Compliance to Hand Hygiene Guidelines in Hospital Care: A stepwise behavioural approach

Healthcare associated infections (HAI) are a threat to the health of people requiring acute or chronic care. Since HAI can often be avoided by taking preventative measures, including proper application of hand hygiene principles, the prevention of these infections has received growing attention over the past decades. However, the application of preventive measures in clinical practice remains problematic and the observed compliance with such measures is often poor. Hand hygiene is one such area where compliance needs to be improved. To be able to develop successful interventions for the improvement of hand hygiene, it is essential to identify the factors influencing hand hygiene behaviour, and to investigate which interventions best target these factors. This thesis reports on a number of studies on the identification of behavioural and environmental correlates of hand hygiene behaviour among healthcare workers, and the translation of these determinants into an intervention. This chapter describes the background, aims and theoretical framework used, and presents an introduction to the individual studies that are part of this thesis

Familial needs: Comparing traditional and non-traditional families of public officials

BACKGROUND: Recognising traditional and non-traditional families in social policy is not sufficient if the policy implementation choices continue to accord more status to traditional families in comparison to non-traditional families. If unattended, this can create discriminatory practices, and human rights on an equal basis can be threatened between traditional and non-traditional families. This descriptive study compared traditional and non-traditional families of public officials with a focus on (1) form and income, (2) familial needs as per key propositions, (3) families perceptions/experiences at community and broader societal levels and (4) familial needs government must assist them with. METHODS: A quantitative research paradigm, a cross-sectional survey design was electronically administered to 600 public officials and culminated in a final sample of 70 respondents, was implemented. The study was contextualized within a contemporary family discourse, primarily influenced by a feminist perspective as well as a critique of the nuclear or traditional family grounded in functionalist theory. RESULTS: The study showed that traditional and non-traditional families of public officials are more the same than different. Public officials’ families, both traditional and non-traditional families, are affected by their inter-connectivity with communities and broader society in terms of how they experience negative treatment/ discrimination on the basis of a variety of equality issues as well as fulfillment of their socio-economic rights as stipulated in the Bill of Rights as enshrined in the South African Constitution. CONCLUSION: The study indicated that public officials, as members of families, live in both traditional and non-traditional families. Public officials have familial needs similar to any other family and are also influenced by similar factors in broader society. As both rights holders and duty bearers they can improve their own family lives and also better serve families in broader society. However they too need to be supported with their own family needs

Experiences of adolescents who lost a parent to aids in the Western Cape, South Africa: a qualitative study

BACKGROUND: AIDS related deaths of parents have resulted in large numbers of children being orphaned. Adolescence, a particularly vulnerable period in a child's developmental life is characterised by uncertainties, role confusion and identity crises. This stage becomes even more complex when adolescents lose their parents through AIDS. The purpose of this qualitative study was to explore the experiences of adolescents who have lost their parents through AIDS. METHODS: In-depth interviews were conducted with 8 adolescents between 14-17 years old who had lost a parent to AIDS. A thematic analysis of the transcripts was performed. RESULTS: Some of these adolescents had to grow up quickly, so as to engage in parental roles before they were of appropriate age. The participants had to endure multiple stresses. The maternal grandparents were seen as the most suitable support compared to the paternal grandparents. CONCLUSIONS: When placing these children into foster care it is important to consider close relatives or members of the community that these children are familiar with. Trauma counselling should be afforded to adolescents who lost their parents due to AIDS. Interventions are urgently needed that are suitable to the local context and that address bereavement as well as other issues that affect the day-to-day lives of these adolescents. Additional studies are needed to identify factors that promote resilience among these adolescents and the role of paternal family in caring for adolescent orphans

Fraction of clear skies above astronomical sites: a new analysis from the GOES12 satellite

Comparing the number of clear nights (cloud free) available for astronomical observations is a critical task because it should be based on homogeneous methodologies. Current data are mainly based on different judgements based on observer logbooks or on different instruments. In this paper we present a new homogeneous methodology on very different astronomical sites for modern optical astronomy, in order to quantify the available night time fraction. The data are extracted from night time GOES12 satellite infrared images and compared with ground based conditions when available. In this analysis we introduce a wider average matrix and 3-Bands correlation in order to reduce the noise and to distinguish between clear and stable nights. Temporal data are used for the classification. In the time interval 2007-2008 we found that the percentage of the satellite clear nights is 88% at Paranal, 76% at La Silla, 72.5% at La Palma, 59% at Mt. Graham and 86.5% at Tolonchar. The correlation analysis of the three GOES12 infrared bands B3, B4 and B6 indicates that the fraction of the stable nights is lower by 2% to 20% depending on the site

Homeless in Observatory, Cape Town through the lens of Max-Neef's Fundamental Human Needs taxonomy

The suburb of Observatory, also affectionately known as ''Obs'', is one of the older suburbs of the City of Cape Town, home to multiple cultures, a student population from the University of Cape Town, a variety of churches, the Provincial Government Groote Schuur Hospital, the Government Psychiatric Hospital Valkenburg, and the home of the South African Astronomical Observatory built in 1897 - hence the name of the suburb. It is one of the oldest areas of Cape Town. Unfortunately Observatory also has a high crime rate and many homeless people. In the beginning of 2014 concerned community members of Observatory approached the authors of this article to conduct a research study to profile the homeless in Observatory. The aim of this article is therefore to describe the profile of the homeless in Observatory, Cape Town and to develop some understanding of the lives of the homeless.ScieL

