; 21%), restrictive ( n = 11; 25%) and mixed ( n = 1; 2%). Conclusions This pilot study suggests that most cured PTB patients have decreased HRQoL, exercise capacity and abnormal lung function. This study is the first to describe the combination of these three outcomes in a South African population. Clinical implications Clinicians must recognise that holistic management of PTB patients is required after cure.
In low- and middle-income countries (LMIC), community health care workers (CHCW) are the primary point of care for millions of people. Mobile phone health applications (mHealth app) are the preferred technology platform to deliver clinical support to CHCW. In LMIC, limited regulatory oversight exists to guide quality and safety for medical devices, including mHealth. During the development of a mHealth app to assist CHCW with patient assessment and clinical diagnosis in rural South Africa, we applied human-centred design (HCD) and a bioethics consultation. The HCD approach enabled us to develop a mHealth app that responded to the needs and capacities of CHCW. The bioethics consultation prompted early consideration of safety concerns, social implications of our mHealth app and our technology's impact on the CHCW-patient relationship. In this study, we found that combining a HCD approach with bioethics consultation improved the design quality and reduced safety concerns for our mHealth app.
One of the constraints that prevent higher education institutions (HEIs) in developing countries from engaging in effective and essential research is a lack of research capacity. This study reports on a north-south collaboration between a group of Flemish universities and an HEI in South Africa with the specific goal of improving productivity, quality and capacity amongst researchers. A collaborative project with multiple subprojects was established in 2003, and extended over two consecutive five-year phases. Document analysis was conducted of annual reports, monitoring and evaluation reports, curriculum vitae of participating members, and progress reports of students and supervisors during this time. The findings of the study illustrate the extent to which research capacity objectives can be achieved through a north-south partnership. Members of the collaboration were able to develop intra-and inter-disciplinary partnerships that resulted in maximising the capacity-building efforts, enhancing both individual and institutional research capacity.
There is consensus that education on the prevention of health risk behaviour and an increased repertoire of life skills could facilitate a reduction in health risk behaviours. This article reports on the results of a survey among 1027 grades 8-10 learners aged 13-18 years and profiles their engagement in smoking, drug use, drinking and sexual activity. It reports on the hypothesis testing for the relationship between life skills, as measured by the Life Effectiveness Questionnaire (LEQ), and engagement in the above mentioned health risk behaviours, as measured by the Youth Risk Behaviour Surveillance Survey (YRBSS). The results concur with South African national surveys of youth risk behaviour regarding the nature and extent of engagement in health risk behaviours. Regression analyses indicated that the combination of the LEQ`s life skill domains (Time management, Achievement, Emotional control, Social competence, Active initiative, Self confidence, Intellectual flexibility and Task leadership) significantly explained between 25% and 56% of the variance in the health risk behaviours (smoking, drinking, drug use, sexual activity). Similarly, this combination of LEQ`s life skill domains significantly explained 4.1% of the variance in physical activity. Time management significantly predicted sexual activity and drug use. Achievement and emotional control significantly predicted drinking, emotional control, time management, social competence, and initiative significantly predicted smoking. Thus, it is recommended that the abovementioned life skill domains be incorporated into intervention programmes or life orientation curricula in order to reduce the incidence of health risk behaviours among South African youth.
A growing shift towards research and evidence based practice in academia is associated with requirements to disseminate research results in the form of publication in peer reviewed journals. Mentoring has been identified as an important component of developing young authors, as it increases confidence and competence, and facilitates professional development. This led to the formation of a support group to stimulate peer-review publication in the physiotherapy department at the University of the Western Cape. The Kirkpatrick Framework of Evaluation was used to evaluate the success of the mentoring process which made use of a participatory action research methodology. The writing group consisted of nine academic members of staff and took place over ten weeks. The programme included writing, giving feedback, discussion and peer review on a weekly basis. Focus group discussions were taped and transcribed in order to evaluate the mentoring process by identifying relationships within the data and categorising key concepts, which were shaped into a thematic framework. The findings indicated that participants experienced a variety of emotions throughout the programme, with an overall feeling of personal growth by the end. In addition, participants also reported improved writing, reviewing and communication skills. Six months following the programme, six participants had submitted at least one article to a peer reviewed journal. It is clear from this study that some academics still find the task of writing and reviewing articles daunting, and that guidance and support in the form of a writing programme can be useful.
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