[No abstract available] / Education, Faculty of / Graduate

A research report submitted in partial fulfillment of the requirements for the degree Master in Audiology, Department of Speech Pathology and Audiology Faculty of Humanities University of the Witwatersrand September 2018 / Newborn hearing screening (NHS) has been successfully implemented in developed countries such as the United States of America and the United Kingdom. This is however not the case in developing countries such as South Africa. The challenges impact on the implementation of such programmes include lack of suitably trained personnel, financial resources for staff and equipment, institutional support and political will. The lack of NHS programmes in South Africa has resulted in the late detection of hearing loss in infants and children and subsequently delayed intervention. In order to address the lack of NHS, a rural clinic-based NHS programme was implemented in July 2014 at three primary health care (PHC) clinics in the Limpopo Province. The main aim of the study was to describe the parental/caregiver perspectives regarding the effectiveness of this rural clinic-based NHS programme. The effectiveness of the programme was also evaluated in terms of meeting national (HPCSA, 2007) and international (JCIH, 2007) benchmarks. A retrospective review of 2 302 audiological records of babies who underwent NHS between July 2014 to June 2015 was conducted. Concurrently, 18 parents of infants who underwent hearing screening as part of the programme were purposefully selected and semistructured interviews were conducted to explore the parental perspectives regarding the programme. The results of the retrospective record review revealed that the mean age of the infants screened during the review period was 112 days (2 – 341; ± 40.26). The overall coverage rate was 87% and the referral rate, 7%. The overall follow-up return rate was 32% and only 15% the infants who failed both the initial and rescreening underwent comprehensive diagnostic assessment to confirm their hearing status. The overall prevalence rate for significant sensorineural hearing loss was 0.4/1000 and 7.8/1000 for middle ear effusion. The parents/caregivers confirmed the perceived effectiveness of the NHS programme. All the participants were satisfied with the programme and confirmed the credibility of the screening programme and screeners. Parents indicated that they were empowered with knowledge regarding the importance of early detection of hearing loss in infants and young children. Accessibility was both a facilitator and a barrier with travel distance and cost the most often cited obstacles to attending follow-up appointments. The findings indicate it is feasible to implement clinic-based NHS programmes that effectively meet the needs of parents/caregivers of infants residing in rural areas of South Africa. Although not all the benchmarks were met within the first year of implementation, the high coverage- and low referral rates are the first steps in improving the outcomes of the screening programme. The study highlight the importance of regular monitoring and evaluation of the NHS programmes to keep track of key outcomes and impacts related to the different components of the programme / MT 2019

Eighty-one patients in Planned Parenthood at East Central Indiana participated in the study. All patients were given a short quiz concerning female anatomy at their intake evaluation. All patients participated in the routine patient education session and intake history. The experimental group (N=41) was given a mirror through which to watch the pelvic examination. The control group (N=40) was given the same sort of examination without the mirror. The quiz was then repeated.Pre-test results were identical in the two groups. Both groups improved significantly on the post-test compared to the pre-test, showing the patient education session to be an effective tool. The experimental group improved more than the control group, however, and the difference was significant at the P=0.06 level.It is concluded that pelvic examinations which routinely include a hand-held mirror through which the patient may visualize her own genitalia are of significant benefit as a patient educational tool.Ball State UniversityMuncie, IN 47306

No description available.

Submitted in compliance with the requirements for the Master's Degree in Technology: Nursing, Durban University of Technology, 2014. / Background : Tuberculosis (TB) is a global public health concern and is identified as the leading cause of morbidity and mortality in the population infected with Human Immune Deficiency Virus (HIV). South Africa (SA), particularly the KwaZulu-Natal Province, is burdened with persistently high rates of both TB and HIV infections. In an attempt to improve TB and HIV co-infection outcomes the South African health care system has adopted the World Health Organisation (WHO) guidelines for intensified TB case findings in all HIV positive individuals for regular screening of TB symptoms in order to promptly diagnose and treat active TB disease or to exclude TB for initiation Isoniazid Prophylactic Therapy (IPT). IPT has proven effective in preventing TB disease in People Living with HIV or AIDS (PLWHA). This critical first step of TB symptom screening is regarded as the intervention that could significantly reduce the challenge currently faced with TB-HIV co-infection. The study was conducted in selected eThekwini Municipality Primary Health Care (PHC) facilities with the focus on an investigation to determine the extent of the implementation of the TB symptom screening tool in HIV infected individuals, in addition to identifying treatment initiation or further investigations based on the tool implementation. It has been found during the literature review, that there is a lack of research in SA to show that this critical first step in TB identification has been investigated, yet one in six South African’s is HIV positive and the incidence of TB-HIV co-infection is not declining. Methodology : A quantitative, descriptive approach was utilised to conduct a retrospective patient chart review. A multistage cluster sampling technique comprising three stages was implemented to identify the sample. There was a random selection of clinics, and the required number of client records was obtained through convenience sampling from the selected clinics. Results : The findings of this study revealed there is inadequate implementation of the current national and provincial TB protocols. The study provides varied levels of information about TB symptom screening in HIV infected individuals in the PHC clinics of eThekwini Municipality. It was observed that Health Care Worker’s (HCW) in some facilities carried out TB symptom screening to an extent. However, the inconsistent and partial application of this screening tool warrants improvement to facilitate the broad success of TB-HIV care strategies.

