iCE (Interactive Curricula Experience) Platform & App Adoption, Use & Evaluation Across Thomas Jefferson University

iCE or the Interactive Curricula Experience Platform and App is a content delivery system designed specifically for the iPad but available to any learner with a web-enabled device. Poster presented at 2016 8th Annual Faculty Days at Thomas Jefferson University

Return to work after stroke: feasibility six year follow-up

Background: In a feasibility trial of early occupational therapy vocational rehabilitation (VR), more VR participants were in work at 12 months compared to those who received usual NHS rehabilitation after stroke (UC) (11 [65%] v 6 [35%]) (Radford et al., 2013). However, the longer-term is unknown. Aim: To follow up and explore work status six years post stroke. Method: Postal questionnaires measuring employment, income, mood, functional ability and quality of life (QoL) were sent to participants in an earlier feasibility trial by the lead stroke clinician. Respondents were invited to participate in interviews exploring working six years after stroke. Ethical and HRA approvals obtained (REC 16/EM/0423) Results: Of 48 identified participants, five (10.4%) had died; 19/43 (44.2%) responded. Fourteen were men; mean age 62 (24-78) years. Respondents classified themselves as in paid work 10/19 (53%), voluntary work 3/19 (16%), full time education 1/19 (5%) and solely retired 5/19 (26%). Six respondents were working over the age of 65 (26.3%). Most remained with preinjury employers (11/13). Half (8/15 53%) reported a decrease in income since stroke. Compared to one year, mean functional ability improved marginally from 56.6 (SD 12) to 59.4 (SD 9) but quality of life reduced from mean 77.4 (SD 11) vs 70.7 (SD14). Six interviewees felt working was the correct decision but lacked support with invisible impairments (fatigue, memory) which impacted workability. Conclusion: Work remains important to stroke survivors. Vocational rehabilitation should address hidden disabilities. Response bias may have influenced these findings

Concerns about physical inactivity among adolescents in the Strand, South Africa

INTRODUCTION: Strong evidence exist to support the assumption that regular physical activity is one of the most cost effective interventions for the prevention and management of chronic diseases of lifestyle, and should therefore be widely promoted. However, concerns about physical inactivity among adolescents have been raised in various countries. The levels of habitual physical activity among urbanized South Africans seems no better than what obtains in similarly urbanized populations in other countries. Objective: The aim of the study was to highlight the type of recreational physical activities, as well as the frequency and duration in which learners from the four high schools (n=1042) in the Strand, Western Cape participated in. Objective: The aim of the study was to highlight the type of recreational physical activities, as well as the frequency and duration in which learners from the four high schools (n=1042) in the Strand, Western Cape participated in. METHODOLOGY: The instrument utilized was a self-administered questionnaire adapted from the one developed by the South Australian Branch of Sports Medicine to determine recreational activities in school children. RESULTS: A high proportion of learners were found to be involved in different recreational physical activities, which included rugby, soccer, netball and walking. However, learners were not participating at a level at which the health benefits of participation could be maximized. DISCUSSION: The outcome of the current study suggests that it is unlikely that the learners maximized the health benefits of participation in physical activities. They may thus be prone to the possibilities of developing chronic diseases of lifestyle. CONCLUSION: High school learners should routinely be informed about the importance of incorporating physical activity into their lives

