bluuebunny/crossref_metadata_2025 huggingface dataset:
Laminated Composite Hypar Shells as Roofing Units
Authors: Sahoo Sarmila
Published: April 2018

This chapter presents a broad perspective of the recent research done on laminated composite hypar shells used as roofing units. Different types of analysis including bending, vibration, buckling, impact, and failure are included. The chapter is collated and categorized based on various aspect of research. The first aspect concentrates on typical analyses including problems in which various boundary conditions and laminations are considered. Then it focuses on the structural complexities which include stiffened shells, shells with cutouts, etc. The basic results of theoretical and experimental investigations of stress-strain state, vibration, buckling, and failure are summarized in this chapter incorporating the review of materials published in scientific and technical journals and proceedings in recent times.
The Urbis Prototype Development
Authors: Junior Ivaldir Honório de Farias , Júnior Nelson Galvão de Sá Leitão , Teixeira Marcelo Mendonça , Junior Jarbas Espíndola Agra
Published: April 2018

Currently, tourists spend a lot of time planning their trips because they need to make the most of every moment. In this sense, technology has been a great ally, especially when performing and adapting this planning in the event of some unforeseen event during the journey. And the emergence of distinct types of mobile devices was presented as an opportunity to improve the experience of tourism significantly. In this context, this chapter aims to identify the main computing needs to a mobile application to support the promotion of tourist sites for the traveler. The authors adopted a literature review as the research methodology. The main result of this chapter is the proposal of the Urbis prototype, an application that aims to help tourists to know better the cities they are visiting, even in the absence of local information or a specialized tour guide.
Development of a Framework for Technological Embedding in Private Social Solidarity Institutions
Authors: Barreto Luis , Amaral António M. , Pereira Teresa , Carvalho Filipe
Published: April 2018

The economic and social challenges felt in recent years because of the financial crisis impact wave were somehow attenuated by the silent work provided by the third sector institutions. Therefore, the incessant instability of the markets, as well as the population life-expectancy increasing and the implications thereof require new approaches towards pointing strategies to mitigate these problematic situations. For that reason, the development of technological solutions and applications for the private social solidarity institutions is an utmost challenge towards guaranteeing their sustainability and efficiency over time. The adoption of such solutions should be properly conceived to enhance their efficiency of the daily routines and to fulfill and inclusion of all users, while trying to reduce the technological literacy. The development of a technological framework to support the adoption of the practices, selection of technical requirements, and functionalities is seen as a great contribution for setting the roadmap that should be followed. This chapter explores the development of a framework for technological embedding in private social solidarity institutions.
Mobile Payment and Its Social Impact
Authors: Yu Liguo , Sun Liping
Published: April 2018

This chapter describes mobile payment, a mobile financial activity born of digital revolution, which is the combination of electronic money and mobile technology. The underlying technologies of mobile payment, its big players, and its status quo and future trend are discussed. In addition, this chapter discusses how mobile payment is related to social equality and social inclusion. Through presenting the historical, technical, economic, and social aspects of mobile payment, this chapter intends to provide readers with a holistic view of one of the fast-evolving financial activities that are transforming business, individuals, and the society.
Monitoring the Physical Activity of Patients Suffering From Peripheral Arterial Disease
Authors: Paulino Dennis , Reis Arsénio , Barroso Joao , Paredes Hugo
Published: April 2018

The peripheral arterial disease (PAD) is characterized by leg pain during walking, and a recommended treatment for this disease is to perform supervised physical activity. In this chapter, a system that monitories the physical activity containing one application for smartwatch, one application for smartphone, and a back-end webservice is presented. The applications collect heart rate, GPS locations, step count, and altitude data. The methodology used for the development of the system was based on the agile method with the production of prototypes. In this chapter, four development cycles, which cover the users' and researchers' needs, are presented. In this work, the main objective is to evaluate the current mobile technologies on the physical activity data collection and the development of a system that assists the users to maintain an active life.
Mobile Technologies for Managing Non-Communicable Diseases in Developing Countries
Authors: Latif Siddique , Khan Muhammad Yasir , Qayyum Adnan , Qadir Junaid , Usman Muhammad , Ali Syed Mustafa , Abbasi Qammer Hussain , Imran Muhammad Ali
Published: April 2018

Non-communicable diseases (NCDs) are the global leading cause of morbidity and mortality and disproportionately affect more in the less developed countries. Mobile technologies are being used for a variety of purposes in healthcare. Most importantly, they are enabling new ways for NCDs management by providing powerful tools to both doctors and patients for effective prevention and treatment. As the common risk factors of NCDs are related to human behavior; therefore, mobile phone-based health solutions can be used to combat with rising burden of NCDs by focusing on behavioral change programs to promote a healthy lifestyle. This chapter discusses the common NCDs, their burden, and future estimated projections, and shows how mobile phone technologies can provide effective NCDs management in developing countries—which have a lot of issues in their healthcare systems.
Adaptive Neural Control for Unknown Nonlinear Time-Delay Fractional-Order Systems With Input Saturation
Authors: Zouari Farouk , Boubellouta Amina
Published: April 2018

