Research Articles (Physiotherapy)

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Association between metabolic syndrome and physical fitness in firefighters: a protocol for a systematic review and meta-analysis
(BMJ Publishing Group, 2025) Ras, Jaron; Grace, Jeanne Martin
Introduction Among the emergency services, firefighters have the highest percentage of mortality (45%) due to sudden cardiac death, with the majority related to underlying cardiovascular disease. This necessitates that firefighters stay in good physical condition and maintain adequate cardiovascular fitness to cope with these stressors and perform their duties with minimal health risks. Therefore, this study aims to determine the association between metabolic syndrome and physical fitness in firefighters. Methods The authors will search the following electronic databases: PubMed/Medline, SCOPUS and Web of Science, with no limitations to publication year. For data extraction, the two principal reviewers will use a general data extraction form to retrieve the key characteristics of each study. The Rayyan intelligent systematic review tool will be used to screen and select studies for inclusion. Thereafter, information from the included studies will be captured on the researcher-generated data extraction form. The Joanna Briggs Institute (JBI) Critical Appraisal Tools for quantitative studies will be used to conduct the methodological assessment of each study included. Data will be analysed using Review Manager 5.3 to determine the exposure effects and MedCalc statistical software Ltd and will be used to determine the pooled correlation effects. The results will be presented using figures, graphs and tables. Ethics and dissemination Details for this systematic review protocol can be accessed on PROSPERO (CRD42024535088). The authors will disseminate this protocol and the findings of the systematic review and meta-analysis in peer-reviewed journals and in national and international conferences. In addition, this review will add significantly to the body of knowledge in the scientific community worldwide and assist academics in exploring research gaps on this topic.
Making sense of the outcome of a rehabilitation implementation trial in the intensive care unit: mixed methods
(South African Medical Association, 2025) Karachi, Farhana; Maritz, Jean J.; Esterhuizen, Tonya M.
Background. Evidence for implementation of evidence-based protocols (EBPs) in resource-constrained intensive care units (ICUs) is sparse. Objectives. To evaluate a tailored best-practice multifaceted strategy for implementation of a validated physiotherapy EBP for the management of surgical ICU (SICU) patients. Also, to explore the physiotherapists’ perceptions regarding the implementation process and factors affecting protocol adherence, guided by the Consolidated Framework for Implementation Research. Methods. A type 2 hybrid implementation study design was applied, including all adult patients admitted over 16 months to two (control and experimental) SICUs in Western Cape Province, South Africa. The physiotherapists eligible to participate in the qualitative study (N=17) were those who participated in the implementation process and worked in the experimental SICU. The Therapeutic Index Scoring System-28 (TISS-28) and four process of care indicators (POCIs) were the primary and secondary outcomes, respectively, both analysed in Stata version 15. Thematic content analysis of textual data generated physiotherapists’ perceptions of the implementation process. Results. The intervention strategy did not result in protocol adherence, with no significant difference (p>0.05) in TISS-28 and POCI outcomes during and after implementation in the experimental unit and all phases of the control. Physiotherapists (71%; n=12/17) perceived that the process affected their thinking and clinical decision-making, but not the organisation of physiotherapy services, except for a more multidisciplinary approach to care in the experimental unit. Organisational factors (time constraints, workload/flow barriers) affected adherence, explaining the lack of practice change. Conclusion. The importance of organisational change and support of the physiotherapy departments providing services to ICUs while also addressing the healthcare needs of a diverse group of hospitalised patients is highlighted.
