List of Titles

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Acceptance of ambulatory blood pressure monitoring in a semi-rural population in South Africa:

- Chiwanza, Farisai, Irwin, Yoland, Dowse, Roslind

Authors: Chiwanza, Farisai , Irwin, Yoland , Dowse, Roslind
Date: 2020
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/157072 , vital:40084 , DOI: https://doi.org/10.4102/hsag.v25i0.1336
Description: Ambulatory blood pressure monitoring is a valuable tool that helps in providing an insight into the diagnosis and management of hypertension; however, no evidence exists of its acceptance in the diverse South African population. We assessed the acceptance of an ambulatory blood pressure monitor in patients attending public sector primary health care (PHC) clinics. Five PHC clinics in the Makana subdistrict in the Eastern Cape.
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Date Issued: 2020

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Applicability of the REALM health literacy test to an English second-language South African population:

- Dowse, Roslind, Lecoko, Lebo, Ehlers, Martina S

Authors: Dowse, Roslind , Lecoko, Lebo , Ehlers, Martina S
Date: 2010
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/156798 , vital:40051 , https://doi.org/10.1007/s11096-010-9392-y
Description: Objective and setting. To investigate health literacy in an English second language population using the REALM test, to evaluate its appropriateness and to compare health literacy between four different education categories. Setting Primary healthcare clinics and participant homes in Grahamstown, South Africa.
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Date Issued: 2010

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Biopharmaceutics of phenylpropanolamine

- Dowse, Roslind

Authors: Dowse, Roslind
Date: 1984
Subjects: Biopharmaceutics Pharmacokinetics Phenylpropanolamine Pharmacology High performance liquid chromatography
Language: English
Type: Thesis , Doctoral , PhD
Identifier: vital:3818 , http://hdl.handle.net/10962/d1004915
Description: Phenylpropanolamine (PPA), a sympathomimetic amine, has been widely used over the past 40 years as a decongestant and, in much larger dosages, as an appetite suppressant. Considerable interest has recently been shown in this drug due to its increasing popularity as an over-the-counter anorectic agent. Much controversy exists concerning the unfavourable side-effects of PPA resulting from the higher doses required for appetite suppression and the potential of this drug for abuse. A literature search revealed a paucity of information concerning the determination of PPA in biological fluids and, most noticeably, on the pharmacokinetics of this drug. An original method for determining PPA in serum and urine using high performance liquid chromatography (HPLC) which has increased sensitivity over other published HPLC methods is presented here. The simplicity of the extraction from biological fluids and subsequent determination by HPLC, enables concentrations of PPA to be monitored after a single dose of the drug. This method is therefore readily applicable to bioavailability and pharmacokinetic studies. The dissolution profiles of 4 sustained-release formulations of PPA were determined in a modified USP rotating paddle apparatus and the samples analysed using HPLC. A mathematical equation was applied to these data which are expressed in terms of dissolution parameters. Oral test dosage forms and solutions of PPA were investigated in bioavailability trials using the developed HPLC method to analyse the urine and serum samples. Linear one body compartment kinetics were assumed and the WagnerNelson method used to transform in vivo serum data to absorption plots which were then fitted to the well known Weibull equation. In order to more appropriately characterize the kinetic processes of absorption, distribution and elimination, a more complex model was utilized which involved numerical integration of a series of differential equations. The data were fitted to these models using nonlinear regression techniques. The pharmacokinetics of PPA are shown to exhibit some evidence of nonlinearity. The absorption of the drug appears to be di scontinuous and PPA seems to favour a two body compartment model.
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Date Issued: 1984

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Cognitive pharmaceutical services and the community pharmacist: are South African patients receiving them and are they willing to pay?

- Hill, Peter W, Dowse, Roslind

Authors: Hill, Peter W , Dowse, Roslind
Date: 2006
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/156829 , vital:40054 , DOI 10.1211/ijpp.15.2.0007
Description: The objectives of this study were to ascertain the opinions of randomly selected South African medical aid members regarding the provision by community pharmacists of patient counselling and information; member satisfaction with pharmacist services; their rating of pharmacist accessibility; and if pharmacists should be reimbursed for providing cognitive pharmaceutical services. Setting A South African private healthcare insurance company.
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Date Issued: 2006

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Comprehension and acceptability of a patient information leaflet (PIL) for antiretroviral therapy:

- Mwingira, Betty, Dowse, Roslind

Authors: Mwingira, Betty , Dowse, Roslind
Date: 2006
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/156902 , vital:40065 , https://doi.org/10.4102/hsag.v11i3.236
Description: The patient information leaflet (PIL) is recognised as playing a key role in informing patients about their medicines. The objectives of this research were to evaluate the readability and understanding of a PIL for the first-line ARV (antiretroviral) regimen available in the South African public health sector, and investigate its acceptability in the target Xhosa population. The study took place between August 2003 and July 2004. A PIL was designed for the antiretroviral regimen of stavudine, lamivudine and efavirenz, using established usability guidelines. South African legal requirements concerning PILs were incorporated and the PILs were available in both English and isiXhosa.
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Date Issued: 2006

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Design and evaluation of a new pharmaceutical pictogram sequence to convey medicine usage

- Mansoor, Leila E, Dowse, Roslind

Authors: Mansoor, Leila E , Dowse, Roslind
Date: 2004
Language: English
Type: Article
Identifier: vital:6402 , http://hdl.handle.net/10962/d1006338
Description: Pictorials may be used to augment textual instructions in the depiction of safety and warning information on medicines. The objective of this study was to design, develop and evaluate a simple and culturally appropriate pictogram sequence for using nystatin suspension, and to assess its understandability in low-literate Xhosa participants. A new pharmaceutical pictogram sequence was designed through focus group discussions and evaluated in a 2-phase process. The results of Phase 1 (30 participants) identified various problems associated with the new pictogram sequence. It was modified accordingly and re-evaluated in Phase 2 with 20 participants. All participants belonged to the Xhosa group, had between 0 and 7 years of formal schooling and had English as their second language. Acceptance of the new pictogram sequence was based on international standards (ANSI and ISO criterion) for evaluating the comprehensibility of pictograms. In Phase 1, the new pictogram sequence was correctly interpreted by 66.7% of the participants and this complied with the ISO criterion of 67% correct. In Phase 2, 95% of the participants were able to correctly interpret the new pictogram sequence. This result complied with the ANSI criterion of 85% correct, therefore, this new pictogram sequence was considered to be acceptable. This study has illustrated the success of using a consultative approach in the design of new pictograms.
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Date Issued: 2004

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Designing and reporting pictogram research: problems, pitfalls and lessons learnt

- Dowse, Roslind

Authors: Dowse, Roslind
Date: 2020
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/157083 , vital:40085 , https://doi.org/10.1016/j.sapharm.2020.08.013
Description: Research describing the design, evaluation or use of pictograms for various health-related applications is receiving increasing attention in the literature. However, recent reviews of this body of literature have commented adversely on the overall quality of the research, highlighting problems with the pictogram design process, as well as calling for improvement in both the methodology and reporting of all aspects of designing, developing, modifying, evaluating and applying pictograms in practice. The heterogeneity in study design, as well as in the interventions and outcomes measured, prevents overall conclusions being drawn about the effectiveness of pictograms on comprehension and medicine-taking behaviour such as adherence and self-care. The reporting of such research should provide adequate detail to enable reproducibility and replicability of the research. This article offers guidance in designing and reporting pictogram-based research, highlighting areas that are often problematic or inadequately addressed.
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Date Issued: 2020

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Determination of phenylpropanolamine in serum and urine by high performance liquid chromatography

- Dowse, Roslind, Haigh, John M, Kanfer, Isadore

Authors: Dowse, Roslind , Haigh, John M , Kanfer, Isadore
Date: 1983
Language: English
Type: Article
Identifier: vital:6361 , http://hdl.handle.net/10962/d1006056
Description: A high-performance liquid chromatographic analysis of phenylpropanolamine in human serum and urine without prior derivatization is presented. Using direct UV detection the method is sufficiently sensitive to detect 25 ng of drug/ml of serum or urine; the coefficients of variation at 25 ng/ml and 500 ng/ml were 5.16 and 2.12, respectively, in serum. The method involves serum and urine extraction at a basic pH with chloroform, a single back-extraction, and chromatography on a reverse-phase column. Serum and urine data following administration of a single 150-mg sustained-release tablet of phenylpropanolamine hydrochloride in 6 healthy volunteers demonstrates the suitability of the analytical method.
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Date Issued: 1983

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Developing visual images for communicating information aboutantiretroviral side effects to a low-literate population:

- Dowse, Roslind, Ramela, Thato, Barford, Kirsty-Lee, Browne, Sara H

Authors: Dowse, Roslind , Ramela, Thato , Barford, Kirsty-Lee , Browne, Sara H
Date: 2011
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/156769 , vital:40048 , https://doi.org/10.2989/16085906.2010.530172
Description: The side effects of antiretroviral (ARV) therapy are linked to altered quality of life and adherence. Poor adherence has also been associated with low health-literacy skills, with an uninformed patient more likely to make ARV-related decisions that compromise the efficacy of the treatment. Low literacy skills disempower patients in interactions with healthcare providers and preclude the use of existing written patient information materials, which are generally written at a high reading level. Visual images or pictograms used as a counselling tool or included in patient information leaflets have been shown to improve patients’ knowledge, particularly in low-literate groups. The objective of this study was to design visuals or pictograms illustrating various ARV side effects and to evaluate them in a low-literate South African Xhosa population. Core images were generated either from a design workshop or from posed photos or images from textbooks. The research team worked closely with a graphic artist. Initial versions of the images were discussed and assessed in group discussions, and then modified and eventually evaluated quantitatively in individual interviews with 40 participants who each had a maximum of 10 years of schooling.
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Date Issued: 2011

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Development and evaluation of pictograms on medication labels for patients with limited literacy skills in a culturally diverse multiethnic population:

- Kheir, Nadir, Awaisu, Ahmed, Radoui, Amina, El Badawi, Aya, Jean, Linda, Dowse, Roslind

Authors: Kheir, Nadir , Awaisu, Ahmed , Radoui, Amina , El Badawi, Aya , Jean, Linda , Dowse, Roslind
Date: 2014
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/156720 , vital:40041 , https://doi.org/10.1016/j.sapharm.2013.11.003
Description: Much of the migrant workforce in Qatar is of low literacy level and does not understand Arabic or English, presenting a significant challenge to health care professionals. Medicine labels are typically in Arabic and English and are therefore poorly understood by these migrant workers. To develop pictograms illustrating selected medicine label instructions and to evaluate comprehension of the pictograms or conventional text supported with verbal instructions in foreign workers with low literacy skills.
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Date Issued: 2014

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Development of an item bank of health literacy questions appropriate for limited literacy public sector patients in South Africa:

- Marimwe, Chipiwa, Dowse, Roslind

Authors: Marimwe, Chipiwa , Dowse, Roslind
Date: 2017
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/156618 , vital:40031 , https://doi.org/10.1080/17538068.2017.1380577
Description: The majority of current health literacy measures emanate from high-income countries. In South Africa, there is no appropriate measure available for use by the diverse public sector population, many of whom have some literacy limitations. The objective was to develop a bank of questions for this population informed by a broader definition of health literacy, which acknowledges both traditional cognitive skills and explores the influence of the collective social environment on health literacy. Thirty questions for the Item Bank were developed to ensure cultural, contextual and educational appropriateness, and were continuously subjected to critical review by an expert consultant panel. Patients (n = 120) were recruited from a local primary care clinic and individually interviewed with the assistance of an interpreter to collect data on the Item Bank, Multidimensional Screener of Functional Health Literacy (MSFHL) and sociodemographics.
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Date Issued: 2017

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Development of written information for antiretroviral therapy: comprehension in a Tanzanian population

- Mwingira, Betty, Dowse, Roslind

Authors: Mwingira, Betty , Dowse, Roslind
Date: 2007
Language: English
Type: Article
Identifier: vital:6404 , http://hdl.handle.net/10962/d1006477
Description: Objective To design and develop a simple, easily readable patient information leaflet (PIL) for a commonly used antiretroviral (ARV) regimen and to evaluate its readability and acceptability in a Tanzanian population. Method A PIL incorporating simple text and pictograms was designed for the antiretroviral regimen of stavudine, lamivudine and efavirenz. The PIL was designed according to established good design guidelines, modified during a multi-stage iterative testing process and piloted in a South African Xhosa population. The PIL was made available in both English and Kiswahili. Sixty Tanzanian participants who were not taking ARVs were interviewed. They were asked to read the PIL in the language of their choice and were then asked a series of two-part questions; the first part required participants to locate the information in the PIL, after which they were asked to explain the information in their own words. Acceptability was assessed through close-ended questions and open-ended feedback. The influence of selected patient characteristics on comprehension of the PIL was investigated using one-way ANOVA and t-tests for independent samples with a significance level set at 0.05. Main outcome measure Comprehension of the written information in an overall percentage understanding. Results The overall average percentage comprehension of the PIL was 95%. The target set by the EC guideline that at least 80% of participants correctly locate and understand the information was achieved for 19 of the 20 questions. Five of the six instructions illustrated by pictograms were correctly understood by all participants. The only patient characteristics significantly associated with comprehension were educational level and self-reported ease of reading the PIL. Acceptability of the PIL was high and positive comments were associated with simplicity, good design, easy readability and user-friendliness, the latter enhanced by the inclusion of pictograms. Conclusion The PIL designed for this study was shown to be effective in communicating information about ARVs. Patient characteristics must be taken into account when developing written information, and the final document must be tested for comprehension in the target population.
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Date Issued: 2007

