Clinicians knowledge and perceptions of point of care testing (poct) in selected hospitals in the free state, South Africa
- Authors: Watkins, Edgar Jeffrey
- Date: 2022-08
- Subjects: Point-of-care testing , Preventive health services , Medical technology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27264 , vital:66487
- Description: Point of care testing (POCT) improves access and equity to health diagnostic services in resource-limited settings like South Africa, where some health facilities do not have on-site laboratories. With recent technological advancements, most traditional laboratory tests can now be conducted on-site at primary health clinics (PHC), hospital wards and clinics. One advantage of the POCT device is that it can be used by a non-medical laboratory expert at the patient’s bed side during hospitalizations or near the patient in the doctor’s consultation rooms. This results in a shorter turnaround time for the availability of test results when compared to that from a specimen sent to a traditional clinical laboratory. Despite the benefits of POCT, many clinicians (doctors and nurses) avoid utilizing POCT for quality assurance reasons. Clinicians believe the results from a POCT device may not be as reliable as the results from tests performed by a medical laboratory scientist in the traditional clinical laboratory. This study used a concurrent mixed method research design to explore clinicians' POCT knowledge and attitudes in a subset of hospitals in the Free state of South Africa. The study population comprised of consenting medical professionals from the ten (10) selected Free State district hospitals (study sites). The findings demonstrated that hospitals in urban areas have easier access to laboratory services. There were two (2) urban study sites that had on-site laboratories which achieved faster Turn-Around-Time (TAT). The participants indicate that they are aware of POCT and routinely use it, but there are far fewer POCT tests available than laboratory tests. When diagnostic options are scarce, point-of-care testing (POCT) can provide a more accurate diagnosis than traditional methods. The improved health care provision and reduced incidence of health complications is the end result. According to the participants, having access to POCT diagnostic services has shown promise in addressing challenges that sometimes present with laboratory-based methods, particularly in settings with limited access to hospitals or when laboratories cannot be accessed. Further, clinicians argue that errors in the usage of POCT may occur due to the quality of these POCTs and improper documentation of the test results by the clinicians. Therefore, poor utilization of POCT by clinicians can be improved if implemented with pre-set strict selection goals and processes to ensure that the right POCT is selected for the right purpose that would reduce resource expenditure by the hospitals and improve patient experiences and health outcomes. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-08
- Authors: Watkins, Edgar Jeffrey
- Date: 2022-08
- Subjects: Point-of-care testing , Preventive health services , Medical technology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27264 , vital:66487
- Description: Point of care testing (POCT) improves access and equity to health diagnostic services in resource-limited settings like South Africa, where some health facilities do not have on-site laboratories. With recent technological advancements, most traditional laboratory tests can now be conducted on-site at primary health clinics (PHC), hospital wards and clinics. One advantage of the POCT device is that it can be used by a non-medical laboratory expert at the patient’s bed side during hospitalizations or near the patient in the doctor’s consultation rooms. This results in a shorter turnaround time for the availability of test results when compared to that from a specimen sent to a traditional clinical laboratory. Despite the benefits of POCT, many clinicians (doctors and nurses) avoid utilizing POCT for quality assurance reasons. Clinicians believe the results from a POCT device may not be as reliable as the results from tests performed by a medical laboratory scientist in the traditional clinical laboratory. This study used a concurrent mixed method research design to explore clinicians' POCT knowledge and attitudes in a subset of hospitals in the Free state of South Africa. The study population comprised of consenting medical professionals from the ten (10) selected Free State district hospitals (study sites). The findings demonstrated that hospitals in urban areas have easier access to laboratory services. There were two (2) urban study sites that had on-site laboratories which achieved faster Turn-Around-Time (TAT). The participants indicate that they are aware of POCT and routinely use it, but there are far fewer POCT tests available than laboratory tests. When diagnostic options are scarce, point-of-care testing (POCT) can provide a more accurate diagnosis than traditional methods. The improved health care provision and reduced incidence of health complications is the end result. According to the participants, having access to POCT diagnostic services has shown promise in addressing challenges that sometimes present with laboratory-based methods, particularly in settings with limited access to hospitals or when laboratories cannot be accessed. Further, clinicians argue that errors in the usage of POCT may occur due to the quality of these POCTs and improper documentation of the test results by the clinicians. Therefore, poor utilization of POCT by clinicians can be improved if implemented with pre-set strict selection goals and processes to ensure that the right POCT is selected for the right purpose that would reduce resource expenditure by the hospitals and improve patient experiences and health outcomes. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-08
