bluuebunny/crossref_metadata_2025_split huggingface dataset:
Access to antiretroviral treatment in South Africa, 2004 - 2011
Authors: Johnson Leigh Francis 
Published: June 2017

Background. South Africa’s National Strategic Plan (NSP) for 2007 - 2011 aimed to achieve new antiretroviral treatment (ART) enrolment numbers equal to 80% of the number of newly eligible individuals in each year, by 2011.
Objectives. To estimate ART coverage in South Africa and assess whether NSP targets have been met.
Methods. ART data were collected from public and private providers of ART. Estimates of HIV incidence rates were obtained from independent demographic projection models. Adult ART data and incidence estimates were entered into a separate model that estimated rates of progression through CD4 stages, and the model was fitted to South African CD4 data and HIV prevalence data.
Results. By the middle of 2011, the number of patients receiving ART in South Africa had increased to 1.79 million (95% CI 1.65 - 1.93 million). Adult ART coverage, at the previous ART eligibility criterion of CD4
Child privacy rights: A ‘Cinderella’ issue in HIV-prevention research
Authors: Strode Ann Elaine , Slack Catherine 
Published: June 2017

Legal debates regarding child participation in HIV research have tended to focus on issues of informed consent. However, much less attention has been given to privacy; accordingly, we classify this as a ‘Cinderella issue’ that has been excluded from ‘the ball’ (academic debate). Here we argue that privacy issues are as important as consent issues in HIV-prevention research. We describe a child’s right to privacy regarding certain health interventions in South African law, and identify four key norms that flow from the law and that could be applied to HIV-prevention research: (i) children cannot have an expectation of privacy regarding research participation if they have not given independent consent to the study; (ii) children may have an expectation of privacy regarding certain components of the study, such as HIV testing, if they consent independently to such services; (iii) children’s rights to privacy in health research are limited by mandatory reporting obligations; (iv) children’s rights to privacy in HIV-prevention research may be justifiably limited by the concept of the best interests of the child. We conclude with guidelines for researchers on how to implement these principles in HIV-related research studies.
Consensus statement: Management of drug-induced liver injury in HIV-positive patients treated for TB
Authors: Jong E , Conradie F , Berhanu R , Black A , John M-A , Meintjes G , Menezes C 
Published: June 2017

Drug-induced liver injury (DILI) in HIV/tuberculosis (TB) co-infected patients is a common problem in the South African setting, and re-introduction of anti-TB drugs can be challenging for the healthcare worker. Although international guidelines on the re-introduction of TB treatment are available, the definition of DILI is not uniform, management of antiretroviral therapy (ART) in HIV co-infection is not mentioned, and the guidance on management is not uniform and lacks a practical approach. In this consensus statement, we summarise important aspects of DILI and provide practical guidance for healthcare workers for different patient groups and healthcare settings on the re-introduction of anti-TB drugs and ART in HIV/TB co-infected individuals presenting with DILI.
HIV risk behaviour among public primary healthcare patients with tuberculosis in South Africa
Authors: Peltzer Karl 
Published: June 2017

Objective. To identify factors associated with HIV in tuberculosis (TB) patients in a public primary healthcare (PHC) setting in South Africa (SA).Method. Among 4 900 consecutively selected TB patients (54.5% men; women 45.5%) from 42 public PHC clinics in 3 districts in SA, a cross-sectional survey was performed to assess new TB and new TB retreatment patients within one month of anti-TB treatment.Results. The sample comprised 76.6% new TB patients and 23.4% TB retreatment patients. Of those who had tested for HIV, 59.9% were HIV-positive; 9.6% had never tested for HIV. In multivariate analysis, older age (odds ratio (OR) 5.86; confidence interval (CI) 4.07 - 8.44), female gender (OR 0.47; CI 0.37 - 0.59), residing in an informal settlement (OR 1.55; CI 1.13 - 2.12), being a TB retreatment patient (OR 0.55; CI 0.42 - 0.72), occasions of sexual intercourse with condom use (OR 1.07; CI 1.02 - 1.13) and having a sexual partner receiving antiretroviral treatment (ART) (OR 7.09, CI 4.35 - 11.57) were associated with an HIV-positive status in TB patients.Conclusion. This study revealed high HIV risk behaviour (e.g. unprotected last sexual intercourse and alcohol and drug use in the context of sexual intercourse) among TB patients in SA. Various factors were associated with HIV risk behaviour. Condom use and substance use risk reduction need to be considered as HIV-prevention measures when planning such strategies for TB patients.
Impact of antiretroviral therapy on pregnancy outcomes
Authors: Aniji C D , Towobola Olakunle A , Hoque Muhammad Ehsanul , Mashamba T J , Monokoane Sam 
Published: June 2017

