The extent to which community service occupational therapists are equipped to treat patients with hand injuries and conditions

South Africa is one of the most violent nations in the world and has an extremely high incidence of road accidents and work place injuries. The precise effect of this on upper limb injury statistics is not known as the incidence and prevalence of these conditions has yet to be determined. Hand injuries are, however, common worldwide and, in South Africa, may be complex in nature. This places a demand on occupational therapy services to provide comprehensive upper limb rehabilitation, a responsibility that inevitably falls on novice occupational therapists at some point. Occupational therapists in South Africa are required to complete a year of compulsory Community Service after graduating before they are permitted to practice independently. These placements are often in rural, under-resourced areas and graduates are faced with multiple new roles while negotiating the transition into practice. No published research to date has described the general experience of Community Service occupational therapists in South Africa or the extent to which these therapists are equipped to treat patients with upper limb injuries and conditions. The study sought to determine the extent to which Community Service occupational therapists are equipped to treat patients with upper limb injuries and conditions

Hand health for all: do undergraduate occupational therapy hand curricula respond to the call?

The call for higher education curricula to be responsive to the South African context is growing louder. Injuries to the hand are common in South Africa and intervention is often provided by novice occupational therapists who may work in complex practice contexts with limited supervision. Comprehensive hand health practice addresses both the biomedical and occupational dimensions of the human hand. Undergraduate education programmes should be responsive to this reality in preparing graduates adequately for hand practice. This article describes the content of hand curricula within occupational therapy undergraduate programmes in South Africa with the purpose of considering how they prepare graduates for the practice realities they may face during community service. A descriptive cross-sectional survey design was used with an online questionnaire aimed at determining the nature and extent of hand curricula presented in South African undergraduate occupational therapy programmes (n=8). Data were analysed using Stata 12. Time allocated to hand impairments varied considerably across universities. While assessment of biomedical performance components were taught by all universities, the occupational perspective was limited. The range and number of hand conditions and treatment modalities that were taught also varied. Findings are discussed against the contextual realities of practice in South Africa, primary health care policy, and national and international minimum standards for the education of occupational therapists. Core aspects of a hand curriculum are proposed as a means to enhance comprehensive hand health practice

Community Service Occupational Therapists: thriving or just surviving?

Introduction: Community Service was introduced to improve access to health care for all South Africans, yet little is known about the experiences of Community Service occupational therapists. This article describes the characteristics and general experiences of Community Service occupational therapists. Methods: A national cross-sectional survey was undertaken. Data were collected with an online questionnaire to all occupational therapists completing Community Service in 2013 (n=240). Data were analysed with IBM SPSS Statistics, version 21.0, and responses to open ended questions were post-coded. Results: A 44.3% (n=104) response rate was achieved. Almost half the participants (44.7%) were located rurally with 51.5% working at primary level at least some of the time. Referrals were frequently received for wheelchair related services (61.2%), interventions related to child development (49.5%), disability grant assessments (36.9%) and treatment of adults with neurological conditions (39.8%). While some therapists felt challenged (54.2%) and frustrated (58.3%), many (75.0%) reported satisfaction from interacting with clients. Although the majority perceived the profession to be poorly recognised (63.5%), most were proud to be occupational therapists (66.7%). Conclusion: Community Service occupational therapists are playing an important role in improving access to services but Community Service needs to be situated within a broader plan to extend and strengthen services in-line with government policy

Investigation into metal contamination of the Berg River, Western Cape, South Africa

A recent decline in water quality of the Berg River, Western Cape, South Africa, has led to the investigation into the degree of metal pollution in the river system. This study was conducted over a period of one year, from May 2004 to May 2005. The nitric acid digestion technique was used to extract metals from water, sediment and biofilm samples collected at various points (Site A . agricultural area, Site B . informal settlement and Site C . Newton pumping station) along the Berg River. Metal concentrations were determined using inductively coupled plasma atomic emission spectrometry (ICP-AES). The highest mean metal concentrations recorded were as follows; water samples, 6 mgE.-1 for Al, 14.6 mgE.-1 for Fe and 18.8 mg..-1 for Mn; sediment samples, 17 448.8 mgEkg-1 for Al and 26 473.3 mgEkg-1 for Fe; biofilm samples, 876.8 mgE.-1 for Al and 1 017.5 mgE.-1 for Fe. The increased availability, or noteworthy incidence of Al and Fe, could be due to the leaching of metals into the river water from waste and household products associated with the informal settlement and the subsequent settling on sediment. No guidelines were available for metals in biofilms. The highest recorded concentrations in water were for Site C (agricultural area). Recorded concentrations in water fluctuated throughout the study period for most of the metals analysed, but Al and Fe were consistently above the recommended guidelines as stipulated by the Department of Water Affairs and Forestry and the Canadian Council of Ministers of the Environment

Bioaccumulation of metals in freshwater crabs (potamonautes perlatus) of the Lourens River, Western Cape, South Africa

