bluuebunny/crossref_metadata_2025 huggingface dataset:
Tradition and the culture of rights at the crossroads: A literary perspective
Authors: Zondi Nompumelelo B. , Khuzwayo Bonginkosi C.
Published: June 2017

Using cultural theories, this article focuses on a literary text that presents a fresh perspective on one of the cultural practices of disposing of a dead body, namely cremation. The scarcity of burial sites is increasingly becoming a concern for municipalities, yet traditional ways of thinking are strongly against cremation. The liberty to investigate the burning issue of cremation as an alternative burial method in this way derives from the fact that through the ages literature (oral and written) has been effectively used by creative writers to offer an allusive quality and fictitious setting which has allowed them to comment on contemporary issues without blatantly seeming to do so. In this sense, the novel Intando kamufi (“Will of the deceased”) by S. Mathaba contributes to various discourses on cremation, either reinforcing or critiquing it.
From the Editor
Authors: Bekker Linda Gail
Published: June 2017

N/A
Message from the Executive
Authors: HIV Clinicians Society Exco Francois, On behalf of the SA
Published: June 2017

N/A
HIV/AIDS-related knowledge, sexual practices and predictors of condom use among long-distance truck drivers in Nigeria
Authors: Aniebue P N , Aniebue U U
Published: June 2017

N/A
Neurocognitive impairment in PLWHA: Clinical features and assessment
Authors: Singh Dinesh
Published: June 2017

No Abstract Available
Treating HIV-infected children
Authors: Cotton Mark , Levin Leon
Published: June 2017

No Abstract
Lipodystrophy syndrome in HIV-infected children on HAART
Authors: Innes Steve , Levin Leon , Cotton Mark
Published: June 2017

Lipodystrophy Syndrome (LD) is common in HIV-infected children, particularly in those taking Didanosine, Stavudine, or Zidovudine. Lipoatrophy in particular causes major stigmatization and interferes with adherence. In addition, LD may have significant long-term health consequences, particularly cardiovascular. Since the stigmatizing fat distribution changes of LD are largely permanent, the focus of management remains on early detection and arresting progression. Practical guidelines for surveillance and avoidance of LD in routine clinical practice are presented. Diagnosis of LD is described and therapeutic options are reviewed. The most important therapeutic intervention is to switch the most likely offending antiretroviral to a non-LD-inducing agent as soon as LD is recognised. Typically, where lipoatrophy or lipohypertrophy is diagnosed, the thymidine nucleoside reverse transcriptase inhibitor (NRTI) is switched to a non-thymidine agent such as Abacavir (or Tenofovir in adults). Where dyslipidaemia is predominant, a dietician review is helpful, and the clinician may consider switching to a protease inhibitor (PI)-sparing regimen or to Atazanavir.
Abacavir: it’s use and hypersensitivity
Authors: Rabie Helena , Lorenc Henning Kristin , Schoeman Pierre , De Villiers Nico , Pretorius G HJ , Cotton Mark F
Published: June 2017

Abacavir, a nucleoside reverse transcriptase inhibitor, is useful in first and second line therapy as well as a substitute for Stavudine and Zidovudine for toxicity. Although safe and well tolerated, a life threatening hypersensitivity reaction can occur. The risk for developing this reaction relates to the presence of specific genotypes especially HLA-B*5701.
From the Editor
Authors: Bekker Linda-Gail
Published: June 2017

No abstract
Effects of dual renin-angiotensin system blockade on proteinuria in a hypertensive black African HIV-infected patient
Authors: Ucciferri Claudio , Falasca Katia , Mancino Paola , Tommasi Roberto , Tatasciore Alfonso , Vecchiet Jacopo
Published: June 2017

Case study
Feasibility and acceptability of sexual abstinence for interruption of HIV transmission among individuals with acute HIV infection - formative data from chavi 001
Authors: MacPhail C , Pettifor A , Corneli A
Published: June 2017

LETTER
Book review
Authors: Regondi Ilaria
Published: June 2017

book review
Message from the Executive
Authors: Venter Francois
Published: June 2017

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Successful treatment of bilateral visual loss caused by HIV-associated optic neuritis
Authors: Cullen Claire , Matlala Baile , Laher Fatima , Pienaar Ané
Published: June 2017

Optic neuritis is not an uncommon diagnosis in HIV-infected patients, but it is rarely idiopathic. We report a case of a young HIV-infected woman who developed optic neuritis as her presenting manifestation of HIV infection. She had initially experienced sudden-onset right-sided painful visual loss; the left eye had become involved within days. Bilateral swollen discs were apparent on fundoscopy. Investigations were performed for meningitis (including bacterial, cryptococcal, tuberculous and syphilitic types), auto-immune diseases, toxoplasma, rubella, cytomegalovirus, viral hepatitis, HTLV-1/2, HIV-1/2 and syphilis. The only positive result was a reactive HIV enzyme-linked immunosorbent assay. The CD4 count was 85 cells/µl. A post-contrast magnetic resonance imaging scan of the brain illustrated enhancement of the optic nerves. Treatment was 3 days of intravenous methylprednisolone 1 g daily, followed by 11 days of oral prednisone 60 mg daily. Highly active antiretroviral therapy was initiated after 2 weeks. Vision improved from day 6 after commencement of steroid therapy, with ongoing recovery at 5 months.
HIV/AIDS and admission to intensive care units: A comparison of India, Brazil and South Africa
Authors: Naidoo Kantharuben , Singh Jerome Amir , Lalloo Umesh Gangaram
Published: June 2017

