Research Articles (Physiotherapy)
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Item Principles for chronic pain management in the adult traumatic spinal cord injury population at the primary healthcare level, in a developing context: a delphi study(SAGE, 2025) Williams, Tammy-Lee; Wikmar, Lena Nilsson; Joseph, ConranIntroduction: Individuals with traumatic spinal cord injury (TSCI) are dissatisfied with their chronic pain management. A biopsychosocial approach has been proven to improve chronic pain. Guidelines are required to holistically manage chronic pain in the TSCI population. Methods: A Delphi study was conducted to gain consensus on design principles for chronic pain in the TSCI population, for the Western Cape of South Africa. Purposive sampling was used to recruit first-line primary health care providers from primary health care settings in the Cape Metropolitan region. Participants were asked for consent on principles pertaining to the assessment, education and planning for chronic pain management, pharmacological and non-pharmacological therapy for neuropathic and nociceptive pain, as well as the monitoring of chronic pain and referral of resistant pain. For consensus analysis, a median of 3.24 or higher was considered in addition to two categories of consensus, namely weak consensus (50%–70%) and strong consensus (>70%). Results: The first-line primary health care providers agreed on eighteen principles to guide chronic pain management in the TSCI population. Consensus could not be reached on the second to fourth line pharmacological management of neuropathic pain. Conclusion: The agreed upon design principles may be considered as starting points for implementation at the primary health care level in the Western Cape of South Africa.Item Guidelines for chronic pain in adult spinal cord injury population: scoping review(AOSIS (Pty) Ltd, 2024) Williams, Tammy-Lee; Phillips, Joliana; Joseph, ConranBackground: Chronic pain among survivors of spinal cord injury (SCI) hurts physical and mental health. Persons with SCI have demonstrated dissatisfaction with the management of their chronic pain. Objectives: This study aimed to identify existing clinical practice guidelines for chronic pain in the SCI population. Method: A scoping review was conducted across various databases available at the University of the Western Cape, in addition to guideline clearing houses (BioMedCentral, Cambridge journals online, CINAHL, Cochrane library, Medline [EbscoHost], Medline [Pubmed], Sabinet Reference, SAGE Journals Online, ScienceDirect, SCOPUS, Wiley Online Library, Springerlink, PubMed, Guideline Central, and agency for healthcare research and quality). The population consisted of adults with SCI, and the interventions that were included were pharmacological and nonpharmacological management of chronic pain. Guidelines that met the inclusion criteria were critically appraised by two reviewers from this study using the AGREE II instrument. Inter-rater reliability was calculated using SPSS 27, and Cohen’s kappa coefficients were established.Item Test-retest, intra- and inter-rater reliability of the reactive balance test in patients with chronic ankle instability(Frontiers Media SA, 2024) Maricot, Alexandre; Meeusen, RomainIntroduction: The Reactive Balance Test (RBT) could be a valuable addition to research on chronic ankle instability (CAI) and clinical practice, but before it can be used in clinical practice it needs to be reliable. It has already been proven reliable in healthy recreational athletes, but not yet in patients with CAI who have shown persistent deficits in dynamic balance. The study aimed to determine the test-retest, intra-, and inter-rater reliability of the RBT in patients with CAI, and the test-retest and inter-rater reliability of the newly developed RBT score sheet. Methods: We used a repeated-measures, single-group design to administer the RBT to CAI patients on three occasions, scored by multiple raters. We included 27 participants with CAI. The study used multiple reliability measures, including Pearson r, intra-class correlations (ICC), standard error of measurement (SEM), standard error of prediction (SEP), minimal detectable change (MDC), and Bland–Altman plots, to evaluate the reliability of the RBT’s outcome measures (visuomotor response time and accuracy). It also assessed the test-retest and inter-rater reliability of the RBT score sheet using the same measures. Results: The ICC measures for test-retest reliability were similar for accuracy (0.609) and VMRT (0.594). Intra-rater reliability had high correlations and ICCs for accuracy (r = 0.816, ICC = 0.815) and VMRT (r = 0.802, ICC = 0.800). Inter-rater reliability had a higher ICC for VMRT (0.868) than for accuracy (0.690). Conclusion: Test-retest reliability was moderate, intra-rater reliability was good, and inter-rater reliability showed moderate reliability for accuracy and good reliability for VMRT. Additionally, the RBT shows robust SEM and mean difference measures. The score sheet method also demonstrated moderate test-retest reliability, while inter-rater reliability was good to excellent. This suggests that the RBT can be a valuable tool in assessing and monitoring balance in patients with CAI.Item Healthcare providers perspective of chronic pain management in personswith traumatic spinal cord injury accessing the public system in a region of South Africa(Taylor and Francis Ltd., 2024) Williams, Tammy-Lee; Nilsson Wikmar, Lena; Phillips, JolianaPurpose: Persons with traumatic spinal cord injury (PWTSCI) have expressed a lack of education from healthcare providers and poor shared-decision making between providers and clients. The aim was to explore the healthcare providers’ perspective on factors influencing the optimal management of chronic pain. Methods: Healthcare providers were recruited from two institutions at tertiary healthcare level. Interviews explored current chronic pain management practices, influencing factors and recommendations for improvement. Data saturation occurred after interviewing 11 participants. Thematic analysis was used through a socio-ecological model. Results: The challenges to optimal pain management include appropriate assessment and management of psychological health (intrapersonal level), substance abuse amongst patients (intrapersonal level), access to medication for providers and lack of knowledge by providers (interpersonal and organizational level). To improve chronic pain management, an interdisciplinary team approach should be operationalized at policy and organizational level, monitoring and adjustment of interventions should take place (interpersonal), and family members/caregivers should be involved in the planning and monitoring (interpersonal). Conclusion: Factors, at the interpersonal, intrapersonal, organizational and policy levels, influence optimal chronic pain management in the traumatic spinal cord injury (TSCI) population. To mitigate challenges, guidelines for chronic pain management should be developed, particularly for low-resourced developing countries.Item Frameworks used to evaluate community-based rehabilitation interventions: a scoping review(AOSIS (pty) Ltd, 2025) Manig, Sarah; Ennion, Liezel; Rowe, MichaelBackground: Community-based rehabilitation (CBR) interventions are important for improving the well-being of people with disabilities. However, there is no universally accepted framework for evaluating these interventions, which limits their effectiveness and integration into policy. Objectives: To explore theoretical frameworks used in evaluating CBR interventions, assessing their suitability, context-specific applicability and cultural relevance. Method: A scoping review methodology was employed to examine the literature. Databases searched included PubMed, CINAHL, EBSCOhost and Web of Science. Broad search terms and keywords used were CBR, analytical and/or methodological and/or theoretical and/or conceptual and/or evaluation framework, impact and evaluation. Only full-text articles written in English and published between 2000 and 2020 were included. Data were analysed using a narrative synthesis methodItem Stakeholder perspectives on promoting health enhancing sport through the Rwanda sports policy(Routledge, 2023) Frantz, Jose M; Mukaruzima, Lela; Duhamahoro, JimmySport is an adaptable channel for change. It has been widely used to enhance health and wellbeing, foster social cohesion, and engender peace and development in different societies. The government of Rwanda developed a Sports Development Policy (SDP) to advance sports within the spectrum of its development agendas. However, the extent to which health constructs are integrated and implemented within the tenets of this policy remain unexplored, despite their pivotal role in population wellbeing and in contributing to the country’s overarching development goals. This study sought to understand if and how the Rwanda SDP promotes sports for health from the stakeholders’ perspectives. In-depth semi structured interviews were used for thirteen purposively sampled stakeholders of the SDP. Thematic and narrative analysis were used to examine and report the findings. Themes highlighted a progressive awareness of the Sports Policy pertaining to health outcomes, less involvement of stakeholders in sport policy formulation which affected its implementation, disproportionate efforts between sports policies for health, competitive, and mass sports activities. Stakeholders further underscored cultural beliefs, attitudes, and contextual environmental factors as the key constraints to bridge the policy theory and practice of sports. Finally, findings emphasise the integral role stakeholders play in the life course of a policy. Further, the SDP does not primarily promote sports for health, but rather elite sports, on the premise that health benefits are automatically achieved through participation in sports activities. Thus, reinforcements are still needed to clearly define the national physical activity plan either through the SDP or other national physical activity guidelines. © 2023 Informa UK Limited, trading as Taylor & Francis Group.Item Principles to award learning achievements for lifelong learning in health using micro-credentials: an international Delphi study(BioMed Central Ltd, 2025) Rhoda, Anthea; Mitchell, Sharon; Hart, JohnBackground: This research investigates micro-credentialing as an approach to recognise learning achievements in health. Establishing international standards can ensure consistency, promote equity, and enhance quality of recognition systems. Achieving stakeholder consensus on the key topic areas is an important precursor to lead to relevant topics from which to build appropriate standards. This research supports the efforts by UN agency representatives and experts in qualification systems, medical education, the health and care sector, regulation, and accreditation, to build foundations from which to launch normative work on the application of