Academic performance appears to be a problem, not only at nursing colleges, but at all academic institutions. An overloaded curriculum, a heavy workload, crowded classes, lack of equipment and scarce resources, amongst others, seem to be the problem. The study was conducted to determine the factors that influence studentsâ academic performance at a nursing college. A qualitative, explorative, descriptive and contextual design was used. Two samples, namely tutors and student nurses in the first year of their four-year diploma programme, were obtained. Both groups were English-speaking and available at the time of the study. Two questions were posed to the target groups. Firstly: âWhat are the factors that influence academic performance at the college?â Secondly: âWhat can be done to improve the academic performance of the students at the college?â Informed consent was obtained after the purpose of the study had been explained to the participants. Consent to conduct the study was also obtained from the Head of the Department of the Free State Department of Health. The eight steps identified by Tesch (1990), as cited in Botma, Greeff, Mulaudzi and Wright (2010: 224), was used during the process of data analysis. The researcher then did a literature review to support the outcome. During focus-group interviews, tutors indicated that the type of students selected for training was not committed enough to become competent professional nurses. Some of the tutors were concerned that students only applied to the nursing college to receive bursaries. The bursaries were then misappropriatedfor personal use, instead of being used for their studies. According to tutors, students only applied for training because they had not been admitted at other institutions which offeredthe courses of their choice. Tutors also complained that, due to administrative responsibilities, they lacked the time to accompany students in the clinical areas. The students identified several factors. They mentioned, for example, that the transition from high school to college and the resultant workloadhad a negative impact on their studies. More freedom at the college and the fact that they no longer studied under the strict supervision of their parents, were also mentioned as factors. Furthermore, it seemed that the study methods that were successful at high school did not have the same effect at college. Students also complained about the appalling living conditions at the nursesâ home. Poor hygienic conditions and unbearable noise levels, the lack of security, and a feeling of not being safe were mentioned. The lack of confidentiality when they consulted the student counsellor also added to studentsâ dissatisfaction. A concern was that confidential information would later be disclosed to other students and tutors. Finally, the researcherâs recommendations were to address the most important factors, such as the management of bursaries and accommodation of students and to ensure that a strategic plan would be developed to improve academic performance.

Objectives: The aim of this study was to determine the dehydration status of u/19 School rugby players during a game of rugby in the Hopetown district in high temperatures. Methods: This study was a cohort-analytical study on certain variables associated with hydration levels of u/19 rugby players from Hopetown High School during two matches in 2007 and two matches in 2009. The group of rugby players was subjected to a pre- evaluation (15min before the game) followed by a re-evaluation performed 10min after the game. In this way the dehydration status of the players could be determined. Thirty-one rugby players participated. Readings were taken of Urine-Specific Gravity (SG), blood haematocrit, and body mass of every rugby player before and after every rugby match. The student t-test was used to test for significant differences within the group. A significance level of 0.05 was used throughout the study. Results: The anthropometric characteristics in our study for 2007 and 2009 are very similar as expected, and showed a mean length of 177 ± 7-8 cm, ranging from 165 to 190 cm, a mean body mass of 71.5 ± 13.7kg and a mean body mass index (BMI) of 22.88 ± 3.98kg/m2. Between 3 (17%) and 10 (67%) of the players were dehydrated post-match according to the decrease in body mass. The pre-exercise urine specific gravity measures were significantly lower (p < 0.05) before all 4 matches than after the matches as expected, and most of the players could have been better hydrated at the beginning of the match. 20% - 94% of the players were dehydrated pre-match and almost all the players (93% and 100%) were dehydrated after the match. The pre-match mean haematocrit (HCT) and the post-match mean HCT was in the range of 0.46 - 0.47. However, in two of the matches significant differences (p < 0.05) in HCT were recorded. Conclusions: It was alarming to find that a large number of the players were dehydrated before the match, but more important, almost all of them after the match. Recommendations for fluid and electrolyte replacement must be carefully considered and monitored in rugby players to promote safe hydration and avoid hyponatremia.