Background.The majority of HIV-positive women in South Africa are of reproductive age, and pregnancies among women using antiretroviral therapy (ART) are common. However, there are mixed data regarding the impact of ART on pregnancy outcomes.Objective. To examine the impact of ART on pregnancy outcome according to the timing of initiation of treatment.Methods. A retrospective cohort study was conducted among women delivering at a tertiary hospital from 1 October 2008 to 31 March 2009.Results. A total of 245 mothers were receiving ART: 76 mothers (31%) started ART pre-conception and 169 mothers (69%) started ART after the first trimester. No significant differences were observed in the rates of preterm delivery and low birth weight (LBW) between the pre- and post-conception groups (21% v. 24% and 21% v. 25%, respectively).Conclusion. In this cohort of women receiving ART in pregnancy, timing of ART initiation did not have any adverse effect on the measured pregnancy outcomes such as preterm delivery and LBW.
Exercise capacity in pulmonary Tuberculosis
Authors: Hall M. , De Charmoy S. 
Published: June 2017

Aims: To determine the exercise capacity of patients suffering from pulmonary tuberculosis infection and then compare thisvalue to the normal. To determine if the regression equation for TB is comparable to that of patients with chronic obstructive pulmonary disease(COPD). To provide guidelines for clinical practice of physiotherapyshould exercise capacity be found to be reduced. Methods: Thirteen black, male subjects between the ages of 19 and 35 years were included in the study. Each subject completed the shuttle walking test in order to determine his VO2peak. This was then compared to historical data for VO2peak. A subgroup of five subjects took part in a treadmill test to calculate a regression equation for VO2peak for TB patients. Results: Exercise capacity, measured as VO2peak, is reduced by an average of 57% when compared to the normal.The mean (SD) VO2peak for this group of thirteen patients is 19.09 (8.19)ml/kg/min. The shuttle walking test is a validand reliable test to determine the VO2peak of patients with pulmonary tuberculosis. Although a trend is evident the regression equation for pulmonary TB is based on a small sample size. Conclusion: Although the exercise capacity of patients with PTB is markedly reduced it does not seem to impact on their function. Based on the above results, a preliminary recommendation is that a pulmonary rehabilitation program is not necessary for patients with pulmonary tuberculosis. Although not originally an aim of the study it isalso evident that the role of the physiotherapist with respect to pulmonary tuberculosis may be one of education.
Prevalence of anterior knee pain among young South African basketball players
Authors: Louw Q. 
Published: June 2017

The aim of the article is to provide an indication of anterior knee pain prevalence among young South African basketball players. A retrospective questionnaire survey was conducted to capture information on injuries sustained over one season. The sample comprised 458 young basketball players in Cape Town and comprised 122 club players and 337 school basketball players. A total of 180 knee injuries were reported indicating a rate of 1 knee injury in 2.5 players. Anterior knee pain was the most commonly reported area ofpain by the 458 basketball players (49.1%, n=141). The most common combination of pain area was anteromedially (18.2%, n=141). The results of our survey are in agreement with other studies indicating that patellofemoral pain is probably the most common knee presentation among young active individuals and arguably the most common condition seen at sports injury clinics.
A pilot survey of the current scope of the practice of South African physiotherapists in the intensive care units
Authors: Van Aswegen H. , Patterson J. 
Published: June 2017

Objective: A pilot study was conducted to determine the currentscope of practice of South African physiotherapists working in intensive care units in the government and the private sectors. These findings were compared to the findings from a European survey with regard to the role of the physiotherapist in European intensive care units.Methodology: Ninety questionnaires were distributed nationwide to secondary and tertiary government hospitals as well as to private practitioners involved in cardiopulmonary physiotherapy. The private practitioners included in this survey were listed in the Private Practitioners Association Official Members Directory. Junior and senior physiotherapists working in the intensive care units of their respective hospitals participated in completing the questionnaire. Comparisons between government and private sector data and between the South African survey and the European survey were carried out using the 2test for non-parametric data. A p-value of less than 0.05 was considered to be statistically significant.Results: Fifty-four questionnaires were analyzed and represented 60% of questionnaires sent out. Respondents to the South African survey reported 28% percent of all ICUs had between 9 - 12 beds; 83% physiotherapists indicated the availability of an on-call service during the night and 96% physiotherapists had a weekend physiotherapy service. Ninety-two percent of physiotherapists working in the government sector supervised students compared to 44% of physiotherapists in the private sector. Between 9% and 27% of physiotherapists in government and private hospitalsactively participated in research in ICU. There were no statistically significant differences in the use of respiratory physiotherapy, mobilization and positioning between respondents to the European survey and those of the South African survey respectively.Conclusion: The response rate to this questionnaire was good. It was evident from this pilot survey that the scope of practice of physiotherapy in ICU didn’t differ significantly between the government and private sector in South Africa. The role of the intensive care physiotherapist in South Africa was similar to that of the European physiotherapist working in ICU.
Teaching health promotion: experiences from the University of the Western Cape
Authors: Struters P. , Phil M. 
Published: June 2017