This chapter focuses on the adaptive neural control of a class of uncertain multi-input multi-output (MIMO) nonlinear time-delay non-integer order systems with unmeasured states, unknown control direction, and unknown asymmetric saturation actuator. The design of the controller follows a number of steps. Firstly, based on the semi-group property of fractional order derivative, the system is transformed into a normalized fractional order system by means of a state transformation in order to facilitate the control design. Then, a simple linear state observer is constructed to estimate the unmeasured states of the transformed system. A neural network is incorporated to approximate the unknown nonlinear functions while a Nussbaum function is used to deal with the unknown control direction. In addition, the strictly positive real (SPR) condition, the Razumikhin lemma, the frequency distributed model, and the Lyapunov method are utilized to derive the parameter adaptive laws and to perform the stability proof.
Design and Optimization of Generalized PD-Based Control Scheme to Stabilize and to Synchronize Fractional-Order Hyperchaotic Systems
Authors: Soukkou Ammar , Boukabou Abdelkrim
Published: April 2018

This chapter will establish the importance and significance of studying the fractional-order control of nonlinear dynamical systems and emphasize the link between the factional calculus and famous PID control design. It will lay the foundation related to the research scope, problem formulation, objectives and contributions. As a case study, a fractional-order PD-based feedback (Fo-PDF) control scheme with optimal knowledge base is developed in this work for achieving stabilization and synchronization of a large class of fractional-order chaotic systems (FoCS). Based and derived on Lyapunov stabilization arguments of fractional-order systems, the stability analysis of the closed-loop control system is investigated. The design and multiobjective optimization of Fo-PDF control law is theoretically rigorous and presents a powerful and simple approach to provide a reasonable tradeoff between simplicity, numerical accuracy, and stability analysis in control and synchronization of FoCS. The feasibility and validity of this developed Fo-PDF scheme have been illustrated by numerical simulations using the fractional-order Mathieu-Van Der Pol hyperchaotic system.
Secure Digital Data Communication Based on Fractional-Order Chaotic Maps
Authors: Hamiche Hamid , Kassim Sarah , Megherbi Ouerdia , Djennoune Said , Bettayeb Maamar
Published: April 2018

The aim of the chapter is twofold. First, a literature review on synchronization methods of fractional-order discrete-time systems is exposed. Second, a secure digital data communication based on synchronization of fractional-order discrete-time chaotic systems is proposed. Two synchronization methods based on observers are proposed to synchronize two fractional-order discrete-time chaotic systems. The first method concerns the impulsive synchronization where sufficient conditions for the synchronization error of the states are given. The second method concerns the exact synchronization which is based on a step-by-step delayed observer. In the same way, conditions are provided in order to allow the reconstruction of the states and the unknown input which is the message in this case. The two synchronization methods are combined in order to design a novel robust secure digital data communication. The performance of the proposed communication system is illustrated in numerical simulations where digital image signal is considered.
DSM for Energy Optimization and Communications Within Smart Grid CPSs
Authors: Abed Sa'ed , Abdelaal Areej , Gawanmeh Amjad
Published: April 2018

Energy demand has increased significantly in the recent years due to the emerging of new technologies and industries, in particular in the developing countries. This increase requires much more developed power grid system than the existing traditional ones. Smart grid (SG) offers a potential solution to this problem. Being one of the most needed and complex cyber-physical systems (CPS), SG has been addressed exhaustively by researchers, from different views and aspects. However, energy optimization yet needs much more studying and examination. Therefore, this chapter presents a comprehensive investigation and analysis of the state-of-the-art developments in SG as a CPS with emphasis on energy optimization techniques and challenges. It also surveys the main challenges facing the SG considering CPS factors and the remarkable accomplishments and techniques in addressing these challenges. In addition, the document contrasts between different techniques according to their efficiency, usage, and feasibility. Moreover, this work explores the most effective applications of the SG as a CPS.
Mycobacterium tuberculosis PPE18 Protein Reduces Inflammation and Increases Survival in Animal Model of Sepsis
Authors: Ahmed Asma , Dolasia Komal , Mukhopadhyay Sangita
Published: April 2018

