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Item Open AccessRadionuclide cisternography: imaging and study of the cerebrospinal fluid circulation(University of the Free State, 1975-12) Iturralde, Mario Paulino; Retief, F. P.English: English: Radionuclide cisternography performed in 200 selected patients with neurological disease has proved to be a simple and relatively safe procedure, v,rithminimal disturbing side effects, which can provide useful information about cerebrospinal fluid (eSF) flow and dynamics. Following the subarachnoid or ventricular injection of an appropiate radiopharmaceutical, the tracer flows with the eSF and demonstrates the pathways of circulation under normal and abnormal conditions with virtually no disruption of the existing eSF physiology. The eventual distribution of the tracer is complex. The range of normal varies from rapid ascent with early absorption of the radiopharmaceutical to slower ascent and absorption, frequently with laterilization of flow to one or other side intracranially and occasionally with transient ventricular reflux. In pathological states the cisternographic picture varies ac= cation (or lack of it) of the ventricles with the subarachnoid cording to the underlying disease. It may lack the ability to establish the precise anatomical features available from air encephalography. However ventricular dilatation, the communispace, and the delay or lack of absorption are only satisfactorily demonstrated by radionuclide cisternography. Repeated examinations may be readily performed to show progression of the disease or the results of surgical treatment. The abnormal flow pattern in patients with normal pressure hydrocephalus proved to be the most important criterion in their selection for extracranial neurosurgical eSF shunting. When properly selected, these patients often respond to surgical treatment. The routine use of radionuclide cisternography in the examination of patients with suspected presenile dementia and compensated hydrocephalus results in a low yield of operable patients. When operation is contraindicated conservative management of the patient is then instituted and unnecessary surgical intervention avoided. Radionuclide cisternography gained wide acceptance in the evaluation of shunt patency. The test is fast and safe in the presence of extracranial diversionary eSF shunts. The rapid flow into the cerebral ventricles and the fast disappearance of the radioactive tracer, as well as the relative size of the ventricular system, are valuable indexes for the determination of patency and efficaccy of the shunt. Another important use of radionuclide cisternography is the investigation of eSF leaks and eSF spinal flow obstruction. It may demonstrate the existence and site of eSF leakage or block and offer valuable assistance to the neurosurgeon. Radionuclide cisternographic images are usually interpreted subjectively on the basis of abnormal regional and temporal concentrations of radiopharmaceuticals in the eSF space. The evaluation of images can be improved by the use of quantitative computerized digital scanning, increasing the sensitivity and value of the measurements. The further extension of these studies involving abnormalities of cerebrospinal fluid dynamics would seem worthwhile, and the value of the methods described in this thesis and their limitations, remain a potential and challenging field for further exploration. Item Open AccessPsigiatriese onderrig aan gesinslede van geestesongesteldes as terapeutiese hulpbron(University of the Free State, 1975-12) Poggenpoel, M.; Steyn, V.; Loots, I.Abstract not available Item Open AccessClozapine: the correlation between clinical improvement and laboratory parameters(University of the Free State, 1977) Gosling, John Albert; Muller, F. O.English: In this study, fifteen Black patients suffering from acute schizophrenia were treated with clozapine for a period of 40 days in order to ascertain whether certain laboratory parameters could be utilized to give an indication of the clinical efficacy of clozapine treatment in these patients. S.l.l Therapeutic efficacy Utilizing the B.P.R.S. and F.C. rating scale as indication of the clinical improvement of the patients, it was found that significant clinical improvement occurred upto day 30 whereafter clinical improvement was only slight. Clozapine was well tolerated by all the patients while more than half the patients (53,3%) were fit for unmndhional discharge on completion .of the study. On completion of the study the working capacity of the majority (80%) was satisfactory. 