Motor-cognitive interaction in adults with spina bifida: dual-task effects
(Springer Nature, 2025) Bezuidenhout, Lucian; Bendt, Martina; Butler Forslund, Emelie
Study design: Cross-sectional design. Objectives: To study motor-cognitive interaction during walking while performing a cognitive task (dual-task [DT]) in ambulatory adults with spina bifida (SB). Setting: A specialized spinal cord center, The Spinalis clinic at Aleris Rehab Station Stockholm, Sweden. Methods: Assessments of muscle strength and ambulatory function were performed. Gait was assessed with a sensor-based system with/without the auditory Stroop. Timed-up-and-go (TUG) with/without a cognitive task was also assessed. Regarding cognitive function, episodic memory, executive function, and processing speed were assessed. The percentage of difference between single-task (ST) and dual-task (DT) was used to calculate the DT effect (DTE) as cost or benefit. Differences were analyzed with t-test and Wilcoxon’s signed rank test. Results: Forty-one persons were included, mean age 37 years (SD 12) and 20 (49%) were women. Thirty-four completed the DTE analysis. Seven could not perform the cognitive task and/or gait data and could not be registered. There was a DT cost on gait speed (4%), stride length (3%) and double support phase (3%), and cognitive function showed a cost of 3%. DTE for TUG was a 26% cost. Conclusion: We showed a DT cost on gait, possibly indicating fall risk during DT walking. The largest DT cost was seen during TUG with a cognitive task, indicating a valuable clinical test for motor-cognitive performance for adults with SB. This study is pioneering in that it increases our understanding of DT performance in ambulatory adults with SB which could facilitate development of targeted rehabilitation interventions and self-management strategies.
Physical activity of community-dwelling adults with traumatic spinal cord injuries in the Cape Metropole
(AOSIS Publishing, 2025) Gabriels, Aeysha; Ismail, Toughieda; Bezuidenhout, Lucian
In developing countries, spinal cord injuries (SCIs) are currently a public health concern (Jesuyajolu et al. 2023). In 2021, the World Health Organization (WHO) estimated that over 15 million people currently live with an SCI worldwide (WHO 2024). In South Africa, the incidence rate for traumatic spinal cord injury (TSCI) was estimated at 76 per million people, which was found to be one of the highest when compared to developed, Western countries (Joseph et al. 2015). Globally, adults with SCIs often lead very sedentary lifestyles, and this predisposes them to develop secondary complications and puts them at an increased risk for developing cardiovascular disease (CVD), diabetes and obesity (Cragg et al. 2013; Garcίa Massó, Serra-Añó & Gonzalez 2015; Nooijen et al. 2015; Warms, Whitney & Belza 2008). In the previous literature, it was noticed that there is a 17% prevalence of CVD among the SCI population compared to a 5% prevalence among the non-SCI population (Cragg et al. 2013). Physical activity (PA), however, is an important modifiable factor in decreasing the risks of CVD, stroke and diabetes (Cragg et al. 2013; Garcίa-Massó et al. 2015; Nooijen et al. 2015; Warms et al. 2008)
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, Conran
Introduction: 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.
Guidelines for chronic pain in adult spinal cord injury population: scoping review
(AOSIS (Pty) Ltd, 2024) Williams, Tammy-Lee; Phillips, Joliana; Joseph, Conran
Background: 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.
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, Romain
Introduction: 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.
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, Joliana
Purpose: 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.
Frameworks used to evaluate community-based rehabilitation interventions: a scoping review
(AOSIS (pty) Ltd, 2025) Manig, Sarah; Ennion, Liezel; Rowe, Michael
Background: 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 method
Stakeholder perspectives on promoting health enhancing sport through the Rwanda sports policy
(Routledge, 2023) Frantz, Jose M; Mukaruzima, Lela; Duhamahoro, Jimmy
Sport 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.
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, John
Background: 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.
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, Paola
Background: 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.
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.
Stakeholder perspectives on promoting health enhancing sport through the Rwanda sports policy
(Routledge, 2023) Frantz, Jose M.; Mukaruzima, Lela; Duhamahoro, Jimmy
Sport 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.
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, P
We 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.
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.
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, E
Background: 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 sector
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 Moulaee
The 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.
Characteristics and outcomes of gunshot-acquired spinal cord injury in South Africa
(South African Medical Association, 2017) Joseph, C
Spinal 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.
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.

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