Mycobacterium tuberculosis PPE18 is a member of the PPE family. Previous studies have shown that recombinant PPE18 (rPPE18) protein binds to TLR2 and triggers a signaling cascade which reduces levels of TNF-α and IL-12, and increases IL-10 in macrophages. Because TNF-α is a major mediator of the pathophysiology of sepsis and blocking inflammation is a possible line of therapy in such circumstances, we tested the efficacy of rPPE18 in reducing symptoms of sepsis in a mouse model of Escherichia coli–induced septic peritonitis. rPPE18 significantly decreased levels of serum TNF-α, IL-1β, IL-6, and IL-12 and reduced organ damage in mice injected i.p. with high doses of E. coli. Peritoneal cells isolated from rPPE18-treated mice had characteristics of M2 macrophages which are protective in excessive inflammation. Additionally, rPPE18 inhibited disseminated intravascular coagulation, which can cause organ damage resulting in death. rPPE18 was able to reduce sepsis-induced mortality when given prophylactically or therapeutically. Additionally, in a mouse model of cecal ligation and puncture–induced sepsis, rPPE18 reduced TNF-α, alanine transaminase, and creatinine, attenuated organ damage, prevented depletion of monocytes and lymphocytes, and improved survival. Our studies show that rPPE18 has potent anti-inflammatory properties and can serve as a novel therapeutic to control sepsis.
Quadriceps Function, Knee Pain, and Self-Reported Outcomes in Patients With Anterior Cruciate Ligament Reconstruction
Authors: Lepley Adam S. , Pietrosimone Brian , Cormier Marc L.
Published: April 2018

Context: 

Interactions among muscle strength, pain, and self-reported outcomes in patients with anterior cruciate ligament reconstruction (ACLR) are not well understood. Clarifying these interactions is of clinical importance because improving physical and psychological function is thought to optimize outcomes after ACLR.

Objective: 

To examine the relationships among neuromuscular quadriceps function, pain, self-reported knee function, readiness to return to activity, and emotional response to injury both before and after ACLR.

Design: 

Descriptive laboratory study.

Patients or Other Participants: 

Twenty patients (11 females and 9 males; age = 20.9 ± 4.4 years, height = 172.4 ± 7.5 cm, weight = 76.2 ± 11.8 kg) who were scheduled to undergo unilateral ACLR.

Main Outcome Measure(s): 

Quadriceps strength, voluntary activation, and pain were measured at presurgery and return to activity, quantified using maximal voluntary isometric contractions (MVICs), central activation ratio, and the Knee Injury and Osteoarthritis Outcome Score pain subscale, respectively. Self-reported knee function, readiness to return to activity, and emotional responses to injury were evaluated at return to activity using the International Knee Documentation Committee questionnaire (IKDC), ACL Return to Sport After Injury scale (ACL-RSI), and Psychological Response to Sport Injury Inventory (PRSII), respectively. Pearson product moment correlations and linear regressions were performed using raw values and percentage change scores.

Results: 

Presurgical levels of pain significantly predicted 31% of the variance in the ACL-RSI and 29% in the PRSII scores at return to activity. The MVIC and pain collected at return to activity significantly predicted 74% of the variance in the IKDC, whereas only MVIC significantly predicted 36% of the variance in the ACL-RSI and 39% in the PRSII scores. Greater increases in MVIC from presurgery to return to activity significantly predicted 49% of the variance in the ACL-RSI and 59% of the variance in the IKDC scores.

Conclusion: 

Decreased quadriceps strength and higher levels of pain were associated with psychological responses in patients with ACLR. A comprehensive approach using traditional rehabilitation that includes attention to psychological barriers may be an effective strategy to improve outcomes in ACLR patients.
Exploring Work-Life Balance of Junior Athletic Training Faculty Members During Role Inductance
Authors: Mazerolle Stephanie M. , Bowman Thomas G. , Kilbourne Brianne F.
Published: April 2018

Context:

Work-life balance has become a growing concern in athletic training, but little is known about the experiences of faculty and finding it. Challenges in finding work-life balance have been reported among faculty in higher education, and those who are new to a role are often susceptible to increased stress and overload.

Objective:

Examine junior athletic training faculty members' experiences with work-life balance during their role inductance.

Design:

Qualitative inquiry.

Setting:

Higher education institutions.

Patients or Other Participants:

Sixteen junior faculty (7 male, 9 female) representing 7 National Athletic Trainers' Association districts participated. The average age of the junior faculty members was 32 ± 3.5 years. Twelve were in tenure track and 4 had non–tenure track positions.

Main Outcome Measure(s):

All participants completed phone interviews with one researcher following a semistructured interview protocol. Recorded interviews were transcribed and analyzed following a phenomenological approach. We intentionally selected 3 primary measures of trustworthiness to establish the rigor of the study: (1) peer review, (2) multiple-analyst triangulation, and (3) researcher triangulation.

Results:

Three factors were identified as inhibitors of work-life balance for junior faculty: (1) role inductance, (2) research and teaching, and (3) upcoming deadlines. Two organizational strategies (flexibility and mentorship) and 2 individual strategies (time management and personal outlets) emerged as facilitators for work-life balance.

Conclusions:

Junior faculty in athletic training can experience conflict in balancing their roles as faculty members as well as their outside and own personal interests. The data support previous literature, and illustrates that organizational factors precipitate imbalance and a combination of organizational and individual strategies promote balance.
Integrating Clinical Prediction Rules Throughout the Curriculum
Authors: Hankemeier Dorice A. , Kirby Jessica L.
Published: April 2018

Context:

Knowledge and understanding of how to evaluate and implement clinical prediction rules (CPRs) is necessary for athletic trainers, but there is a lack of information on how to best teach students about CPRs.

