Browsing by Author "Chipps, Jennifer"
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Item Acceptability and feasibility of a screening protocol for antenatal depression (SPADe) in Blantyre District, Malawi(BMC, 2022) Chorwe‑Sungani, Genesis; Mwagomba, Modesta; Chipps, JenniferDepression is one of the most common perinatal mental health problems that afect pregnant women. Antenatal depression can adversely afect the well-being of the pregnant woman and her foetus. Depression is rarely detected by midwives due to the unavailability of relevant screening instruments in Malawi. A Screening Pro‑ tocol for Antenatal Depression (SPADe) was developed and recommended for possible use to screen for depression in antenatal clinics in the country. The acceptability and feasibility of using the SPADe protocol to screen for depression has not been established. The aim of this study was to assess the acceptability and feasibility of screening for depres‑ sion by midwives using SPADe in antenatal clinics in Blantyre district.Item Acceptance and commitment therapy in the prevention of mother to child transmission of HIV program among pregnant women living with HIV in South Western States of Nigeria(University of the Western Cape, 2017) Ishola, Adeyinka Ganiyat; Chipps, JenniferThe objective of this study was to determine if introducing acceptance and commitment therapy in the prevention of mother to child HIV transmission (PMTCT) program using weekly mobile phone messages would result in improved mental health status of HIV-positive, pregnant women in Nigeria. The study used a quantitative approach using a Solomon four-group (two intervention and two control groups) randomised design to evaluate the impact of an acceptance and commitment therapy program. The study population was 132 randomly selected (33 per site), HIV-positive pregnant women attending four randomly selected PMTCT centres in Nigeria. Two were Intervention and two were Control sites which functioned as Intervention and Control groups. The intervention groups were exposed to one session of acceptance and commitment therapy with weekly value-based health messages sent by mobile phone for three months during pregnancy. The control groups received only post-HIV test counselling.Item Admission rates as an indicator of the prevalence of severe asthma in the community(Wiley, 1998) Jalaludin, Bin; Chey, Tien; Holmwood, Marvin; Chipps, Jennifer; Hanson, Ralph; Corbett, Stephen; Leeder, StephenBACKGROUND: A reliable indicator of the prevalence of severe asthma in the community is needed to monitor population-based asthma control strategies. We examined the potential use of asthma admissions to hospital as such an indicator. METHODS: We recruited subjects from the Emergency Department (ED) of a children's hospital. The attending doctor completed the 'physician questionnaire' which included questions on the patient's asthma severity and interval severity/chronicity of asthma. The parent/guardian completed the 'parent questionnaire'. It included questions on demography, asthma knowledge and attitudes, asthma history and social support. We performed univariate and multiple logistic regression to determine predictors for hospital admission. RESULTS: Interval severity of asthma, pre-treatment severity of wheeze and low post-treatment pulse oximetry best predicted whether children presenting with asthma were admitted. Demographic variables, factors associated with access to health services and factors related to the asthma history and management were not significant predictors of admission. DISCUSSION: At the population level, it may be possible to utilise routine hospital admission rates as an indicator of the prevalence of severe asthma in the community, especially within the context of monitoring trends in asthma prevalence. Our study was conducted in a metropolitan tertiary paediatric hospital. The reliability of hospital admission rates as indicators of the prevalence of severe asthma in other hospital settings, in different population groups and over time remains to be established.Item Analysis of depressive symptoms and cognitive impairment in residents using the interRAI-LTCF in a long-term care facility in the Cape metropole in South Africa(University of the Western Cape, 2018) Mayer, Linda; Chipps, Jennifer; Julie, HesterWorldwide concerns have been raised about the presence and association of depressive symptoms, cognitive impairment, and dementia in older adults (60 years and older), which are often unrecognised and untreated in long-term care facilities (LTCF’s). The progression of cognitive impairment to dementia reduces quality of life with negative consequences of physical, mental, and psychosocial health. In many LTCF’s internationally, the standardised interRAI system is used to capture depressive symptoms and cognitive impairment. However, there is a fragmentation of systems for making evidence-based decisions to plan and manage care for residents with depressive symptoms, cognitive impairment, and dementia. This study, being the first of its kind in South Africa, addressed this gap, by describing a profile of depressive symptoms and cognitive impairment in residents, and analysing their coexistence, using the interRAI-LTCF in a LTCF in the Cape Metropole in South Africa. A quantitative, descriptive, and