“Managing Staff WFH in Crisis Times” - How Are Teacher Education Managers Supporting Staff Working Remotely at an Odel College?

The sudden onslaught of the Covid-19 pandemic changed how university managers operate. Staff working from home (WFH) needed support and teacher education managers (TEM) played an important role in giving such support. This study is underpinned by the crisis leadership theory and ubuntu-oriented management style. The aim of this exploratory study is to ascertain the support strategies provided by TEM to staff WFH during the Covid-19 pandemic. To achieve the aim, this study investigates motivational support TEM provided to staff WFH during the pandemic. The aim included establishing which stress management techniques TEM used to support staff WFH and explore communicative tools used to support staff WFH.  The constructivist-interpretivist lens is foregrounding the qualitative single case research, exploring the kind of support that six distance managers provided to staff WFH at an open distance e-learning university. Results revealed that staff WFH were acknowledged and rewarded for hard work and excellence. Several web-based video-conferencing sessions were offered through online Teams webinars, seminars, workshops and stress management techniques. Further research needs to be undertaken to determine, through a mixed-method design, how TEM employed stress management techniques for staff WFH, which may yield different results

Investigation of energetic particle distribution from high-order detonations of munitions

Military training with munitions containing explosives will result in the deposition of energetic materials on ranges. These residues contain compounds that may result in human health impacts when off-range migration occurs. Models exist that predict the spatial and mass distribution of particles, but they have proven to be difficult to apply to detonating munitions. We have conducted a series of tests to determine if modelling results can be directly applied to simple detonation scenarios. We also command detonated several rounds to obtain an initial indication of high-order detonation particle distributional heterogeneity. The detonation tests indicate that particle distributions will be quite heterogeneous and that the model used did not adequately describe the distribution of detonation residues. This research will need to be expanded to build an empirical database sufficient to enable the refinement of existing models and improve their predictions. Research on low-order detonations should be conducted as low-order detonations will result in higher mass deposition than high-order detonations. Distribution models verified with empirical data may then be incorporated into range management models

Open Access A Quality Improvement Intervention to Inform Scale-Up of Integrated HIV-TB Services: Lessons Learned From KwaZulu-Natal, South Africa

In South Africa, mortality rates among HIV-TB coinfected patients are among the highest in the world. The key to reducing mortality is integrating HIV-TB services, however, a generalizable implementation method and package of tested change ideas to guide the scale-up of integrated HIV-TB services are unavailable. We describe the implementation of a quality improvement (QI) intervention, health systems’ weaknesses, change ideas, and lessons learned in improving integrated HIV-TB services. / Methods: Between December 1, 2016, and December 31, 2018, 8 nurse supervisors overseeing 20 primary health care (PHC) clinics formed a learning collaborative to improve a set of HIV-TB process indicators. HIV-TB process indicators comprised: HIV testing services (HTS), TB screening among PHC clinic attendees, isoniazid preventive therapy (IPT) for eligible HIV patients, antiretroviral therapy (ART) for HIV-TB coinfected patients, and viral load (VL) testing at month 12. Routine HIV-TB process data were collected and analyzed. / Results: Key change interventions, generated by health care workers, included: patient-flow redesign, daily data quality checks; prior identification of patients eligible for IPT and VL testing. Between baseline and post-QI intervention, IPT initiation rates increased from 15.9% to 76.4% (P=.019), HTS increased from 84.8% to 94.5% (P=.110), TB screening increased from 76.2% to 85.2% (P=.040), and VL testing increased from 61.4% to 74.0% (P=.045). ART initiation decreased from 95.8% to 94.1% (P=.481). / Discussion: Although integrating HIV-TB services is standard guidance, existing process gaps to achieve integration can be closed using QI methods. QI interventions can rapidly improve the performance of processes, particularly if baseline performance is low. Improving data quality enhances the success of QI initiatives

The Responsiveness of Teacher Education Managers at an ODeL College to Resilience and the Well-Being of Staff Working from Home During COVID-19

The Coronavirus disease (COVID-19) pandemic has increased anxiety and stress among teacher education managers and has given rise to the question of whether they have the competencies to execute their operational responsibilities productively. The theories of resilience and transformational leadership underpin this study in which teacher education managers’ resilience and their responsiveness to the well-being of staff executing their operational practices in an open distance e-learning context were explored. A qualitative approach was adopted and virtual video conferencing interviews with teacher education managers were used to explore how they mitigated their strategic and operational roles and their managerial functions to ensure the well-being and organisational performance of staff working from home. Results revealed the experiences of distance managers to have been positive in that they implemented organisational strategies to mitigate the challenges faced to ensure wellness and performance among staff working from a distance. Further research applying a mixed-method design should be undertaken to determine how resilient managers and staff working from home are. That may yield different results