Objective:

To provide an overview of the derivation, validation, and analysis of the different types of CPRs and to provide examples and strategies on how to best implement CPRs throughout didactic and clinical athletic training curricula.

Background:

Clinical prediction rules are used in a variety of health care professions to aid in providing patient-centered care in diagnosis or intervention. Previous research has identified that many athletic trainers have a limited knowledge of CPRs and often do not implement them in clinical practice even if they do know about them. Using these evidence-based decision-making tools can help improve patient outcomes while also decreasing unnecessary medical costs.

Description:

This article discusses the derivation and validation of CPRs as well as how to implement the concepts of CPRs in multiple courses to allow students numerous opportunities to understand how CPRs can be beneficial.

Clinical Advantage(s):

Teaching students how to critically analyze CPRs and understand the derivation process of CPRs will develop students' decision-making skills and encourage students to be evidence-based clinicians. In addition, the teaching strategies described here aim to create dialogue between students and preceptors regarding evidence-based practice concepts.

Conclusion(s):

Athletic trainers must be able to function in the larger health care environment, and understanding how to correctly evaluate and apply CPRs will be helpful. Teaching students a variety of CPRs and how to evaluate their impact on clinical practice will prepare students to step into this role when they become independent clinicians.
The Progress and Promise of Interprofessional Education in Athletic Training Programs
Authors: Breitbach Anthony P. , Eliot Kathrin , Cuppett Micki , Wilson Mardell , Chushak Maria
Published: April 2018

Context:

Interprofessional education (IPE), an emerging theme in health professional education programs, intends to prepare students for collaborative practice in order to improve patient outcomes. In 2012, the profession of athletic training strategically began to increase program participation in IPE.

Objective:

This article compares 2 studies that examined the presence of IPE in athletic training.

Design:

Cross-sectional design utilizing similar surveys regarding athletic training program participation in, and readiness for, IPE initiatives were administered via Qualtrics in 2012 and 2015.

Patients and Other Participants:

Program directors of Commission on Accreditation of Athletic Training Education–accredited athletic training programs were surveyed in 2012 and 2015 using the “Interprofessional Education Assessment and Planning Instrument for Academic Institutions” in addition to program demographic information and IPE participation.

Data Collection and Analysis:

The participants involved included 160 of 367 surveyed (43.6%) in 2012 and 162 of 380 surveyed (42.6%) in 2015.

Results:

Data were analyzed, and χ2 analysis revealed a significant relationship between level of accreditation and academic unit housing the program in both studies. Significant change was also shown in program participation in IPE from 2012 to 2015. However, institutional readiness and infrastructure for IPE was low in nearly all categories.

Conclusions:

Interprofessional education has a greater presence in Commission on Accreditation of Athletic Training Education professional programs that reside in health science–related academic units and are accredited at the master's level. However, less than 50% of the programs participate in IPE. There is also a need for greater institutional infrastructure and readiness for IPE.
The BETA® nursing measure: Calibrating construct validity with Rasch analyses*
Authors: Loubser Hendrik J. , Casteleijn Daleen , Bruce Judith C.
Published: April 2018

Background: The BETA nursing measure has been introduced as a tool to routinely measure and monitor the outcomes of patients' activities of daily living in a restorative nursing care context.Objectives: To investigate the BETA's construct validity using the Rasch model with specific reference to the BETA's potential to be used as an interval scale providing metric or interval data.Method: A quantitative analytical design was followed using Rasch analyses whereby BETA raw data was collected from patients (n = 4235) receiving nursing care in 28 South African sub-acute and non-acute nursing facilities. The data was prepared for Rasch analyses and imported into WINSTEP® Software version 3.70.1.1 (2010). Final results were shown by means of figures and graphs.Results: A successful outcome was achieved by dividing the BETA into four subscales. In this process one of the original BETA items was omitted and seven other items required collapsing of their categories before the four subscales achieved a satisfactory fit to the Rasch model.Conclusion: The four BETA subscales achieved “very well” to “excellent” levels of fit to the Rasch model. This finding thus creates an opportunity to convert the BETA's Likert qualities into an interval measure to calculate change in patients' activities of daily living metric allyas a direct result of effective restorative nursing.
The effect of lumbosacral manipulation on growing pains
Authors: De Beer Dawid , Bester Charmaine M.
Published: April 2018