5.1.2 Side effects The most common side effects encountered were daytime sedation which was especially prominent during the early stages of the study and hypersalivation which occurred with equal frequency throughout the study period. Other side effects encountered in descending order of frequency were nausea and vomiting, dizziness, headache, disturbance of visual accomodation, constipation and diarrhoea, disturbed sleep, sweating, inhibition of micturition, and collapse. 5.1.3 Blood pressure and pulse rate Clozapine had no significant' prolongated effect on blood pressure while a significant and sustained rise in pulse rate during the treatment period was noted. It is suggested that this rise in pulse rate could be utilized as a convenient clinical aid in checking patient compliance in patients being treated with clozapine. 5.1.4 Serum concentration of clozapine, clozapine plus metabolites, and metabolites only. 126.96.36.199 No correlation was found between serum levels of clozapine, clozapine plus its metabolites, or its metabolites only and clinical improvement. 188.8.131.52 It was found that on treatment day 5 steady state serum levels of clozapine and of clozapine plus it metabolites had been reached. 184.108.40.206 No auto-induction of the metabolism of clozapine appeared to occur during the treatment period. 220.127.116.11 No accumulation of clozapine or its metabolites appeared to occur during the treatment period. 18.104.22.168 It can be concluded that a certain period of exposure to a more or less constant serum level of clozapine and/or its metabolites is necessary to effect clinical improvement. 22.214.171.124 A significant correlation was found between the lying pulse rate and serum levels of clozapine plus its metabolites. The lying pulse rate can thus offer a reasonable indication of the expected serum levels of clozapine plus its metabolites. 5.1.5 Prolactin serum levels No rise in serum prolactin levels occurred in these patients after institution of treatment with clozapine. Therefore no correlation between clinical improvement and prolactin serum levels could be ascertained. 5.1.6 5-hydroxytryptamine-induced platelet aggregation No enhancement of 5-HT-induced platelet aggregation could be determined in these patients undergoing treatment with clozapine. Therefore no correlation could be established between clinical improvement and enhancement of 5-HT-induced platelet aggregation. 5.1.7 Plasma cholinesterase and red blood cell ace~- cholinesterase activitX' Both the plasma cholinesterase and red blood cell acetylcholinesterase activity fell within the normal range prior to the institution of treatment with clozapine. These parameters can therefore not be used as diagnostic aids in the diagnosis of schizophrenia. The activity of both parameters also fell within the normal range on conclusion of the study. It would thus appear that treatment with clozapine did not significantly affect these·.parameters. Item Open Access'n Ondersoek na wangebruik van geneesmiddels by bejaardes te Bloemfontein: 'n verpleegkundige studie.(University of the Free State, 1980-01) Van der Lingen, Estelle Christine; Viljoen, M. J.; Pistorius, G. J.Afrikaans: Slot: Die navorsingsbevindings word ten slotte aan die hand van die volgende beskrywing saamgevat: Die gemiddelde bejaarde persoon te Bloemfontein wat voorgeskrewe geneesmiddels gebruik, kan beskryf word as 'n 70-jarige dame wat haar geneesmiddels slegs by die polikliniek by die Nasionale Hospitaal ontvang. Sy is self verantwoordelik vir die neem van haar geneesmiddels, maar neem egter nie al haar geneesmiddels korrek volgens voorskrif nie, want sy maak slegs op haar geheue staat en vergeet soms om dit te neem. Ander geneesmiddels beskou sy weer as onnodig om gereeld te neem en sommige veroorsaak reaksies indien dit gereeld gebruik word. In verband met laasvan die geneesmiddels is in onbruik omdat die geneesheer dit gestaak het of die simptome verdwyn het. Sy is van plan om die geneesmiddels wat in onbruik is terug te neem na die polikliniek. Verder hou sy nie die geneesmiddels in die oorspronklike pakkies nie omdat die pakkies breek en sy dit geriefliker vind as die geneesmiddels in botteltjies is. Sy plaas dit in afsonderlike houertjies maar bring nie etikette op almal aan nie omdat sy die geneesmiddels goed ken en tog net volgens die voorkoms onderskei omdat die naam niksseggend is. Ongelukkig kan sy nie goed sien nie, want sy moet 'n nuwe bril kry. Laasgenoemde veroorsaak dat dit soms moeilik is om die geneesmiddels van mekaar te onderskei. Sy sal nooit van haar geneesmiddels aan iemand anders gee nie omdat sy dit as gevaarlik beskou. Wat die geneeshere aanbetref, verkies sy om elke keer by dieselfde geneesheer 'n afspraak te kry omdat sy voel dat hy haar dan leer ken en verstaan. Laastens verlang sy van 'n geneesheer om vriendelik te wees, opregte belangstelling te toon, deeglik te wees in sy werk en haar eerlik mee te deel wat fout is. Volgens die bevindings van die ondersoek is die wangebruik van geneesmiddels wel 'n probleem by die bejaardes te Bloemfontein. Hierdie ondersoek was, soos reeds bespreek, daarop gerig om die omvang van die probleem en die oorsake daarvan te bepaal. 