micro-credentials to award learning achievements for health and care workers. Methods: A modified Delphi study following methodological steps was conducted. From April to May 2021, a literature review investigated existing standards in continuing professional development and the use of micro-credentialing in health. Results from the review informed the initial draft of statements that were then refined through three iterative Delphi rounds between May to September 2021. The process culminated in a final workshop in March 2023. Results: A total of 53 participants completed the Delphi, with results analysed by researchers using qualitative analysis. Consensus was achieved on the core principles to recognise learning achievements. The expert panel agreed on the need for standards that are competency-based, and require evidence of learning indicating what a learner can do. There was also consensus that the characteristics of a valid digital award or micro-credential should be portable, standardised, secure, interoperable, stackable and verifiable. Conclusions: The growing body of literature on micro-credentialing highlights its potential as a method to recognise learning achievements. The interest in alternative pathways to award health practitioners, through short competency-based micro-learning opportunities, has spurred discussions on the practical application of micro-credentials. This research outlines the categories and principles for a proposed framework to implement micro-credentialing to recognise learning achievements within the health and care sector.Item Years of running, chronic diseases, and allergies are associated with gradual onset achilles tendon injuries in 61,252 running race entrants: SAFER XXXIX study(John Wiley and Sons Inc, 2024) Young, Jonah; Jordaan, Esmè; Wood, PaolaBackground: Gradual-onset achilles tendon injuries (GoATIs) in runners are common. Data show that chronic diseases are associated with GoATI. Objective: To determine risk factors associated with a history of GoATIs among long-distance runners (21.1 and 56 km) entering a mass community-based running event. Methods: Online pre-race medical screening questionnaire data from 76,654 consenting Two Ocean Marathon race entrants (71.8% entrants) were collected prospectively over 4 years (2012–2015); this cross-sectional study is a retrospective analysis of these data. A total of 617 entrants (0.8%) reported a GoATI in the last 12 months; 60,635 entrants reported no history of any running injury (controls). Categories of factors associated with GoATI were explored (univariate and multiple regression analyses): demographics (age group, sex, race, distance), training/racing history, and history of allergy, history of chronic disease, and composite chronic disease score. Prevalence and prevalence ratios (PRs; 95% CI) are reported. Results: Factors associated with a higher prevalence of a history of GoATI (univariate analysis vs. controls) were older age (>31 years) (p <.001), male sex (PR = 1.76; p <.001), and longer race distance (56 km vs. 21.1 km) (PR = 2.06; p <.001). Independent factors associated with a history of GoATI (multiple regression) were increased years of recreational running (PR = 1.17 for every 5-year increase, p <.001), higher composite chronic disease score (PR = 2.07 for every 2-unit increase, p <.001), and allergy history (PR = 1.98 p <.001). Conclusion: Novel independent factors associated with a history of GoATI in distance runners were increased years of recreational running, chronic disease history, and allergy history. Runners at risk for GoATI could be targeted for injury prevention interventions. Future studies should focus on establishing a causal relationship.Item Psychosocial reintegration post-traumatic spinal cord injury in Rwanda: an exploratory study(AOSIS (Pty) Ltd, 2024) Kanyoni, Maurice; Philips, Joliana; Wikmar, Lena N.Background: Traumatic spinal cord injury (TSCI) survivors are confronted by both physical and psychosocial barriers when returning to their communities. Therefore, reintegration is an important aspect of their journey back into social life. Objectives: To assess psychosocial reintegration after TSCI in Rwanda. Method: All community-dwelling adults who were registered in the previous epidemiological study were recruited and injury characteristics questionnaire and the Sydney psychosocial reintegration scale version 2 (SPRS-2) were used to collect data through a telephone interview. Results: The study traced 58 participants, 77.6% (n = 45) were male and 56.9% (n = 33) were categorised with paraplegia. Overall, the results show poor community reintegration. The SPRS-2 and domain mean (SD) scores were: overall SPRS-2 of 20.95 (11.56), occupational activity (OA) of 3.68 (4.31), interpersonal relationship (IR) of 7.11(4.31) and living skills (LS) of 7.43 (5.32). Gender significantly influenced overall SPRS-2 (p = 0.011) and two domains: OA (p = 0.005) and LS (p = 0.012). Level of injury was significantly associated with an OA domain score of SPRS-2 (p = 0.002). Gender explained 29% of the variance in the LS domain of SPRS-2, with males reporting better psychosocial reintegration. Conclusion: Gender strongly predicted psychosocial reintegration following a TSCI, which is an indication of the role of social support. Clinical Implications: Traumatic SCI rehabilitation should be holistic to help prepare the person to return to the community. There should be an assessment of an individual’s readiness to return to the community