Background: Growing pains are a frequent clinical presentation that continues to puzzle practitioners, with very little conclusive evidence in any medical field, including chiropractic.Objective: The aim of this study was to determine whether lumbosacral manipulations have an effect on growing pain symptoms.Methods: Thirty participants with growing pains between the ages of 4 and 12 years were recruited. The participants were placed into two groups of 15 participants each. Group 1 received lumbosacral manipulations to restricted joints as determined by motion palpation, while Group 2 never received any professional intervention. Often parent(s)/guardian(s) of children who suffer from growing pains will rub the child's legs and offer verbal reassurance in an attempt to console their children. Parent(s)/guardian(s) of both groups were encouraged to continue to do this throughout the duration of the trial. Instructions were given to the parents so that the same rubbing technique and rubbing cream (aqueous cream) were used. Subjective changes were tracked using a pain diary that the parent(s)/guardian(s) were asked to complete, a six-week post-study follow-up question regarding children's growing pains and the Oucher self-report pain scale. Objective measures consisted of pressure algometer readings of the tibialis anterior muscle belly.Results: The statistical data was analysed using the Friedman test, Manne—Whitney test and the Wilcoxon Signed-Rank test. The results demonstrated that both groups responded favourably to their specific treatment over time. However, the group that received lumbosacral manipulations proved to show a quicker response to treatment; and the post study follow-up of this same group showed markedly more positive feedback than the group that did not receive the treatment. These results highlighted the positive effects of chiropractic manipulation on growing pain symptoms.Conclusion: The results from this study, specifically the feedback from parent(s)/guardians(s) and the pain diaries, indicated that spinal manipulation is beneficial in the treatment of growing pains. The results also showed that other methods of treating growing pains, such as simple leg rubs, may also bring relief.
Editorial comments: HealthSAGesondheid 2014
Authors: Poggenpoel Marie
Published: April 2018

No abstract available.
Facilitation of self-empowerment of women living with borderline personality disorder: A concept analysis
Authors: Ntshingila N. , Temane A. , Poggenpoel M. , Myburgh C. P.H.
Published: April 2018

Background: Borderline personality disorder is characterised by a pattern of instability in interpersonal relationships, self-image, affects and marked impulsivity.Objective: : The objective is to define the central concept of “facilitation of self empowerment”.Method: Analysis and synthesis reasoning methods as indicated by Walker and Avant (2011) were used to define the central concept.Results: A definition of the concept “facilitation of self-empowerment” was formulated from the dictionary and subject definitions.Conclusion: The central concept is important for developing a model as a frame of reference to assist psychiatric nurse practitioners in facilitating the mental health of women living with borderline personality disorder.
Basic student nurse perceptions about clinical instructor caring
Authors: Meyer Gerda-Marie , Nel Elsabe , Downing Charlene
Published: April 2018

Background: Caring is the core of nursing and should be cultivated in student nurses. However, there are serious concerns about the caring concern in the clinical environment and in nursing education. Clinical instructors are ideally positioned to care for student nurses so that they in turn, can learn to care for their patients.Methods: A descriptive, comparative, cross-sectional and correlational quantitative research design with convenience sampling was conducted to describe the perceptions of junior student nurses (n = 148) and senior student nurses (n = 168) regarding clinicalin structor caring. A structured self administered questionnaire using the Nursing Student Perceptions of Instructor Caring (NSPIC) (Wade & Kasper, 2006) was used. Descriptive statistics and hypotheses testing using parametric and non parametric methods were conducted. The reliability of the NSPIC was determined.Results: Respondents had a positive perception of their clinical instructors' caring. No relationship could be found between the course the respondents were registered for, the frequency of contact with a clinical instructor, the ages of the respondents and their perceptions of clinical instructor caring. The NSPIC was found to be reliable if one item each from two of the subscales were omitted.Conclusions: Student nurses perceived most strongly that a caring clinical instructor made them feel confident, specifically when he/she showed genuine interest in the patients and their care, and when he/she made them feel that they could be successful.
Knowledge and psychosocial wellbeing of nurses caring for people living with HIV/AIDS (PLWH)
Authors: Makhado Lufuno , Davhana-Maselesele Mashudu
Published: April 2018

The challenges of caring for people living with HIV (PLWH) in a low-resource setting has had a negative impact on the nursing profession, resulting in a shortage of skilled nurses. In response to this shortage and perceived negative impact, we conducted a descriptive, cross-sectional study to describe the level of knowledge and psychosocial wellbeing of nurses caring for PLWH at a regional hospital in Limpopo Province, South Africa. A total of 233 nurses, the majority being female, participated and were stratified into professional nurses (n =108), enrolled nurses (n = 58) and enrolled nursing auxiliaries (n = 66). Data were collected using HIV/AIDS knowledge questionnaire, Maslach Burnout Inventory; AIDS Impact Scale and Beck's Depression Inventory. The total knowledge score obtained by all the participants ranged from 2 to 16, with an average of 12.93 (SD = 1.92) on HIV/AIDS knowledge. Depersonalization (D) (83.7%) and emotional exhaustion (EE) (53.2%) were reported among participating nurses caring for PLWH. Burnout was higher among professional nurses as compared to both enrolled nurses and enrolled nursing auxiliaries. There was a moderate negative significant correlation between HIV knowledge with the nurses' emotional exhaustion (r = 0.592), depression (r = 0.584) and stigma and discrimination (r = 0.637). A moderate to high level of burnout was evident among all levels of nurses. These findings lead to the recommendations for support of nurses caring for PLWH that include structured nursing educational support, organisational support with respect to employee wellness programmes that address depression and work burnout, as well as social support. The provision of these support mechanisms has the potential of creating a positive practice environment for nurses in the Vhembe District of the Limpopo Province in particular, and South Africa in general, and in improved care for PLWH.
Keep pushing! Limiting interruptions to CPR; bag-valve mask versus i-gel® airway ventilation
Authors: Vincent-Lambert Craig , Makkink Andrew , Kloppers Fredrick
Published: April 2018

