Assessing patients' experience of care in four referral hospitals: a cross-sectional survey of outpatients in two South African rural provinces.

Background: Patient experience of care surveys are an important component of performance improvement and clinical effectiveness because they serve as a good proxy for patient's satisfaction and the quality of care. The purpose of this study was to assess patients' experience of care in four referral hospitals in two of South Africa's rural provinces.

Methods: A cross-sectional study was conducted in four public hospitals in Eastern Cape (Nelson Mandela Academic (NMAH) and St.

Quantitative Assessment of Human Health Risks Associated with Heavy Metal and Bacterial Pollution in Groundwater from Mankweng in Limpopo Province, South Africa.

Heavy metal and microbial pollution in groundwater raises health concerns due to its adverse effects. This study aimed to assess the health risks associated with heavy metal and bacterial pollution in groundwater in Mankweng. Heavy metals and were detected using inductively coupled plasma mass spectrophotometry and a Colilert system, respectively.

A programme theory for a transition programme for novice nurses in emergency departments: A realist review.

Aims: To develop a programme theory for a transition programme for novice nurses working in emergency departments.

Design: A realist review was conducted, guided by the Realist and Meta-narrative Evidence Synthesis-Evolving Standards publication standards.

Data Sources: PubMed, CINAHL, Web of Science, Scopus, and the Wiley Online Library.

A new ground level neutron monitor for space weather assessment.

We report on a new ground-level neutron monitor design for studying cosmic rays and fluxes of solar energetic particles at the Earth's surface. The first-of-its-kind instrument, named the NM-2023 after the year it was standardised and following convention, will be installed at a United Kingdom Meteorological Office observatory (expected completion mid 2024) and will reintroduce such monitoring in the UK for the first time since ca. 1984.

Application of a fuzzy multi-criteria decision framework for safety-critical maritime infrastructure evaluation.

This present paper is an investigation of a framework for Safety-Critical Maritime Infrastructure (SCMI) evaluation. The framework contains three Multi-Criteria Decision-Making (MCDM) tools, namely: fuzzy Step-wise Weight Assessment Ratio Analysis (SWARA), Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) and Weighted Aggregates Sum Product Assessment (WASPAS). It also contains five safety practice criteria: people's safety, property safety and monitoring capabilities, response to regular and irregular threats in a robust yet flexible manner, and breaches in physical security.

Effect of Training Healthcare Providers in Helping Babies Breathe Program on Neonatal Mortality Rates.

Background: Training in the Helping Babies Breathe (HBB) Program has been associated with a reduction in early neonatal mortality rate (ENMR), the neonatal mortality rate (NMR), and fresh stillbirth rate (FSBR) in low- and middle-income countries (LMICs). This program was implemented in five different healthcare facilities in the Oliver Reginald Tambo (ORT) District, South Africa from September 2015 to December 2020.

Objective: To determine and compare the FSBR, ENMR, and NMR between 2015 before initiation of the program (baseline) and subsequent years up to 2020 following the implementation of facility-based training of HBB in five hospitals in ORT District.

Geophagic practice in Mashau Village, Limpopo Province, South Africa.

Large quantities of earth materials are consumed daily in Mashau Village; nonetheless, this practice had not been studied. Furthermore, the motivations for this geophagic behaviour in the study area were unclear. Thus, questionnaires were distributed to 200 participants in the study area with the aim of generating data on the motivations of and potential medical conditions associated to this practice.

Areas of delay related to prolonged length of stay in an emergency department of an academic hospital in South Africa.

Introduction: Globally, length of stay of patients in emergency departments remains a challenge. Remaining in the emergency department for >12 h increases health care costs, morbidity and mortality rates and leads to crowding and lower patient satisfaction.The aim of this research was to describe the areas of delay related to prolonged length of stay in the emergency department of an academic hospital.

Twenty-four hour ambulatory blood pressure reference values in Africans.

Objective: We aimed to establish reference values for 24 h ambulatory blood pressure (ABP) monitoring in an African community.

Patients And Methods: We randomly recruited 1219 participants of African ancestry from Soweto, a township in Johannesburg. Twenty-four hour ABP was measured using ABP monitors (model 90207; Spacelab).

Breaking Down Barriers to Tell: A Mixed Methods Study of Health Worker Involvement in Disclosing to Children That They Are Living with HIV in Rural South Africa.

Disclosing to a child that s/he is living with HIV is necessary to promote adherence to treatment and improve health outcomes. Facilitating disclosure between caregivers and children remains a challenge for health workers. Understanding how health workers are involved in and perceive the disclosure process is integral to engaging with such challenges.

Obesity masks the relationship between dietary salt intake and blood pressure in people of African ancestry: the impact of obesity on the relationship between sodium and blood pressure.

Previous studies conducted to investigate the relationship between sodium intake and blood pressure in our African population have yielded contradictory results. With the high prevalence of obesity in this population, it is possible that these contradictory findings are due to the masking effects of obesity on this relationship. We measured 24-hour ambulatory blood pressure and 24-hour urine excretion on 547 South Africans of African ancestry.

Comparison of digital and film chest radiography for detection and medical surveillance of silicosis in a setting with a high burden of tuberculosis.

Background: Continuing use of analog film and digital chest radiography for screening and surveillance for pneumoconiosis and tuberculosis in lower and middle income countries raises questions of equivalence of disease detection. This study compared analog to digital images for intra-rater agreement across formats and prevalence of changes related to silicosis and tuberculosis among South African gold miners using the International Labour Organization classification system.

Methods: Miners with diverse radiological presentations of silicosis and tuberculosis were recruited.

Low levels of physical activity in female adolescents cause overweight and obesity: are our schools failing our children?

