Infection prevention and control audit-feedback instrument for oral health care in South Africa

Thesis (D. Tech. (Biomedical Technology)) -- Central University of Technology, Free State, 2015This study reviewed national and international literature to develop an audit-feedback instrument (AFI) to monitor adherence of South African oral health care facilities with compliance to infection prevention and control precautions. In a multi-phased literature search, existing infection prevention and control recommendations, guidelines and audit-feedback instruments were reviewed and broadened to include “dental audit tools”, as well as audit tools from other health care disciplines. Audit-feedback instruments were scrutinised for user friendliness, the use of simple language, electronic calculations and feedback possibilities. A new South African AFI was proposed, considering the differences between public and private oral health care facilities and also the diversity of training levels of oral health care personnel employed. Eleven focus areas supporting all aspects of infection prevention and control in oral health care facilities, including administrative controls; personnel protection controls; environmental- and work controls; surface contamination management; equipment maintenance, service or repair; air- and waterline management; personal protective equipment usage; personal and hand hygiene practices; sterilisation practices; safe sharps handling and waste management were included. The AFI was tested in a sample of 50 oral health care facilities. None of the participating facilities demonstrated 100% compliance. Personal- and hand hygiene practices and waste management performed the best, at respectively 75% and 63%, while administrative controls and air- and waterline management scored the lowest mean values; 31% and 36% respectively The general lack of compliance with infection prevention and control precautions in the participating oral health care facilities clearly poses a safety hazard to both patients and oral health care workers. Results indicate that adherence of South African oral health care facilities with compliance to infection prevention and control precautions need to be improved. The AFI should go a long way towards improving safety and the high expectations about providing quality infection prevention and control outcomes in oral health care

Infection control techniques used in South African dental practices

ThesisIn dentistry, blood borne microorganisms, including hepatitis B virus and human immunodeficiency virus (HIV), pose a risk for occupational exposure among oral health care workers. Impressive technological advances enable dental practitioners to use valid, practical, measurable and sustainable infection control practices. The unique nature of dental procedures and settings, requires specific and unique preventative strategies to minimise disease transmission. Since 1993 it has been recommended that South African dentists adhere to the recommendations for infection control of the Centers for Disease Control and Prevention. The main objective of this study was to examine the adherence to infection control recommendations in dental practices in South Africa, with specific attention paid to practices associated with the use of a steam autoclave steriliser. All dental practitioners registered with the Health Professions Council of South Africa were included in this study. Practitioners with foreign addresses were not included. A postal questionnaire was used for collecting data. 738 respondents returned completed questionnaires. 87% of respondents indicated that they treat each patient as a possible source of infection. Many respondents (53%) admitted that their preferred method of sterilising handpieces is wiping/soaking in liquid chemicals. Only 17% of the respondents indicated that they autoclave handpieces after each patient. These results indicate a serious need for South African infection control guidelines and audit recommendations specific to dental practices in order to promote a safer dental environment for the health care worker and patient

Looking closely by candle light

A Research Report submitted in fulfilment of the requirements for the Degree of Master of Arts in History of Art to the Faculty of Humanities at the University of the Witwatersrand, Johannesburg, 2016In this research, I study the work by contemporary South African artist, Johannes Phokela, in relation to the Western art historical canon. I undertake a close analysis of his painting Candle Bathing (1997) that quotes Samson and Delilah (1609-1610) by the seventeenth century Flemish Baroque painter, Peter Paul Rubens. Through a comparative analysis and close looking I read Candle Bathing’s ‘visual argument’ within a postcolonial context. To argue that Candle Bathing is not a mere ‘quotation’ I look closely from multiple angles. To deal with the complexity of a quotation that crosses socio-political time and space, I interpret the painting from various theoretical frameworks: poststructuralism (semiotics), postmodernism (irony); and postcolonial theory to situate my contextual analysis. I am interested in how we can read beyond the literal and how a close reading of this ironic quotation can surface the complexities of contemporary South African art in relation to the art historical canon and colonialism. Through close looking I read Candle Bathing as addressing the art canon, colonialism, critiquing issues of race, and marginalisation. This research contributes to filling a knowledge based gap by researching a previously marginalised artist and a close engagement with Candle Bathing. In addition, this research offers a way of looking and a method on how to begin looking closely at contemporary African art quoting canonical works. I illustrate the value of close looking to read multifaceted and layered interpretations.MT201

An explorative study of social workers' knowledge, experience and approach to factitious disorder

Includes bibliographical references.Factitious disorder is characterised by a compulsion with an unconscious motivation to intentionally fabricate signs and symptoms of physical or psychological illness. Factitious disorder by proxy is a form of abuse which usually presents as a parent portraying their child as being ill. Factitious behaviour indicates severe psychological dysfunction, and these clients could pose a danger to themselves as well as their families. There is limited research on factitious disorder in social work practice. This study aimed to explore social workers’ knowledge of factitious disorder, the presentation and prevalence of factitious disorder in social work practice, the experience of social workers with clients with factitious behaviour, and social workers’ approach to the assessment and treatment of factitious disorder. This study used a qualitative exploratory research approach with a phenomenograpy design that enabled the researcher to explore the variation in social workers’ knowledge, experience and approach to factitious disorder

