bluuebunny/crossref_metadata_2025_split huggingface dataset:
The roles, training and knowledge of community health workers about diabetes and hypertension in Khayelitsha, Cape Town
Authors: Tsolekile Lungiswa P. , Schneider Helen , Puoane Thandi 
Published: March 2018

Background: The current roles and capacity of community health workers (CHWs) in the management and control of non-communicable diseases (NCDs) remain poorly understood.Objectives: To assess CHWs’ current roles, training and knowledge about diabetes and hypertension in Khayelitsha, Cape Town.Methods: A cross-sectional study of 150 CHWs from two non-governmental organisations contracted to provide NCD care as part of a comprehensive package of services was conducted. An interviewer-administered closed-ended questionnaire was used to determine the roles, training, in-service support, knowledge and presence of NCDs. Descriptive analyses of these domains and multivariate analyses of the factors associated with CHWs’ knowledge of hypertension and diabetes were conducted.Results: The vast majority (96%) of CHWs were female, with a mean age of 35 years; 88% had some secondary schooling and 53% had been employed as CHWs for 4 years or more. Nearly half (47%) reported having an NCD. CHWs’ roles in NCDs included the delivery of medication, providing advice and physical assessment. Only 52% of CHWs reported some formal NCD-related training, while less than half of the trained CHWs (n = 35; 44%) had received follow-up refresher training. CHWs’ knowledge of diabetes and hypertension was poor. In the multivariate analyses, higher knowledge scores were associated with having an NCD and frequency of supervisory contact (≥1 per month).Conclusions: The roles performed by CHWs are broad, varied and essential for diabetes and hypertension management. However, basic knowledge about diabetes and hypertension remains poor while training is unstandardised and haphazard. These need to be improved if community-based NCD management is to be successful. The potential of peer education as a complementary mechanism to formal training needs as well as support and supervision in the workplace requires further exploration.
Neonatal chest image quality addressed through training to enhance radiographer awareness
Authors: Friedrich-Nel Hesta , Van der Merwe Belinda , Kotzé Beatrix 
Published: March 2018

Background: Diagnostic radiographers working in the neonatal intensive care unit primarily aim to produce an image of optimal quality using optimal exposure techniques without repeating exposures, to keep neonatal radiation dose to a minimum. Objectives: The aim of the study was to determine whether radiographers were producing optimal quality chest images and, if not, whether additional training could contribute to reaching this goal in the Free State Province of South Africa. Methods: Neonatal chest image quality was determined in the Neonatal Intensive Care Unit by using a checklist based on and compiled from published guidelines to evaluate the quality of 450 randomly-selected images. Thereafter, a training programme was designed, based on the evaluation criteria of the checklist and image quality areas identified. The training also referred to positioning techniques that should be applied to ensure optimal image quality. After presentation of the training, 450 newly-produced neonatal chest images were evaluated. These images were selected through purposive sampling as this evaluation only included images of participating radiographers who completed the training. Results: Image quality that showed significant improvement included a reduction in electrocardiogram lines superimposed on chest anatomy, a tendency to centre closer to thoracic vertebra four, and visible four-sided collimation on images. Image quality areas with no significant enhancement were the absence of lead markers and radiation shielding. Conclusion: The study has shown that a training programme has the potential to improve neonatal chest image quality.
Supervisory trust to be earned: The role of ethical leadership mediated by person-organisational fit
Authors: Grobler Anton , Holtzhausen Maggie M.E. 
Published: March 2018