Thesis (MTech (Environmental Health))--Cape Peninsula University of Technology, 2007Urban rivers are the most utilised and yet degraded rivers worldwide. The urban rivers of the Western Cape are no different. The Lourens River flows through the agricultural and urban areas of Somerset West in the Western Cape and as a result is subjected to a variety of pollution sources. In the upper reaches this river flows through two large farms where metal containing pesticides are used. Further downstream it passes through an urban area where a variety of pollution sources could contribute to the contamination of the river. The extent to which the Lourens River, and the ecosystem it supports, is affected by metal pollutants is not known. The aim of this study was to determine the concentrations of metals in the Lourens River as well as the contribution of agricultural and urban activities to metal contamination of the river. Sediment and crab (Potamonautes perlatus) samples were collected over a period of one year from seven sites over the length of the river. Sediment samples were also collected from a sedimentation pond on the bank of the river where orchard run-off water is remediated. Preliminary analysis of samples was done for ten metals (AI, Cd, Co, Cu, Cr, Fe, Mn, Ni, Pb and Zn). Results from these analyses determined the selection of six metals (AI, Cr, Cu, Fe, Mn and Zn) for further investigation in this study. The concentrations of metals detected in collected samples varied significantly throughout the sampling period. This can be attributed to various factors such as rainfall patterns, the fact that pesticide application varies throughout the year and other urban activities. AI, Cr, Fe and Zn were found in significantly higher concentrations in the urban areas. These higher levels of contamination, relative to the upper parts of the river, can probably be attributed to various urban activities contributing to the contamination of run-off into the river. The sedimentation pond results revealed high concentrations of AI and Fe, while Cu, Cr, Mn, and Zn were found in lower concentrations. All six metals however followed the same pattern where the first four sampling occasions showed higher concentrations than the last three occasions. It can be concluded that agricultural and urban activities do contribute significantly to the metal contamination of the Lourens River

Development of a floor made from fiber reinforced polymers (FRP) with integrated installations

Fiber reinforced polymers (FRP) is a type material which is more and more used to create structures, for example yachts and airplanes. The materials generally have a high strength to weight ratio, allowing lightweight structures. In buildings little use is made of FRP, in this study the possibility to use the material to create lightweight floors is explored. The goal of the study is the design of a long span floor (25 m) with the use of FRP. The total thickness should be limited to 1.0 m, as a result a plenum is not possible. The installations need to be integrated in the structural height of the floor. The floors should be safe and comfortable for its users. The first part of the study is a design part. The shape of the floor plate and the distribution system for the ventilation and lighting are adapted to each other. To be able to build fast and be able to reuse the floor plates simple connections are made which depend on shape and bolts. A radiating ceiling is developed with a water-filled layer. This ceiling can be used for heating and cooling, also during fire, as a structural layer and for improvement of acoustics. In the second part of the study the safety of the floor during a fire is determined and the comfort of the floor regarding sound insulation and vibrations caused by walking is determined. For a sufficient long fire safety level, provisions are needed. A layer of mineral wool, also improving the room acoustics, can insulate the ceiling leading to a fire safety of at least 40 minutes. The alternative is the use of the water-filled ceiling, with this solution the fire safety is close to infinite. The sound insulation of the floor is determined with an adaptation of the mass-law, taking sound insulation reducing effects into account. The resulting sound insulation is sufficient for most uses, but not for floors separating residences. Due to their low weight the floors will vibrate well due to footfall. With the use of the SBR publication ‘Trillingen van vloeren door lopen’ and FEM analysis the performance of the floor is determined. The result was insufficient, the floor plates need a higher stiffness, increasing material use and as a result cost. Conclusions: Long span FRP floors can be made. The floors can be safe and comfortable with a high level of integration of the installations. The floors can be disassembled and reused. A drawback is the high costs, these are caused by the expensive materials used. A shorter span (7.2 m) floor will be less expensive, but compared with conventional floors the cost are still a factor three too high to be competitive.Design and ConstructionCivil Engineering and Geoscience

Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study

Background: In Cape Town, the under-5 mortality rate has plateaued to 20 per 1000 live births, with 60% of child deaths occurring out of hospital. The southern subdistrict has the largest paediatric population in Metro West and accounts for 31% of deaths. This study aimed to uncover the access barriers and facilitators underlying this high burden of out-of-hospital deaths.Methods: An exploratory mixed-methods case study design employed three data collection strategies: a quantitative survey with randomly sampled community members, semi-structured interviews with purposively sampled caregivers whose children presented critically ill or deceased (January 2017 – December 2020) and a nominal group technique (NGT) to build solution-oriented consensus among purposively sampled health workers, representing different levels of care in the local health system.Results: A total of 62 community members were surveyed, 11 semi-structured caregiver interviews were conducted, and 11 health workers participated in the NGT. Community members (74%) experienced barriers in accessing care. Knowledge of basic home care for common conditions was limited. Thematic analysis of interviews showed affordability, acceptability, and access, household and facility factor barriers. The NGT suggested improvement in community-based services, transport access and lengthening service hours would facilitate access.Conclusion: While multiple barriers to accessing care were identified, facilitators addressing these barriers were explored. Healthcare planners should examine the barriers within their geographic areas of responsibility to reduce child deaths.Contribution: This study uncovers community perspectives on childhood out-of-hospital deaths and makes consensus-based recommendations for improvement