Background: Recent recommendations made by ILCOR have de-emphasised the role of advanced airway management such as “endotracheal intubation” (ETI) during cardiac arrest in favour of maximising the number of chest compressions performed by rescuers. Maximising time available for compressions is achieved by minimising hands-off time (HOT). This has led to first responders and paramedics performing single rescuer CPR using a bag-valve-mask (BVM) device as opposed to the historical practice of intubating and ventilating via an endotracheal tube. Bag-valve-mask ventilations, especially during single rescuer CPR, are however associated with complications potentially resulting in increased ventilation times. More time spent on ventilations in the single rescuer scenario naturally leads to an increase in HOT and less time being available for compressions. It is postulated that the use of an appropriate supraglottic airway device (SAD) may decrease the time spent on the ventilation component of CPR and result in a decrease in HOT.Objectives: This pilot study evaluated how interruptions to chest compressions or hands-off time (HOT) are affected by the placement of an i-gel® airway vs. simple BVM ventilation during single rescuer CPR.Method: 16 participants performed two, ten-minute single rescuer CPR simulations, firstly using the BVM and later the i-gel® airway for ventilation. Data pertaining to ventilations and HOT in each scenario was statistically analysed and compared.Results: The i-gel® airway demonstrated a superior ease of ventilation compared to BVM alone and resulted in a reduction of time spent on ventilations overall. The i-gel® however took a mean of 29 s, ± 10 s, to secure which contributes considerably to HOT.Conclusion: The use of the i-gel® airway resulted in a considerable decrease in the amount of time spent on ventilations and in more compressions being performed. The overall reduction in HOT was, however, offset by the time it took to secure the device. Further investigation into the use and securing of the i-gel® airway in single rescuer CPR is recommended.
Knowledge, opinions and practices of healthcare workers related to infant feeding in the context of HIV
Authors: Janse van Rensburg Liska , Nel Riette , Walsh Corinna M.
Published: April 2018

Background: The importance of healthcare workers' guidance for women infected with human immunodeficiency virus (HIV) regarding infant feeding practices cannot be overemphasised.Objective: To determine the knowledge, opinions and practices of healthcare workers in maternity wards in a regional hospital in Bloemfontein, Free State Province, South Africa, regarding infant feeding in the context of HIV.Methods: For this descriptive cross-sectional study, all the healthcare workers in the maternity wards of Pelonomi Regional Hospital who voluntarily gave their consent during the scheduled meetings (n = 64), were enrolled and handed over the self-administered questionnaires.Results: Only 14% of the respondents considered themselves to be experts in HIV and infant feeding. Approximately 97% felt that breastfeeding was an excellent feeding choice provided proper guidelines were followed. However, 10% indicated that formula feeding is the safest feeding option. 45% stated that heat-treated breast milk is a good infant feeding option; however, 29% considered it a good infant feeding option but it requires too much work. Only 6% could comprehensively explain the term “exclusive breastfeeding” as per World Health Organisation (WHO) definition. Confusion existed regarding the period for which an infant could be breastfed according to the newest WHO guidelines, with only 26% providing the correct answer. Twenty per cent reported that no risk exists for HIV transmission via breastfeeding if all the necessary guidelines are followed.Conclusion: Healthcare workers' knowledge did not conform favourably with the current WHO guidelines. These healthcare workers were actively involved in the care of patients in the maternity wards where HIV-infected mothers regularly seek counselling on infant feeding matters.
“Consider our plight”: A cry for help from nyaope users
Authors: Mokwena Kebogile
Published: April 2018

Nyaope is a relatively new drug which until recently was not classified as illegal. It is widely used by many young and poor people in predominantly Black townships and users can be easily identified as they usually assemble in open spaces such as parks and taxi ranks and have formed a community through which they support one another in the habit. In addition to this, users often display poor personal hygiene and often resort to stealing and selling stolen goods in order to sustain their habit. There is a paucity of literature on nyaope and its use and impact, and the present study is a qualitative exploration of the experiences of nyaope users in three provinces, namely Gauteng, Mpumalanga and North West. The findings highlight the strong addictive nature of the drug, the ease of access, and the unfavourable social environment which promotes initial use and difficulty in quitting. Nyaope users typically express a desire to find and utilise help in order to overcome their current circumstances.
An integrative review of Albertina Sisulu and ubuntu: Relevance to caring and nursing
Authors: Downing Charlene , Hastings-Tolsma Marie
Published: April 2018