In resource-constrained settings and in the context of HIV-infected patients requiring intensive care, value-laden decisions by critical care specialists are often made in the absence of explicit policies and guidelines. These are often based on individual practitioners’ knowledge and experience, which may be subject to bias. We reviewed published information on legislation and practices related to intensive care unit (ICU) admission in India, Brazil and South Africa, to assess access to critical care services in the context of HIV. Each of these countries has legal instruments in place to provide their citizens with health services, but they differ in their provision of ICU care for HIV-infected persons. In Brazil, some ICUs have no admission criteria, and this decision vests solely on the ‘availability, and the knowledge and the experience’ of the most experienced ICU specialist at the institution. India has few regulatory mechanisms to ensure ICU care for critically ill patients including HIV-infected persons. SA has made concerted efforts towards non-discriminatory criteria for ICU admissions and, despite the shortage of ICU beds, HIV-infected patients have relatively greater access to this level of care than in other developing countries in Africa, such as Botswana. Policymakers and clinicians should devise explicit policy frameworks to govern ICU admissions in the context of HIV status.

S Afr J HIV Med 2013;14(1):15-16. DOI:10.7196/SAJHIVMED.887
Association of HIV prevalence and concurrency of sexual partnerships in South Africa’s language groups: An ecological analysis
Authors: Kenyon Chris
Published: June 2017

Background. There is considerable variation in HIV prevalence between different language groups in South Africa (SA). Sexual partner concurrency has been linked to the spread of HIV, but its effect on differential HIV transmission within SA’s language groups has not been investigated quantitatively.

Objective. This ecological analysis was intended to explore the degree to which the variation in HIV prevalence according to language group can be explained by differential concurrency rates.

Method. Linear regression was used to assess the association between each language group’s HIV prevalence and four risk factors: the prevalence of concurrency, multiple sexual partners in the preceding year, circumcision, and condom utilisation.

Results. In multivariate analysis, only the point prevalence of concurrency remained associated with HIV prevalence.

Conclusion. There is evidence of a high prevalence of point concurrency in sexual partnerships in SA’s most HIV-affected language groups. Together with evidence that relatively small decreases in concurrency can lead to large declines in HIV incidence, this provides impetus for interventions to promote having only one sexual partner at a time.

S Afr J HIV Med 2013;14(1):25-28. DOI:10.7196/SAJHIVMED.884
Combined antiretroviral and antituberculosis drug resistance following incarceration
Authors: Stott Katharine Elizabeth , De Oliveira Tulio , Lessells Richard John
Published: June 2017

We describe a case of HIV/tuberculosis (TB) co-infection from KwaZulu-Natal, South Africa, characterised by drug resistance in both pathogens. The development of drug resistance was linked temporally to two periods of incarceration. This highlights the urgent need for improved integration of HIV/TB control strategies within prison health systems and within the broader public health framework.
Chylothorax associated with non-endemic Kaposi’s sarcoma
Authors: Verma Kamal , Haverkamp Miriam , Kayembe Mukendi , Musimar Zola
Published: June 2017

Chylothorax is a rare cause of pleural effusion, seen in approximately 2% of cases. In HIV-positive patients with Kaposi’s sarcoma (KS), the development of chylothorax presents as a diagnostic challenge with an aggressive course and poor, often lethal outcome. In this clinical scenario, the aetiology of chylothorax may include infections and malignancy, while pleural fluid examination and computed tomography of the mediastinum may fail to establish a cause. We present a case of KS-associated non-traumatic chylothorax resulting in death, and a review of available literature on this condition.
Antiretroviral therapy-induced Leber’s hereditary optic neuropathy
Authors: Moodley Anand , Bhola Sudika , Omar Fierdoz , Mogambery Jade
Published: June 2017

Optic neuropathy in HIV-infected patients results from the HIV infection itself, post-infectious auto-immune disease, opportunistic infections and drugs. Nucleoside reverse transcriptase inhibitors (NRTIs) such as zidovudine and stavudine have known mitochondrial toxicity and can cause mitochondrial myopathies, neuropathies, hyperlactataemia, and can induce mitochondrial genetic disorders. Individuals with the mutation for Leber’s hereditary optic neuropathy (LHON), a mitochondrial disorder, are usually asymptomatic but develop visual loss when exposed to external triggers such as smoking. We report on two HIV-infected patients with LHON mutations (m.14484T>C and m.11778G>A) who developed profound visual loss with antiretroviral therapy. We postulate that the phenotypic expression of LHON in these genetically predisposed individuals was triggered by NRTI drugs lamivudine and tenofovir when used in combination, despite their relatively weak mitochondrial toxic effects.
Management of mental health disorders and central nervous system sequelae in HIV-positive children and adolescents
Authors: Nassen R , Donald K , Walker K , Paruk S , Vujovic M , Duncan W , Laughton B , Moos B
Published: June 2017

