35 research outputs found
The development of a contextually based programme designed to increase family resilience processes for families in a rural community on the West Coast South Africa
Philosophiae Doctor - PhD (Psychology)Family environments can greatly affect the prospects of the children and their succeeding
generations. South Africa's socio-political history and contextual circumstances continue to
affect the structure and functioning of families. However, in spite of - or perhaps because of -
these factors, many families thrive in such adversity. Research has explored and identified
many processes such as social support, self-efficacy, availability of resources, and family
resilience, which can moderate the effects of adversity. Family resilience processes have been
shown to significantly reduce deleterious consequences of adversity in families
Perceived vulnerability to disease and the relationship with teacher satisfaction in South Africa during Covid-19: The serial role of burnout, role conflict, and ambiguity
Teachersâ work roles and responsibilities have changed dramatically because of the
COVID-19 pandemic. These unprecedented changes have the potential to generate role stress and
burnout and reduce teachersâ job satisfaction. This study investigated the serial relationship between
perceived vulnerability to disease, role stress, burnout, and teaching satisfaction. It was hypothesised
that individuals who perceive themselves to be at high risk of contracting COVID-19 would report
high role conflict and ambiguity in the workplace, which would in turn lead to high levels of burnout
and low satisfaction with teaching. Participants were schoolteachers (N = 355) who completed the
Perceived Vulnerability to Disease Questionnaire, the Role Orientation Questionnaire, the Maslach
Burnout Inventory, and the Teaching Satisfaction Scale
Identity matters: Validation of the professional identifcation scale in a sample of teachers in South Africa during the Covid 19 pandemic
Professional identity has been linked to organizational outcomes such as job performance and commitment, as well as health and well-being indices such as burnout
and depression. Professional identity is a powerful mechanism that can be afected
by social and environmental factors. It is therefore important to establish a reliable
and valid measurement of professional identity that is useful in diferent contexts.
The current study examines the psychometric properties of Brownâs Professional
Identifcation Scale (PIS) using three diferent but complementary approaches:
classical test theory, Mokken analysis, and Rasch analysis. The study participants
(N=355), school teachers recruited from all over South Africa, completed the PIS,
the Satisfaction with Life Scale, and the Teacher Satisfaction Scale. The reliability
and validity of a reduced 8-item version of the PIS was confrmed
Fostering family resilience: A community participatory action research perspective
Theoretically, increasing family resilience, may contribute to an increase the resilience of communities. However families in South Africa experience challenges to their resilience, often owing to a variety of historic, socio-economic, and political factors. Research and intervention planning that attempts to ameliorate the effects these factors, especially upon families who live within disenfranchised communities, should begin with a consideration of the relationships between researcher and community stakeholders. The aim of this paper is to discuss lessons learned during the process of intervention development in which the whole community (should they choose to) can participate. The Family Resilience Strengthening Programme is an intervention that was developed with the aim of strengthening family resilience processes using a participatory action research approach (PAR). Participants of this project were from a small, rural community from the West Coast of South Africa. We argue that PAR can be used to foster family resilience and, in so doing, can mobilise communities and their resources to increase community resilience. Key lessons learned during this project is discussed and addresses aspects important in community engagement such as the quality of communication and a unifying of different stakeholder community groups. Moreover, we encourage researchers and practitioners engage with the value that communities contribute to research and intervention planning, and the need to maintain, and further develop, those relationships both throughout and after the research proces
An exploration of the family resilience needs of a rural community in South Africa: a sequential explanatory mixed methodological study design
The aim of the study is to identify and explore
family resilience needs in a rural community in the West
Coast region of South Africa. An explanatory mixed methodological
sequential design was implemented. Firstly, Sixbeyâs
(2005) Family Resilience Assessment Scale, was employed to
conduct the quantitative assessment via a door-to-door sample
of convenience identified with the assistance of a local nongovernmental
organisation. Of the 656 participants, 39.8%
were male and 60.2% were female, with an average age of
37.90 years (standard deviation 13.92). Secondly, four focus
groups involving 27 community participants provided qualitative
data. Results from the quantitative assessment show that
family connectedness and utilising social and economic
resources were the lowest scoring, and belief systems the
highest scoring, dimensions in family resilience. Based on
the quantitative findings and the discussions, three thematic
categories emerged: community and family challenges; community
belief systems; and current family functioning and
organisational patterns. A number of families and groups
within the community were able to provide feedback, recommendations
and work collaboratively in this study. This contributed
to the argument we make for the transformative
mixed methods paradigm that is discussed. This study provides
further insight into the theory of family resilience.ISI & Scopu
Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization.
