Background: Beta blockers are recommended by the American College of Cardiology/American Heart Association Guidelines for high and intermediate-risk cardiac patients undergoing non-cardiac surgery. Beta blockers are a class of drugs that moderate the effects of increased catecholamine levels on the heart by selectively blocking beta receptors in the heart and blood vessels, resulting in a lower heart rate and blood pressure. Beta blocker use perioperatively has been shown to reduce the risk of ischemia and infarction. Purpose: The purpose of this project is to address beta blocker use in a group of anesthesia providers who routinely attend to high-risk and intermediate-risk cardiac patients undergoing non-cardiac surgery in a medium-sized private hospital in suburban South Florida. There are barriers to the implementation of the published guidelines for beta blocker administration, including lack of awareness of the best current practice and a lack of a formal beta blocker protocol at the institutional level. Methods: A simple and inexpensive beta blocker protocol was implemented and evaluated by various means. Beta blocker administration practices were examined and documented prior to and after protocol implementation. Beta blocker usage was examined prior to and after protocol implementation Findings/Implications: It was hypothesized that increased anesthesia provider awareness would lead to increased administration of perioperative beta blockers to high-risk and intermediate-risk cardiac patients undergoing non-cardiac procedures. Although there was a knowledge increase related to the new beta blocker protocol, no change in practice was observed.

Evidence suggests that caring for orphans and vulnerable children affected by HIV and AIDS remains one of the greatest challenges facing South Africa. Statistics indicate that there are 1.91 million AIDS orphans in the country (UNICEF, 2012; Statistics South Africa, 2009:8)). The majority of these orphans live in rural and poor urban households. Caring for orphans and vulnerable children places severe strain on support systems, such as the extended family; this spills over into the community. Providing care and support also places an extra burden on the already overstretched welfare sector and drains state resources. The primarily objective of this study was to explore community resilience strategies on challenges faced by orphans and vulnerable children affected by HIV and AIDS in Ekurhuleni Metropolitan Municipality, Gauteng. A purposive sample of 32 participants was selected and field data were collected over a period of two months using a structured research guide. A combination of data collection methods was employed in order to explore different perspectives of community resilience strategies on challenges faced by orphans and vulnerable children affected by HIV and AIDS in Benoni. Emerging data illustrate a clear account on the impact of the AIDS epidemic in Benoni. All of the respondents were directly or indirectly affected by the epidemic. This should be located within the high prevalence of HIV and AIDS and the high number of orphans in Ekurhuleni. The study findings further suggest a correlation between socioeconomic challenges and the AIDS epidemic in Ekurhuleni. This is demonstrated through the challenges experienced by orphans and vulnerable children in Benoni, which include: non-disclosure by parents of their illness; economic deprivation and disrupted schooling; children caring for an ill parent with AIDS and child-headed households; emotional, sexual and economic exploitation, stigmatisation and discrimination. Despite these challenges, through community resilience the Benoni community has taken some initiatives to mitigate against these challenges. This includes the establishment of a community based organisation which provides basic services to orphans and vulnerable children in Benoni. To date this organisation has successfully provided material and psychosocial to more than 278 orphans. The success of this initiative confirms the importance of community driven interventions using the resilience framework to supports orphans and vulnerable, rather than dependency on the government imposed programmes- top down approach. However, community based programmes need to be strengthened by the government and non-governmental organisations in order to maximise benefits. / Psychology / M.A. (Social Behaviour Studies)

Statistics on HIV/AIDS are alarming. Very little is known about how communities are actually coping with this disease and what methods seem to be working to empower them to deal with it. Psychosocial distress is one of the dimensions of the impact of AIDS on children and families, and stresses the necessity to enhance the capacities of extended families and friends to be able to deal with these psychosocial issues. Using qualitative research and a case study as the strategy of inquiry, this dissertation of limited scope explores and describes the factors influencing the capacity of extended families in providing psychosocial support to AIDS orphans. A literature study was done to give a theoretical overview on the following aspects: * AIDS orphans * The extended family and HIV/AIDS To reach the first objective of this study, an empirical study was done and semi-structured interviews were used to obtain information from four extended families in the Mukwe area of the Kavango Region in Namibia. The literature study and the empirical study enabled the researcher to draw conclusions on the factors which influence the capacity of extended families to provide psychosocial support to AIDS orphans. The information was analysed, interpreted and published in this research report so as to reach the other objectives of this study. / Social Work / M. Diac. (Play therapy)

Ethiopia faces large and growing numbers of child household heads, mainly due to AIDS-related parental deaths. Many of them are vulnerable to abuse and are forced to look after themselves and their siblings, drop out of school and find work. This exploratory study employed qualitative research methods using purposive sampling. The aim was to ascertain how child household heads affected by AIDS adapted to changed life circumstances. The study entailed fieldwork for five weeks in Addis Ababa, the capital of Ethiopia, where evidence was gathered from 10 selected households headed by children (aged 12 to18), their siblings and key informants. It was found that all the children in the study are in dismal living conditions although some reported feelings of satisfaction and happiness. The need to provide special recognition and support to child household heads and their siblings by policy makers and service providers in Ethiopia is highlighted. / M.A. (Social Behaviour Studies in HIV/AIDS) / Social Work