HIV-positive children and adolescents are at increased risk of both central nervous system (CNS) sequelae and mental disorders owing to a number of factors, including the impact of HIV infection on the brain, social determinants of health (e.g. poverty and orphanhood) and psychosocial stressors related to living with HIV. Every effort should be made to identify perinatally HIV-infected children and initiate them on antiretroviral therapy early in life. HIV clinicians should ideally screen for mental health and neurocognitive problems, as part of the routine monitoring of children attending antiretroviral clinics. This guideline is intended as a reference tool for HIV clinicians to support the early identification, screening and management of mental health disorders and/or CNS impairment in children and adolescents. This guideline covers mental disorders (section 1) and HIV-associated neurocognitive disorders (section 2) among children and adolescents.
Reasons for failure of prevention of mother-to-child HIV transmission in a rural South African district hospital
Authors: Kendall Clifford , Claessens Lore , Dorward Jienchi , Mfeka Gloria , Gate Kelly
Published: June 2017

Further reduction of mother-to-child transmission (MTCT) of HIV requires improved understanding of the reasons for MTCT. We reviewed maternal and infant case notes for HIV- positive infants diagnosed by polymerase chain reaction at Bethesda Hospital. Nineteen cases were analysed. Median gestation at first antenatal consultation (ANC) was 22.5 (interquartile range [IQR] 19.25–24). Eleven (57.9%) mothers were HIV positive at first ANC, whilst eight tested negative and later positive (2 antepartum, 6 postpartum). Median maternal CD4 was 408 cells/μL (IQR 318–531). Six (31.6%) received no antenatal antiretroviral therapy (ART) because they were diagnosed as HIV positive postpartum; 9 (47.3%) received antenatal ART and 3 (15.8%) were never initiated on ART. At 6 weeks postpartum, 5 infants (26.3%) were not on prophylactic nevirapine (NVP) because their mothers had not yet been diagnosed. Maternal seroconversion in pregnancy and breastfeeding, and possibly false-negative HIV tests, were important reasons for prevention of mother-to-child transmission (PMTCT) failure.
Outcomes from the implementation of a counselling model supporting rapid antiretroviral treatment initiation in a primary healthcare clinic in Khayelitsha, South Africa
Authors: Wilkinson Lynne , Duvivier Helene , Patten Gabriela , Solomon Suhair , Mdani Leticia , Patel Shariefa , De Azevedo Virginia , Baert Saar
Published: June 2017

Background: Lengthy antiretroviral treatment (ART) preparation contributes to high lossesto care between communicating ART eligibility and initiating ART. To address this shortfall, Médecins Sans Frontières implemented a revised approach to ART initiation counsellingpreparation (integrated for TB co-infected patients), shifting the emphasis frompre-initiation sessions to addressing common barriers to adherence and strengthening postinitiationsupport in a primary healthcare facility in Khayelitsha, South Africa.Methods: An observational cohort study was conducted using routinely collected data forall ART-eligible patients attending their first counselling session between 23 July 2012 and 30April 2013 to assess losses to care prior to and post ART initiation. Viral load completion andsuppression rates of those retained on ART were also calculated.Results: Overall, 449 patients enrolled in the study, of whom 3.6% did not return to the facilityto initiate ART. Of those who were initiated, 96.7% were retained at their first ART refill visitand 85.9% were retained 6 months post ART initiation. Of those retained, 80.2% had a viralload taken within 6 months of initiating ART, with 95.4% achieving viral load suppression.Conclusions: Adapting counselling to enable rapid ART initiation is feasible and has thepotential to reduce losses to care prior to ART initiation without increasing short-term lossesthereafter or compromising patient adherence.
Breastfeeding and the 2015 South African guidelines for prevention of mother-to-child transmission of HIV
Authors: Kuhn Louise , Kroon Max
Published: June 2017

No abstract available
Overview of medical management of victims of sexual abuse
Authors: Wulfsohn A. H.
Published: June 2017

No abstract available.
Diagnosis of perinatal HIV-1 infection
Authors: Webber Lynne M. , Cotton Mark , Stevens Wendy
Published: June 2017

No abstract available.
The palliative medical approach to the management of HIV/AIDS patients
Authors: Browde Selma
Published: June 2017

No abstract available.
HIV legal and ethical issues
Authors: Klinck Elsebe
Published: June 2017

No abstract available.
Challenges ahead
Authors: Bekker Linda-Gail
Published: June 2017

No abstract available.
An overview of some of the key legal developments in HIV/AIDS and the law - 2003
Authors: Gerntholtz Liesl
Published: June 2017

No abstract available.
Building bridges of understanding and empowerment between society and researchers
Authors: Galloway Michelle Rotchford
Published: June 2017

No abstract available.
Medical Schemes overcoming HIV/AIDS hurdles
Authors: Office Editorial
Published: June 2017

No abstract available.
Living positively with HIV/AIDS
Authors: Nala Geddes M.
Published: June 2017

No abstract available.
Sustainability of long-term treatment in a rural district: The Lusikisiki model of decentralised HIV/AIDS care
Authors: Ford Nathan , Reuter Hermann , Bedelu Martha , Schneider Helen , Reuter Helmuth
Published: June 2017