Assessment of an audit-feedback instrument for oral health care facilities in South Africa

Published ArticleThe assessment of an audit-feedback instrument (AFI) for infection prevention and control was conducted on a population of South African oral health care facilities, mainly to test its workability in the varied facility configurations. A purposive selection strategy was followed, selecting 50 South African oral health care facilities. Results from 49 completed AFIs revealed demographic details and information on infection prevention and control practices for the 11 AFI focus areas: Administrative controls; personnel protection controls; environmental- and work controls; surface contamination management; equipment maintenance; air- and waterline management; personal protective equipment usage; personal- and hand hygiene practices; sterilisation practices; sharps handling and waste management. None of the participating facilities demonstrated 100% compliance. Notably, administrative controls and air- and waterline management scored the lowest mean values; 31% and 36% respectively, while personal- and hand hygiene practices and waste management performed the best, at respectively 75% and 63%. The general lack of compliance with infection prevention and control precautions in the participating oral health care facilities clearly poses a safety hazard to patients and oral health care workers. These findings demonstrate the urgent need for a monitoring system, such as the AFI, to be instituted in South African oral health care facilities

A study of some aspects of the toxaemias of late pregnancy in the City of Cape Town

The General Introduction in Section 1, Page 1 describes briefly the scope of the work in this thesis. Section 2 deals with the Historical facts with emphasis on the History in South Africa which has never been published previously. In addition the.general history as well as the literature concerning the Etiology, Pathogenesis and follow up studies is summarised. Section 3 is a study of the incidence of the Toxaemias of late pregnancy within the municipal boundaries of the city of Cape Town and the Langa Native Township, and their racial grouping. A separate introduction on page 38 as well as the problems investigated on page 48 and the standards employed on page 49 as well ·as the methods and material on page 50 indicate how this problem was investigated. The conclusions of this aspect of the study are summarised on page 850. Section 4 deals with follow up studies of 100 cases of non-convulsive toxaemia and 100 cases of eclampsia, and the material and methods are described on pages 88 and 94 respectively. Section 5 portrays the results of the follow up studies and the conclusions reached in this regard. In addition fields for further investigation are suggested on page 22,9. Section 6, the Appendix, gives additional case history information and Section 7 reproduces the Bibliography used

Educare work in Ciskei with special reference to the Keiskammahoek district

High drop-out rates in the sub-standards in developing countries prompted the researcher to investigate preschool education in first and third world countries, and attend to the related problem of school readiness. The rapidly expanding Educare preschool project in the rural area ot Keiskammahoek in Ciskei was investigated as an example ot community-based low-cost preschool education. A final sample of 41 children who had attended Educare Centres were matched to a control group on age, sex, primary school (where possible), and breadwinner's occupation. The Abbreviated Aptitude Test for School Beginners (standardised on Xhosa-speaking school beginners) was used to test tor significant differences between the two groups six to seven weeks atter school entry. A t-test was used on raw scores and chi-squared tests on staves. No signiticant difference was found between the means of the experimental and control groups. On a subjective rating scale for general-linguistic development and socio-emotional adjustment, no significant difference between means of the experimental and control groups was found. The experimental group's tailure to perform better than the control group, could be ascribed to various reasons, amongst others, the possible shortcoming that the pairs were not matched on intelligence, severe lack ot equipment in Educare Centres, large numbers of children in the majority of groups, uniform programmes for a wide age range, irregular attendance ot children, the low level of training of supervisors and poor home conditions. Scholastic abilities of school beginners in the Keiskammahoek District, as tested, were poor. Results deviated grossly from standardised norms. The expected percentage for the combined categories Very Weak and Weak is, tor instance, 31%; in this investigation, however, 73% of the testees fell in these two classes. Chronologically older children generally performed better. A highly significant difference existed between testees under six years and those over six years. This investigation indicated the need for better organised preschool education in rural areas in Ciskei. proposals with substantial financial implications are: Better training of para-professional staff by qualified staff. Training of qualified staff to provide expertise in preschool education in Ciskei. Provision of sufficient educational materials by Government subsidies and private sponsors. Institution of bridge classes by the Ciskei Department of Education to promote school readiness. Suggestions without financial implications include: An investigation of regulations regarding entrance age for basic education. Only in exceptional cases should children under six be admitted. Daily programmes in Educare Centres geared towards learning readiness without becoming academic. An age limit of three years for admittance to Educare Centres. Very young children should be catered for separately. Liaison between Sub A teachers and Educare staff.Adobe Acrobat 9.53 Paper Capture Plug-i

Compliance with infection control recommendations in South African dental practices: a review of studies published between 1990 and 2007