Background: The trust relationship between employees and their supervisors (called supervisory trust) has a definite impact on employee behaviour and attitudes. Furthermore, various studies found that ethical leadership impacts on supervisory trust, but in different contexts, and often with homogeneous or limited samples. The interactionist construct of person-organisational fit (P-O fit), consisting of a combination of supplementary fit (indirect fit or value congruence) and complementary fit (direct or person-job fit, as well as needs-supply fit), may however impact on the relationship between ethical leadership and supervisory trust. The unique permutations of these relationships are important not only for conceptualisation purposes, but also for intervention design to enhance the employees’ trust in their supervisors;this would contribute to positive employee behaviour and attitudes. Aim: The purpose of this study was to determine whether a relationship exists between ethical leadership and supervisory trust, with possible mediation by P-O fit. Setting: The research was conducted among ±60 employees from each of 17 private sector and 4 public sector organisations in South Africa. Method: This study utilised a positivist methodology based on an empirical approach, while using a cross-sectional design and quantitative analysis. The sample is relatively representative (in terms of race, gender and the South African work force), as it consisted of 60 employees from each of the 21 South African organisations that participated in the study, with 1260 respondents in total. Results: Significant, positive relationships were found between ethical leadership, P-O fit and supervisory trust. Additionally, it was found that P-O fit partially mediates the relationship between ethical leadership and supervisory trust, confirming the proposed model. Conclusion: A strong, positive relationship exists between ethical leadership (consisting of morality and fairness, role clarification leadership and power-sharing leadership) and supervisory trust, which is partially mediated by P-O fit (consisting of supplementary fit and complementary fit).
Mechanical lower back pain and sacroiliac joint dysfunction in golfers at two golf clubs in Durban, South Africa
Authors: Kunene Siyabonga H. , Luthuli Hlengiwe , Nkosi Mthandeni , Haffejee Maqsood , Jooma Iftikaar , Munro Scott 
Published: March 2018

Background: Mechanical lower back pain (MLBP) and sacroiliac joint dysfunction (SIJD) are common problems among golfers. There are currently few studies on golfers regarding the relationship between MLBP and SIJD.Objective: The objective of this study was to determine the prevalence of MLBP and SIJD and their association in golfers at two golf clubs in Durban, South Africa.Method: A correlation design included convenience sampling. The Standardised Nordic Questionnaire for the analysis of musculoskeletal symptoms determined the prevalence of MLBP. Sacroiliac joint pain provocative tests determined the prevalence of SIJD. Institutional ethical clearance was granted and consent from participants was obtained. Data were collected over 3 weeks and SPSS was used to calculate descriptive and inferential statistics.Results: There were 271 participants dominated by males (86.7%) aged between 39 and 47 years (33.2%). A total of 123 (45%) of the participants presented with MLBP and 62 (23%) with SIJD. The MLBP prevalence was moderately associated with age (χ2 = 71.22, p = 0.004) and years of experience (χ2 = 69.93, p = 0.001). The SIJD prevalence was moderately associated with age (χ2 = 55.49, p = 0.003) and poorly associated with years of experience (χ2 = 44.93, p = 0.005). Twenty-two per cent (60) had both MLBP and SIJD and 54% (146) had neither. A strong association (χ2 = 88.234, p = 0.000) between MLBP and SIJD was observed.Conclusion: There was a high prevalence of MLBP and SIJD and a strong association between them. A comprehensive management approach is recommended for golfers with MLBP and SIJD.Clinical Implications: This study will provide valuable knowledge that will assist clinicians, especially physiotherapists, in their clinical management of golfers with MLBP and SIJD. Intervention studies are needed to address lower back and sacroiliac joint problems reported in this study.
Happiness among South African private sector physiotherapists
Authors: Elliot Michael , Cullen Margaret , Calitz Andre 
Published: March 2018