No abstract available.
Opinion - The fight against Kaposi's sarcoma in AIDS - lessons from Brazil
Authors: Caterino-de-Araujo Adele
Published: June 2017

No abstract available.
Research and Law - Ethical legal challenges in adolescent HIV vaccine trials
Authors: Slack Catherine , Strode Ann , Mamasela Mothokoa
Published: June 2017

No abstract available.
From the editor
Authors: Bekker Lind-Gail
Published: June 2017

No abstract available.
Opinion: In defence of rational AIDS activism: How the irrationality of Act Up-Paris and others is risking the health of people with HIV or at risk of HIV infection
Authors: Geffen Nathan
Published: June 2017

No abstract available.
Blood flow in the forearm in patients with Rheumatoid arthritis and healthy subjects under local thermotherapy
Authors: Mucha C.
Published: June 2017

Objectives: Muscle blood flow in the forearm of patients with rheuma-toid arthritis and healthy volunteers following treatment with temperature increasingarm baths, mudpacks and short- or decimeter-wave diathermy was studied in thisinvestigation. The aim of the study was to find out the difference of reactive hyperemia between the different temperature methods as well as the influence on theconsensual reaction. Subjects: Eighty patients with rheumatoid arthritis, stage 3 according toSteinbrocker, as well as 80 healthy human subjects had been assigned numerically in the four therapy- and controlgroups. Patients with diseases influencing the peripheral blood flow were excluded. Design: Blood flow was measured by venous occlusion plethysmography in both forearms with the subjects lyingsupine. The application of the local heat therapies had been excluded on the left forearm. The forearm blood flow wasmonitored before heat therapy, directly after as well as in two further 10 minutes intervals. An analysis of variancewas used to determine the influence on blood flow of the response to the heat therapies in patients with rheumatoidarthritis and healthy subjects.Results: Under homogeneous starting conditions and a statistically uniformed high blood flow in rest the reactive values of blood flow on the left-hand side of application and the right consensual side showed high significant differencesbetween all methods of therapy. Differences between the patients and the healthy subjects only showed tendencies withpartially lower reactions, concerning the patients with rheumatoid arthritis. All methods of heat therapy caused a statistically provable consensual reaction that turned out smaller after diathermic methods. Here the post therapeuticreaction of the blood flow on the side of application was also lower or rather shorter. Conclusion: Greater differences of the blood flow in rest between the patients with rheumatoid arthritis and healthysubjects could not be observed. Temperature increasing arm baths and mud packs induced a provable higher increaseof local and consensual forearm blood flow than did diathermic methods. These results lead to the conclusion thatthere are differences in temperature distribution between the methods of therapy. Increasing arm baths and mud packsseem to have a stronger influence on the thermo reflexive skin perfusion.
Measurement of the magnitude of force applied by students when learning a mobilisation technique
Authors: Smit E. , Conradie M. , Wessels J. , Witbooi I. , Otto R.
Published: June 2017

Passive accessory intervertebral movements (PAIVM’s) are frequently used by physiotherapists in the  assessment and management of patients. Studies investigating the reliability of passive mobilisation techniques have shown conflicting results. Therefore, standardisation of PAIVM’s is essential for research and teaching purposes, which could result in better clinical management. In order to standardise graded passive mobilisation techniques, a reliable, easy-to-use, objective measurement tool must be used. The aim of this  study was to determine whether it is necessary to quantify the magnitude of force applied when teaching a grade I central  posteroanterior (PA) mobilisation technique (according to Maitland) on the cervical spine. An objective measurement tool (FlexiForceTM) was used to determine the consistency of force applied by third and fourth year physiotherapy students while performing this technique. Twenty third- and 20 fourth year physiotherapy students (n=40) were randomly selected. Each subject performed a grade I central PA on sensors placed on C6 for 25 seconds. The average maximum grade 1 force applied by the third year students was  significantly higher than the force applied by the fourth year students (p=0.034). There was a significantly larger variation in applied force among third years (p=0.00043). The results indicate that the current teaching method is insufficient to ensure inter-therapist reliability amongst students, emphasising the need for an objective measurement tool to be used for teaching students. The measurement tool used in this study is economical, easily applied and is an efficient method of measuring the magnitude of force. Further research is needed to demonstrate the reliability and validity of the tool to assist teaching and research in a clinical setting.
The effect of compressed air massage on untraumatised rabbit skeletal muscle - a morphometric and ultrastructural study
Authors: Gregory M. A. , Mars M.
Published: June 2017