In vitro investigation of the anti-hyperglycemic and chemical composition of Heteromorpha arborescens (Spreng.) Cham leaf extracts used in the management of diabetes mellitus
- Abifarin, Taiwo Oluwafunmilola https://orcid.org/00000003-4994-4638
- Authors: Abifarin, Taiwo Oluwafunmilola https://orcid.org/00000003-4994-4638
- Date: 2021-09
- Subjects: Diabetes
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/22798 , vital:52760
- Description: Diabetes mellitus is currently a major threat all over the world. It is a chronic disorder characterized by elevated blood glucose levels and disturbance in carbohydrate, fat and protein metabolism which often times leads to several complications such as, atherosclerosis, diabetic nephropathy, retinopathy and neuropathy. Due to the side effects associated with synthetic oral hypoglycemic drugs, herbal remedies have become the alternative in the management of diabetes mellitus. Heteromorpha arborescens is one of the many plants used as herbal remedies for the management of diabetes mellitus in South Africa. In addition, the roots, barks and leaves are used in other parts of Southern Africa for the treatment of mental problems, asthma, cough, dysentery and tuberculosis. The roots are fed to malnourished children in Botswana and Swaziland. However, despite the high medicinal importance, there is little or no scientificinformation to prove this claim. Therefore, the basis of this study is to determine the chemical composition as well as perform and invitro investigation of the antihyperglycemic potential of H. arborescens leaf extracts to provide information that could validate the ethno-medicinal claims for the use of this plant in the management of diabetes mellitus. Phytochemical contents and antioxidant activity of the leaf extracts were determined. Phytochemical analysis of the acetone, ethanol, aqueous and blanched extracts of H. arborescens leaves indicated that the total phenol content of the extracts ranged between 15.10 mg GAE/g- 42.50 mg QAE/g, proanthocyanidin, 459-8402.1 mg QE/g and the flavonoid content, 109.24- 235.79 mg QE/g. In addition, alkaloids (7.65percent) and saponin (25.33percent) were present in significantamounts. Based on the IC50 values, the ethanol extract exhibited the highest total antioxidant activity (0.0125 mg/mL) with highest inhibition against DPPH and ABTS radicals (0.06 and 0.049 mg/mL respectively). Relatively high antioxidant activity may be attributed to the polyphenolic contents which possess hypoglycemic potentials. Minimum Inhibitory Concentrations (MIC) of H. arborescens leaf extracts against Bacillus pumilus, Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli and Klebselia pneumoniae was also determined and results indicated considerable antibacterial activity in the acetone, ethanol and blanched extracts with MIC values ranging from 1.563-12.5 mg/mL; however, the aqueous extract was inactive against all the bacteria strains. The antibacterial activity of the leaf extracts could be advantageous against diabetic related infections. The cytotoxicity, anti-obesity and antidiabetic potentials of blanched, aqueous and ethanol extracts of Heteromorpha arborescens (Spreng.) Cham leaves were also investigated. The results revealed that both ethanol and aqueous extracts indicated considerable inhibition against α-glucosidase (IC50 of 627.29 ± 4.33 μg/mL and 576.46 ± 3.21 μg/mL respectively) while the blanched extract showed weak α- glucosidase inhibition (IC50; 855.38 ± 4.29 μg/mL). The aqueous extract showed the best α- amylase inhibition (IC50; 583.74 ± 5.87 μg/mL) among the assessed extracts. However, weak α- amylase inhibition was observed in the ethanol (IC50; 724.60 ± 4.33 μg/mL) and blanched extracts (IC50; 791.63 ± 3.76 μg/mL) of H. arborescens leaves. Some level of glucose utilization in both C3A and L6 cells was also observed for the aqueous and ethanol extracts which may be attributed to the relatively lower toxicity levels present in them, however, glucose utilization was very weak for the blanched extract, which may be due to higher level of cytotoxicity it possessed. Relatively weak lipase inhibition was observed for the ethanol (IC50; 699.3 ± 1.33 μg/mL), aqueous (IC50; 811.52 ± 3.52 μg/mL) and blanched extract (IC50; 1152.7 ± 4.61 μg/mL) as compared to orlistat (IC50; 56.88 ± 0.11 μg/mL). However, there was no reasonable reduction in lipid accumulation observed in all the extract treated cells. The results obtained suggest that H.arborescens leaf extracts can serve as a potential tool for the development of new strategies for the treatment of diabetes and obesity. However, further analysis is required