Background: Happiness of people can affect their daily functioning and work performance. There is limited research assessing the happiness levels of various disciplines within the health care industry. This article is the first attempt to evaluate the happiness levels of private sector physiotherapists in South Africa.Objectives: Research in happiness and physiotherapy studies are two research areas that are not associated with one another in a global perspective. The objective of this study was to assess the happiness levels of private sector physiotherapists in South Africa.Methods: A hypothesised model was statistically tested using a quantitative questionnaire, which was completed online. The target population of this study were all private sector physiotherapists who are members of the South African Society of Physiotherapy. A total of 395 respondents participated in the study.Results: This study confirmed that factors such as influence, social relations, life balance, optimism, work and leisure are all positively associated with the happiness levels of private sector physiotherapists in South Africa. These variables are recommended as key focus areas for physiotherapy practice owners to address, in order to positively affect the happiness levels of all people in their workplace.Conclusion: The study concludes the following: if happiness becomes a priority, then owners of physiotherapy practices need to generate a workforce who are more productive, demonstrate greater collaboration with colleagues and patients, are more positively energised, are less absent and are more loyal to the practice.Clinical Implications: The contribution of this study is that it highlights the importance of managing staff in private physiotherapy practices in a holistic manner.
Solidarity as a global bioethical principle: Own reasons for a culture of solidarity from a Protestant perspective
Authors: Rheeder Riaan 
Published: March 2018

In the development and acceptance of Article 13 of the Universal Declaration of Bioethics and Human Rights (UDBHR), the Protestant faith tradition was not involved in the consultation process (other traditions were indeed consulted). This brings the universality (United Nations Educational, Scientific and Cultural Organization [UNESCO] perspective) as well as the acceptability of the declaration and its principles (civic perspective) into question. To address this issue, it is necessary to involve the Protestant tradition in the discourse by presenting own reasons to support the universal principles in the declaration (theological perspective). In order to achieve the aim, two facets of Article 13 will be studied. In the first place, to present satisfactory own reasons, it is important to investigate and construe beforehand what UNESCO’s understanding is of the content of Article 13 of the declaration. In the second place, with sufficient understanding of Article 13, a theological evaluation and grounding will be undertaken. From a broad Protestant perspective, this discourse has shown that solidarity as a shared value can be grounded in a Trinitarian approach. It is clear that Article 13 of the UDBHR can be grounded in a broad Protestant social teaching; therefore, the call for solidarity can be encouraged, wholeheartedly supported and executed.Intradisciplinary and/or interdisciplinary implications: This study gives attention to global bioethics and human rights, an underdeveloped subject within the field of theological ethics. The study overlaps with political science, philosophy (global ethics) and human rights. It joins the discussion in this discipline and supports the promotion of solidarity within this field, which is very important within the health sector in South Africa.
Assessment of osteoporotic fracture risk in urban Indian population using quantitative ultrasonography & FRAX tool
Authors: Vaishya Raju , Vijay Vipul , Agarwal Amit K. , Maheshwari Prashant 
Published: March 2018

Background & objectives:
There have been studies around the world on the prevalence of osteoporosis and its related risk factors, but there have been limited studies on risk factors and osteoporosis in the Indian population. In this study, the incidence of osteoporosis and the associated clinical risk factors (CRFs) were studied in the urban Indian population.

Methods:
Bone mineral density of 445 individuals >38 yr of age using qualitative ultrasound (QUS) was assessed. The patients were also questioned regarding the presence of the various CRFs as per the FRAX tool. The patients were categorized into normal, osteopenia and osteoporosis groups on the basis of T-score from QUS.

Results:
There were 223 males and 222 females in this study. Sex was significantly associated with T-score (P<0.001). Forty (8.99%) patients were osteoporotic, 265 (59.55%) were osteopenic and the remaining 140 (31.46%) were normal. A significant association of T-score was found with parent history of fracture (P<0.05), rheumatoid arthritis (P<0.05) and secondary osteoporosis (P<0.05). Previous history of fracture's association was not found to be significant. Smoking, alcohol intake and steroid intake were not found to be significantly associated with T-scores.

Interpretation & conclusions:
The incidence of osteoporosis was found to be high in the urban Indian population. More care and attention should be targeted towards elderly, especially the ones with the risk factors to prevent osteoporosis in future.
Spectrum of hyperosmolar hyperglycaemic state in neurology practice
Authors: Misra U.K. , Kalita J. , Bhoi S.K. , Dubey D. 
Published: March 2018

Background & objectives:
Hyperosmolar hyperglycaemic state (HHS) is a medical emergency, but there is a paucity of studies reporting the spectrum of neurological manifestations of HHS. We, therefore, report the neurological spectrum, triggering factors and outcome of HHS in general neurology practice.