analytical cross-sectional secondary data analysis was conducted using the records of all 173 resident’s medical records of residents with a last interRAI-LTCF assessment from 2014 and 2016. The objectives were to determine the levels of depressive symptoms and cognitive impairment, and to assess variously associated demographics and clinical variables between depressive symptoms and cognitive impairment of the interRAI-LTCF in residents in a LTCF. Secondary data were analysed, using the IBM Statistical Package for Social Sciences (SPSS) software, version 25, to test any statistically significant relationship between the extracted variables (Significance was set as p˂0.05). The prevalence of possible depression, using the Depression Rating Scale (DRS) of the interRAI-LTCF in the residents in this study was 36.4%, of whom 54.3% had a documented clinical diagnosis of depression. The prevalence of cognitive impairment was 39.3%, using the Cognitive Performance Scale (CPS), of whom 34.1% had a documented clinical diagnosis of cognitive impairment/dementia. There were more females than males with the possibility for depression and cognitive impairment, especially in those who were older than 80 years of age, those without partners, and who had ≤12 years of education. The DRS and the CPS were able to predict the possibility for depression and CI. There is a 55.9% risk of possible depression with CI present as compared to a 23.8% risk of possible depression when CI is not present. That means that people meeting criteria for CI on the CPS are 2.3 times more likely to meet the criteria for possible depression on the DRS. Similarly, there is a 60.3% risk of CI with possible depression present as compared to a 27.3% risk of CI when possible depression is not present. That means that people meeting criteria for possible depression on the DRS are 2.2 times more likely to meet the criteria for CI on the CPS. The logistic regression confirmed the coexistence between depressive symptoms and cognitive impairment.Item Depression in older adults: prevalence and risk factors in a primary health care sample(MedPharm Publications, NISC (Pty) Ltd and Informa UK Limited, 2017) Padayachey, U.; Ramlall, Suvira; Chipps, JenniferBACKGROUND: Depression in the geriatric population has been identified as a significant problem in view of the associated negative outcomes regarding poor functioning, increased perception of poor health and increased utilisation of medical services. Significantly associated with increased morbidity and mortality, depression has been found to be an independent cause of disability as well as adding to disability due to primary physical illnesses. Early identification and treatment of depression reduces medical costs and lessens caregiver burden. Epidemiological data and prevalence rates of geriatric depression in Africa are limited, although such data are vital to mobilise and plan government mental health initiatives aimed at screening and early intervention. OBJECTIVE: To determine the prevalence of depression and associated clinical and socio-demographic factors amongst older adult patients attending a primary health care clinic in the Ethekwini District in Kwa-Zulu Natal, South Africa. METHODS: The 15-item Geriatric Depression Scale and a socio-demographic questionnaire were administered in English to 255 geriatric outpatients, randomly selected, at a local community clinic in Durban. DATA ANALYSIS: Data were analysed using SPSS version 23®. Descriptive statistics were used to summarise the sample demographics and response rate and non-parametric statistics were used to test for associations and differences. RESULTS: A Cronbach’s alpha for the GDS was calculated (p = 0.793). Some 40% of participants screened positive for depression. Female gender, widowhood and a negative subjective health status rating were significantly associated with depression and marriage appeared to be protective (p < 0.001). Participants with a poor subjective health rating were 21 times more likely to be depressed and widowhood conferred an almost fourfold increased risk of being depressed, with widows at greater risk than widowers. No association between depression and specific medical conditions was identified. CONCLUSION: There is a high rate of undetected depression among the elderly attending a local primary health care clinic with widowhood and poor subjective health being strong predictors of mood disorders. The findings warrant replication in bigger samples.Item Depressive symptoms in community-dwelling persons aged≥60 years in Inanda, Ntuzuma and KwaMashu in eThekwini, KwaZulu-Natal(AOSIS Publishing, 2015) Chipps, Jennifer; Narainsamy, Jayalakshmi; Cassim, BilkishBACKGROUND. Physical and psychological ailments increase with age; while the physical ailments are well documented, mental health issues have received less attention. OBJECTIVE. To determine the prevalence of depressive symptoms and associated risk factors in individuals aged ≥60 years living in a lowresource peri-urban area in South Africa. METHODS. Secondary analysis was performed on data obtained from a primary study conducted to determine the influence of socioeconomic and environmental factors on the health status and quality of life in older persons living in the Inanda, Ntuzuma and KwaMashu (INK) area. The