to ascertain its anti- obesity potential. Also, caution should be taken in the use of the plant at high concentrations in order to ensure safety and efficacy. Analyses were also carried out to determine the nutritional and antinutritional constituents of the plant for possible inclusion in the diet of diabetic patients. Proximate analysis revealed the presence of 8.5 percent total ash, 4.92 percent crude fat, 8.41 percent moisture, 15.74 percent crude protein, 21.48 percent crude fiber, 40.95 percent carbohydrates and 271.04 kcal/100g energy value. Mineral analysis showed that H. arborescens leaves are very rich in K, Ca, and Fe. Considerable amounts of Mg, Mn, Na, P, Cu and Zn were also present. Vitamin analysis showed that the plant has a high content of vitamins A, C and E. The anti-nutrients evaluated were phytate, oxalate, saponin, and alkaloids, all of which were below toxic levels except for saponin which was observed in moderately high level. This study revealed that H. arborescens leaves are a good source of nutrients and mineral elements, (with low anti-nutrient content) that are highly beneficial to human health especially in diabetic individuals, therefore, encouraging its possible inclusion as a vegetable. Essential oil composition of fresh Heteromorphaarborescens leaves were also determined by Solvent-Free-Microwave-Extraction (SFME) and Hydrodistillation (HD) methods and the compositions of both mehods were compared in terms of their chemical compositions, yield, CO2 emission and energy consumption. Solvent Free Microwave extraction method indicated higher oil yield of 0.7 mL/200 g (0.35 percent) as compared to 0.59 mL/200 g (0.295 percent), lower energy consumption and CO2 emission as compared to the hydrodistillation method. In conclusion, H. arborescens leaves indicated considerable potential efficacy in the management for diabetes mellitus and may require further structural elucidation and characterization in order to identify the bioactive constituents. , Thesis (PhD) -- Faculty of Science and Agriculture, 2021
- Full Text:
- Date Issued: 2021-09
- Authors: Abifarin, Taiwo Oluwafunmilola https://orcid.org/00000003-4994-4638
- Date: 2021-09
- Subjects: Diabetes
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/22798 , vital:52760
- Description: Diabetes mellitus is currently a major threat all over the world. It is a chronic disorder characterized by elevated blood glucose levels and disturbance in carbohydrate, fat and protein metabolism which often times leads to several complications such as, atherosclerosis, diabetic nephropathy, retinopathy and neuropathy. Due to the side effects associated with synthetic oral hypoglycemic drugs, herbal remedies have become the alternative in the management of diabetes mellitus. Heteromorpha arborescens is one of the many plants used as herbal remedies for the management of diabetes mellitus in South Africa. In addition, the roots, barks and leaves are used in other parts of Southern Africa for the treatment of mental problems, asthma, cough, dysentery and tuberculosis. The roots are fed to malnourished children in Botswana and Swaziland. However, despite the high medicinal importance, there is little or no scientificinformation to prove this claim. Therefore, the basis of this study is to determine the chemical composition as well as perform and invitro investigation of the antihyperglycemic potential of H. arborescens leaf extracts to provide information that could validate the ethno-medicinal claims for the use of this plant in the management of diabetes mellitus. Phytochemical contents and antioxidant activity of the leaf extracts were determined. Phytochemical analysis of the acetone, ethanol, aqueous and blanched extracts of H. arborescens leaves indicated that the total phenol content of the extracts ranged between 15.10 mg GAE/g- 42.50 mg QAE/g, proanthocyanidin, 459-8402.1 mg QE/g and the flavonoid content, 109.24- 235.79 mg QE/g. In addition, alkaloids (7.65percent) and saponin (25.33percent) were present in significantamounts. Based on the IC50 values, the ethanol extract exhibited the highest total antioxidant activity (0.0125 mg/mL) with highest inhibition against DPPH and ABTS radicals (0.06 and 0.049 mg/mL respectively). Relatively high antioxidant activity may be attributed to the polyphenolic contents which possess hypoglycemic potentials. Minimum Inhibitory Concentrations (MIC) of H. arborescens leaf extracts against Bacillus pumilus, Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli and Klebselia pneumoniae was also determined and results indicated considerable antibacterial activity in the acetone, ethanol and blanched extracts with MIC values ranging from 1.563-12.5 mg/mL; however, the aqueous extract was inactive against all the bacteria strains. The antibacterial activity of the leaf extracts could be advantageous against diabetic related infections. The cytotoxicity, anti-obesity and antidiabetic potentials of blanched, aqueous and ethanol extracts of Heteromorpha arborescens (Spreng.) Cham leaves were also investigated. The results revealed that both ethanol and aqueous extracts indicated considerable inhibition against α-glucosidase (IC50 of 627.29 ± 4.33 μg/mL and 576.46 ± 3.21 μg/mL respectively) while the blanched extract showed weak α- glucosidase