Background: Concussion is a common medical problem which can have devastating complications, particularly in young adults and children. Due to the nature of rugby, concussions are frequently sustained by the players engaging in this contact sport. Since children are more susceptible to sustain a concussion, medical personnel such as doctors or paramedics should theoretically be the role players responsible for medical decision making next to the school rugby field. Coaches, who are often teachers, are often the primary source of medical support next to school sports field. Since failure to recognise or mismanagement of a concussion may lead to serious medical complications and delayed recovery, all role players involved with a potentially concussed child should be knowledgeable on the factors influencing medical decision making. These factors include knowledge on the prevention, recognition and management of a concussion, knowledge on the consequences of a sustained concussion and when to clear a child to Return to Play (RTP). Aims: This study aimed to report on the general and essential knowledge to be able to recognise a concussion of role players potentially involved with a concussed primary school rugby player and knowledge of role players regarding the prevention and consequences of concussion. In addition, knowledge and practices of role players regarding the management of a suspected or confirmed concussion, as well as knowledge and practices of role players regarding Return to Play (RTP) decision making following a concussion were assessed. Methods: A self-administered questionnaire was developed according to guidelines from literature to assess the child-specific concussion knowledge and practices of role players. These questionnaires were completed by primary school rugby coaches (n=51), paramedics (n = 39) and doctors (n = 20) in the Klerksdorp, Orkney, Stilfontein and Hartbeesfontein (KOSH) area in the North West Province. The outcome measures consisted of scores (out of a potential 100% if all the correct answers were given) on the prevention, management, recognition, RTP and consequences of a concussion. In addition, the knowledge regarded by literature as being essential to the safe practice of doctors were also assessed among all role players. Results: It was found that coaches and paramedics were generally the most senior persons responsible for medical decision making next to the rugby field. A substantial proportion of coaches (60.8%) were not BokSmart certified at the time of data collection and therefore not adhering to this requirement set out by SA Rugby. There was no relationship between the time since the coaches received their last concussion-related information and their concussion knowledge. There was also no relationship between the coachesâ concussion knowledge and whether they attended a recognised concussion training programme such as BokSmart. The only variable to show a relationship (p = 0.001) with the coachesâ overall essential knowledge needed for safe practice was the amount of years they have been coaching rugby. The coaches, who were also teachers, displayed a general lack in knowledge on the effect of a concussion on a childâs school work and the need for cognitive rest following a concussion. The paramedics displayed a widespread weakness in their knowledge pertaining to the cognitive aspects associated with a concussion. There was general consensus that the decision to clear a child to Return to Play (RTP) should rest with a doctor. However, the results from this study indicates that a considerable proportion of doctors (30.0%) were unaware of the fact that a child should be free from concussion symptoms not only during physical activity, but also at rest, which may result in premature RTP. The role players displayed a less than adequate knowledge on sport-related concussion with the coaches scoring 71.44 ± 12.03%, the paramedics scoring 67.01 ± 12.29% and the doctors scoring 76.67 ± 6.56% on the overall essential knowledge needed for safe practice Conclusions: Despite the fact that the doctors scored significantly better compared to the coaches and paramedics on their overall essential knowledge score (all of the essential knowledge items combined), very few doctors did not present with considerable gaps in their essential knowledge needed for safe practice when dealing with a concussed child. By implication the findings from this study indicates that children suffering from a concussion may be at risk for receiving inappropriate or insufficient medical care when sustaining a concussion. These findings should be communicated to sport governing bodies such as SA Rugby and further research undertaken to address the lack in knowledge among role players potentially dealing with concussed athletes as a matter of urgency.