Center for Epidemiologic Studies Short Depression Scale (CES-D 10) was used to screen for depressive symptoms in the week preceding the interview, and respondents were categorised as having no (score <10), mild (10 - 14), or severe (>14) depressive symptoms. Risk factor associations were tested using Pearson’s χ2 tests and logistic regression. RESULTS. There were 1 008 respondents (mean (standard deviation) age 68.9 (7.4) years), of whom 503 (49.1%) did not meet criteria for depressive symptoms. Of the 505 (50.1%) respondents who met the CES-D 10 criteria for depressive symptoms, 422 (41.9%) had mild and 83 (8.2%) had severe depressive symptoms. In the univariate analysis, significant associations were found with age (p=0.011), household size (p=0.007), income (p=0.033), disability (p=0.001), nutritional status (p≤0.001), the inability to count on family (p=0.008) and lack of mastery (p≤0.001). In direct binary logistic regression, there were significant associations with lack of mastery (p≤0.001), inability to count on family (p=0.027), malnutrition (p≤0.001) and household size (p=0.024). CONCLUSION. This study highlights the high prevalence of depressive symptoms in the elderly in the INK area, and the need to promote successful ageing of the elderly population in this area.Item Developing telepsychiatry services in KwaZulu-Natal - an action research study(OMICS Publishing Group, 2012) Chipps, Jennifer; Ramlall, Suvira; Madigoe, Thebe; King, Howard; Mars, MauriceOBJECTIVE: In 2009, the Departments of Psychiatry and Telehealth of the University of KwaZulu-Natal (UKZN) initiated a three year project to develop telepsychiatry services in KwaZulu-Natal. This paper describes the challenges and opportunities of this project. METHOD:This was a collaborative, in situ health service project and an action research framework was adopted. Over the three years, following a needs assessment and an e-health Readiness Assessment, two action research cycles were completed. Cycle 1: The preparation, implementation and evaluation of educational material, technical requirements and clinical guidelines and clinical support materials. Cycle 2: Preparation and evaluation of educational and clinical outreach sessions. RESULTS: Videoconference education sessions were beneficial to health staff without post-qualification psychiatry training. A flexible format for education improved knowledge outcomes. Clinical sessions are feasible, but require administration and technical support for facilitation. With facilitator training, 128Kbps is a suitable bandwidth for education but 384Kbps is preferred for clinical consultation. CONCLUSION: Telepsychiatry offers tremendous potential to facilitate the three strategies suggested by the World Psychiatric Association to address the treatment gap, save time and costs and improve access to the small pool of specialist psychiatrists in resource constrained environments.Item Development of a health education programme for self-management of Type 2 diabetes in Edo State, Nigeria(University of the Western Cape, 2016) Afemikhe, Juliana Ayafegbeh; Chipps, Jennifer; Kooste, K.Diabetes is a chronic, metabolic disease that requires lifelong medical management, health education and self-management. According to a World Health Organisation report, there is a global increase in the prevalence of diabetes and even more so in the low-and middle-income countries, specifically Nigeria, which has the highest number of people with diabetes in the African region of the World Health Organisation. As a global issue, the positive health outcomes of diabetes are tied to health education and self-management of the disease and using the health resources of nations. However, in the context of limited resources in Nigeria, there is a need for improvement of health education in self-management of Type 2 diabetes. Health education that is provided in some Nigerian health facilities is reported to be unstructured, without patients’ active participation, not tailored to the needs and the interests of the patients and limited collaboration between multi-disciplinary professionals. In this context, the aim of the study was to develop a structured health education programme for self-management of patients with Type 2 diabetes, to facilitate the quality of the lives of these patients .An adapted intervention mapping framework provided a structured process for development of an evidenced based programme. A mixed method approach was followed. In the first phase of the study an exploratory descriptive qualitative research design was followed. A purposive sampling approach was used in selecting (i) participants, who were patients with Type 2 diabetes and (ii) health-care professionals working in two health-care institutions in Benin City, Edo State, Nigeria. In phase 1, Step1 of the research was a situation analysis, which consisted of conducting 30 semi-structured interviews with patients; observation of nurses providing health education; and five focus group discussions with health-care professionals (nurses, dieticians and social workers). Qualitative data analysis was accomplished through using Tesch’s (1990) steps of analysis to identify themes and categories. The situation analysis revealed, firstly, that there was a lack in the knowledge and self-management of Type 2 diabetes