The knowledge, attitudes and perceptions of healthcare students and professionals regarding the interdisciplinary health worker team at Stellenbosch University and Tygerberg Academic Hospital

Objective: To determine the knowledge, attitudes and perceptions of healthcare students and qualified health professionals regarding theinterdisciplinary health worker team.Design: A cross-sectional descriptive study.Setting: Stellenbosch University (Tygerberg Campus) and Tygerberg Academic Hospital, Western Cape.Subjects: The sample (n = 529) consisted of first-year students, final-year students and working professionals in the fields of medicine,dietetics, physiotherapy, occupational therapy and speech-language and hearing therapy.Outcome measures: Self-administered, face-validated questionnaire.Results: There was an increase in knowledge in the final-year students when compared to the first-year students of their understanding ofeach profession. However, this improvement was not apparent when the working professionals’ understanding was compared to the finalyearstudents. The results indicated an increase in understanding of the scope of practice of allied health sciences (p-value = 0.001), andagreement that the patient would always benefit from an interdisciplinary approach. It was found that better patient prognosis was stronglyassociated with the care provided by an interdisciplinary team. This association increased from first-year students to final-year students(p-value = 0.019). Doctors were considered to be most valuable in the interdisciplinary team. The allied health sciences received comparablevalue ratings. The more advanced the years of experience, the less comfortable participants were to assume some of the roles of anotherdiscipline. Knowledge of the role of the dietitian increased from first-year students to final-year students (p-value = 0.001), but it remainedthe same for the professionals.Conclusion: There was an increase in knowledge and a positive change in the attitudes and perceptions of healthcare students and professionals in accordance with years of experience

Reconstruction of an Extensive Midfacial Defect Using Additive Manufacturing Techniques

Published ArticleMalignant peripheral nerve sheath tumors are extremely rare tumors arising in peripheral nerves. Only 17 cases involving the trigeminal nerve have ever been reported. These tumors have a very poor prognosis and very high rates of recurrence and metastases. Their recommended treatment involves complete tumor resection followed by radiation. This can be problematic in the head and neck region. We present a clinical case involving a 33-year-old female patient presenting with a slow-growing, exophytic mass of the anterior maxilla. Incisional biopsy and subsequent histological examination revealed a diagnosis of a malignant peripheral nerve sheath tumor. Surgical resection involved a complete maxillectomy, rhinectomy, and resection of the upper lip and aspects of the left and right cheeks. Reconstruction of the subsequent defect incorporated the placement of four zygomatic oncology implants to aid in retention of a facial prosthesis. These implants, however, were subsequently lost; and an anatomical model of the hard tissues was manufactured via 3D printing. This model was used to design and manufacture a titanium frame (customized implant) for the patient. The frame was then fixated and secured intraoperative with 21 cortical screws. A maxillary denture and silicone facial prosthesis were also made to fit onto this frame. This is the first known case where additive manufacturing, via the use of rapid prototyping and 3D printing, was employed to manufacture a facial prosthesis

Factors that influence the geometric detection pattern of vehicle-based licence plate recognition camera systems

CITATION: Rademeyer, M. C., Booysen, M. J. & Barnard, A. 2018. Factors that influence the geometric detection pattern of vehicle-based licence plate recognition camera systems. In Southern African Transport Conference, 9-12 July 2018, Pretoria, South Africa.The original publication is available at http://www.satc.org.zaLicence plate recognition (LPR) systems are used to automatically extract the characters from licence plates positioned in front of a camera. The geometric detection pattern is the region within which the system can accurately recognise licence plates and is of special interest when the system is mounted in a moving vehicle. In this research, the theory surrounding camera optics was investigated and used as the basis of a software simulation model. Inspired by the simulation measurements, a real-world experimental test was conducted to further explore the influence various factors have on the geometric detection pattern. Analysis of these measurements provided greater insight how multiple factors individually contribute to the shape and size of the geometric detection pattern and serves as a guide in the design of vehicle-based LPR systems.Post-prin

Developing a Patient-Specific Maxillary Implant Using Additive Manufacturing and Design