The purpose of this study was to develop a laboratory based Comprehensive Care, Management and Treatment of HIV and AIDS (CCMT) programme status reporting system using a methodological research study design. Quantitative data was collected using a request form and qualitative data was collected using structured questionnaires. For the study 1190 eligible CD4 samples were received, of which 1004 (84%) had a valid CCMT programme status. Overall 32% of the CD4 samples had a pre-ART status (n=383) and 52% had an ART status (n=621). The remaining 16% of CD4 samples (n=186) did not have a valid CCMT programme status. A pre-ART register was generated and assessed using a structured questionnaire. Based on the study findings a recommendation has been made to adopt the two-tick design for all NHLS request forms where programmatic data is collected. Additionally the CCMT programme status reporting system is recommended for rollout to other health districts / Health Studies / M.A. (Public Health with specialisation in Medical Informatics)

This study articulates the phenomenon of living under a constant threat of Ebola haemorrhagic fever, including what people’s reactions towards individuals and families affected by the illness symbolizes as well as the meanings ascribed to Ebola. The study was conducted in Kibale district in Midwestern Uganda to aid understanding of the human aspects of Ebola which has continued to result in widespread fear and anxiety, thereby creating challenges for affected individuals, families and health care professionals. A phenomenological inquiry was undertaken using Wertz’s (1983, 2005, 2011) empirical psychological reflection approach for data analysis, after utilizing purposive, convenience and criterion sampling techniques to select twelve (12) adult survivors and caregivers who anticipated, experienced and survived the outbreak and were in good health and also willing to take part in the study. Data were generated using in-depth qualitative interviews and the interviews continued until data redundancy was reached. The interview proceedings were digitally audio-recorded in addition to taking field notes and these were transcribed verbatim. Data analysis occurred at idiographic and nomothetic levels according to the principles of Wertz’s empirical psychological reflection. Thematic analysis of the research data revealed seven (7) themes, namely:  Living under constant threat of Ebola  Nature of Ebola experience: unique and general meanings  Surviving Ebola: physical, psychological, social, spiritual and economic implications on survivors  Caring for Ebola patients: social and psychological implications  Public reaction toward persons affected by Ebola  Social-cultural beliefs and practices related to Ebola  Coping with and living in the aftermath of Ebola outbreaks Adaptation emerged as the single most encompassing and accommodating concept that united the various themes, categories and sub-categories. It further grounded survivors’, caregivers’ and community’s experience of anticipating, experiencing and coping with challenges associated with Ebola. The findings add substantial knowledge about how survivors and caregivers experience Ebola outbreaks. Important recommendations are made and guidelines that may be used to increase survivors’, caregivers’ as well as the community’s resilience to challenges of future Ebola outbreaks are suggested. / Health Studies / D. Lit. et Phil. (Health Science)

The study explored the psychosocial needs of Orphans and Vulnerable Children (OVCs) affected by HIV and AIDS in Gokomere, a rural area of Masvingo Province, Zimbabwe. The participants of the study included OVCs, caregivers and members of non-governmental organisations (NGOs) and faith-based organisations (FBOs). The data was gathered using semi-structured in-depth interviews and a focus group discussion. The audio-taped data was transcribed, coded and interpreted to generate themes, categories and sub-categories. The main psychosocial needs of OVCs affected by HIV and AIDS were found to be the need for relationships, succession planning, social protection and emotional and spiritual support. Kinship care emerged to be the most important form of care for OVCs while home-based care and child-headed households emerged as new forms of care for OVCs. This study recommends that coordinated efforts by the government, NGOs/FBOs/CBO and the community at large is needed to address the challenges facing OVCs affected by HIV and AIDS. / Health Studies / M.A. (Social Behaviour Studies in HIV/AIDS)