Background: Caring forms the core component of nursing. The history of the nature of caring in South Africa is non-specific and is unknown. The impact of nurse and activist Albertina Sisulu – known as the Mother of the Nation – has the potential to offer uniquein sights into what could be the context of caring for nurses.Aims: The study aimed at 1) critically synthesising the available evidence of caring as portrayed by Albertina Sisulu within the South African context, and 2) interpreting Sisulu's work within the Ubuntu philosophy as a framework for nursing and caring.Method: An integrative review was completed using Whittemore and Knafl's framework. Key electronic databases, selected references and web-based search engines were scoured for articles meeting the inclusion criteria. This systematic and iterative approach yielded 18 non-research reports related to Sisulu; eight reports (three research, five non-research) related to ubuntu and nursing. Data was extracted that related to relevant and conclusive new and innovative practices in caring.Results: The findings provided a context for practice guidelines of caring concerning knowledge and critical thinking about caring by nurses. Two primary factors emerged that demonstrated a culture of caring as seen through the prism of Sisulu's life: devoted dancer and creation of a healing environment. These factors also reflect African ubuntu principles, where the focus is on the relationships between people and how these relationships could be conducted.Conclusions: Ubuntu and Sisulu's approach to caring have much to offer for the nursing profession in terms of developing of new directions for nursing pedagogy, curriculum,practice patterns, and policies that emphasise caring constructs.
The use of observation on patients who self-harm: Lessons from a learning disability service
Authors: Sandy Peter T.
Published: April 2018

Background: Observation is an important approach to care that is commonly used in inpatient learning disability services to prevent self-harming behaviours. It is often implemented when there is a perceived increase risk of self-harm. Most nurses who implement observation have little or no training in the use of this practice. The literature on this subject is also biased towards mental health settings with learning disability services much neglected.Aim: To explore nurses' knowledge and understanding of the use of observation on patients who self-harm in a learning disability service in the United Kingdom.Design: and methods: This study adopted a qualitative approach, and utilised interpretative phenomenological analysis as a design and as a tool of analysis. The study was conducted in a secure learning disability service in the United Kingdom. Data were obtained from registered nurses using individual interviews (n = 20) and focus groups (n = 3 x 5 = 15). Data were analysed thematically using the principles of interpretative phenomenological analysis.Results: Three superordinate themes emerged from data analysis: 1) observation: its meaning, 2) observation: does it prevent self-harm? 3) Observation: making it work.Conclusion: Observation is a useful practice in in-patient learning disability services, which can be used to prevent or reduce the incidence of self-harm in these settings. This approach should therefore be an integral part of nurses' daily therapeutic activities in inpatient learning disability services.
Strategies to facilitate professional development of the occupational health nurse in the occupational health setting
Authors: De Jager Nicolene , Nolte Anna G.W. , Temane Annie
Published: April 2018

Background: Education and experience are important components in the ability of occupational health nurses (OHNs) to promote high-quality care and competence. OHNs will increasingly require the skills and knowledge to base care on best evidence, to use critical thinking and demonstrate advanced leadership and decision-making skills to develop and enhance services in a more complex and diverse occupational healthcare environment.Objective: The purpose of this study was to identify the needs for professional development of the OHN in the occupational health setting.Method: An explorative, descriptive, contextual generic and qualitative research method was used in this study. The purposive sampling method was used as the OHNs surveyed described their personal need for professional development in the occupational health setting. Data was collected by means of semi-structured individual interviews. Eight interviews were done by an interviewer who held a doctoral degree in community health nursing and a qualification in occupational health and was affiliated with a private occupational health institution at the time of the study. The interviews were conducted during August 2012.Results: The OHNs reported that professional development needs have to be identified by the OHNs. Short courses need to be designed by training institutions and should be attended by the OHNs to improve their operational functioning on a day-to-day basis in the occupational health setting. The OHNs experienced that their role and function in the workplace were not valued by their managers. The results of this study revealed four major themes, namely constraints hindering the OHN in developing professionally, positive aspects identified by the OHNs regarding the need for professional development, professional development needs of the OHN and suggestions of how to meet the OHNs' professional development needs.Conclusion: There is a need for OHNs to identify their professional development needs and recommendations were made to meet these needs.
The bloody truth: Investigating nurse phlebotomy competencies at a private laboratory in Johannesburg, South Africa
Authors: Crous Lizelle , Armstrong S. J.
Published: April 2018