Published Conference ProceedingsMaxillectomy is the surgical removal or resection of the maxilla or upper jaw bone. A total or partial maxillectomy can be performed depending on how far the tumour has spread. This paper will discuss a patient diagnosed with an aggressive tumour in half of the top jaw who had to undergo an operation to remove the hemi-maxilla and orbital floor. Due to the extent and complexity of the defect, it was decided to manufacture an anatomical model of the hard tissues for planning a possible laser-sintered titanium implant using Additive Manufacturing (AM). The CRPM had only two weeks to design and manufacture the titanium implant, due to the severity of the tumour. The anatomical model was sent to the surgeon to cut the nylon model where the bone resection was planned. Furthermore, the prosthodontist made a wax model of the planned titanium frame that was reverse- engineered and used as reference geometry in the design software.Materialise® design suite was used to design the patient-specific maxilla and cutting jig. The EOS M280 Direct Metal Laser Sintering (DMLS) system was instrumental in achieving the direct manufacturing of the bio-compatible titanium implant. The EOS P385 system was used to manufacture the pre-operation planning model as well as the cutting jig.The process chain followed to complete this case study will be discussed showing how this intervention improved the quality of life of a SA patient. Furthermore, the proposed paper and presentation will discuss the post-operation review of the patient showing the impact AM had in accelerating patient-specific implant manufacturing. The authors seek to claim a progressed level of maturity in the proposed manufacturing value chain. The claim is based on the successful completion of the analysis and synthesis of the problem , the validated proof-of-concept of the manufacturing process and the in-vivo implementation of the final product

Using tracking data and an electro-mobility simulator to establish the energy requirements of electric minibus taxis in Tshwane

Papers presented virtually at the 41st International Southern African Transport Conference on 10-13 July 2023.The minibus taxi (MBT) is the dominant form of public transport across Sub-Saharan Africa (SSA). With a growing global call for greener transport, MBTs are seen as a key sector of implementation. The electrification of MBTs entails many challenges, including limited electricity resources and the lack of understanding of MBTs’ operational behaviour. In this paper, we estimate the electricity demand for future electric MBTs in the City of Tshwane, South Africa. We use existing origin and destination mobility data, which originated from vehicle-based tracking, and a micro-mobility simulation tool with an embedded electric vehicle model, called EV-Fleet-Sim. This simulation tool uses various SUMO packages to simulate mobility and calculate energy expenditure. The mobility dataset consists of various stop locations from a MBT fleet’s daily operation. The simulator uses a routing model, a virtual map, and a virtual driver model to convert the origin and destination data to high-fidelity mobility traces. The results are used in the electro-kinetic model to estimate the vehicles’ energy needs, from which charging opportunities can be derived. To illustrate this process and outputs, eight exemplar taxis with different operational patterns are selected for analysis. The results show a minimum and maximum median daily energy usage of 56 kWh and 215 kWh respectively, based on the mean observed daily distances travelled of 94 km to 330 km. While the energy demand varies significantly according to trip length and type of operation of the sub-fleet of 8 vehicles, clear morning and afternoon peaks are identified, along with charging opportunities during midday and at night

Saving on household electric water heating : what works best and by how much?

CITATION: Nel, P. J. C., Booysen, M. J. & Van Der Merwe, B. Saving on household electric water heating : what works best and by how much?. In IEEE Innovative Smart Grid Technologies - Asia (ISGT-Asia), 4-7 December 2017, Auckland, New Zealand, doi:10.1109/ISGT-Asia.2017.8378439.The original publication is available at https://ieeexplore.ieee.orgElectric heating of water for domestic use is a substantial component of total household energy costs. Thermal energy in a water heater is either used (as warm water) or lost to the environment. Various approaches to reduce the losses and improve the efficiency of these notoriously inefficient and costly water heaters have been proposed and are employed. However, given the complex factors at play, making sense of the savings approaches and choosing the right one for the right use case is not a simple task and often misunderstood. This paper addresses this problem by comparing some of the commonly employed approaches, including schedule control, change in set temperature, use of thermal insulation, and reduction in consumed volume. We also compare the impact of environmental factors, such as changing the ambient temperature around the water heater and the cold inlet temperature. The results show that for the consumption profiles and use cases evaluated, schedule control is the most effective, followed by insulation of the tank and piping. Combined, these two interventions save up to 25%. We also find that the effect of the temperature of the cold inlet water dwarfs that of the ambient temperature, is in line with other approaches, and means the installation status quo needs to be reconsidered.https://ieeexplore.ieee.org/document/8378439/Preprin

Assessing household wealth in health studies in developing countries: a comparison of participatory wealth ranking and survey techniques from rural South Africa