The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain âŒ8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD
BHPR research: qualitative1.âComplex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis
Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 â, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duckâ). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?â). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has goneâ). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining aboutâ). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes
Oral Abstracts 7: RA ClinicalO37.âLong-Term Outcomes of Early RA Patients Initiated with Adalimumab Plus Methotrexate Compared with Methotrexate Alone Following a Targeted Treatment Approach
Background: This analysis assessed, on a group level, whether there is a long-term advantage for early RA patients treated with adalimumab (ADA) + MTX vs those initially treated with placebo (PBO) + MTX who either responded to therapy or added ADA following inadequate response (IR). Methods: OPTIMA was a 78- week, randomized, controlled trial of ADA + MTX vs PBO + MTX in MTX-naĂŻve early (<1 year) RA patients. Therapy was adjusted at week 26: ADA + MTX-responders (R) who achieved DAS28 (CRP) <3.2 at weeks 22 and 26 (Period 1, P1) were re-randomized to withdraw or continue ADA and PBO + MTX-R continued randomized therapy for 52 weeks (P2); IR-patients received open-label (OL) ADA + MTX during P2. This post hoc analysis evaluated the proportion of patients at week 78 with DAS28 (CRP) <3.2, HAQ-DI <0.5, and/or ÎmTSS â€0.5 by initial treatment. To account for patients who withdrew ADA during P2, an equivalent proportion of R was imputed from ADA + MTX-R patients. Results: At week 26, significantly more patients had low disease activity, normal function, and/or no radiographic progression with ADA + MTX vs PBO + MTX (Table 1). Differences in clinical and functional outcomes disappeared following additional treatment, when PBO + MTX-IR (n = 348/460) switched to OL ADA + MTX. Addition of OL ADA slowed radiographic progression, but more patients who received ADA + MTX from baseline had no radiographic progression at week 78 than patients who received initial PBO + MTX. Conclusions: Early RA patients treated with PBO + MTX achieved comparable long-term clinical and functional outcomes on a group level as those who began ADA + MTX, but only when therapy was optimized by the addition of ADA in PBO + MTX-IR. Still, ADA + MTX therapy conferred a radiographic benefit although the difference did not appear to translate to an additional functional benefit. Disclosures: P.E., AbbVie, Merck, Pfizer, UCB, Roche, BMSâProvided Expert Advice, Undertaken Trials, AbbVieâAbbVie sponsored the study, contributed to its design, and participated in the collection, analysis, and interpretation of the data, and in the writing, reviewing, and approval of the final version. R.F., AbbVie, Pfizer, Merck, Roche, UCB, Celgene, Amgen, AstraZeneca, BMS, Janssen, Lilly, NovartisâResearch Grants, Consultation Fees. S.F., AbbVieâEmployee, Stocks. A.K., AbbVie, Amgen, AstraZeneca, BMS, Celgene, Centocor-Janssen, Pfizer, Roche, UCBâResearch Grants, Consultation Fees. H.K., AbbVieâEmployee, Stocks. S.R., AbbVieâEmployee, Stocks. J.S., AbbVie, Amgen, AstraZeneca, BMS, Celgene, Centocor-Janssen, GlaxoSmithKline, Lilly, Pfizer (Wyeth), MSD (Schering-Plough), Novo-Nordisk, Roche, Sandoz, UCBâResearch Grants, Consultation Fees. R.V., AbbVie, BMS, GlaxoSmithKline, Human Genome Sciences, Merck, Pfizer, Roche, UCB PharmaâConsultation Fees, Research Support. Table 1.Week 78 clinical, functional, and radiographic outcomes in patients who received continued ADA + MTX vs those who continued PBO + MTX or added open-label ADA following an inadequate response ADA + MTX, n/N (%)a PBO + MTX, n/N (%)b Outcome Week 26 Week 52 Week 78 Week 26 Week 52 Week 78 DAS28 (CRP) <3.2 246/466 (53) 304/465 (65) 303/465 (65) 139/460 (30)*** 284/460 (62) 300/460 (65) HAQ-DI <0.5 211/466 (45) 220/466 (47) 224/466 (48) 150/460 (33)*** 203/460 (44) 208/460 (45) ÎmTSS â€0.5 402/462 (87) 379/445 (86) 382/443 (86) 330/459 (72)*** 318/440 (72)*** 318/440 (72)*** DAS28 (CRP) <3.2 + ÎmTSS â€0.5 216/462 (47) 260/443 (59) 266/443 (60) 112/459 (24)*** 196/440 (45) 211/440 (48)*** DAS28 (CRP) <3.2 + HAQ-DI <0.5 + ÎmTSS â€0.5 146/462 (32) 168/443 (38) 174/443 (39) 82/459 (18)*** 120/440 (27)*** 135/440 (31)** aIncludes patients from the ADA Continuation (n = 105) and OL ADA Carry On (n = 259) arms, as well as the proportional equivalent number of responders from the ADA Withdrawal arm (n = 102). bIncludes patients from the MTX Continuation (n = 112) and Rescue ADA (n = 348) arms. Last observation carried forward: DAS28 (CRP) and HAQ-DI; Multiple imputations: ÎmTSS. ***P < 0.001 and **iP < 0.01, respectively, for differences between initial treatments from chi-squar