One of the therapeutic uses of massage is to facilitate repairof damaged tissue. A potential hazard of massage is that direct pressure onmuscle is known to damage skeletal myofibres. This study examines theeffect of a new form of massage using compressed air on the morphology ofuntraumatised rabbit skeletal myofibres. Under anaesthetic, the left and right vastus lateralis muscles of 16 New Zealand, white rabbits were treated with 10 minutes of compressed air therapy at 1 Bar using a single hole (5 mm) applicator head and control biopsies were taken from the opposite limb. Biopsies were prepared for light microscopy and transmission electronmicroscopy. Morphometry, using image analysis revealed a significant increase in myofibre diameters 10 minutes  (p < 0.001) and 24 hours (p<0.01) after compressed air massage. Six days after treatment diameters were significantly reduced (p < 0.01). Morphologically, myofibres in control specimens were normal. Shortly after compressed air  massage, juxta-nuclear and intermyofibrillar oedema was present and electron-lucent spaces were filled with swollen mitochondria and elements of the sarcoplasmic reticulum (SR). Glycogen and other non-contractile organelles were sometimes aggregated in oedematous, sub-sarcolemmal regions. Twenty four hours after treatment, intermyofibrillar oedema was reduced, but SR swelling remained and many fibres were characterised by focal and large areas of myofibrillar disorganisation. With the exception of occasional swollen elements of the SR and a single internalised nucleus, myofibres morphology had returned to normal 6 days after treatment. Compressed air massage causes less damage to skeletal myofibres than a similar form of localised pressure treatment, deep transverse frictions. Clinicalstudies using this new modality are warranted.
A pilot study comparing two physiotherapy techniques in patietnts with cystic fibrosis
Authors: Milne S. M. , Eales C. J.
Published: June 2017

The flutter is a simple hand held device designed to facilitate the mobilisation of excess bronchial secretions by means of oscillating positive pressure. Traditionally patients at the Johannesburg Hospital Cystic Fibrosis clinic used the active cycle of breathing technique as a means of facilitating secretion mobilisation and clearance. When the flutter became available in South Africa in 1999 many cystic fibrosis patients wanted to change to this technique. Minimal research has been conducted comparing these two techniques. The aim of this pilot study was therefore to determine which technique is more effective in the mobilisation of  secretions in cystic fibrosis patients. The pilot study was conducted on seven cystic fibrosis patients (mean age 28 years, range 16-42 years) admitted to the Johannesburg Hospital for antibiotic therapy. The study lasted four days and consisted of two treatment days  separated by a washout day on which no physiotherapy was performed. Patients randomised into Group A performed the flutter technique on day two and the active cycle of breathing technique on day four. Group B performed the active cycle of breathing technique on day two and the flutter on day four. The techniques were performed twice a day for  15 minutes. The measurements taken were daily 24-hour sputum samples and daily lung function tests. A questionnaire to determine patient preference to a technique concluded the study.  The results showed no statistical difference between the two techniques with regard to sputum weight or lung function (p<0.05). The questionnaire indicated that on a whole, patients had no preference for a technique.
HIV - implications for exercise in treatment and rehabilitation
Authors: Mars M.
Published: June 2017

Exercise is an integral part of many forms of rehabilitationfollowing muscle injury or surgery. It is usual to advise patients with a viral infection to avoid exercise because of the risk of developing myocarditis. Should HIV+ patients should be encouraged to undertake exercise as part of rehabilitation and should they further be advised to participate in regular exercise? There is sufficient evidence to support the benefits of regular exercise in the HIV+ patient. They will experience a training effect dependent on the normal parameters of frequency, intensity, duration, and mode of exercise.  The disease does place potential limitations to exercise, as the HI virus directly affects pulmonary, cardiac, skeletal muscle and endocrine function.  The effects of these changes may be  exacerbated by secondary infection and other pathological changes may be induced by treatment.  The advent of highly active antiretroviral therapy has brought with it a range of metabolic changes that may also influence exercise  participation. The limitations to exercise imposed by HIV infection and its treatment are reviewed.
An innovative strategy to expand clinical education: a report on the students`view
Authors: Frieg A. , Lochner R.
Published: June 2017

Clinical education is an integral part of undergraduate physiotherapy training.  The minimum hours of clinical training required differ from country to country.  As a result of a magnitude of reasons, academic institutions find it increasingly difficult to place their students at appropriate clinical sites.  Consequently, the physiotherapy department at Stellenbosch University has embarked on an innovative approach to substitute this shortness of placements for 3rdyear physiotherapy students in 2003.  Once all the students had rotated through this new cluster of learning opportunities, the students evaluated this approach.  A self-developed questionnaire consisting of open-ended questions was used for this survey.  The response rate was 83%.  The vast majority of students found the structure of this new block enjoyable and meaningful.  It will therefore be continued in the future and evaluated on a regular basis.
Perceived needs of caregivers of stroke patients’ receiving out-patient physiotherapy treatment in Lusaka, Zambia
Authors: Khondowe O. , Rhoda A. , Mpofu R.
Published: June 2017

Caregivers of stroke patients have needs that should be addressed. The aim of this study was to gain information regarding the expressed needs of informal caregivers of stroke patients who are receiving out-patient physiotherapy treatment at the University Teaching Hospital in Lusaka, Zambia. A qualitative study, using indepth interviews, was carried out to collect data regarding the needs of these caregivers. Ten caregivers formed the study sample. The interviews were audiotaped, transcribed and analysed into themes that emerged from the data. Five themes relating to the needs of the care-givers emerged following the analysis of the data. These included: the lack of information regarding stroke; the need for skills training to enable the caregiver to assist the patient at home; the need for financial support; a need for home-based therapy and the need for physical assistance when caring for patients at home. The caregivers of patients need more information regarding strokes as well as a community-based rather than an institution-based approach to rehabilitation.  Rehabilitation professionals in Zambia could use the information gained from this study to implement rehabilitation programmes, which wouldaddress the needs of caregivers in that country
The psychometric properties of the Roland Morris disability questionnaire for patients with chronic mechanical low back pain
Authors: Buchanan H.
Published: June 2017

