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The effect of distance to health facility on the maintenance of INR therapeutic ranges in rheumatic heart disease patients from Cape TownBarth, Dylan Dominic January 2013 (has links)
Includes abstract. / Includes bibliographical references. / Part A: is the research protocol which outlines the background and the process of this research. This study is a population-based observational study nested within the Groote Schuur Hospital (GSH) cohort of a global study, REMEDY which is a prospective, multicentre, hopital-based registry for rheumatic heart disease (RHD). This study made use of geographical information systems (GIS) as a tool to investigate the effect of distance on the maintenance of INR therapeutic ranges in RHD patients. Part B: elaborates on the background and highlights the importance of this research by exploring the existing theoretical and empirical literature relevant to the topic. It describes the importance of the maintenance of the INR therapeutic range and how geographical factors can influence patient adherence to medication, and how it can act as a barrier to access health care. It provides examples of how GIS has been used to investigate the effect of distance on adherence in other studies. This literature review aimed to establish whether the maintenance of therapeutic ranges in RHD patients on anticoagulant therapy is correlated with the distance travelled from patient's residence to the clinic where INR monitoring takes place. Part C: presents the entire project in a format suitable for journal submission. The background of this research project is summarised and the results are presented and discussed.
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A survey-based, descriptive study of the occupational health experience of pregnant women doctors working in the public health sector in the Western Cape from 2009-2015Hiscock, Colleen J B January 2016 (has links)
THE PURPOSE OF THE STUDY is to explore the experiences of pregnant women doctors working in public sector health facilities in the Western Cape and to ascertain whether occupational health laws and guidelines are being implemented for pregnant women doctors. This is being done in order to provide feedback to Western Cape department of health, so that if found necessary, recommendations for the improved occupational health of pregnant doctors can be implemented. THE OBJECTIVES are to conduct an internet-based survey of woman doctors who have experienced pregnancies while working in the public sector. The three main objectives are: 1. To describe the demographics of the respondents 2. To explore the experiences of the respondents with regard to working while pregnant 3. To assess the knowledge of occupational and other laws that relate to pregnant women at work. HYPOTHESIS: There is currently poor implementation of occupational health laws and services for pregnant doctors in the various government health facilities in the Western Cape SIGNIFICANCE OF THIS RESEARCH: "The progress of women in medicine is a long and continuing journey," AMA Women Physicians section (Anon.2013). The number of women graduating as doctors has increased. Many of these women form the mainstay of the public-sector workforce. Attention needs to be focused on ensuring the safety of pregnant women doctors and the safety of their unborn babies. METHODOLOGY OF STUDY: Study Design: This is a retrospective, survey-based, descriptive study using an electronic survey/ questionnaire as a tool. The survey includes both set answer options from which to choose as well as areas for respondents to give comments, which will add a qualitative element to the research. CHARACTERISTICS OF THE STUDY POPULATION: The study population consists of women doctors who took maternity leave while working in the state sector in the Western Cape from 2009-2015. INCLUSION AND EXCLUSION CRITERIA: Inclusion criteria: All women who complete and submit the survey will be included in the sample. No exclusion criteria are envisioned.
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A cost-effectiveness analysis of managing chronic diarrhoea diseases in Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome adult patients in an academic hospital in Lusaka, ZambiaYavwa, Felistah M K January 2001 (has links)
Includes bibliographical references. / The high burden of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) related chronic diarrhoea diseases (CDD) has strained the meager resources of the health sector and yet the effectiveness of management strategies leaves much to be desired. As study was done at a university teaching hospital (UTH) in Lusaka to evaluate two management strategies for these patients. The first strategy involved managing patients without investigations, while the other included investigations in the management strategy.
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The determinants of adhering to rehabilitation in diabetics who have undergone lower limb amputationSifunda, Sibusiso January 2001 (has links)
Bibliography: leaves 54-56. / Chronic diseases of lifestyle (CDLs) have been rapidly increasing in population groups which had previously been least affected by this kind of illness. Diabetes Mellitus in particular has been shown to be rapidly increasing in South Africa among the non-white population which traditionally, had low reported prevalence rates of the condition. The rapid increase in urbanisation and adoption of a western diet by the urbanised black population has been one of the main contributing factors. In contrast to this picture the socio-economic status of this population has remained relatively low and the high costs of long term management of CDLs poses a potential time bomb to the public health system. This study sought to explore the psychosocial determinants of adhering to rehabilitation for diabetic amputees.
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Environmental Prevalence of Shiga toxin-producing Escherichia coli in a Veal Production System in Northeast OhioVaughn, Andrew W. January 2020 (has links)
No description available.
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The nervous system effects of occupational exposure to manganese - measured as respirable dust - in a South African manganese smelterYoung, Taryn January 2003 (has links)
Bibliography: leaves 33-35.