'n Verdere studie en ondersoek word egter benodig in verband met die wyse waarop voorligting aan die bejaarde gegee moet word en die metodes wat aan die bejaarde gedemonstreer kan word om hulle in staat te stel om die geneesmiddels korrek te neem. Item Open AccessVitamien B6 metabolisme in die eritrosiet met aspartaataminotransferase as biologiese merker(University of the Free State, 1983-01) Schoombie, Elsie Maria Susanna Petronella; Barnard, H. C.Afrikaans: In hierdie studie is daarin geslaag om 'n gestandaardiseerde metode vir die bepaling van AST aktiwiteit op 'n outomatiese analiseerder (Gilford 3500 sisteem) te ontwikkel. 'n Preïnkubasietyd van minstens 10 minute is nodig om die totale AST aktiwiteit in normale plasma te bepaal. 'n Aanvanklike inhibisie van plasma AST aktiwiteit is waargeneem na die in vitro byvoeging van PLP. Hierdie inhibisie kon nie opgehef word deur die PLP konsentrasie of die preïnkubasie-temperatuur te verhoog nie. In teenstelling met normale plasma is 'n preïnkubasietyd van net 2 1/2 minute nodig vir die volle aktivering van die eritrosiet AST aktiwiteit. Die totale aktivering van die AST apoensiem in die plasma van hart en lewerpasiënte vind , soos in die gevalvan eritrosi et AST, ook binne 2i minute plaas. Daar is dus 'n verskil in aktivering van die apoensiem in normale plasma en in die plasma van sekere siek persone. Daar is aangetoon dat piridoksien, wat deur die volwasse eritrosiet opgeneem word en na die aktiewe derivaat, naamlik piridoksaalfosfaat, omgeskakel word, nie beskikbaar is vir die aktivering van die onaktiewe AST in die volwasse eritrosiet nie. Die spesifieke rede hiervoor is nog onbekend en word verder ondersoek. Verskeie Vitamien 86 derivate het egter wel die verlies van ensiem uit die eritrosiete, tot 'n mate beperk. 'n Toename in beide basale sowel as totale AST aktiwiteit is in die eritrosiete na In addisionele daaglikse vitamien B6 innamme oor 'n tydperk van vier weke waargeneem. Die ensiem in die plasma sowel as in die hemolisaatbereidings was tot 'n groter mate versadig met PLP na die addisionele vitamien B6 inname, hoewel die totale AST aktiwiteit in die plasma nie toegeneem het nie. Hieruit blyk dit dat die 'CAS' beginsel vir die bepaling van 'n vitamien status van die liggaam, nie suksesvol in die geval van vitamien B6 toegepas kan word nie. Item Open Access'n Bepaling van die behoefte aan voetversorging by 'n groep bejaardes(AOSIS, 1985) Bothma, Y.; Botma, Y.; Viljoen, M. J.A survey was done to determine the demand for foot care amongst groups of elderly people in old age homes. A history was taken and a clinical examination was done according to criteria on an evaluation scale to determine the extent of foot-problems amongst the sample. The results indicated that 93 % of the elderly had foot-problems and that 46,51 % of these people tried to take care of their own feet. Item Open AccessAlgemene voetversorging van die bejaarde(AOSIS, 1985) Botma, Y.; Viljoen, M. J.The role of the nurse in the prevention of problems of the feet in the elderly is discussed, and the common foot problems that could be caused by negligence and ignorance are referred to. Routine foot care including care of the skin, nails, choice of shoes and massaging of the feet is discussed, and exercises that the elderly can do to prevent foot problems are illustrated. Item Open Access'n Ondersoek na die behoefte en deelname aan sport en fisieke rekreasie van technikonstudente met spesiale verwysing na die Orange-Vrystaat(University of the Free State, 1987-06) Venter, Everhardus Johannes; Cruywagen, F. M.Afrikaans: Hierdie verhandeling het eerstens ten doelom die toeretiese grondslae met betrekking tot bewegingskundige studies van vryetyd en vryetydsbesteding na te gaan ten einde 'n teoretiese verwysingsraamwerk vir die empiriese gedeelte van die studie te bepaal. Die klem val hier op die tyd en ruimtelike aspek van menslike beweging, waar tyd in besonder na vryetyd verwys, ruimte na die natuurlike- en geskepte omgewing wat die mens aanwend vir die benutting van sy vryetyd * en beweging na daardie aktiwiteite wat in hoofsaak tydens vrye tyd * beoefen word. In plaas van 'n holistiese, segmentalistiese of pluralistiese benadering volg die navorser 'n fenomenologiese benadering vir die beskrywing van vryetyd. In navolging van die beskrywende paradigma van Immorlica val die fokus in die studie op dieveelheid van dimensies van vryetyd. Vryetyd is ingevolge hierdie benadering in verskeie dimensies verdeel. Vir die dimensionele