Controlled trial of hypnotherapy as a treatment for irritable bowel syndrome

Nineteenth century philosophy and anatomy regarded the nervous system as the only pathway of communication between the brain and body but now, research in the field of psychoneuroimmunology (PNI) has provided evidence to prove the age-old belief that there is a connection between the mind (or mental/emotional states) and the body. Researchers in PNI have now shown that the communication between the nervous and immune systems is bi-directional – i.e. there is a psychological reaction to physical disease and a somatic presentation of psychological disorders - and that the immune system, the autonomic nervous system, the endocrine system and the neuropeptide systems all communicate with each other by means of chemicals called messenger molecules or ligands. This paper outlines research into the treatment of Irritable Bowel Syndrome (IBS) with hypnotherapy, taking into account the mind-body connection and treating both the patient’s physiological and emotional/psychological symptoms rather than treating the physiological symptoms only. In other words, using a more holistic approach to the treatment of IBS. IBS is probably the most common functional gastrointestinal disorder encountered by both gastroenterologists and physicians in primary care. It is estimated that from 10% to 25% of the general population suffer from this condition and that it comprises about 30-50% of the gastroenterologists’ workload, yet the aetiology of IBS is unknown and, so far, there is no cure. Researchers are beginning to view IBS as a multi-faceted disorder in which there appears to be a disturbance in the interaction between the intestines, brain, and autonomic nervous system, resulting in an alteration in the regulation of bowel motility and/or sensory function. Most researchers agree that a subset of IBS sufferers have a visceral hypersensitivity of the gut or, more specifically, an increased perception of sensations in the gut. To date, studies of IBS have proposed previous gastroenteritis, small intestine bacterial overgrowth, psychosocial factors, a genetic contribution, and an imbalance of neurotransmitters as either possible causes or playing a part in the development of IBS. It is generally agreed that a patient’s emotional response to stress can exacerbate the condition. In section 1 of the thesis, the introduction, a detailed description and background appropriate to the study undertaken are provided, including aspects of epidemiology, diagnostic symptom criteria and clinical relevance of the Irritable Bowel Syndrome. Previous studies of various forms of treatment for IBS are discussed with the main emphasis being on treatment with hypnotherapy. All these therapies have concentrated on either mind or body treatments whereas this study demonstrates how hypnotherapy, and the use of imagery, addresses both mind and body. Finally, the rationale for the current study and the specific aims of the thesis are outlined. In section 2, the methodology and assessment instruments used in the clinical trial are discussed, as well as recruitment processes, research plan and timetable, and treatment schedule. Statistical analyses are provided and the main outcomes measures of the clinical trial, its limitations and scientific implications are addressed

Translation and validation of a patient satisfaction survey: the isiXhosa version

Background: Although the use of surveys has been supported for assessing understanding of health care service quality, it could also be argued that their main function is to quantify perceptions. The importance of assessing patient satisfaction in individuals’ own language has been highlighted in research. However, important culture-specific differences can be revealed during the adaptation process of a scale, and if not attended to can influence the validity of the scale. Objectives: The aim of this study was to assess the validity and reliability of the isiXhosa version of the Patient Survey for Quality of Care (PSQC) in primary health care (PHC) facilities in a selected district in the Western Cape, South Africa. Method: The PSQC was translated into isiXhosa by two independant translators and the translated back into English by a third translator. All three translators reviewed the back translation. Face and content validity of the scale were assessed. Fifteen isiXhosa-speaking clients with type 2 diabetes mellitus who had a mean age of 62.27 years (SD 10.33) and came from a randomly selected community health centre participated in the test-retest reliability. Results: Internal consistency of the scale was good (Cronbach alpha 0.70). Alpha values of individual items relating to quality of care as well as items flagged for inferior service quality were between 0.772 and 1.000, indicating good to high internal consistency. Conclusion: Results of this study indicated that the isiXhosa version of the PSQC was as reliable as the English version. It can be implemented at PHC level to assess isiXhosa-speaking patients’ satisfaction with health care services

Factors influencing utilisation of postnatal services in Kampala, Uganda

BACKGROUND: Maternal, child-health and health education are three major concerns of public health organizations and researchers throughout the world. Over half a million women encounter complications due to childbirth annually and many even die. Health education for mothers is thus a strategy many countries have adopted to improve maternal and child-health. OBJECTIVES: This study investigated possible factors influencing the use of postnatal services at two hospitals in Kampala- Uganda. STUDY DESIGN: A cross-sectional survey was completed by a convenient sample of women. METHODS: A structured questionnaire was administered to three hundred and thirty (330) women six to eight weeks after delivery. The participants were selected from a list of all women who delivered in two hospitals in Kampala, Uganda. RESULTS: The main barriers to utilisation of postnatal services identified were lack of awareness about postnatal services, distance from hospitals and lack of somebody to take care of the children at home. CONCLUSIONS: The results from this study reinforce the need for education of women and the communities about the importance of postnatal care

HIV/AIDS-related knowledge and behaviour of FET college students: implications for sexual health promotion