Purpose: Functional status measures are currently not widelyused in South Africa to facilitate clinical decision-making or document treatment outcomes for patients with low back pain (LBP). This study investigated the internal consistency and clinical utility of a back-specific functional status measure, the Roland Morris Disability Questionnaire (RMDQ), and determined its ability to confirm the need for spinal fusion surgery. Method: Aretrospective, descriptive design was used with 42 patients with chronic mechanical low back pain who consulted a private Orthopaedic surgeon in Cape Town over a one year  period. All patients completed the RMDQ prior to their consultation. On completion of the medical examination, a rating for surgery was determined for each patient. The completed questionnaires were analysed using Statistical Package for the Social Sciences (SPSS). Results: The mean RMDQ score was 8.6 (N=42; median=9.0; range=2-21). Cronbach’s alpha showed a high internal consistency between items (.92). A categorical principal component analysis (CATPCA) identified two distinct dimensions in the RMDQ. Item reduction improved the internal consistency and thus the construct validity of the RMDQ. There was a low correlation between the surgeon’s rating for surgery and RMDQ scores (r=.40; P<.01). Conclusion: The RMDQ shows some good psychometric properties but some adjustments could improve it. The RMDQ cannot be used to predict the need for spinal fusion surgery.
Physical activity levels in male and female diabetic patients at the Pretoria academic hospital, South Africa
Authors: Nel C. , Van Rooijen A. J. , Van der Westhuizen Van der Westhuizen , Viljoen I. , Steenkamp E. M. , Mamadi S.
Published: June 2017

Introduction: A comprehensive literature review indicated the existence of a gap in the studying of gender difference and physical activity in people with Diabetes Mellitus (DM) in South Africa. Objectives: The aims of this study was to determine the level of physical activity (LPA) of diabetes patients of the Diabetes clinic of the Pretoria Academic Hospital (DCPAH), to compare the LPA between male and female diabetes patients and to explore the reasons for possible differences. Design: A descriptive and comparative quantitative study.Setting: Diabetes Clinic of the Pretoria Academic Hospital.Subjects: The convenience sample consisted of 65 subjects (29 males and 36 females) between the ages of 18 and 83 yearsResults: The average physical activity of male subjects was 5164.05 METs compared to 4843.83 METs in female subjects. A p-value of 0.3660 was calculated. Of the subjects, 46,15% achieved a high LPA, 27,69% achieved a moderateLPA and 26.15% achieved a low LPA according to the IPAQ scoring system. The seven main barriers found was health, diabetes, time, laziness, socio-economic circumstances, perceptual adequate exercise and other.Conclusion: The overall LPA of diabetes patients is high according to the IPAQ Categorical scoring. The difference between LPA of males and females is not significant as indicated by the p-value (p>0.05). It was however found that males have higher levels of work related activities than females and that females have higher home and garden related activities than males. The two most frequently mentioned barriers for male and female subjects were time and health related conditions.
The views of patients with spinal cord injuries on their rehabilitation experience
Authors: Mothabeng D. J. , Malinga C. P. , Van der Merwe C. , Qhomane P. T. , Motjotji S. N.
Published: June 2017

Background and Purpose: Spinal rehabilitation programs seek toenhance the residual functional abilities of people who have an acquired disabling impairment because of SCI. Very little has been published on how patients experience rehabilitation, and what the implication of their experience is on rehabilitation outcomes. The aim of this pilot study was to explore the views of patients with SCI regarding their experience of rehabilitation while in hospital.Materials and Methods: A qualitative exploratory study using semi-structured interviews was employed. Twelve patients constituted the sample of convenience. Qualitative techniques were used to analyze the data.Results: The study revealed a variety of psycho-emotional issues related to the patients’ experience of rehabilitation. Positive issues included being treated humanly, being told the truth abouttheir condition early on, family involvement in rehabilitation and being allowed to contribute to decision making regarding their rehabilitation. Negative issues were mainly their lack of insight into their health condition.Conclusion: The study highlighted important psycho-emotional issues related to the patients’ experience of rehabilitation. Rehabilitation personnel must consider these issues when working with patients with spinal cord injury, to ensure effective rehabilitation outcomes.
Physiotherapy in a whiplash injury: a case report
Authors: Van Eck C.
Published: June 2017

Study Design: Case ReportObjectives: To describe physiotherapy intervention in an individual with asuspected whiplash injury.Background: The patient was a 29-year old male with complaints of neckpain and tightness following a motor vehicle accident. Methods and Measures: The focus of the case study is physiotherapyassessment and intervention in a stage II whiplash injury. Results: Following intervention, positive changes occurred in outcome measures such as pain, work status and activities of daily living. Conclusion: Physiotherapy intervention is successful in addressing whiplash associated disorders.
High levels of self-efficacy in patients with type 2 diabetes attending a tertiary level clinic
Authors: Mostert Wentzel K. , Nel C. , Van Rooijen A.J. , Francis J. , Gibbs G. , Hacker K. , Gebert S.
Published: June 2017