among patients. Secondly, that the health-care professionals acknowledged their collective role in health education and were burdened with the patients who were non-adherent to self-management. The result also revealed the necessity to change from a traditional teaching method to a structured educational process that is patient-centred. The second phase of the research was the stage of developing the educational programme through collaboration with the stakeholders (health-care professionals and patients with Type 2 diabetes) using the findings from the data-analysis of the first phase supported with literature. In phase 2, Step 2 was to develop matrices from the data analysis in Phase 1 for the programme. Step 3 added theory-based intervention methods and practical applications to the preliminary program and in Step 4 the programme was described. This was followed in Step 5 by preparing health-care professionals for offering the programme to patients and implementing and evaluating the programme. The evaluation of the programme was by means of a quantitative pilot study in which a pre-post-test in a quasi-experiment was conducted with 28 patients and qualitative interviews after the program and post intervention interviews with the participants. The evaluation showed that the program was effective in meeting its objectives. In Step 6 a plan for the adoption, implementation, sustainability and evaluation of future implementations was developed.Item Development of a screening protocol for depresion in antenatal clinics in Malawi(University of the Western Cape, 2017) Chorwe-Sungani, Genesis; Chipps, JenniferDepression is a source of significant disease burden of pregnant women although protocols for screening antenatal depression are lacking in Malawi. This research study aimed at developing a screening protocol for depression in antenatal clinics in Malawi. This thesis reports data from 4 studies to develop a screening protocol for antenatal depression, one peer reviewed published paper, one peer reviewed accepted paper and two papers submitted to peer reviewed journals.Item Development of a user centered mobile phone diabetes self-management intervention for people with type-2 diabetes in the ho municipality of Ghana(University of the Western Cape, 2022) Johnson, Beatrice Bella; Chipps, JenniferSelf-management remains a key goal for people living with Type-2 diabetes but globally has been an ongoing challenge. The inefficiencies of traditional health education approaches to diabetes care, concerns about the skills deficit and the technological explosion of mobile phone use have provided an opportunity for technologically driven innovations to facilitate selfmanagement of diabetes. Mobile phones are emerging as a tool for healthcare delivery and access to mobile phones is on the increase in the Low- and Middle-Income Countries (LMICs). The related low cost of mobile technology, especially text and voice messaging, has been reported to offer effective options for managing non-communicable diseases and highlighted the need to test this in the self-management of Type-2 diabetes.Item The development of palliative care protocols for the emergency and oncology nurses in the government hospitals of the Western Cape(University of the Western Cape, 2019) February, Christine; Arunachallam, Sathasivan; Chipps, JenniferBackground: Palliative care is specialised health care to support people living with a terminal illness, and their families. Palliative care aims to prevent and relieve suffering, to help people to live as well as possible until they die, and to support the processes of dying and bereavement. Palliative care is holistic care provided by Emergency and Oncology Nurses caring for cancer patients. Palliative care protocols for Professional Nurses working in Emergency Units and Oncology Departments are not always posted or in full view in the government hospitals of the Western Cape. The researcher had noted that the development of a palliative care protocol would be unique in its use at the three targeted government hospitals. Aims and Objectives: This study focused on the development and implementation of palliative care protocols for Emergency and Oncology Nurses in the targeted government hospitals of the Western Cape, i.e., protocols could be beneficial for cancer patients and their families. The overall aim of the research was to develop applied palliative care protocols for Emergency and Oncology Nurses to provide best practice palliative care nursing for Oncology Patients who may present at any one of three Western Cape Provincial Hospitals.Item Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence(OMICS Publishing Group, 2012) Chipps, Jennifer; Mars, MauriceOBJECTIVE: A review of systematic reviews of the effectiveness and feasibility of videoconference-based telepsychiatry services for resource constrained environments was conducted. Specifically with the aim of producing an evidence-based review of the effectiveness and feasibility of videoconference-based telepsychiatry services in resource constrained countries like South Africa. METHODS: Eight key questions on telepsychiatry effectiveness and feasibility were identified and inclusion and exclusion criteria were developed. Review of citations from 2000-2011 from CINAHL, Medline, Pubmed, PsycInfo, EBSCOhost, SABINET, Cochrane