Published ArticleIn a country where the prevalence of infectious diseases ranks among the highest in the world, infection control in health care facilities should not be debatable. This unfortunately does not seem to be the case in South African oral health care facilities. This study is a systematic review of available literature on the adherence of South African oral health care professionals to infection control recommendations. Nine focus areas were investigated with regard to infection control practices: knowledge of infectious occupational hazards; personal hygiene and care of hands; correct application of personal protective equipment; use of environmental barriers and disposable items; sterilisation (recirculation) of instruments and handpieces; disinfection (surfaces) and sound housekeeping; management of waste disposal; quality control of dental unit waterlines, biofilms and water; as well as other special considerations. Although South African studies are limited and most of them relied on self-reports, which could have resulted in a serious overestimation of compliance, even these studies indicate serious shortcomings with regard to infection control practices in oral health care facilities in this country. This review highlights opportunity for improvement. Furthermore, it identifies possibilities for future research in infection control and also opportunities to improve infection control education for all oral health care workers in the country

Redefining Maputo downtown : flood management through a sustainable landscape architecture intervention

“All countries are vulnerable to climate change and instability in weather patterns but the poorest countries and the poorest people within them are most vulnerable, being the most exposed and having the least means to adapt” (IMF and World Bank Development Committee, 2006). African cities, as other cities around the world, are prone to flooding within in urban areas. The increased flooding from climate change, could have seriously destabilising effects for Africa (Commission for Africa, 2005). Climate records shows that most of Africa warmed by approximately 0.7°C during the twentieth century (IPCC Working Group II, 2001). Future changes in rainfall will depend greatly on the influence of global warming. In addition, a United Nations World Water Report states that in the beginning of the twenty-first century, the Earth with its diverse and abundant life forms (including over six billion humans), is facing a serious water crisis. Water needs to be conserved in any way possible. (United Nations World Water Report, n.d.). This study aims to explore the role in which floodingin urban landscapes can be addressed, but simultaneously stored for future use. It argues that the negative element of flooding can rather be used, i.e the water could be conserved and used in the build environment, rather than inhibiting social, economic and ecological factors. The pilot project in this stage can at the same time, serve as an urban generator. An innovative solution (urban water park) is analysed and tested and serves as a possible outcome to address flooding problems within an African city (Maputo, Mozambique). Afrika, 2005).Stede in Afrika, soos in ander in die wêreld, is onderhewe aan vloedrampe in stedelike areas. Die toenemende vloedegevalle, tesame met die impak van klimaatsverandering, kan uiterse destabilisering vir die Afrika kontinent inhou (Kommissie vir Afrika, 2005). ‘n Klimaatsrekord, bewys dat gedurende die twintigste eeu, ‘n groot deel van Afrika onderworpe was aan ‘n hittetoename van omtrent 0.7°C (IPPC Werksgroep II, 2011). Toekomstige veranderinge in reënval sal grootliks afhang van die invloed van aardsverwarming. Ter aanvoering van die argument word daar adisioneel toegevoeg dat die Verenigde Nasies se Wêreldswater Verslag die volgende aanlas: dat die aarde, met sy diverse en verskeidenheid van lewende wesens (wat oor die ses miljioen mense insluit), aan die begin van die een-en-twintigste eeu onderworpe sal wees aan ernstige watertekorte. Water moet dus in alle moontlike maniere gespaar word (Verenigde Nasies se Wêreldswater Verslag, geen datum). Die studie beoog om die rol van vloede in die verstedelike landskap te ondersoek en aan te spreek tot voordeel van die bouomgewing. Die ontwerp poog om die huidige negatiewe element van water eerder te bewaar en die gebruik daarvan te aan te moedig. Hierdeur word word die omswaai in sosiale, ekonomiese en ekologiese faktore inplekgestel. ‘n Projek sal dan terselfdertyd as verstedelike genereerder dien. ‘n Innoverende oplossing, ‘n stedelike water park, is geondersoek en getoets. Hierdie sal moontlik as die oplossing dien van die huidige vloedprobleme in hierdie Afrika stad (Maputo, Mosambiek).Dissertation (ML(Prof))--University of Pretoria, 2011.Architectureunrestricte

Compliance with infection prevention and control in oral health-care facilities: a global perspective

Published ArticleMany publications are available on the topic of compliance with infection prevention and control in oral health-care facilities all over the world. The approaches of developing and developed countries show wide variation, but the principles of infection prevention and control are the same globally. This study is a systematic review and global perspective of the available literature on infection prevention and control in oral health-care facilities. Nine focus areas on compliance with infection-control measures were investigated: knowledge of infectious occupational hazards; personal hygiene and care of hands; correct application of personal protective equipment; use of environmental barriers and disposable items; sterilisation (recirculation) of instruments and handpieces; disinfection (surfaces) and housekeeping; management of waste disposal; quality control of dental unit waterlines, biofilms and water; and some special considerations. Various international studies from developed countries have reported highly scientific evidence-based information. In developed countries, the resources for infection prevention and control are freely available, which is not the case in developing countries. The studies in developing countries also indicate serious shortcomings with regard to infection prevention and control knowledge and education in oral health-care facilities. This review highlights the fact that availability of resources will always be a challenge, but more so in developing countries. This presents unique challenges and the opportunity for innovative thinking to promote infection prevention and control