Self-management is a vital element in the care of type 2diabetes patients.  In turn, self-efficacy plays a major role in patients’ self-management. Self-efficacy is the patient’s personal judgement of his/herconfidence in performing aspects of diabetes self-management.  This study investigated the level of self-efficacy of patients attending the Pretoria Academic Hospital Diabetes Clinic, in the light of high levels ofre-admission due to complications, suggesting low self-efficacy levels. Eighty type 2 diabetes patients, mean age of 59 years, completed thepublished IDEA LL baseline questionnaire, to establish a self-efficacyscore.  Relationships between self-efficacy and demographic factors wereinvestigated using the chi-square test. The mean self-efficacy level of thesample population is excellent (mean = 85.44%).A lthough self-reported self-efficacy levels are excellent, in comparison to the Sarkar study (2006) in which participants only scored “fair”, it is speculated that self-efficacy is not transferred to self-management behaviour in thispopulation.  Afrikaans and English speaking participants score significantly better than those from other language categories. There is a positive relationship between self-efficacy and level of education and employment status (tendedtowards significance with p values of 0.06 and 0.07 respectively). A lthough self-efficacy scores of clients at this tertiary level outpatient clinic are excellent, further research is necessary to quantify self-management strategies andto correlate these with self-efficacy levels.
Cycle ergometer and rebound exercises with chest physiotherapy - a useful adjunct for sputum expectoration in mild to moderately symptomatic hiv infected children.
Authors: Maharaj S.S. , Jeena P.M.
Published: June 2017

Background: Sputum expectoration of lung secretionsin HIV  infected children with associated respiratory conditions is oftendifficult. Chest physiotherapy is often recommended to assist in thisprocess but is not always successful. A erobic exercises may have bene-ficial effects on sputum expectoration but its safety is uncertain. Aim: The primary aim of this study was to determine if cycle ergometerand rebound exercises are safe for mild to moderately symptomatic HIV  infected children and if these aerobic exercises followed by chestphysiotherapy could augment sputum expectoration.Method: Thirty six A frican 8-12 year old males performed 15 minutesof either cycle ergometer or rebound exercises. A  modified 6 minutewalking test to ensure fitness of the enrolled subjects prior to randomization was performed. Heart and respiratoryrates, blood pressure and oxygen saturation was monitored for safety. Sputum expectorated was measured in a calibratedvial at baseline, 5, 10, and 15 minutes post exercise followed by 30 minutes of conventional chest physiotherapy. R esults: Total sputum produced during and post rebounding exercise was significantly higher than cycle ergometerexercises (12.6 vs. 9.8mls p=0.0002). The quantity of sputum obtained over each time point after rebound exercise wassignificantly more than cycle ergometer (5, 10 & 15 minutes; p=0.0084, p= 0.0002, p=0.0002 respectively). There wereno significant differences in heart and respiratory rates, blood pressure and oxygen saturation of enrolled subjectsbetween these exercises and no cases reached the threshold for stopping the exercise.Conclusion: Cycle ergometer and rebound exercises are safe for mild to moderately symptomatic HIV  infected children. Rebound exercises followed by chest physiotherapy can be used as a safe adjunct to significantly increasesputum expectoration.
Physiotherapy management of low back pain - a review of surveys
Authors: Basson A.
Published: June 2017

Low back pain (LBP) is an increasingly debilitating and costly problem. One of the research focuses in LBP is an attempt to improve patient outcomes. It is believed that the promotion of evidence based practice (EBP) should improve patient outcomes and also reduce the cost of care. There seems to be a need to establish how physiotherapists manage LBP and whether management is in accordance with best practice based on published research evidence. The aim of this study was to determine what management strategies physiotherapists employ in the management of LBP by performing a review of the literature and to compare this with recent guidelines Fourteen studies were included for the review.  The treatments most frequently reported as being used for the management of LBP were education/ advice, exercise, spinal mobilisation and electrotherapy. Over a 14 year period there were no major changes in the way physiotherapists manage LBP. Physiotherapist use interventions that are evidence based as well as interventions with little evidence in the management of LBP.
Sensorimotor impairments of paretic upper limb correlates with activities of daily living in subjects with chronic stroke
Authors: Shamay Ng S.M. , William Tsang W.N. , Patrick Kwong W.H. , Philip Tse T.F. , Jefferry Wong C.H.
Published: June 2017