In the South African Military Health Service (SAMHS) clinical supervision is the responsibility of both the nurse educator and the professional nurse. However, the insufficiency of clinical departments in the military service triggered the researcherâs interest in how clinical supervision is experienced by the different nursing categories. The objectives of the study were to determine the views of nurse educators, professional nurses, nursing students and pupil enrolled nurses with regard to clinical supervision in the SAMHS and to formulate recommendations for improving clinical supervision based on the results. The following research question was evaluated: How do the different categories of nurses view clinical supervision in the South African Military Health Services? The research methodology constituted a non-experimental descriptive exploratory design with a quantitative approach. Self-administered questionnaires were used for data collection. The population comprised of nurse educators, professional nurses, nursing students and pupil enrolled nurses employed in the SAMHS. A random sampling technique was used and all students available at the time of data collection were included in the study. The final sample of nursing students and pupil enrolled nurses was n=148 (56%:264) of a total population of 264 students and the sample size of nurse educators and professional nurses was n=136 (20%:691). Prior to commencement of the research, approval for conducting the study was obtained from the Ethics Committee of the Faculty of Health Sciences at the University of the Free State (UFS), the Military Health Ethics Committee, the Chief Executive Officers of the various military hospitals, the Commanding Officer of the SAMHS nursing colleges, the Officers in Charge of each nursing college as well as the respondents who participated in the study. Data for the study was collected in a four-week period, the first of which took place at 3 Military Hospital. The second week saw data collection at 2 Military Hospital and the nursing college in Cape Town. The last two weeks were spent at 1 Military Hospital and the nursing college in Thaba Tshwane. The ethical principles stated in the proposal were strictly adhered to as the research involved human respondents. The respondents were asked to complete questionnaires voluntarily and they were assured that their participation and the information they provided would not be used against them. They were also assured of their right to confidentiality and anonymity. Anonymity was preserved by not revealing any of the names of the respondents who took part in the research study. Confidentiality was ensured by denying unauthorised access to data. Respondents were informed of their right to withdraw from the study at any stage. Each complete questionnaire was coded, before a biostatistician of the UFSâs Department of Biostatistics assisted with the data analysis. Descriptive statistics measures such as frequency and percentage distributions were obtained. A conceptual framework of three dimensions, namely the clinical supervision prerequisites, the core of clinical supervision and the outcomes of clinical supervision were used to guide the discussion in Chapter 2 on clinical supervision. Certain recommendations were made. Some of these included that clinical supervision should be given priority and that the appointment of clinical mentors and preceptors and the establishment of clinical departments in the SAMHS should be investigated. Nurse educators and professional nurses should be jointly responsible for clinical teaching and support of students in the clinical learning environment. Furthermore, it is recommended that nurse educators should provide professional nurses with a structured clinical supervision programme and that formal written contracts between nurse educators and students be drawn up. The supernumerary status of students needs to be maintained, and, lastly, the nurse-educator student ratio needs to be adjusted.

The purpose of this study was to identify the problems that study leaders from the School of Nursing, at the University of the Free State encountered with giving study guidance to students and thereafter to develop strategies to improve study guidance. The implementation of these strategies would then improve the through put of postgraduate students. A qualitative, descriptive study design was used and information was gathered through the nominal group technique. The findings were that study leaders experienced a deficit in their training as study leaders, as well as a deficit in experience of providing study guidance. Study leaders also experienced uncertainty with regard to administrative procedures and a challenge to stay abreast of the development regarding research methodologies as well as development concerning the different sub-disciplines. A high workload was also identified as being problematic. Further problems experienced were studentsâ deficit regarding skills needed to complete research studies. Students also do not keep appointments and reacted negatively on feedback that were given to them. It is recommended that study leaders receive training with regard to giving of study guidance. Other strategies that were formulated are that study leaders be exposed to group study guidance before they embark on giving individual study guidance. Group study guidance can also diminish study leadersâ workload. New study leaders can also initially be allocated as co-study leaders to provide them with experience . With regard to the students, it is suggested that a contract should be implemented at the commencement of their studies. Such a contract could address what is expected from the students as well as the study leaders; it can guide the study guidance process and may diminish possible conflict. The lack of identified skills of the students can be addressed by implementing a more strict selection process and implementation of a pre-study module. If other skills deficits are identified during the study guidance process, it should be addressed either by the study leader or by referring the students to applicable resources. More emphasis should also be directed towards the development of research skills in undergraduate programs. Some of the identified study guidance problems in this study are universal, while others were unique to the specific institution and situation. Some of the proposed strategies, such as training of study leader are universal, while others such as administrative issues are specific to the institution.

