“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

A multisectoral investigation of a neonatal unit outbreak of Klebsiella pneumoniae bacteraemia at a regional hospital in Gauteng Province, South Africa

BACKGROUND. Rates of healthcare-associated infections (HAIs) among babies born in developing countries are higher than among those born in resource-rich countries, as a result of suboptimal infection prevention and control (IPC) practices. Following two reported deaths of neonates with carbapenem-resistant Klebsiella pneumoniae bloodstream infections (BSIs), we conducted an outbreak investigation in a neonatal unit of a regional hospital in Gauteng Province, South Africa. OBJECTIVES. To confirm an outbreak of K. pneumoniae BSIs and assess the IPC programme in the neonatal unit. METHODS. We calculated total and organism-specific BSI incidence risks for culture-confirmed cases in the neonatal unit for baseline and outbreak periods. We conducted a clinical record review for a subset of cases with K. pneumoniae BSI that had been reported to the investigating team by the neonatal unit. An IPC audit was performed in different areas of the neonatal unit. We confirmed species identification and antimicrobial susceptibility, and used polymerase chain reaction for confirmation of carbapenemase genes and pulsedfield gel electrophoresis (PFGE) for typing of submitted clinical isolates. RESULTS. From January 2017 to August 2018, 5 262 blood cultures were submitted, of which 11% (560/5 262) were positive. Of 560 positive blood cultures, 52% (n=292) were positive for pathogenic organisms associated with healthcare-associated BSIs. K. pneumoniae comprised the largest proportion of these cases (32%; 93/292). The total incidence risk of healthcare-associated BSI for the baseline period (January 2017 - March 2018) was 6.8 cases per 100 admissions, and that for the outbreak period (April - September 2018) was 10.1 cases per 100 admissions. The incidence risk of K. pneumoniae BSI for the baseline period was 1.6 cases per 100 admissions, compared with 5.0 cases per 100 admissions during the outbreak period. Average bed occupancy for the entire period was 118% (range 101 - 133%), that for the baseline period was 117%, and that for the outbreak period was 121%. In a subset of 12 neonates with K. pneumoniae bacteraemia, the median (interquartile range (IQR)) gestational age at birth was 27 (26 - 29) weeks, and the median (IQR) birth weight was 1 100 (880 - 1 425) g. Twelve bloodstream and 31 colonising K. pneumoniae isolates were OXA-48-positive. All isolates were genetically related by PFGE analysis (89% similarity). Inadequate IPC practices were noted, including suboptimal adherence to aseptic technique and hand hygiene (57% overall score in the neonatal intensive care unit), with poor monitoring and reporting of antimicrobial use (pharmacy score 55%). CONCLUSIONS. Overcrowding and inadequate IPC and antimicrobial stewardship contributed to a large outbreak of BSIs caused by genetically related carbapenemase-producing K. pneumoniae isolates in the neonatal unit.http://www.samj.org.zaam2021School of Health Systems and Public Health (SHSPH