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Health literacy assessment: relexicalising a US test for a South African population

- Hunt, Sally, Dowse, Roslind, La Rose, Christopher M

Authors: Hunt, Sally , Dowse, Roslind , La Rose, Christopher M
Date: 2009
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/139131 , vital:37708 , DOI: 10.2989/SALALS.2008.26.2.7.571
Description: The problems of illiteracy in health contexts have been well documented in the literature and include such serious repercussions as medication non-compliance and failure to seek medical help during the course of an illness. The Rapid Estimate of Adult Literacy in Medicine (REALM) is a standardised health literacy test developed in the United States that has been previously administered and researched in South Africa (Lecoko, 2000). It is an objective vocabulary test, designed as a screening instrument to identify the health literacy levels of patients in clinics, which uses item recognition of 66 health-related words. Lecoko found that, in a South African setting, only 8 out of the 66 words in the US-developed test could be deemed acceptable. Therefore, the current study focused on the principled relexicalisation of the REALM, using words gathered from health information and promotional texts in local clinics, hypothesising that this would improve its applicability. After administration to a statistically similar group of respondents, the number of acceptable words on the test increased from eight to 38. Thus it is concluded that principled relexicalisation may be one way of improving the applicability of standardised health literacy tests to local populations and settings. However, the limitations of standardised tests may prove to be a significant barrier overshadowing the value of relexicalisation.
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Date Issued: 2009

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Health literacy test for limited literacy populations (HELT-LL): validation in South Africa

- Marimwe, Chipiwa, Dowse, Roslind

Authors: Marimwe, Chipiwa , Dowse, Roslind
Date: 2019
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/156652 , vital:40035 , https://doi.org/10.1080/2331205X.2019.1650417
Description: The majority of health literacy measures emanate from high-income countries and are inappropriate for use in limited literacy individuals who are usually excluded from participation in health literacy studies. There is currently no appropriate health literacy measure for the educationally diverse South African population. This study, which reports the validation of the Health Literacy Test for Limited Literacy individuals (HELT-LL), was conducted in primary health-care clinics with 210 isiXhosa-speaking patients with a maximum of 12 years of schooling. The HELT-LL has varied cognitive demands, assesses functional literacy skills as well as local burden of disease knowledge, and also includes self-reported questions.
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Date Issued: 2019

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In vitro release of amoxycillin from lipophilic suppositories

- Webster, Jessica A, Dowse, Roslind, Walker, Roderick B

Authors: Webster, Jessica A , Dowse, Roslind , Walker, Roderick B
Date: 1998
Subjects: To be catalogued
Language: English
Type: text , article
Identifier: http://hdl.handle.net/10962/184377 , vital:44213 , xlink:href="https://doi.org/10.3109/03639049809085636"
Description: The in vitro release characteristics of amoxycillin from different lipophilic suppository bases were investigated using the USP rotating basket method. Suppositories containing 250 mg amoxycillin were prepared in theobroma oil and in the semisynthetic bases Witepsol W35, Suppocire A32, Novata BD, and Novata 299. Both freshly prepared and 1-month-old suppositories were tested. Analysis of amoxycillin was performed using a validated high-performance liquid chromatographic (HPLC) technique. Release profiles differed significantly between bases, with the greatest amount of amoxycillin being released from both newly made and 1-month-old Novata BD bases (87.57 ± 8.18 and 99.66 ± 6.63%, respectively), and the lowest amount released from the newly manufactured theobroma suppositories (8.82 ± 0.75%) and the 1-month-old Suppocire A32 suppositories (7.78 ± 0.27%).
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Date Issued: 1998

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