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Evaluating measles vaccination coverage in high incidence areas of the Western Cape Province, following the mass vaccination campaignBernhardt, Gina Leanne January 2012 (has links)
Includes abstract. / Includes bibliographical references. / Measles virus is known to be one of the most contagious of infectious agents and despite considerable progress towards elimination, a number of Sub-Saharan African countries experienced epidemics in 2009-2011, including South Africa, in which there were over 18 000 confirmed cases. The South African measles vaccination programme started in 1975 with 1 dose schedule, and from 1996-8 has followed the World Health Organization-United Nations Children’s Fund strategy. This includes a 2 dose routine vaccination schedule for children at 9 and 18 months of age, supplementary mass vaccination campaigns (MVCs) for children conducted 4 yearly, improved case management and casebased laboratory surveillance. Administrative monitoring of routine vaccination coverage is problematic, and often overestimated, because of denominator and numerator inaccuracies. The potential for a significant outbreak in the Western Cape Province was therefore not recognized. Over 2000 cases were confirmed in the Western Cape epidemic which began in September 2009 and peaked in March 2010. The Metropole district was mainly affected and over 60% of the cases were under 5 years of age, with 29% aged 6 to 11 months. A MVC, against measles had already been planned; however as a result of the epidemic the targeted age group for measles vaccination was extended from 9 to 59 months, to include children from 6 months to 15 years. This was conducted nationally from 12 to 23 April 2010.
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Risk factors for non-communicable disease and healthcare expenditure in South African employees with private health insurance presenting for health risk appraisalKolbe-Alexander, Tracy January 2013 (has links)
Includes abstract. / Includes bibliographical references. / The main aims of this research study were to determine the extent to which insufficient physical activity clustered with other risk factors for noncommunicable disease (NCD), with specifically cardiovascular and metabolic disease, and whether these risk factors were associated with higher healthcare costs.
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Factors associated with Contraceptive Use in a rural area in the Western Cape, South AfricaPeer, Nazia January 2012 (has links)
BACKGROUND: Safe and effective contraceptive use can improve women's reproductive health. Although the contraceptive prevalence rate in South Africa is comparable to rates globally, the distribution is inequitable and marginalises poor and rural women. This study aimed at identifying factors associated with contraceptive uses in a rural area in South Africa. METHO D: Cross-sectional survey data based on face-to-face interviews with female participants between 18 to 44 years were collected for a primary FAS prevention study in rural and urban South Africa. This study examined data for rural women only. The outcome variable was Effective Contraceptive use (ECC) which included use of oral contraceptives, condoms or injectables, or having been sterilised. Independent variables included socio-demographic factors, substance use, psychosocial factors, community factors, childbearing characteristics and partner characteristics RESULTS: Women were more likely to use ECC if they reported high self-esteem (compared to low or moderate self-esteem PRR=1.53; 95% CI: 0.99-2.39 ); if they strongly or moderately agreed that their culture entitled men to children compared to those who disagreed (PRR=1.55; 95% CI: 0.95-2.52); and if they had one child or more compared to no children (PRR=2.51; 95% CI: 1.64-3.84). CONCLUSION: To promote contraceptive use in in similar rural populations, family planning programmes could focus on increasing men's approval of contraception, improving partner communication around family planning and bolstering women's confidence in their reproductive decision-making, particularly their self-esteem. There should be greater focus on nulliparous women and women between 18 and 24 years old who have th e lowest Contraceptive prevalence rate (CPR).
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The effect of food deserts on early childhood developmentTran, Long Duc 09 November 2019 (has links)
Food deserts were first mentioned in the early 1990s to describe an urban or rural area with low access to healthy, affordable foods. Thus, food desert residents often have trouble maintaining a healthy diet which puts them at higher chances of developing adverse health outcomes. Food security, the idea of having access to enough food for a healthy life, is often associated with food deserts. Food security studies including those involving children living in food insecure household have already provided strong evidence showing the harmful impacts it has on childhood growth and development. While numerous studies on food security and childhood development are readily available, fewer studies exist that provide any strong evidence between food deserts and childhood development. This longitudinal study attempts to make the association between food deserts and childhood development with the hypothesis that children living in food deserts are more at risk of poorer growth and development. The study recruits eligible household children between the ages of 12-14 months living in a known local food desert along with children in the surrounding non-food desert areas. The participants are tracked in clinic over the course of four years at six month intervals while measuring for the desired outcomes. The primary outcome in the study is mid-upper arm circumference (MUAC), though length/height, weight, and food security are additional outcomes that are measure during the study. The MUAC data is converted into a Z-score for both the food desert and non-food desert groups respectively. The mean change in Z-score for both groups is compared with one another using the independent sample T-test looking for statistical significance. The results of this study would address a large gap in the current literature on food deserts. Prior studies have employed a cross-sectional approach in looking at the data and have been limited in the strength of the study. This will be the first known study to propose a longitudinal approach towards looking at food deserts and its effect on the study participants. In doing so, this study hopes to provide new context on food deserts in the field of public health. The significance of such would allow public law makers to implement new strategies or policies that could address the detrimental impacts food deserts have in the local community.
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