inhibition (IC50; 855.38 ± 4.29 μg/mL). The aqueous extract showed the best α- amylase inhibition (IC50; 583.74 ± 5.87 μg/mL) among the assessed extracts. However, weak α- amylase inhibition was observed in the ethanol (IC50; 724.60 ± 4.33 μg/mL) and blanched extracts (IC50; 791.63 ± 3.76 μg/mL) of H. arborescens leaves. Some level of glucose utilization in both C3A and L6 cells was also observed for the aqueous and ethanol extracts which may be attributed to the relatively lower toxicity levels present in them, however, glucose utilization was very weak for the blanched extract, which may be due to higher level of cytotoxicity it possessed. Relatively weak lipase inhibition was observed for the ethanol (IC50; 699.3 ± 1.33 μg/mL), aqueous (IC50; 811.52 ± 3.52 μg/mL) and blanched extract (IC50; 1152.7 ± 4.61 μg/mL) as compared to orlistat (IC50; 56.88 ± 0.11 μg/mL). However, there was no reasonable reduction in lipid accumulation observed in all the extract treated cells. The results obtained suggest that H.arborescens leaf extracts can serve as a potential tool for the development of new strategies for the treatment of diabetes and obesity. However, further analysis is required to ascertain its anti- obesity potential. Also, caution should be taken in the use of the plant at high concentrations in order to ensure safety and efficacy. Analyses were also carried out to determine the nutritional and antinutritional constituents of the plant for possible inclusion in the diet of diabetic patients. Proximate analysis revealed the presence of 8.5 percent total ash, 4.92 percent crude fat, 8.41 percent moisture, 15.74 percent crude protein, 21.48 percent crude fiber, 40.95 percent carbohydrates and 271.04 kcal/100g energy value. Mineral analysis showed that H. arborescens leaves are very rich in K, Ca, and Fe. Considerable amounts of Mg, Mn, Na, P, Cu and Zn were also present. Vitamin analysis showed that the plant has a high content of vitamins A, C and E. The anti-nutrients evaluated were phytate, oxalate, saponin, and alkaloids, all of which were below toxic levels except for saponin which was observed in moderately high level. This study revealed that H. arborescens leaves are a good source of nutrients and mineral elements, (with low anti-nutrient content) that are highly beneficial to human health especially in diabetic individuals, therefore, encouraging its possible inclusion as a vegetable. Essential oil composition of fresh Heteromorphaarborescens leaves were also determined by Solvent-Free-Microwave-Extraction (SFME) and Hydrodistillation (HD) methods and the compositions of both mehods were compared in terms of their chemical compositions, yield, CO2 emission and energy consumption. Solvent Free Microwave extraction method indicated higher oil yield of 0.7 mL/200 g (0.35 percent) as compared to 0.59 mL/200 g (0.295 percent), lower energy consumption and CO2 emission as compared to the hydrodistillation method. In conclusion, H. arborescens leaves indicated considerable potential efficacy in the management for diabetes mellitus and may require further structural elucidation and characterization in order to identify the bioactive constituents. , Thesis (PhD) -- Faculty of Science and Agriculture, 2021
- Full Text:
- Date Issued: 2021-09
Humanitarian intervention in conflict management in Africa: selected case study analysis of Sudan and Libya
- Authors: Muruviwa, Tapiwa Gladmore
- Date: 2015-04
- Subjects: Humanitarian intervention , Conflict management -- Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/24772 , vital:63550
- Description: The study investigates the effectiveness of humanitarian intervention as a strategy in conflict management in Africa drawing from case studies in Sudan and Libya. The research utilized an interaction of both primary and secondary data sources. Primary sources used are African Union (AU) official reports, United Nations Security Council (UNSC) official reports as well as official International Commission on Intervention and State Sovereignty (ICISS) reports. Secondary sources used include journal articles, newspapers, books and other online publications. Among others, the study found out that humanitarian intervention in Sudan by the AU from 2004 until 2006 lacked the capacity and political will to effectively manage the conflict. At the same time, an analysis of the North Atlantic Treaty Organization‟s (NATO) military intervention in Libya in 2011 reveals that western-led interventions in Africa are often driven by geostrategic interests rather than the need to save people in danger. Against this backdrop, the study recommends amongst others that the AU should have a capacitated standby-force that will rapidly respond to manage conflicts in Africa. Also, UN peacekeeping operations in Africa should be coordinated by the African Union. , Thesis (MSoc) -- Faculty of Social Sciences and Humanities, 2015
- Full Text:
- Date Issued: 2015-04
- Authors: Muruviwa, Tapiwa Gladmore
- Date: 2015-04
- Subjects: Humanitarian intervention , Conflict management -- Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/24772 , vital:63550