Database of Systematic Reviews (CCTR), Cochrane Controlled Trial Registry (CCTR), Database of Abstracts of Reviews of Effectiveness (DARE), unpublished abstracts through NEXUS and internet search engines (Google/Google scholar) was conducted. RESULTS: Ten systematic reviews were included for review. Despite the methodological limitations and heterogeneity of the systematic reviews, there appears to be good evidence of effectiveness (reliability and improved outcomes) and feasibility (use, satisfaction, acceptability and cost) for videoconference-based telepsychiatry internationally. The application of this evidence in lower middle income countries is dependent on the integration of telepsychiatry into local health system contexts. CONCLUSION: Based on the evidence, resource constrained countries such as South Africa should be encouraged to develop telepsychiatry programs along with rigorous evaluation methods.Item The effectiveness of cultural competence training for health professionals in community based rehabilitation: a systematic review of the literature.(Wiley, 2008) Chipps, Jennifer; Brysiewicz, Petra; Simpson, BarbaraAims: To find and review studies in which investigators evaluated cultural-competence training in community-based rehabilitation settings; critique study methods, describe clinical outcomes, and make recommendations for future research. Background: A review of the effectiveness of cultural-competence training for health professionals in community-based rehabilitation settings was conducted. Data Sources: Research citations from 1991–2006 in CINAHL, Medline, Pubmed, PsycInfo, SABINET, Cochrane, Google, NEXUS, and unpublished abstracts were searched. Methods: Searching, sifting, abstracting, and assessing quality of relevant studies by three reviewers. Studies were evaluated for sample, design, intervention, threats to validity, and outcomes. A meta-analysis was not conducted because the studies did not address the same research question. Results: Five studies and one systematic review were evaluated. Positive outcomes were reported for most training programs. Reviewed studies generally had small samples and poor design. Conclusions/Implications: The paucity of studies and lack of empirical precision in evaluating effectiveness necessitate future studies that are methodologically rigorous to allow confident recommendations for practice.Item An evaluation of a low-intensity cognitive behavioral therapy mhealth-supported intervention to reduce loneliness in older people(MDPI, 2019) Jarvis, Mary Ann; Padmanabhanunni, Anita; Chipps, JenniferThere is a high prevalence of loneliness among older people, especially in residential care settings. Loneliness is often accompanied by maladaptive cognitions which can a ect the maintenance and establishment of meaningful social connections. This study implemented and evaluated a low-intensity Cognitive Behavior Therapy (LI-CBT) mHealth-supported intervention which targeted maladaptive cognitions in older people ( 60 years) experiencing loneliness. The three-month intervention using WhatsApp was implemented with older people in four inner-city residential care facilities. The intervention included three components: technology acceptance, psycho-education, and individualized positively worded messages addressing maladaptive cognitions. The intervention was evaluated using a randomized control design.Item An evaluation of a multidisciplinary patient centred type 2 diabetes self-management education programme in Edo State, Nigeria(UNISA Press, 2015) Afemikhe, Juliana A.; Chipps, JenniferDiabetes is on the increase globally, especially in African countries. Nigeria in particular has a high prevalence of diabetes type 2. There is evidence that improved type 2 diabetes outcomes are related to self-management and improved health education. The purpose of the research was to pretest whether a structured multidisciplinary patient centred self-management education programme for type 2 diabetes would improve selected primary and secondary diabetes outcome measures. The setting is diabetes outpatient clinics in one tertiary and one secondary health facility in Edo State, Nigeria. The study design is quasi-experimental, a two group before and after study. Two groups of participants (n=28) were selected using quota sampling from alternate day clinic attendances, 15 for the intervention group and 13 for the control group. A multidisciplinary patient centred diabetes self-management education programme was developed and implemented over 5 weeks in October 2014.Item Factors associated with increased Neonatal deaths at a Regional hospital in Namibia(University of South Africa, 2020) Hatupopi, Saara K; Bimerew, Million S; Chipps, JenniferThe increased neonatal mortality rate in a regional hospital in Namibia is a concern. According to the 2013 records of the hospital, there were 333 neonatal deaths from 1 January to 31 December 2013. The aim of the study was to investigate the causes of the increased neonatal deaths at this regional hospital in Namibia. A retrospective descriptive survey design was employed to conduct the study.Item Factors influencing adherence to antiretroviral treatment in the Queenstown region Eastern Cape (South Africa)(University of the Western Cape, 