Methods:
The records of the patients with HHS were extracted from computerized hospital information system and those managed currently were prospectively included. The demographic, clinical manifestations, duration of diabetes and precipitating events such as infection, stress and stroke were noted. Patients with HHS were categorized into seizure, movement disorder and encephalopathy groups. Their electroencephalography, magnetic resonance imaging (MRI) findings and outcome were noted.

Results:
There were 17 patients with HHS (age range 40 and 75 yr) and seven were females. Seven patients were diabetic for five years, one for four years, one for one year and four were diagnosed after the occurrence of HHS. Four patients had epilepsia partialis continua persisting for 72-360 h, one patient had focal seizures and his MRI revealed T2 hyperintensity in frontal region in one patient and cerebellar vermian hyperintensity in another. All the five patients improved, but two had neurological deficits on discharge. Nine patients had encephalopathy which was precipitated by stroke in six patients, urinary infections in two and meningitis in one. Three females had hemichorea-hemiballismus syndrome, which was triggered by infections. Abnormal movements lasted 5-10 days and responded to correction of hyperosmolarity. Nine out of 17 patients improved completely whereas the remaining eight had partial recovery, these patients had stroke, ventilator-related complications or meningoencephalitis.

Interpretation & conclusions:
The most common presentation of HHS was encephalopathy (9) followed by seizure (5) and hemichorea-hemiballismus syndrome (3) which responded to the correction of hyperosmolar state.
Comunicación turística 2.0 en Ecuador. Análisis de las empresas públicas y privadas
Authors: Altamirano Benitez Verónica , Marín-Gutiérrez Isidro , Ordóñez González Kruzkaya 
Published: March 2018

El turismo en el Ecuador representa el tercer ingreso no petrolero para la economía y se pretende que en el 2020 sea la principal fuente de divisas. Por lo tanto, la promoción turística interna como externa son esenciales para alcanzar estos objetivos. La presente investigación parte de un estudio cuantitativo para determinar la evolución de la comunicación turística 2.0 en Ecuador desde la gestión de las empresas que ofrecen productos y servicios turísticos. Objetivos. El objetivo de esta investigación es identificar y evaluar la comunicación 2.0 en las empresas públicas y privadas de Ecuador. Método. Se utiliza la metodología mixta, cualitativa y cuantitativa, para lo cual se emplea el Modelo de Evaluación de la Comunicación 2.0 que cuantifica las acciones e interacciones en los medios sociales e identifica los indicadores claves de desempeño (KPI) para evaluar las variables de: presencia, crecimiento, actividad, nivel de servicio, participación y Engagement. Conclusiones. En Ecuador la comunicación turística 2.0 es incipiente y la convergencia hacia los medios sociales es baja.
Built-in bad luck: Evidence of near-miss outcomes by design in scratch cards
Authors: Stange Madison , Brown Dan G. , Harrigan Kevin , Dixon Michael 
Published: March 2018