This article describes and assesses the University of theWestern Cape’s (UWC) second year Community and Health Science students’experience in their interdisciplinary, community based health promotion module. Health promotion is a rapidly growing discipline for health professionals internationally. The World Health Organisation (WHO) has described health promoting schools as effective settings for the promotion of the health of learners, teachers, parents and the broader community. The health promotion module at UWC introduces the university students to the practical development of health promoting schools. The aim of this study was to assess undergraduate students’ attitudes to and impressions of their learning experience during the health promotion module. These interventions included addressing teenage pregnancy; addressing drug abuse including smoking; addressing poor personal hygiene; and addressing the poor classroom environment. Small interdisciplinary teams of students worked with school learners at a high school in a poorly resourced area in Cape Town, where they planned, implemented and evaluated small scale interventions. Students indicated they had learnt far more from the interdisciplinary, experiential learningthan from classroom based learning or textbooks located within their own discipline. The results suggest that health promotion is an ideal subject for physiotherapy students to study collaboratively with the other health disciplines. One group of students wrote: “We have learnt much more than any textbook or lecturer could ever teach us.”
Perspectives on physiotherapy guidelines for chronic low back pain
Authors: Berger P. 
Published: June 2017

The prevalence of chronic low back pain presents a world widedilemma to patients, physiotherapists and clinicians. There is scant evidence for prevention and treatment however it is now acknowledged that the use of physiotherapy in a multidimensional context has proved the more appropriate model as a vital component of the collaborative approach required for effective pain management. The following article reviews the current literature, evaluates and combines the guidelines that have been proposed from various international studies to provide a practical approach to the management of chronic back pain. This approach recognizes a broad biopsychosocial model of health and the positive role of activity in health and healing with emphasis on function, rather than impairment. Therefore the development of a patient-centred rehabilitative approach has emerged that emphasizes the restoration of normal movement and function with the addition of physical modalities where appropriate. Recent advances in neurophysiology, the modulation of pain and its perception and the fact that biological systems are known to be greatly affected by electrical treatment provide a clearer rationale for the use of physical agents for rehabilitation of patients with pain and relateddisability. The modalities used in conjunction with active exercises include thermal, massage, electrical stimulation, traction, transcutaneous electrical nerve stimulation (Tens), myofascial release, dry needling, mobilization and acupuncture. An algorithm is provided with the intention of developing protocols for breaking the pain cycle in both nociceptive and neuropathic pain states and in reducing inflammation which is a component of both peripheral and central sensitization. Pain rehabilitation is a useful and cost-effective approach to chronic pain management and makes patients’ responsible partners in their own progress. It encourages planning, pacing of activities and activity related goal setting into a clear and goal-oriented context that provides the patient with control and improved quality of life.
Patient satisfaction with a pilot chronic pain management programme in Cape Town, South Africa
Authors: Parker R. , Burgess S. , Dubaniewicz A. , Gouws L. , Krone J. , Madden V. , Nortje C. , Parsons C. 
Published: June 2017

Background: The goals of a chronic pain management clinic includeincreasing patient knowledge about pain, developing pain management skillsand increasing patients’ confidence in their pain management abilities.A Chronic Pain Management Programme (CPMP) based on evidence basedguidelines was developed at a chronic pain management clinic to facilitatepatient discharge to a primary healthcare level. Aim: The aim of this study was to explore patient satisfaction with, acceptability of and the perceived success which could be due to the CPMP developed at the Chronic Pain Management Clinic of Groote Schuur Hospital,Cape Town.Methods: Patients (n=14) were referred to the pilot study from the Chronic Pain Management Clinic. A s a pilot, four courses were run over a period ofone year. In order to reach the research aim, an eleven-question, structuredopen-ended interview was conducted with all participants. Results: Fourteen patients enrolled in the CPMP. Responses were favourable with participants emphasising the roleof increased knowledge about pain, the role of exercise and of stress management techniques. Participants also recog-nised a positive change in behaviours and attitudes following participation in the CPMP.Conclusions: Findings suggest that participants found the format of the course acceptable as regards course content,structure and delivery. Participant responses suggest that the course was acceptable and perceived as useful. However,future courses would benefit from refresher courses or structured support groups.
The use of information and communication technology by South African physiotherapy students
Authors: Rowe M. , Struthers P. 
Published: June 2017