Mode of access: World Wide Web. / Thesis (Ph. D.)--University of Hawaii at Manoa, 2005. / Evidence suggests that routine screening of primary care patients for exposure to traumatic life events, and particularly assaultive trauma, may yield both clinical and cost benefits for healthcare systems (e.g., Green, Epstein, Krupnick, & Rowland, 1997; Lecrubier, 2004). However, although advocated by authorities, such screening has yet to be widely adopted. A sample of female university healthcare patients (N = 339) was assessed for exposure to trauma in order to examine several unaddressed issues that may diminish the clinical utility of screening for trauma in primary care patients. First, because the length of the traditional trauma history assessment makes it less acceptable for use in time-pressured primary care settings, the discriminative validity of a brief, self-administered screening question about exposure to trauma, the Structured Clinical Interview for DSM-IV (SCID) posttraumatic stress disorder (PTSD) module's screening question (First, Spitzer, Williams & Gibbon, 1997) was compared to a longer, inventory method of assessment, the Traumatic Life Events Questionnaire (TLEQ, Kubany et al., 2000). Second, because it is unclear whether patients who have experienced assaultive trauma will disclose these experiences when asked in a primary care setting, the relative predictive efficacy of informing respondents that their responses would, or would not be, disclosed to health center personnel was evaluated. Two versions of the brief screening question were assessed across two instructional sets regarding disclosure, to determine each condition's relative classification accuracy for identifying respondents who reported experiences of sexual or physical assault, and/or symptoms of PTSD. The brief screen identified more than three-quarters of the survivors of traumatic assault; and more importantly, identified almost all of the women who reported significant PTSD symptomatology: the inventory method identified only 2 additional women of the 47 who met criteria for PTSD. Although survivors of sexual assault were significantly less likely to disclose their history to their provider, no differences were found for those assault survivors who also reported symptoms of PTSD. Results suggest that a brief screening question about traumatic life events may be an acceptable option in settings where more time-consuming assessment procedures are not practical. / Includes bibliographical references (leaves 83-98). / Electronic reproduction. / Also available by subscription via World Wide Web / x, 98 leaves, bound 29 cm

Five Tucson, Arizona, mothers of adolescent daughters participated in exploratory, descriptive nursing research employing ethnographic interviews during July, 1987, to determine what cultural knowledge informs the behaviors of mothers as they enculturate their daughters regarding Breast Self-Examination (BSE). Five major taxonomies of cultural knowledge emerged: "Caring For Yourself Means Surviving As A Species"; "Being Unsure, Thinking 'Why Bother?'   "; "It Can't Happen To Me"; "If I Don't Know About It, It Isn't There"; and "It's Unnatural To Touch Yourself." Six pairs of conflicting cultural themes both presented BSE as a self-care means to promote human-species survival and simultaneously accounted for women's BSE non-compliance via their uncertainty over BSE techniques, sense of invulnerability to cancer, fear of uncovering disease, and unease with their own bodies. Nursing intervention should reinforce positive cultural knowledge about the female breasts which could be communicated by mothers to their daughters along with procedural knowledge in promoting BSE practice.

A research thesis submitted for the degree of Doctor of Philosophy in Audiology in the Faculty of Humanities the University of the Witwatersrand March 2016. / Purpose: The main objective of the current study was to explore risk-based new-born hearing screening within a developing country by conducting early hearing detection in high-risk neonates within an academic hospital complex in Gauteng, South Africa. Specific objectives describing the case history factors and audio logical function in a group of high-risk determining the relationship between the case history factors and audio logical establishing the true-positive (TP) and true-negative (TN) results with different combinations of screening measures; establishing the percentage of TP and NT screening results in the total sample; and exploring the factors associated with follow-up return rate for hearing screening and diagnostic audio logical assessment. / GR2017

Globally there is a lack of radiologists, which results in unreported radiographic examinations, or a delay in reporting on radiographic images even in emergency situations. In order to mitigate and alleviate the situation, and optimise the utilisation of radiographers a red dot system was introduced in the United Kingdom, which later aided in the transformation of the role of radiographers in terms of formal reporting of various radiographic examinations. Although there is a shortage of medical practitioners and radiologists in South Africa the extended role of radiographers has not been yet realised for radiographers. At present, radiographers and medical practitioners work in collaboration to interpret and report on radiographic examinations informally, to facilitate effective and efficient patient management, but this is done illegally because the regulations defining the scope of the profession of radiography does not allow for such practice, putting radiographers and organisations at risk of litigation. In order to gain an in-depth knowledge of the phenomena, to enable the researcher to provide recommendations to the Professional Board of Radiography and Clinical Technology (PBRCT) of the Health Professions Council of South Africa (HPCSA), a qualitative, exploratory, descriptive, and contextual research study was undertaken. Radiographers and medical practitioners were interviewed in order to elicit rich descriptions of their experiences regarding reporting of trauma related radiographic images in the after-hours trauma units. Data were gathered using in-depth semi-structured interviews, and the data were analysed using kesch’s method of thematic synthesis. Three themes emerged from the data, namely the challenges radiographers and medical practitioners face in the after-hours trauma units respectively, with regards to reporting of trauma related adiographs, and suggestions were proposed to optimize the participation of radiographers with regard to trauma related radiographs in these units. A thick description and literature control was done using quotes from participants. Measures to ensure trustworthiness and ethical research practices were also implemented. Thereafter, recommendations were put forward for the PBRCT of the HPCSA, using current literature and inferences made from the findings of the study.

published_or_final_version / abstract / toc / Speech and Hearing Sciences / Master / Master of Science in Audiology