2014) Magadla, Nobuhle; Chipps, JenniferBACKGROUND: Failure to adhere to antiretroviral therapy (ART) has negative consequences not only for patients themselves, but for health systems. Strict adherence to ART therapy together with modified life style will result in a positive outcome (WHO, 2003a). AIM: The aim of the study was to describe factors that may influence adherence to ART treatment. METHOD: A quantitative research approach was used to conduct a survey using an interviewer administered questionnaire in the Queenstown region in three clinics with patients on ART. A random sample of 118 was selected out of a possible 594 patients. The response rate was n=97 (80.5%). The majority were females, n=77 (79%) with most of the respondents being 35-44 years, n=46 (47.4%) and single, n=76 (78%). Social and economic results: Respondents were economically inactive (unemployed), n= 49 (50, 5%) and n=40 (41.2%) on disability grant with no significant association between the employment status and acceptance of antiretroviral treatment. Males had higher rates for acceptance of ART and with more males n= 8/20 (40%) as compared to women n= 13/77 (16.8%) stating that they accepted their outcome (X2=5, p=.035). High levels of emotional support were reported n= 79 (81.4%). HEALTH CARE SERVICE RESULTS: Only n=3 (3.1%) of the respondents reported to have their own transport, resulting in 72 respondents (74.2%) reporting that it was difficult to comply with treatment if they lived far from the clinic. CONDITION RELATED RESULTS: Only n= 17 (17.5%) respondents reported that they suffered from OIs in the last six months with Diarrhoea being the most common n= 93 (94.9%). Patient related results: Only 7 respondents reported to take alcohol at an average of 1.4 bottles a week. About n=81 (83.5%) of respondents reported difficulty in taking treatment at work. TREATMENT RELATED RESULTS: The majority of respondents n= 43 (44.3%) reported to be on their current regiment for less than a year. Almost 100% of the respondents had correct knowledge of their treatment regimen and prescriptions for OIs and ART therapy. Most of the respondents (90.7%) agreed with the statement, that HIV patient's family should facilitates their intake of medication and this was significantly higher in respondents who have not accepted their diagnosis and the need to be on medication for the rest of their lives. CONCLUSION: Treatment adherence management should take into consideration the factors that may influence adherenceItem Factors influencing first year nursing students' career choice at a University in the Western Cape(University of Western Cape, 2020) Nibagwire, Jeanne D'Arc; Dison, Arona; Chipps, JenniferThe nursing profession is the backbone of the healthcare system glob-ally. However, due to the ongoing shortage of nurses there is a growing demand for nurses across the world. This demand puts pressure on the continued recruitment of new nursing students. The factors that influence students’ reasons for entering nursing vary and require investigation to improve recruitment practices.Item Fluid use in mountain bikers – self-reported practices.(Health medical publishing group (HMPG), 2007) Rose, S; Chipps, Jennifer; Peters, EBACKGROUND AND OBJECTIVES. Little is known of the fluid replacement habits of participants in mountain bike (MTB)endurance events. This survey set out to determine the current perceptions and practices of this group of endurance athletes. Method. Four hundred and twelve participants in the 3-day 2006 Sani2C (MTB) race completed questionnaires that elicited information regarding their regular fluid intake practices during competitive MTB endurance events. This included their general approach to fluid replacement, their fluid intake practices (type, amount and frequency), urine output and hydration status. RESULTS. While 70% (N = 290) reported that they based their fluid intake practices on personal past experiences, less than half the group (N = 177, 43%) were aware of official sport-specific guidelines. Although 86% (N = 354) reported making use of commercially available sport-specific drinks, consumption of water alone was reported by 34% of respondents (N = 140). The majority (N = 225, 55%) of the mountain bikers reported drinking every 16 - 30 minutes during an endurance ride, while 35% (N =144) reported drinking every 0 - 15 minutes. Fifty-three per cent (N = 182) of the male respondents and 45% (N= 23) of female respondents reported a routine intake of ≥ 750 ml per hour during endurance rides. This included 2 women who reported regular intakes of between 1 500 and 2 000 ml/hr. Only 7 (2%) reported receiving medical care for dehydration following their participation in previous MTB rides. CONCLUSIONS. This survey indicates that although more than half of the mountain bikers did not acknowledge specific awareness of the official fluid replacement guidelines, over 80% reported drinking regularly during a race, and 52% (N = 212) reported a usual intake of ≥ 750 ml/hr during endurance races. Until scientific studies have carefully examined the hydration status and fluid replacement needs of mountain bikers, MTB cyclists are cautioned against the practice of over-hydrating.Item Global and diverse evidence: challenges in application to lower middle income countries(2012) Chipps, Jennifer; Brysiewicz, Petra