E-Selectin and markers of HIV disease severity, inflammation and coagulation in HIV-infected treatment-naïve individuals

Background: E-selectin has been shown to play a role in atherosclerosis and to be increased in HIV-infected individuals due to chronic immune activation. There is a paucity of studies on E-selectin in HIV-infected treatment-naïve individuals. Objectives: This study aimed to determine whether E-selectin levels were increased in HIV-infected treatment-naïve individuals and whether these correlated with markers of disease severity, inflammation and coagulation to determine if this population is at risk for cardiovascular disease (CVD).Methods: E-selectin levels were determined in 114 HIV-infected treatment-naive and 66 HIV-negative individuals, compared between groups and correlated with markers of disease severity, inflammation and coagulation.Results: There were statistically significant differences (p<0.01) in levels of WCC, CD4+ count, %CD38/8, albumin, IgG, hsCRP and D-dimer between groups and no statistically significant differences in E-selectin (p=0.84) and fibrinogen (p=0.65) levels. E-selectin correlated with age (p=0.02) and gender (p=0.01). Conclusion: E-selectin was a poor marker in this setting. There was no correlation with any of the markers of disease severity, inflammation and coagulation. E-selectin is most likely raised in an acute inflammatory setting, rather than chronic stage of HIV-infection. We recommend that other markers be utilized to identify patients at increased risk of CVD; as these were significantly increased untreated in individuals.Keywords: E-selectin, inflammation and coagulation in HIV-infected treatment-naïve individuals

Dysphagia limit in children with cerebral palsy aged 4 to 12 years

AIM: To assess the dysphagia limit in children with cerebral palsy (CP) according to Eating and Drinking Ability Classification System (EDACS) level, sex, and age compared to typically developing children. METHOD: Seventy‐seven children with CP (54 males, 23 females; mean age 7y 6mo, SD 2y 2mo, age range 4–12y) were assessed with the Maximum Volume Water Swallow Test. Median dysphagia limit in the CP group was compared with data of typically developing children. RESULTS: The dysphagia limit of children with CP differed significantly (p<0.001) from typically developing children. The latter showed a threefold higher median dysphagia limit (22mL) compared to children with CP in EDACS level I (7mL). The higher the EDACS level, the lower the dysphagia limit in children with CP. EDACS level explained 55% of the variance in the dysphagia limit of the CP group. INTERPRETATION: Where children with CP in EDACS levels IV and V showed that their capacity met the level of their performance, children in EDACS level I had the ability to perform a maximum capacity task, but still had a threefold lower median dysphagia limit than typically developing children. Establishment of the dysphagia limit should be part of general swallowing assessment in children with CP

1-(2,4-Dinitro­phen­yl)-5-ferrocenyl-3-methyl-1H-pyrazole

In the title compound, [Fe(C5H5)(C15H11N4O4)], the dinitro­phenyl and cyclo­penta­dienyl rings make dihedral angles of 53.61 (6) and 23.11 (9)°, respectively, with the pyrazole unit. The two cyclo­penta­dienyl rings are in an eclipsed conformation. The crystal structure is stabilized by inter­molecular C—H⋯O inter­actions, which link mol­ecules into chains parallel to the b axis

Personal preferences of participation in fall prevention programmes: A descriptive study

Background: Participation in fall prevention programmes is associated with lower risk of injurious falls among older adults. However participation rates in fall prevention interventions are low. The limited participation in fall prevention might increase with a preference based approach. Therefore, the aims of this study are to a) determine the personal preferences of older adults regarding fall prevention and b) explore the association between personal preferences and participation. Methods: We assessed the personal preferences of older adults and the association between their preferences, chosen programme and participation level. Nine different programmes, with a focus on those best matching their personal preferences, were offered to participants. Twelve weeks after the start of the programme, participation was assessed by questionnaire. Logistic regression was performed to test the association between preferences and participation and an ANOVA was performed to assess differences between the number of preferences included in the chosen programme and participation level. Results: Of the 134 participants, 49% preferred to exercise at home versus 43% elsewhere, 46% preferred to exercise alone versus 44% in a group and 41% indicated a programme must be free of charge while 51% were willing to pay. The combination of an external location, in a group and for a fee was preferred by 27%, whereas 26% preferred at home, alone and only for free. The presence of preferences or the extent to which the programme matched earlier preferences was not associated with participation. Conclusion: Despite the fact that preferences can vary greatly among older adults, local programmes should be available for at least the two largest subgroups. This includes a programme at home, offered individually and for free. In addition, local healthcare providers should cooperate to increase the accessibility of currently available group programmes

The effect of religion on parenting in order to guide parents in the way they parent: a systematic review

Religion has a growing influence on parenting, and there remains a need to understand the influence of religious values in order to inform parents, and other professional bodies, on how religious beliefs can influence child-rearing practices. A systematic review was conducted to explore relevant articles during the time period 2004–2014. The aim of the review was to explore the effect of religion on parenting, and to establish effective ways in which religious parents can be guided in parenting. The findings show that religion does influence parenting, and that with intervention aimed at increasing specific skills, parenting practices may improve.Scopu