The increasing prevalence of overweight and obesity among female adolescents is a global health problem. In developing countries such as South Africa, this increase is often associated with urbanisation and the adoption of a Western lifestyle. Two aspects of the Western lifestyle that contribute to the development of overweight and obesity are a decrease in physical activity levels and an increase in the consumption of energy-dense food, high in fats and refined sugar.

Self-report measurement of pain & symptoms in palliative care patients: a comparison of verbal, visual and hand scoring methods in Sub-Saharan Africa.

Background: Despite a high incidence of life-limiting disease, there is a deficit of palliative care outcome evidence in sub-Saharan Africa. Providers of end of life care call for appropriate measurement tools. The objective is to compare four approaches to self-report pain and symptom measurement among African palliative care patients completing the African Palliative Care Association African Palliative Outcome Scale (APCA African POS).

Stressors and resources of caregivers of patients with incurable progressive illness in sub-Saharan Africa.

Family caregivers are central to palliative care in sub-Saharan Africa. Yet although supporting caregivers requires a comprehensive understanding of caregiver burden, there has been little research into this topic in Africa. Using the Stress Process Model to investigate the burden experienced by caregivers in South Africa and Uganda, we interviewed 37 caregivers and analyzed the data thematically.

'Peace' and 'life worthwhile' as measures of spiritual well-being in African palliative care: a mixed-methods study.

Background: Patients with incurable, progressive disease receiving palliative care in sub-Saharan Africa experience high levels of spiritual distress with a detrimental impact on their quality of life. Locally validated measurement tools are needed to identify patients' spiritual needs and evaluate and improve spiritual care, but up to now such tools have been lacking in Africa. The African Palliative Care Association (APCA) African Palliative Outcome Scale (POS) contains two items relating to peace and life worthwhile.

Diversity and antibiograms of bacterial organisms isolated from samples of household drinking-water consumed by HIV-positive individuals in rural settings, South Africa.

Diarrhoea is a hallmark of HIV infections in developing countries, and many diarrhoea-causing agents are often transmitted through water. The objective of the study was to determine the diversity and antibiotic susceptibility profiles of bacterial organisms isolated from samples of household drinking-water consumed by HIV-infected and AIDS patients. In the present study, household water stored for use by HIV-positive patients was tested for microbial quality, and isolated bacterial organisms were analyzed for their susceptibility profiles against 25 different antibiotics.

How to analyze palliative care outcome data for patients in Sub-Saharan Africa: an international, multicenter, factor analytic examination of the APCA African POS.

Context: The incidence of life-limiting progressive disease in sub-Saharan Africa presents a significant clinical and public health challenge. The ability to easily measure patient outcomes is essential to improving care.

Objectives: The present study aims to determine the specific factors (if any) that underpin the African Palliative Care Association African Palliative Outcome Scale to assist the analysis of data in routine clinical care and audit.

Intensity and correlates of multidimensional problems in HIV patients receiving integrated palliative care in sub-Saharan Africa.

Background: Despite global clinical guidance that HIV patients should have multidimensional care integrated into their management, there has been very limited data to guide practice since the advent of treatment. This study aimed to determine the three-day period intensity of problems (physical, psychological, social and spiritual) among HIV patients receiving integrated palliative care in sub-Saharan Africa, and to identify associations with problem severity.

Methods: A sample of 230 consecutive adult patients attending five sites in South Africa and Uganda gave self-report data using a well-validated outcome scale.

Prevalence, burden, and correlates of physical and psychological symptoms among HIV palliative care patients in sub-Saharan Africa: an international multicenter study.

Context: Despite HIV remaining life limiting and incurable, very little clinical research focus has been given to the prevalence and related burden of physical and psychological symptoms for those accessing palliative care. Despite evidence of problems persisting throughout the trajectory and alongside treatment, scant attention has been paid to these manageable problems.

Objectives: This study aimed to measure the seven-day period prevalence and correlates of physical and psychological symptoms, and their associated burden, in HIV-infected individuals attending palliative care centers in sub-Saharan Africa.

The "Spirit 8" successfully captured spiritual well-being in African palliative care: factor and Rasch analysis.

Objective: To describe the dimensionality of a measure of spiritual well-being (SWB) (the "Spirit 8") in palliative care (PC) patients in South Africa and Uganda, and to determine SWB in this population.

Study Design And Setting: A cross-sectional survey was conducted using the Missoula Vitas Quality of Life Index (MVQOLI). Translated questionnaires were administered to consecutively recruited patients.

Quality of life among patients receiving palliative care in South Africa and Uganda: a multi-centred study.

Background: Quality of life (QOL) is a core outcome of palliative care, yet in African settings there is a lack of evidence on patients' levels of QOL. We aimed to describe QOL among patients with incurable, progressive disease receiving palliative care in South Africa and Uganda, to compare QOL in cancer and HIV, to determine how domains of QOL correlate with overall QOL, and compare levels of QOL in this population with those in other studies using the same tool.

Methods: A cross-sectional survey was conducted using the Missoula Vitas Quality of Life Index (MVQOLI), a 26-item QOL questionnaire with five subscales (Function, Symptom, Interpersonal, Well being, Transcendent) covering physical, social, psychological and spiritual domains and one global QOL item.

The MVQOLI successfully captured quality of life in African palliative care: a factor analysis.

Objective: To examine the factor structure of the Missoula Vitas Quality of Life Index (MVQOLI) in palliative care patients in South Africa and Uganda and to assess the tool's appropriateness for measuring quality of life (QOL) in this context.

Study Design And Setting: Cross-sectional survey using the MVQOLI, a 26-item QOL measure containing five subscales (Function, Symptoms, Interpersonal, Well being, and Transcendent), in five palliative care services in South Africa and Uganda.

Results: Two hundred eighty-five patients were recruited; mean age was 40.