The impact of the HIV/AIDS pandemic is mostly felt by adolescents as half of all new HIV/AIDS infections have occurred in people aged 15-24 years. Statistics show that campaigns implemented by the South African government have failed to bring about positive behavioural change among young people. The aim of this study was to determine the HIV/AIDS-related knowledge among students at a college and the association between knowledge, self-efficacy, self-concept in sexual practices. This study was conducted at a Further Education and Training College in Cape Town. Data were collected using self-administered questionnaires consisting of five sections including demographic information; sexual practices; knowledge of HIV/AIDS, levels of self-efficacy; and self-concept. Fifty four percent of the participants indicated no condom use when having sex, either by themselves or by a partner; 43% indicated that they had more than 2 sexual partners in the 12 months prior to the study. The odds that a person with higher HIV/AIDS knowledge will use a condom were 1.047 times greater than someone with less HIV/AIDS knowledge. The odd’s ratio for self-efficacy indicates a positive relationship with the number of partners of an individual. The findings of the present study suggest adequate/high HIV/AIDS knowledge among the study sample. The study further highlights that for males, there is a greater likelihood that lower self-efficacy would predict more sexual partners in comparison to females. The results further suggest that although governmental organisations’ efforts improved knowledge of HIV/AIDS, programmes avidly promoting self-efficacy for males should be implemented.Department of HE and Training approved lis

Management of type 2 diabetes mellitus: Adherence challenges in environments of low socio-economic status

BACKGROUND: The efficacy of treatment for clients with diabetes is highly dependent on the individual’s ability to manage the disease. Several constraints, such as poverty, illiteracy and insufficient resources (finances and specialised healthcare professionals), especially communities of low socio-economic status, could influence clients’ ability to manage their disease. AIM: The main aim of this study was to outline the obstacles encountered by individuals with type 2 diabetes mellitus from an urban community with regard to management of their disease. Setting: The study was conducted at a primary health care facility in the Western Cape, South Africa. Methods: Ethical clearance was obtained from all relevant authorities. Eight (8) conveniently selected clients with type 2 diabetes mellitus per participating community healthcare centre (six approved centres in total) were invited to take part in focus group discussions. Twenty six clients, 15 females and 11 males, with a mean age of 58.92 years (SD = 7.33), agreed to participate. Audiotaped data were transcribed verbatim followed by content analysis and identification of themes. RESULTS: Themes that emerged were challenges with: a healthy eating plan, physical activity, financial constraints, other people’s understanding of the disease, and service received at the community healthcare centre. Verbatim quotes were used to exemplify the themes. CONCLUSION: Clients with type 2 diabetes mellitus experienced several challenges in the management of their disease. These challenges should be addressed to assist with better glycaemic control and to curb the emergence of diabetic complications and their attendant cost implications.Department of HE and Training approved lis

Drinking, binge drinking, and substance use among health professional students

Alcohol abuse is a major concern on college and university campuses. Heavy episodic drinking or binge drinking has also become a major health hazard. The aim of this study was to examine the relationship between binge drinking and substance use among 2nd year health profession students at a university in the Western Cape, South Africa. Two hundred-and-one (201) health profession students were selected to participate in a cross-sectional study. A self-administered questionnaire adopted from the National College Health Risk Behaviour Survey and the American College Health Association National College Health Assessment was used to collect the data. Overall, 34.3% of the study sample reported binge drinking, i.e. having had five or more alcoholic drinks at a sitting. The prevalence of binge drinking varied significantly by gender and race. A strong relationship between binge drinking and other substance use was found(p<0.05). Binge drinking has become a key health hazard and the current study provides evidence that the prevalence of binge drinking among university students remain a public health concern.Department of HE and Training approved lis

Physical activity among adults with diabetes mellitus in Rwanda

Diabetes mellitus is one of the most common non-communicable diseases, and is the fifth leading cause of death in most developing countries. Regular physical activity is strongly recommended for individuals with diabetes for its beneficial effects in the improvement of blood glucose control and insulin sensitivity, prevention and reduction of morbidities and complications, as well as for its cardiovascular benefits. Using a cross-sectional design, this study examined the demographic, social and health-related factors associated with physical activity participation among adults with diabetes mellitus in Kigali, Rwanda. One hundred-and-fifty six (156) adults with diabetes mellitus participated in the study. More than a third (39%) of the participants was categorized as inactive. Active participants were significantly younger than those categorized as inactive. Age, marital status, level of education and self-efficacy for diabetes were all significantly associated with levels of physical activity. Common barriers to participation in physical activity were cited as poor health status, lack of motivation and lack of awareness about the importance of physical activity. It is thus clear that efforts should be made to educate adults with diabetes mellitus about the benefits of integrating regular physical activity in their daily routine.Department of HE and Training approved lis