The global shift toward the use of information and commu -nication technology (ICT) in health education and practice has been shown toenhance both the educational opportunities and the support provided to studentsand healthcare professionals. This study aimed to investigate the use of ICTby South A frican physiotherapy students and what their experiences and perceptions were regarding their use of ICT as part of their studies. The studydesign was a cross-sectional, descriptive survey using a self-administered questionnaire. The survey populationincluded all of the undergraduate physiotherapy students from six of the eight universities offering the physiotherapydegree in South A frica (N=1105). The sample size consisted of 529 students from the survey population who completed and returned questionnaires, indicating a response rate of 48%. The results of the study showed that the useof ICT by South A frican physiotherapy students varied according to task, racial group and university attended.Furthermore, the reported use of ICT for communication, research and continuing professional development was low.In conclusion, this study indicates that with a move toward the use of ICT to enhance health education and practice in South A frica, certain groups of physiotherapy students may be at a disadvantage if required to make use of ICT asa means of improving communication, enhancing education, participating in lifelong learning opportunities andaccessing support.
The effects of a 12-week program of static upper extremity weight bearing exercises on weight bearing in children with hemiplegic type of cerebral palsy
Authors: Jayaraman P. , Puckree T. 
Published: June 2017

The major objective of this study was to quantify the effects of a 12-week program of weight bearing exercises on weight borne through the hand and grip pressures in children with hemiplegic cerebral palsy. This study also sought to monitor the change in spasticity immediately following weight-bearing exercises. A quasi-experimental, one group pre-test, post-test study was used. Eleven children with hemiplegic type of cerebral palsy from a special school in KwaZulu Natal participated after fully informed written consent. The intervention consisted of a 12-week program of weight bearing. The Tekscan Grip system was used to quantify weight borne through the hand during extended arm prone and quadruped positions and whilst holding a pencil and a tumbler. The modified Ashworth grading of spasticity was used to monitor spasticity. The data was analysed using the random effects GLS model Wald Chi Square test. Significant increases in contact pressure in extended arms prone (p=0,012) and quadruped (p=0,002) and when holding a pencil (p=0,045) was noted post-test compared to pre-test. Significant increases in contact area of the hand was also noted in prone (p=0,000), quadruped (p=0, 03 at assessment 7) and when holding a pencil (p=0,035). A significant decrease in spasticity during elbow extension (p=0,004), and wrist flexion (p=0,026) and extension (p=0,004) was noted. An overall significant effect of static weight bearing exercises on weight borne through the hands, grip strength and spasticity justifies the use of static weight-bearing in therapy.
The effect of gluteus medius training on hip kinematics in a runner with iliotibial band syndrome
Authors: Schreiber R. , Louw Q. 
Published: June 2017

Iliotibial band syndrome (ITBS) is a common clinical presentation in runners. There are several hypotheses to explain this condition including faulty control of the hip joint in the frontal plane during the stance phase of running. It is postulated that improving activity in the gluteus medius muscle may assist in produc-ing more appropriate stabilization and therefore reduce the stress on the Iliotibial band (ITB). This single case study provides an interesting clinical scenario where a single-subject with ITBS was measured for hip kinematics during running, before and after a trial period of classic gluteus medius exercises. The biomechanical data show an initial (pre-intervention) increase in adduction position during the stance phase of running on the affected side (in contrast to the unaffected side). This was measured using a Moven motion analysis suit. After the trial intervention period, the relative position of the affected hip had reduced in adduction at both heel strike and at 30° knee flexion. This study provides support for the theory that hip control in the frontal plane may be a contributing factor in ITBS. Clinicians are encouraged to monitor hip control as well as ITBS symptoms when they utilise this gluteus medius protocol. Further research to establish whether change in pelvic control results in decrease in ITBS symptoms is warranted.
Effects of electrical stimulation in early Bells palsy on facial disability index scores
Authors: Alakram P. , Puckree T. 
Published: June 2017

Recovery following facial nerve palsy is variable. Physiotherapists try to restore function in patients with Bell’s palsy. The choice of treatment modality depends on the stage of the condition. Although limited evidence exists for the use of electrical stimulation in the acute stage of Bell’s palsy, some physiotherapists in South Africa have been applying this modality. This study examined the effects of electrical stimulation on functional recovery from Bell’s palsy using the Facial Disability Index, a tool that documents recovery from the patients’ perspective. A two group pre-test post-test experimental design comprising of 16 patients with Bell’s Palsy of less than 30 days duration was utilized. Patients with a clinical diagnosis of Bell’s Palsy were systematically allocated to the control and experimental groups. Patients (n=16) were pre-tested and post-tested using the Facial Disability Index. Both groups were treated with heat, massage, exercises and given a home program. The experimental group also received electrical stimulation. The FDI of the control group improved between 17, 8% and 95, 4% with a mean of 52, 8%. The improvement in the experimental group ranged between 14, 8% and 126% with a mean of 49, 8%. Certain clinical residuals persisted in a mild form in both groups on discharge from the study. The effects of electrical stimulation as used in this study during the acute phase of Bell’s palsy, quantified as the FDI was clinically but not statistically significant. A larger sample size, longer stimulation time or both should be investigated.