Thesis (MPhil)--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: This reflexive study of responses to the HIV/AIDS pandemic was set in Stellenbosch, a town in the Cape Winelands that, with its diverse but disjointed population, in many ways is a microcosm of South African society. My question was what happens when the experience of HIV/AIDS, with its personal impacts and global connections, reaches a particular locality in South Africa. I worked on the assumption that the reach of the disease in this specific locality reflects the disconnectedness of people through historical, political, social and economic processes, and that responses to the disease attempt to repair ruptures through integrating people into caring systems of support. By tracking and interrogating responses at public health and service organisation levels as a participant observer, I noted recurrent references to the importance of engaging patients in the treatment process. My observations revealed a transformation in the dyadic relationship between doctor and patient, as well as an embracing reach of networked service organisations, both initiatives striving to render more effective services. In the process relationships developed between patients and service providers at health and social levels, and between providers themselves. Much of the impetus for these local developments was derived from global inputs as local players draw down packaged practices and funds from the global assemblage that Nguyen refers to as the “AIDS industry” (2005a). Thus, I suggest that HIV/AIDS becomes a catalyst for local innovation within globally standardised structures, such innovation being driven principally by building social relationships. / AFRIKAANSE OPSOMMING: Hierdie reflektiewe studie aangaande die response tot die MIV/VIGS pandemie is in Stellenbosch, ‘n dorp in die Kaapse Wynlande, gedoen. Stellenbosch se diverse, maar tog onsamehangende, populasie is in verskeie maniere ‘n mikrokosmos van die Suid- Afrikaanse samelewing. My vraag het gevra wat gebeur as die ondervinding van MIV/VIGS, wat persoonlike impakte en globale konneksies insluit, ‘n spesifieke lokaliteit in Suid-Afrika bereik. Ek het gewerk volgens die aanname dat die omvang van die siekte in dié spesifieke lokaliteit die uitskakeling van mense deur historiese, politieke, sosiale en ekonomiese prosesse reflekteer, en dat response tot die siekte poog om ontwrigtings te herstel deur die integrasie van mense in versorgende ondersteunings sisteme. Deur response, op publieke gesondheid en dienslewerings organisasie vlak, as deelnemende waarnemer op te volg en te ondersoek, het ek herhaaldelike verwysings gekry na die noodsaaklikheid om pasiente te betrek in die behandelings proses. My observasies het ’n transformasie in die wederkerige verhouding tussen dokters en pasiente ontbloot, sowel as ’n omvattende omvang van netwerke van dienslewerings organisasies. Beide inisiatiewe streef daarna om meer effektiewe dienste te lewer. In die proses ontwikkel verhoudings tussen pasiente en diensverskaffers op gesondheids and sosiale vlakke, asook tussen diensverskaffers. ’n Groot gedeelte van die dryfkrag agter hierdie plaaslike ontwikkelings spruit uit globale insette namate plaaslike spelers verpakte praktyke en fondse ontvang/trek van die globale groep, wat Nguyen na verwys as die ’VIGS industrie’ (2005a). Daarvoor, stel ek voor dat HIV/VIGS ’n katalisator vir plaaslike innovasie binne globaal gestandardiseerde strukture word, en dat inovasies van die aard hoofsaaklik deur die bou van sosiale verhoudings gedryf word.

This study articulates the phenomenon of living under a constant threat of Ebola haemorrhagic fever, including what people’s reactions towards individuals and families affected by the illness symbolizes as well as the meanings ascribed to Ebola. The study was conducted in Kibale district in Midwestern Uganda to aid understanding of the human aspects of Ebola which has continued to result in widespread fear and anxiety, thereby creating challenges for affected individuals, families and health care professionals. A phenomenological inquiry was undertaken using Wertz’s (1983, 2005, 2011) empirical psychological reflection approach for data analysis, after utilizing purposive, convenience and criterion sampling techniques to select twelve (12) adult survivors and caregivers who anticipated, experienced and survived the outbreak and were in good health and also willing to take part in the study. Data were generated using in-depth qualitative interviews and the interviews continued until data redundancy was reached. The interview proceedings were digitally audio-recorded in addition to taking field notes and these were transcribed verbatim. Data analysis occurred at idiographic and nomothetic levels according to the principles of Wertz’s empirical psychological reflection. Thematic analysis of the research data revealed seven (7) themes, namely:  Living under constant threat of Ebola  Nature of Ebola experience: unique and general meanings  Surviving Ebola: physical, psychological, social, spiritual and economic implications on survivors  Caring for Ebola patients: social and psychological implications  Public reaction toward persons affected by Ebola  Social-cultural beliefs and practices related to Ebola  Coping with and living in the aftermath of Ebola outbreaks Adaptation emerged as the single most encompassing and accommodating concept that united the various themes, categories and sub-categories. It further grounded survivors’, caregivers’ and community’s experience of anticipating, experiencing and coping with challenges associated with Ebola. The findings add substantial knowledge about how survivors and caregivers experience Ebola outbreaks. Important recommendations are made and guidelines that may be used to increase survivors’, caregivers’ as well as the community’s resilience to challenges of future Ebola outbreaks are suggested. / Health Studies / D. Litt. et Phil. (Health Science)

Statistics on HIV/AIDS are alarming. Very little is known about how communities are actually coping with this disease and what methods seem to be working to empower them to deal with it. Psychosocial distress is one of the dimensions of the impact of AIDS on children and families, and stresses the necessity to enhance the capacities of extended families and friends to be able to deal with these psychosocial issues. Using qualitative research and a case study as the strategy of inquiry, this dissertation of limited scope explores and describes the factors influencing the capacity of extended families in providing psychosocial support to AIDS orphans. A literature study was done to give a theoretical overview on the following aspects: * AIDS orphans * The extended family and HIV/AIDS To reach the first objective of this study, an empirical study was done and semi-structured interviews were used to obtain information from four extended families in the Mukwe area of the Kavango Region in Namibia. The literature study and the empirical study enabled the researcher to draw conclusions on the factors which influence the capacity of extended families to provide psychosocial support to AIDS orphans. The information was analysed, interpreted and published in this research report so as to reach the other objectives of this study. / Social Work / M. Diac. (Play therapy)