The anatomy of the obturator nerve and its branches in a South African cadaver sample

PURPOSE : Several surgical and clinical procedures are performed in the area of the medial compartment of the thigh. This places the obturator nerve and its branches in potential danger of injury. This study aimed to provide a clear description of the anatomy and course of the obturator nerve and its branches. METHODS : One hundred and one formalin-fixed cadavers were dissected just lateral to the lumbar vertebra to describe the origin and course of the obturator nerve, as well as its relation to other anatomical structures. The location of the obturator nerve within the obturator foramen was quantified by measuring the distance from three bony landmarks of the obturator foramen to the nerve. FINDINGS : In 20% of cases the obturator nerve originated from L3 and L4 rather than L2 to L4 in the combined sample. The bifurcation of the nerve occurred intrapelvically in 2% of cases, within the obturator canal in 93% of cases and extrapelvically in 5% of the sample. Regarding the course in the abdomen, the L3 root joined the L4 root more distally after exiting the psoas major muscle. In all cases on the left (n = 97) and 99% on the right, the anterior branch innervated the muscles of the medial thigh, in one case on the right the anterior branch innervated the pectineus muscle. The posterior branch assisted the anterior branch in the innervation adductor brevis in 10% on the left and 11% on the right sides. CONCLUSION : The results of this study may be used in the pre-operative preparation of surgeons that are to perform surgery in the area of the obturator foramen such as obturator nerve blocks for pain relief of adductor muscle contractions, prevention of adduction of the thigh during transurethral bladder surgery, additional analgesia after knee surgery, chronic hip pain, as well as postoperative analgesia after hamstring harvest for anterior cruciate ligament reconstruction.The Research Development Programme (RDP) of the University of Pretoria and the National Research Foundation – Competitive Support for Unrated Researchers.https://www.elsevier.com/locate/triaam2023AnatomyStatistic

Impact of ‘Ideal Clinic’ implementation on patient waiting time in primary healthcare clinics in KwaZulu-Natal Province, South Africa: A before-and-after evaluation

Background. Long waiting times are a major source of dissatisfaction for patients attending public healthcare facilities in South Africa (SA). The National Department of Health has identified this as one of six priority areas for improvement. Health system-strengthening (HSS) interventions to improve patient waiting time are being implemented in public health facilities across SA as part of the ‘Ideal Clinic’ model. The effect of these interventions on patient waiting time needs to be assessed and evidence generated for system improvement.Objectives. To determine the effect of Ideal Clinic HSS intervention on patient waiting time in public health facilities in Amajuba District, KwaZulu-Natal Province, SA.Methods. We implemented 12 months of HSS activity, including facility reorganisation and patient appointment scheduling. The major outcome of interest was the total time spent by patients in a facility during a visit. This was calculated as the median time spent, obtained through a ‘before-and-after’ intervention survey. Univariate and multivariate factors associated with waiting time were determined.Results. A total of 1 763 patients from nine clinics were surveyed before and after the intervention (n=860 at baseline and n=903 at follow-up). The median overall waiting time after the intervention was 122 minutes (interquartile range (IQR) 81 - 204), compared with 116 minutes (IQR 66 - 168) before (p<0.05). Individual facility results after the intervention were mixed. Two facilities recorded statistically significant reductions in patient waiting time, while three recorded significant increases (p<0.05). Patient load per nurse, type of service received and time of arrival in facilities were all independently associated with waiting time. Patients’ arrival patterns, which were determined by appointment scheduling, played a significant role in the results obtained.Conclusions. Implementation of the Ideal Clinic model in the selected facilities led to changes in patient waiting time. Observed changes were positive when a clinic appointment system was successfully implemented and negative when this was unsuccessful. We recommend strengthening of the appointment system component of the Ideal Clinic model to improve patient waiting time. Assessing facility waiting time performance in terms of average time spent by patients during a clinic visit was shown to be inadequate, and we suggest the inclusion of ‘proportion of clients who spent above the national waiting time threshold during their visit’ as a sensitive measure of performance.