- Description: The study investigates the effectiveness of humanitarian intervention as a strategy in conflict management in Africa drawing from case studies in Sudan and Libya. The research utilized an interaction of both primary and secondary data sources. Primary sources used are African Union (AU) official reports, United Nations Security Council (UNSC) official reports as well as official International Commission on Intervention and State Sovereignty (ICISS) reports. Secondary sources used include journal articles, newspapers, books and other online publications. Among others, the study found out that humanitarian intervention in Sudan by the AU from 2004 until 2006 lacked the capacity and political will to effectively manage the conflict. At the same time, an analysis of the North Atlantic Treaty Organization‟s (NATO) military intervention in Libya in 2011 reveals that western-led interventions in Africa are often driven by geostrategic interests rather than the need to save people in danger. Against this backdrop, the study recommends amongst others that the AU should have a capacitated standby-force that will rapidly respond to manage conflicts in Africa. Also, UN peacekeeping operations in Africa should be coordinated by the African Union. , Thesis (MSoc) -- Faculty of Social Sciences and Humanities, 2015
- Full Text:
- Date Issued: 2015-04
Teachers' experiences of English as the language of teaching and learning: a case study of two primary schools in East London education district
- Authors: Mkohlwa, Tantaswa
- Date: 2015-01
- Subjects: Language and languages , English language -- Study and teaching , Primary school teachers
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26515 , vital:65519
- Description: This study investigates teachers‘ experiences on English as the language of learning and teaching of isiXhosa learners. It critically examines the teachers‘ practices and experiences towards English as the sole language of learning and teaching LOLT at two different primary schools in Ncerha in the East London District in the Eastern Cape. The study is guided by the fact that most learners use their mother tongue isiXhosa in classroom as well as outside classroom contexts. Furthermore, some teachers use the translation method as they code-switch to their home language when teaching content subjects as well as English but learners are expected to answer the test and examination questions in English Maphalala 1988.Theoretically, this study is underpinned by the constructivist view of language learning Gaserfeld 2003 and English as an international language Sivasubramaniam, 2011. On the basis of the ecological and the constructivist approaches to language learning, Sivasubramaniam 2011 p53 views language as a creative instrument of meaning which has the power to create meaning anew and afresh‘ each time that someone uses it. The study makes use of the qualitative research method with a case study design. The data collected was analysed within the framework of discourse analysis.The findings of this study suggest some instrumental motivations for the use of English as LOLT. Some of these motivations are studying abroad, business with foreign investors Abongdia, 2009 and integrative motivations as the learner might be able to communicate with people from different countries Lambert and Gardner, 1972 Baker 2006 and Abongdia 2009. , Thesis (MEd) -- Faculty of Education, 2015
- Full Text:
- Date Issued: 2015-01
- Authors: Mkohlwa, Tantaswa
- Date: 2015-01
- Subjects: Language and languages , English language -- Study and teaching , Primary school teachers
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26515 , vital:65519
- Description: This study investigates teachers‘ experiences on English as the language of learning and teaching of isiXhosa learners. It critically examines the teachers‘ practices and experiences towards English as the sole language of learning and teaching LOLT at two different primary schools in Ncerha in the East London District in the Eastern Cape. The study is guided by the fact that most learners use their mother tongue isiXhosa in classroom as well as outside classroom contexts. Furthermore, some teachers use the translation method as they code-switch to their home language when teaching content subjects as well as English but learners are expected to answer the test and examination questions in English Maphalala 1988.Theoretically, this study is underpinned by the constructivist view of language learning Gaserfeld 2003 and English as an international language Sivasubramaniam, 2011. On the basis of the ecological and the constructivist approaches to language learning, Sivasubramaniam 2011 p53 views language as a creative instrument of meaning which has the power to create meaning anew and afresh‘ each time that someone uses it. The study makes use of the qualitative research method with a case study design. The data collected was analysed within the framework of discourse analysis.The findings of this study suggest some instrumental motivations for the use of English as LOLT. Some of these motivations are studying abroad, business with foreign investors Abongdia, 2009 and integrative motivations as the learner might be able to communicate with people from different countries Lambert and Gardner, 1972 Baker 2006 and Abongdia 2009. , Thesis (MEd) -- Faculty of Education, 2015
- Full Text:
- Date Issued: 2015-01
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