Background: With the introduction of the phlebotomist technician-certification programme in South Africa, nurses' phlebotomy competence, an acquired skill during basic training, was questioned. Various studies indicate that the majority of errors occur during the collection phase, causing negative outcomes for the patient.Objective: Despite in-service training, samples were rejected and linked to the nurse phlebotomist's sample collection technique. The purpose of this study was to establish if nurses' phlebotomy techniques could be improved through a workplace-training programme in the attempt to improve the quality of the test results.Method: The methodology used was a quantitative, experimental, pilot intervention study, based on a one group pre-test - post-test design. Data was collected by means of peer video recordings of the nurses (n = 20) based at outpatient departments of the laboratory. Independent evaluators evaluated the recordings against criterion-based observationalchecklists.Results: Compliance to standards on the venepuncture procedure was identified during the pre-test, with an average score of 61.9%. The training programme, developed to address all deviations from the standards, proved to be effective as the post-test compliance score was 85%.Conclusion: The reason for improving nurses' phlebotomy skills is to ensure accurate results that will assist clinicians caring for their patients. The results suggest that knowledge and skills were acquired, however further investigations are needed for guidance in the standardisation of training programmes and at what intervals should these training programmes be presented.
The types and levels of physical activity and sedentary behaviour of Senior Phase learners in Potchefstroom
Authors: De Vos Johanna C.W. , Du Toit Dorita , Coetzee Dané
Published: April 2018

Background: Worldwide, the health risks of decreasing physical activity levels and increasing sedentary behaviour among adolescents are a raising concern.Objective: To determine the types and levels of physical activity as well as that of sedentary behaviour of a group Senior Phase learners in South Africa.Methods: The adapted Children's Leisure Activities Study Survey (CLASS) questionnaire was used for determining the types and levels of physical activity and sedentary behaviour of 230 Grade 7 learners, from three schools in Potchefstroom. Data were analysed by means of the SAS statistics programme, and descriptive statistics, as well as independent t-tests andeffect sizes (ES) were used.Results: Moderate to high-intensity physical activity levels of between 334 and 361 min per week were found, and sedentary behaviour of between 3077 and 3410 min per week, which implies that between 70.7% and 71.9% of the participants, did not meet the recommended health-based guidelines. Higher activity levels were shown during weekends, where the boys were significantly more active than girls (p < 0.001; ES between 0.21 and 0.56), and girls showed more sedentary behaviours than the boys (ES between 0.18 and 0.20). The leisure time physical activities with the highest participation were soccer, recreational swimming, jogging and dancing, while the sedentary activities were listening to music, riding a vehicle and being busy on the phone.Conclusion: Strategies need to be implemented to raise the physical activity levels of Senior Phase learners, especially during weekdays, and to decrease sedentary behaviour. With this view in mind, recommendations are made for Physical Education teachers.
Uterine artery Doppler screening as a predictor of pre-eclampsia
Authors: Casmod Yasmin , Van Dyk Barbara , Nicolaou E.
Published: April 2018

Hypertensive disorders represent the second most common cause of maternal death, affecting 5–10% of pregnancies worldwide and accounting for 19% of maternal deaths in South Africa. Pre-eclampsia is believed to develop from inadequate trophoblast invasion of the maternal spiral arteries. Doppler imaging permits non-invasive evaluation of the uteroplacental circulation and is invaluable in the management of high risk pregnancies.A prospective quantitative experimental study tested the hypothesis that uterine artery (UA) spectral Doppler screening is able to identify patients at risk for developing preeclampsia. Convenience sampling allowed for the recruitment of 144 patients (11–14 weeks gestation) who attended the antenatal clinic at Rahima Moosa Mother and Child Hospital between November 2008 and July 2010. A complete record of 121 participants was available for the final analysis.The results of this study revealed that 7 (5.8%) participants developed pre-eclampsia. Race was identified as the most significant independent variable with an odds ratio of 1.5; 26 and 9 to 1 for developing PET in the 1st, 2nd and 3rd trimesters respectively.Uterine Artery Doppler is promising. An ultrasound screening programme in high risk pregnant women would offer clinicians the opportunity to pre-empt the disease before it manifests clinically.
Lived experience of patients on tuberculosis treatment in Tshwane, Gauteng province
Authors: Akeju Oluwafunmilayo O. , Wright Susanna C.D. , Maja Todd M.
Published: April 2018

Tuberculosis is one of the communicable diseases that still contributes substantially to the worldwide disease burden and is still a major health threat worldwide. In order to gain abetter understanding of being a patient taking tuberculosis treatment and to improvead herence to treatment, this phenomenological study was conducted to explore the lived experience of patients on tuberculosis treatment.The population comprised patients in an identified tuberculosis clinic in Tshwane who had been on treatment for at least four months and who were able to communicate in English. The data gathering instrument was self-report by in-depth interview. Some of the main themes that emerged include influence of personal social situation, influence of good social support and disclosure, experience of taking medication daily and knowledge about tuberculosis treatment.Findings revealed that the personal social situations of the participants which include accommodation, unemployment and nutritional requirements influenced the adherence of the participants to treatment. It was discovered that good social support had an influence on adherence which could only be enjoyed when the treatment and diagnosis of tuberculosis is disclosed to the family members and friends. Some of the participants, who had been non adherentin the past, attributed the reasons for their non-adherence to the side effects that they experienced. Lastly, participants also reported knowledge about tuberculosis, that is, knowledge about its causes, treatment and prevention, as crucial for adherence to treatment.