Scratch cards are a pervasive form of gambling in the Canadian marketplace. Despite their widespread appeal, we are only beginning to understand the influence of their structural characteristics on the player. The most widely studied of these characteristics is the near-miss, a game outcome in which the player gets two of the three needed symbols to win a jackpot prize. Although other authors have noted the existence of these outcomes in scratch cards, no systematic investigation has been undertaken to understand their occurrence in these games. We present the results of an analysis to determine the frequency of these outcomes using two samples (sample A, n = 41; sample B, n = 61) of a popular scratch card game available in Ontario, Canada. Our results suggest that certain scratch card games may be designed to include more pairs of jackpot symbols (i.e., more near-miss outcomes) than any other symbol pair. In the game that we analyzed, the top prize symbol occurred more often than any other symbol and appeared to be manipulated to appear in clusters of two, creating many near-miss outcomes to the jackpot prize. This work has strong implications for the study of gambling behaviour, responsible gambling strategies, as well as for the scientific investigation of scratch card games. Les cartes à gratter sont une forme très répandue de jeux sur le marché canadien. Malgré leur grand attrait, nous commençons à comprendre l’influence de leurs caractéristiques structurelles sur le joueur. La caractéristique la plus étudiée parmi elles est un résultat s'approchant du résultat gagnant; le joueur obtient deux des trois symboles nécessaires pour gagner un gros lot. Bien que d’autres auteurs aient noté l’existence de ce genre de résultats dans des cartes à gratter, aucune enquête systématique n’a été entreprise pour comprendre leur occurrence dans ces jeux. Nous présentons les résultats d’une analyse pour déterminer la fréquence de ces résultats en utilisant deux échantillons (échantillon A, n = 41; échantillon B, n = 61) d’un jeu de cartes à gratter populaire, vendu en Ontario, au Canada. Selon nos résultats, certains jeux de cartes à gratter peuvent être conçus pour inclure plus de paires de symboles pour le gros lot (c’est-à-dire des résultats plus proches) que n’importe quelle autre paire de symboles. Dans le jeu que nous avons analysé, le symbole du prix le plus élevé était présent plus souvent que tout autre symbole et semblait être manipulé pour apparaître en grappes de deux, créant de nombreux résultats proches du résultat gagnant. Ce travail a de fortes répercussions pour l’étude du comportement du jeu, du jeu et des stratégies responsables, de même que pour l’étude scientifique des jeux de cartes à gratter.
Exploring the Relationship Between Body Mass Index, Obesity, and Gambling Level Across Different Gambling Types
Authors: Lam Desmond , Mok Man 
Published: March 2018

Individuals’ body weight, measured in terms of body mass index (BMI), has been linked to various health issues in the literature. Recently, a positive relationship has been found between obesity and the level of problem gambling. In this exploratory study, we investigate the association between BMI, obesity, and gambling frequency across multiple types of leisure gambling. Data collected by the Pew Research Center among 1,473 gamblers was used to tests the links between BMI and gambling frequency for 16 types of leisure gambling activities. After we accounted for the effects of age, educational level, and family income and corrected for multiple comparisons, the results showed that obese participants (BMI ³ 30) conducted significantly more gambling activities in two types of gambling, namely, playing bingo for money and buying state lottery tickets. Moreover, among female gamblers only, BMI was positively associated with frequency of gambling related to casinos, college basketball, and video poker machines. The findings of this exploratory study allow a better understanding of the potential risk factors of obesity and may be of value to public policy makers.Dans diverses études antérieures, le poids corporel des personnes, mesuré en termes d’indice de masse corporelle (IMC), a été lié à divers problèmes de santé. Récemment, un lien positif a été constaté entre l’obésité et le niveau de jeu compulsif. Dans cette étude exploratoire, nous examinons la relation entre l’indice de masse corporelle, l’obésité et la fréquence du jeu, en nous basant sur divers types de jeux de hasard récréatifs. À l’aide de données recueillies par Pew Research Center auprès de 1 473 joueurs, l’étude sonde les liens entre l’IMC et la fréquence du jeu dans le cas de seize types de jeux récréatifs. Les résultats montrent qu’après avoir tenu compte de l’effet de l’âge, du niveau d’instruction et du revenu familial, ainsi que de la correction de comparaisons multiples, les participants obèses (IMC ≧ 30) ont mené beaucoup plus d’activités de jeu dans deux types de jeux, à savoir le bingo lucratif et l’achat d’une loterie d’État. De plus, seulement chez les joueurs de sexe féminin, l’IMC est positivement associé à la fréquence du jeu dans les cas du casino, du basketball universitaire et de la machine de vidéo poker. Les résultats de cette étude exploratoire nous permettent de mieux comprendre les facteurs de risque éventuels de l’obésité et peuvent être utiles aux décideurs publics.