before discharge from the hospital.Item Stakeholder perspectives on promoting health enhancing sport through the Rwanda sports policy(Routledge, 2023) Frantz, Jose M.; Mukaruzima, Lela; Duhamahoro, JimmySport is an adaptable channel for change. It has been widely used to enhance health and wellbeing, foster social cohesion, and engender peace and development in different societies. The government of Rwanda developed a Sports Development Policy (SDP) to advance sports within the spectrum of its development agendas. However, the extent to which health constructs are integrated and implemented within the tenets of this policy remain unexplored, despite their pivotal role in population wellbeing and in contributing to the country’s overarching development goals. This study sought to understand if and how the Rwanda SDP promotes sports for health from the stakeholders’ perspectives. In-depth semi structured interviews were used for thirteen purposively sampled stakeholders of the SDP. Thematic and narrative analysis were used to examine and report the findings. Themes highlighted a progressive awareness of the Sports Policy pertaining to health outcomes, less involvement of stakeholders in sport policy formulation which affected its implementation, disproportionate efforts between sports policies for health, competitive, and mass sports activities. Stakeholders further underscored cultural beliefs, attitudes, and contextual environmental factors as the key constraints to bridge the policy theory and practice of sports. Finally, findings emphasise the integral role stakeholders play in the life course of a policy. Further, the SDP does not primarily promote sports for health, but rather elite sports, on the premise that health benefits are automatically achieved through participation in sports activities. Thus, reinforcements are still needed to clearly define the national physical activity plan either through the SDP or other national physical activity guidelines.Item Bayesian jackknife tests with a small number of subsets: application to HERA 21 cm power spectrum upper limits(Monthly Notices of the Royal Astronomical Society, 2023) Wilensky, M.J; Kennedy, F; Bull, PWe present a Bayesian jackknife test for assessing the probability that a data set contains biased subsets, and, if so, which of the subsets are likely to be biased. The test can be used to assess the presence and likely source of statistical tension between different measurements of the same quantities in an automated manner. Under certain broadly applicable assumptions, the test is analytically tractable. We also provide an open-source code, CHIBORG, that performs both analytic and numerical computations of the test on general Gaussian-distributed data. After exploring the information theoretical aspects of the test and its performance with an array of simulations, we apply it to data from the Hydrogen Epoch of Reionization Array (HERA) to assess whether different sub-seasons of observing can justifiably be combined to produce a deeper 21 cm power spectrum upper limit. We find that, with a handful of exceptions, the HERA data in question are statistically consistent and this decision is justified. We conclude by pointing out the wide applicability of this test, including to CMB experiments and the H0 tension.Item Learning with technology in physiotherapy education: Design, implementation and evaluation of a flipped classroom teaching approach(BMC, 219) Røe, Yngve; Rowe, Michael; Ødegaard, Nina B.The purpose of the study was to describe the design, implementation and evaluation of a flipped classroom teaching approach in physiotherapy education. The flipped classroom is a blended learning approach in which students receive digital lectures as homework, while active learning activities are used in the classroom. Flipped classroom teaching enables a learning environment that aims to develop higher-order cognitive skills. The study design was a historically controlled, prospective, cohort study. An eight week theoretical course on musculoskeletal disorders was redesigned, moving from a conventional approach to a flipped classroom model. Pre-class learning material consisted of about 12 h of video lectures and other digital learning resources that were split up over the duration of the course. In-class activities consisted of seven full-day seminars where students worked in groups in order to solve problem-based assignments. The assignments were designed to reflect authentic clinical problems and required critical thinking and reasoning. Outcomes were measured with coursegrades and compared with historical controls of conventional teaching, using descriptive statistics. Self-perceived learning outcomes and students’ experiences were also collected in a survey.Item Prevalence of secondary health conditions and mental status in persons with long-term spinal cord injury in South Africa: Comparison between public and private healthcare sectors(South African Medical Journal, 2023) Rhoda, A; Joseph, C; Thurston, C; Nizeyimana, EBackground: Spinal cord injuries typically result in a range of negative health outcomes and health states, which impacts overall functioning, health and well-being. It remains important to establish the prevalence (burden) of health outcomes to help with the development of optimal treatment strategies. Objectives: To determine the prevalence and treatment rates of secondary health conditions (SHCs) and mental health states in persons with long-term spinal cord injury (SCI) receiving public compared with private healthcare services in South Africa. METHODS: A cross-sectional survey included 200 community-dwelling persons with long-term SCI, 60% with paraplegia, 53% with complete injuries and 156 from the public and 44 from private healthcare sectors. The following modules of the International Spinal Cord Injury (InSCI) community survey were used: (i) demographic and injury characteristics; (ii) SHCs and treatment rates; and (iii) vitality and emotional well-being. All statistical analyses were stratified according to healthcare sectorItem The role of environmental factors on health conditions, general health and quality of life in persons with spinal cord injuries in South Africa(MDPI, 2023) Bezuidenhout, Lucian; Rhoda, Anthea; Conradsson, David MoulaeeThe objective was to describe the individual items of the environmental factors and to investigate the relationship between the environmental factors to health conditions, general health and quality of life in people with SCI in South Africa. Methods: Two hundred persons with SCI participated in a cross-sectional survey design. This study formed part of the International Spinal Cord Injury (InSCI) Community Survey. Four major domains, environmental factors, health conditions, general health and quality of life of the survey questionnaire responses, were used for the analysis. Regression models were used to determine the association between the independent variable, which consisted of the specific environmental factors items, and the dependent variables comprising health conditions, general health and quality of life. Results: The commonly reported environmental barriers were public access, lack of short- and long-distance transport and finances. Environmental factors such as public access (p < 0.001), short- (p < 0.001) and long-distance transport (p = 0.001), and friends’ (p = 0.003) and colleagues’ (p < 0.001) attitudes and communication (p = 0.042) were significantly associated with the presence of secondary health conditions. Finances (p = 0.026), family attitudes (p = 0.037) and communication (p = 0.039) had a significant association with worsened mental health. Services (p = 0.022) and communication (p = 0.042) were also significantly associated with decreased general health.Item Characteristics and outcomes of gunshot-acquired spinal cord injury in South Africa(South African Medical Association, 2017) Joseph, CSpinal cord injuries (SCIs) caused by assault present a unique challenge facing the healthcare system, in that very little is known about how these injuries manifest compared with other causes of injury. Understanding the nuances of gunshot SCIs could contribute towards better care provision. To determine the characteristics of gunshot SCI and compare both injury characteristics and outcomes between gunshot SCI and all other traumatic causes taken together. The gunshot SCI sub-cohort was derived from a 1-year prospective, population-based study, including both tertiary-level hospitals providing SCI care in the Cape Metropolitan area of South Africa (SA). All consenting 145 survivors, after a window period of 7 days, were included, and their demographic and injury characteristics were captured according to the International SCI Core Basic Data Set. Further, selected secondary medical complications (outcomes) were prospectively and routinely assessed throughout acute care. Both descriptive and inferential statistics were used to describe and compare characteristics and outcomes, respectively.Item Towards an interprofessional competency-based model in South Africa: A Delphi study(PubMed, 2022) Filies, Gérard Charl; Frantz, Jose M.Background: The overall objective of any health professional curriculum is to ensure that the knowledge, skills and attitudes of the students are influenced by the curriculum and to instil these attributes into the students, to help them become capable, compassionate and inquisitive health professionals. Therefore, there is the need for medical educators to align their learning objectives with the core competencies needed to achieve this. Currently, in interprofessional education, it is not always clear which activities may be used to facilitate the development of interprofessional core competencies. However, if health professional students are exposed to the interprofessional core competencies effectively, it may result in health care professionals who have an improved understanding of interprofessional practices, thus improving these practices within their specific professions. The objective of this study was to identify teaching strategies and activities that aim to develop interprofessional competencies in undergraduate health care students at the University of the Western Cape, South Africa. Methods: In this study the Delphi method was used to reach a consensus on the most appropriate activities and assessment methods to use in an interprofessional curriculum that would assist in instilling interprofessional core competencies in undergraduate health care students. Results: 19 experts out of 69 invited participants took part in this Delphi study. The activities highlighted were case studies, joint clinical placements, simulations, role plays and workshops/discussions. The assessment forms highlighted by participants were portfolios, reflection and rubrics. Conclusion: It was evident from this study that such activities can be used to instil more than one core competency in undergraduate health care students.Item