The  main objective  of  this  study  was  to  investigate  the correlations  between sensorimotor  impairments  of  paretic  upper  limb  and the  hand  functions of  activities of daily  living  (ADLs)  scores  in  persons  with chronic stroke.This is a cross-sectional  study  with  19  chronic  stroke  survivors.  Hand function was measured by the Jebsen-Taylor Hand Function Test (JTHFT). Impairments in upper extremity motor function were measured by upper limb items  of  Fugl-Meyer  Assessment  (FMA-UE).  Forearm  muscles  strength, handgrip  and  pinch  grip  power  were  assessed  using  handheld  dynamo-meters. Tactile sensation threshold was measured by monofilaments.Significant differences were found between the affected and unaffected side in the total JTHFT scores, forearm muscle strength, handgrip and pinch grip (p≤0.017), but not the tactile sensa-tion threshold.  The total JTHFT scores were found to be correlated with total score of FMA-UE (rs = -0.789), hand-grip  power  (rs = -0.588) and pinch grip power (rs = -0.657) on the affected side, but not the tactile sensation. The total JTHFT scores were correlated with FMA-UE scores, handgrip and pinch grip of the affected side.  This is the first study in documenting the correlation between the sensorimotor impairments and JTHFT scores in persons with  chronic stroke. Our findings highlights the importance of including upper limb and grip strength training in stroke rehabilitation program in order to improve hand functions in activities of daily living in patients with chronic stroke.
Description of physiotherapy services in a mental health institution in Nigeria
Authors: Gbiri C.A. , Akinpelu A.O. , Odole A.C.
Published: June 2017

Physiotherapy  has  long  been  recognised  as  adjunct  to  drug therapy in the management of individuals with mental illness. however, little evidence existed on the utilization of physiotherapy in mental health especially in developing worlds.This study reviewed the utilization of physiotherapy in a Mental health  Institution in lagos, nigeria and determined its contribution to quality of  patient-care in the hospital.This study involved review of clients’ activity profile and patients’ record in a federal neuro-psychiatric hospital in lagos, nigeria between 2002 and 2006. The hospital records were used as source of information for socio- demographic details. Information on the physical diagnosis was extracted from the patients’ records in the departmental records. Data were summarized using descriptive statistics.Six thousand, four hundred and seventy-three (3.3%) out of the 195,686  patients of the hospital within the study period enjoyed physiotherapy ser vices. only 766 (14%) of the hospital in-patients enjoyed physiotherapy services. In addition, 808 clients enjoyed the health promotion services. low back pain (85; 21.7%), osteo-arthritis (82; 20.9%), stroke (64; 16.3%) and shoulder pain  (29; 7.4%) were the most common co-existing health problems referred for physiotherapy.The importance of physiotherapy in mental health is evidenced in the number of patients/clients who benefited from its services. Therefore, physiotherapy is an integral and indispensible member of the mental health team. however, physiotherapy  is  still  under-utilized  in  the  hospital.  This  points  to  the  need  for  proper  integration  of  physiotherapy  into mental health team in the hospital and other similar health institutions.
Knowledge, perceptions and attitudes of final year medical, occupational therapy and sport science students regarding physiotherapy, in KwaZulu Natal.
Authors: Puckree T. , Harinarain R. , Ramdath P. , Singh R. , Ras J.
Published: June 2017

Knowledge, perceptions and attitudes about physiotherapy  has affected its status. In a developing profession whose patient base is still significantly dependent on referral from medical practitioners, certain stereo-typic attitudes about it require attention. This study investigated the knowledge, perceptions and attitudes of the 2009 final year medical, occupational therapy and sport science students at one university in KwaZulu natal, regarding  physio therapy. A saturation sample of 292 students from the selected groups was  invited  to  participate  in  the study. The  cross  sectional  survey  used a questionnaire  with  open  and  closed ended  questions.  The  data  was  reduced to percentages and analysed using chi square tests at p< 0, 05. The overall response rate was 51% with 95% occupational therapy, 71% sport science and only 31% medical students responding. About 74% of the respondents had adequate knowledge about physiotherapy. Seventy five percent of medical and 50% of oT students knew that physiotherapists were first contact practitioners. over 50% of the respondents who had experienced physiotherapy displayed positive attitudes and felt that physio-therapy was a good career choice. Massage was the best known (95%) and electrotherapy the least known (44%) modality. orthopedics (88%), sports physio therapy (84%) and rehabilitation (78%) were better known. we conclude that the response rate to the study especially by medical students is of concern despite the overall positive attitudes displayed by the participants.
The accurate assessment and physiotherapeutic treatment of rotator cuff myofascial Pain Syndrome: A case report
Authors: Barker B. B. , Olivier B.
Published: June 2017

Management  of  patients  with  rotator  cuff  myofascial  pain syndrome varies  and  successful  intervention  is  dependent  on accurate assessment. The aim of this case report is to show the importance of accurate assessment  and  clinical  reasoning  in  the  physiotherapeutic management  of a  patient  suffering  from  ante-cubital  and  anterior shoulder  pain.  The  patient was  referred  for  physiotherapy  after proving refractory  to  treatment  with  non-steroidal anti-inflammatory medication. The physiotherapist diagnosed a rotator cuff myofascial pain syndrome and treatment proceeded on that basis. Treatment consisted of twitch-obtaining dry needling, myofascial release and exercise therapy.  The result was a change in the harryman rotator cuff functional Assessment Scale score from 22/52 to 43/52 over eight treatments. Strength was regained and subjective pain report on the visual rating scale was improved to 1/10. The case study highlights the importance of accurate assessment and consideration of alternative myofascial sources for pain even in circumstances which initially seem trauma related. Precise diagnosis of the cause - in this case rotator cuff myofascial pain syndrome – will result in effective treatment being administered.