Background: Exercise-induced bronchospasm (EIB) is a common medical condition which can have devastating complications, particularly in otherwise healthy active athletes. Since EIB is unpredictable but preventable, medical personnel and coaches are often the primary support givers in such events and need to be informed about the risk factors and proper management of the athlete with this, sometimes undiagnosed, respiratory problem. The periodic health evaluation (PHE) is mandatory in some, but not all, sports and covers a few basic questions regarding the athleteâs respiratory health. Aims: The objective of this study was to determine the prevalence of underlying respiratory disease in a population of varsity level athletes. In addition, the study aimed to test whether the addition of a specific tool would increase the sensitivity of the PHE as it is implemented by the International Olympic Committee (IOC), therefore investigating if spirometry before and after an exercise challenge would diagnose any new athletes with exercise-induced bronchospasm (EIB). Methods: Thirty-two participants met the inclusion criteria. Periodic health evaluations were done to enquire about a detailed history from the athletes and physical examination with special attention to the respiratory system. Baseline spirometry followed by an exercise challenge test and serial post-exercise spirometries were done on all the participants according to the guidelines provided by the American Thoracic Society. Results: The results of this study confirmed that a thorough history and clinical examination alone do not lead to the diagnosis of EIB. Furthermore, we conclude that a resting baseline spirometry does not indicate that an athlete is at risk for or has EIB. In the absence of eucapnic voluntary hyperpnea (EVH) as the preferred challenge test according to the International Olympic Committee-Medical Commission (IOC-MC), an exercise challenge test will be as valuable. Almost 10% of the athletes in our study, which were healthy according to the PHE and baseline spirometry, had a positive spirometry for EIB after an exercise challenge test as indicated by a fall of ⥠10% from the baseline forced expiratory volume in one second (FEV1).

Objectives: The aim of this study was to determine the effect of weight training on pain relief and fatigue in patients with fibromyalgia (FM). Methods: This study was a randomized control study on patients diagnosed with FM. The group of FM patients was subjected to inclusion and exclusion criteria. Randomization was done on the patients who have met the inclusion criteria by the Department of Biostatistics at the University of The Free State. The experimental group was subjected to a training programme under supervision while the control group received verbal instructions to follow a training programme and the benefits thereof (Glombiewski et al., 2010), but did not undergo supervised training. The training period was 12 weeks. The subjects maintained their ordinary daily chores and physical activity. The experimental group started a supervised strength training period. Training was carried out 3 times a week and. During the first 3 weeks patients started with 8 - 12 repetitions for each set, with loads of 40 â 60% of the one repetition maximum (1 RM) and continued during the next 4 weeks with 10 â 12 repetitions with loads of 60 â 70% of 1 RM. Subsequently, during week 8 â 12 the number of repetitions was 10 for each set with loads of 60 â 80% of 1 RM. In addition to the muscle strengthening exercises each session ended with 5 â 10 minutes of core strengthening. All training sessions included warm up and cool down exercises using either a treadmill or bicycle ergometer and muscle stretching. Moreover, the subjects continued their ordinary chores and physical activities. The patients did a 15 minute warm up consisting of 10 minutes light aerobic work followed by 30 â 40 minutes weight training followed by 10 â 15 minutes of cool down. The programme differed from a Monday, to a Wednesday, to a Friday, where different muscle groups were targeted by the weight training. Results: The anthropometric characteristics in the current study for the exercise and control group are very similar. The Student T-Test was used to test for significant differences between the control and experimental group Fibromyalgia Impact Questionnaire (FIQ) scores over the 12 weeks. A 95% confidence interval was used to determine the difference between the two groups. The confidence interval shows that there is no statistical difference between the FM experimental (FMT) and FM control group (FMC). The following variable, V = FIQ: W4-W1 is where the FIQ score of week 4 were subtracted from week 1. No statistical difference (p<0.05) was observed between the control and the exersice group between week 1 and 4. The exercise groupâs progress was statistically better (p<0.05) than control group in week 4 - 8. At week 8 the FMT groupâs fibromyalgia impact questionnaire score median was 39 compared to the FMC groupâs median of 63. Unfortunately, the exercise group deteriorated statistically significant (p<0.05) in the FIQ scores compared to control group improvement from week 8 â 12. Lastly, there was no statistical difference (p<0.05) between week 1 and week 12 between the FM control group and the exersise group regarding improvement of symptoms as reported in the FM impact questionnaire. Conclusions: It is still unclear what combination of type, intensity and duration of exercise treatment works best in the treatment of FM. It is important to recognize that in the case of a chronic pain disorder like FM, treatment must be focused not just on immediate symptom relief but also on maintaining long term lifestyle behaviour. As long as FM aetiology remains unclear, there is a need to explore mediating variables that can be used to intervene in order to ameliorate symptoms. Research efforts must continue to explore methods to relieve symptoms short term and support ongoing long term behaviour change to improve functioning and enhance the quality of life for patients with FM.

The problem is, to determine the correct interpretation of the Texas statutes which govern the relationships between the municipality and the school district.

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