Adapting the learning environment of a first year interprofessional module towards collaborative-ready graduates(Nurse Education Today, 2022) Filies, G.C.; Kock-Africa, L.Background: There has been a global call for a more collaborative workforce to combat the complex healthcare challenges experienced in societies. As a result, health professions education has amended their curricula to include interprofessional education as a strategy to allow students to learn from, with and about each other across disciplines during their training. It is imperative to review the learning environment of these interprofessional modules. To determine the learning environment for the acquisition of the interprofessional core competencies, there needs to be an understanding of the changes to the module, and the impact it has on student performance over a selected period. Objective: This study aimed to determine how have the changes to the material dimension of the learning environment for first-year students in an IPE curriculum promoted student learning. Methods: A document analysis research design was used to extract data over a two-year period. An adaptation of the Context, Input, Process, Product and Outcomes evaluation model was to determine how changes to the learning environment of students registered for a first year interprofessional module, promoted learning. Results: The findings reveal that curriculum changes made to the location and setting can yield improvements in the development and enhancement of the selected interprofessional education core competencies. Conclusion: This study concludes that in alignment with the learning styles of the 21st century student, curriculum development should include an enhanced form of deeper learning in the light of the fourth industrial revolution.Item Exploration of the experiences of persons in the traumatic spinal cord injury population in relation to chronic pain management(MDPI, 2023) Williams, Tammy-Lee; Joseph, Conran; Nilsson-Wikmar, LenaChronic pain amongst individuals with traumatic and nontraumatic spinal cord injury (SCI) has high prevalence rates, with severe impact on the activities of daily living, mood, sleep and quality of life. This study aimed to explore the experiences and challenges of chronic pain management amongst the traumatic spinal cord injury (TSCI) population in the Western Cape region of South Africa. A qualitative descriptive approach was chosen for the study, in which 13 individuals living with TSCI were purposively recruited and interviewed telephonically. An inductive thematic analytic approach was used. The results indicate ineffectiveness of standard pain management, with a lack of education regarding pain physiology and pain management strategies as well as unbalanced decision-making between clinician and patient. Thus, patients develop coping strategies to survive with pain. Current pain regimes are suboptimal at best, underpinned by the lack of clarity or a mutually agreed plan to mitigate and eradicate pain.Item Institutional policies, practices and initiatives impacting research productivity: The strengthening of collaboration, leadership and professionalism in research management in the Southern African Development Community (SADC) and European Union (EU) higher education institutions (storm)(Society of Research Administrators International, 2022) Frantz, Jose M.; George, Althea; Hunter-Hüsselmann, M.Research productivity and research excellence are elements essential to the creation of a conducive research environment, in which research publications, research dissemination, and research utilization, are key in fostering the sustainability of higher education institutions. In this study, the current institutional policies, practices, and initiatives that encourage research productivity were explored. A mixed-method methodology, embodying a sequential exploratory approach, was adopted for the study. Non-probability, convenient sampling was used to select Higher Education Institutions (HEIs). A survey questionnaire comprising closed and open-ended questions was used for data collection. The data collection tool was piloted and refined. An integrative analysis consisting of descriptive statistical analysis and thematic analysis was used to analyze the collected data. The findings of this study highlight the instrumental role of university staff and students for research productivity. Building an institutional research culture was seen to boost research productivity. Increasing research capacity and visibility, the implementation of appropriate management infrastructure and the adoption of research policies were found to be effective strategies to support research productivity within Higher Education settings.Item Factors influencing employment among people with spinal cord injury in South Africa(Taylor and Francis Group, 2022) Bezuidenhou, Lucian; Rhoda, Anthea; Conradsson, David MoulaeeTheunemploymentratepostspinalcordinjury(SCI)in SouthAfricais highwithlimitedknow-ledgeof environmentalfactorsoutsidethehealthservices,especiallyin an unevenlydevelopedresourcesettinglikeSouthAfrica,affectingtheemploymentratein peoplewithSCI.Ourpurposewasto investi-gatefactorsassociatedwithemploymentin peoplewithSCIin SouthAfrica. TwohundredpersonswithSCIparticipatedin a cross-sectionalsurveydesign.Thisstudyformedpartof theInternationalSpinalCordInjuryCommunitySurvey.Subsectionsof thequestionnaireresponseswereusedas explanatoryvariablesto predictemploymentafterSCIusinglogisticregres-sionanalysis.