BACKGROUND: Accurate tools for assessing household wealth are essential for many health studies in developing countries. Household survey and participatory wealth ranking (PWR) are two approaches to generate data for this purpose. METHODS: A household survey and PWR were conducted among eight villages in rural South Africa. We developed three indicators of household wealth using the data. One indicator used PWR data only, one used principal components analysis to combine data from the survey, while the final indicator used survey data combined in a manner informed by the PWR. We assessed internal consistency of the indices and assessed their level of agreement in ranking household wealth. RESULTS: Food security, asset ownership, housing quality and employment were important indicators of household wealth. PWR, consisting of three independent rankings of 9671 households, showed a high level of internal consistency (intraclass correlation coefficient 0.81, 95% CI 0.79-0.82). Data on 1429 households were available from all three techniques. There was moderate agreement in ranking households into wealth tertiles between the two indicators based on survey data (spearman rho = 0.69, kappa = 0.43), but only limited agreement between these techniques and the PWR data (spearman rho = 0.38 and 0.31, kappa = 0.20 and 0.17). CONCLUSION: Both PWR and household survey can provide a rapid assessment of household wealth. Each technique had strengths and weaknesses. Reasons for differences might include data inaccuracies or limitations in the methods by which information was weighted. Alternatively, the techniques may measure different things. More research is needed to increase the validity of measures of socioeconomic position used in health studies in developing countries

Scrambling for access: availability, accessibility, acceptability and quality of healthcare for lesbian, gay, bisexual and transgender people in South Africa

BACKGROUND: Sexual orientation and gender identity are social determinants of health for people identifying as lesbian, gay, bisexual and transgender (LGBT), and health disparities among sexual and gender minority populations are increasingly well understood. Although the South African constitution guarantees sexual and gender minority people the right to non-discrimination and the right to access to healthcare, homo- and transphobia in society abound. Little is known about LGBT people's healthcare experiences in South Africa, but anecdotal evidence suggests significant barriers to accessing care. Using the framework of the UN International Covenant on Economic, Social and Cultural Rights General Comment 14, this study analyses the experiences of LGBT health service users using South African public sector healthcare, including access to HIV counselling, testing and treatment. METHODS: A qualitative study comprised of 16 semi-structured interviews and two focus group discussions with LGBT health service users, and 14 individual interviews with representatives of LGBT organisations. Data were thematically analysed within the framework of the UN International Covenant on Economic, Social and Cultural Rights General Comment 14, focusing on availability, accessibility, acceptability and quality of care. RESULTS: All interviewees reported experiences of discrimination by healthcare providers based on their sexual orientation and/or gender identity. Participants recounted violations of all four elements of the UN General Comment 14: 1) Availability: Lack of public health facilities and services, both for general and LGBT-specific concerns; 2) Accessibility: Healthcare providers' refusal to provide care to LGBT patients; 3) Acceptability: Articulation of moral judgment and disapproval of LGBT patients' identity, and forced subjection of patients to religious practices; 4) Quality: Lack of knowledge about LGBT identities and health needs, leading to poor-quality care. Participants had delayed or avoided seeking healthcare in the past, and none had sought out accountability or complaint mechanisms within the health system. CONCLUSION: Sexual orientation and gender identity are important categories of analysis for health equity, and lead to disparities in all four dimensions of healthcare access as defined by General Comment 14. Discriminatory and prejudicial attitudes by healthcare providers, combined with a lack of competency and knowledge are key reasons for these disparities in South Africa

Economic Returns to Investment in AIDS Treatment in Low and Middle Income Countries

Since the early 2000s, aid organizations and developing country governments have invested heavily in AIDS treatment. By 2010, more than five million people began receiving antiretroviral therapy (ART) – yet each year, 2.7 million people are becoming newly infected and another two million are dying without ever having received treatment. As the need for treatment grows without commensurate increase in the amount of available resources, it is critical to assess the health and economic gains being realized from increasingly large investments in ART. This study estimates total program costs and compares them with selected economic benefits of ART, for the current cohort of patients whose treatment is cofinanced by the Global Fund to Fight AIDS, Tuberculosis and Malaria. At end 2011, 3.5 million patients in low and middle income countries will be receiving ART through treatment programs cofinanced by the Global Fund. Using 2009 ART prices and program costs, we estimate that the discounted resource needs required for maintaining this cohort are $14.2 billion for the period 2011–2020. This investment is expected to save 18.5 million life-years and return$12 to $34 billion through increased labor productivity, averted orphan care, and deferred medical treatment for opportunistic infections and end-of-life care. Under alternative assumptions regarding the labor productivity effects of HIV infection, AIDS disease, and ART, the monetary benefits range from 81 percent to 287 percent of program costs over the same period. These results suggest that, in addition to the large health gains generated, the economic benefits of treatment will substantially offset, and likely exceed, program costs within 10 years of investment