kategorisering van vryetyd is slegs die sentrale idee gebruik wat in die verskillende definisies oor vryetyd vervat is. Hiervolgens is vryetyd verdeel in universele, unieke, supraorganiese, organiese, dinamiese en statiese dimensies, as synde algemene dimensies en kwantitatiewe, ruimtelike, kwalitatiewe, funksionele, kognitiewe, konfigurale, idiële, reële en gekonstrueerde dimensies, as synde besondere dimensies daarvan. Wat die verhouding tussen vryetyd, rekreasie, spel en sport betref, is in teenstelling met die integrasionistiese, segmentalistiese en molekulêre benadering, 'n kwalitatiewe benadering in die studie gevolg. Rekreasie, spel en sport is as die konkrete onderbou van die kwalitatiewe dimensie van vryetyd beskou. Binne die bestek van die kwalitatiewe benadering is die empiriese, normatiewe en psigologiese paradigmas met betrekking tot vryetyd, spel, rekreasie en sport geakkomodeer. Die belangrikheid van vryetyd en die sinvolle benutting daarvan is by wyse van 'n omvangryke literatuurstudie ondersoek. 'n Omvattende studie is gemaak van spel, rekreasie en sport as synde die kwalitatiewe onderbou van vryetyd. Uit die literatuur blyk dit dat spel oor 'n intrinsieke beloning beskik en derhalwe hoofsaaklik proses-georiënteerd is. Rekreasie is dus weer 'n emosionele ervaring en aktiwiteit en is dus proses- sowel as produkgeoriënteerd. Beide verteenwoordig positiewe komponente van vryetyd. Sport daarenteen is in hoofsaak produk-georiënteerd. Vryetyd is 'n belangrike komponent van die daaglikse lewe van die student. Die student is inderwaarheid nie alleen "homo faber" - mens die werker nie, maar ook "homo ludens" - mens die speler. Voortreflike en produktiewe akademiese arbeid is daarom net so noodsaaklik vir die student as positiewe produktiewe vryetyd en dit setel in 'n besonder rekreatiewe sportervaring. Daarom moet spel steeds die grondslag van die rekreasie- en sporthandeling bly. Daarsonder word beide aktiwiteite gestroop van hul kwalitatiewe inhoud, word die kwalitatiewe waarde daarvan gereduseer tot die momentele en is dit nie meer 'n ryke lewenservaring nie. Wat die praktiese ondersoek betref, is 'n opname gemaak van die behoeftes- en deelnamepatrone ten opsigte van sport en fisieke rekreasie van die studentekorps aan die Technikon O.V.S. In die verband is ondersoek, ingestel na die invloed van veranderlikes soos geslag, ouderdom, kursus en woonplek op die sport- en fisieke rekreasie behoeftes- en deelnamepatrone. Die ondersoek toon dat die genoemde veranderlikes 'n beduidende invloed op die deelnamepatroon van die technikonstudent wat sport en rekreasie betref uitoefen. Oor die algemeen dui die studentegemeenskap se aktiewe deelname aan sport en rekreasie op 'n gunstige syfer van bykans 70%. Wat die 30% fisiek onaktiewe studente betref, behoort stappe geneem te word om die groep tot deelname, veral wat fisieke rekreasie betref, aan te moedig. Die oorgrote meerderheid van die damestudente is sterk ten gunste van massadeelname, terwyl die manstudente voorkeur gee aan daardie aktiwiteite met 'n oorheersende kompetisie-element. Aangesien die studentegemeenskap se voorkeure met betrekking tot sport en rekreasie na hul toetrede tot die technikon wegbeweeg van die tradisionele sportsoorte wat op skoolvlak beoefen is, kan die geleentheid benut word om veral die manstudente aan te spoor om in 'n groter mate aktiwiteite te beoefen waar die intrinsieke beloning sterker figureer. Item Open Access'n Verpleegkundige begeleidingsprogram vir persone wat infektering met die menslike immuniteitsgebrekvirus vermoed(University of the Free State, 1992-05) Basson, Petro Magdalena; Van Wyk, N. C.; Viljoen, M. J.Afrikaans: VIGS is 'n wesenlike probleem in Suid-Afrika. Indien die verspreiding van die Menslike Immuniteitsgebrekvirus (HIV) nie gestop word nie, kan die siekte epidemiese afmetings aanneem. Diegene wat hoë risiko seksgedrag beoefen moet gelei word om dit te staak. VIGS is 'n gevreesde siekte omdat HIV infeksie 'n chroniese infeksie is en gekenmerk word deur die progressiewe agteruitgang van die menslike immuunsisteem. Daar bestaan geen geneesmiddel teen die siekte nie en die verloop daarvan eindig altyd in die dood. Persone wat hoë risiko seksueelgedrag openbaar, vermoed dikwels dat hulle moontlik met HIV geïnfekteer kan wees. Met aanmelding vir evaluering ter bevestiging van hul vermoedens, benodig hulle reeds verpleegkundige tussentredes. ' Die tussentredes behoort daarop gerig, te wees om hulle in staat te siel om hul kommer te hanteer. Indien die persone egter nie ook gelei word om hul gedrag te verander nie, kan hulle weer met die virus in aanraking kom of dit selfs versprei. Omdat verpleegkundiges dikwels die ondersteuning van hierdie persone hanteer, kan aanvaar word dat 'n verpleegkundige begeleidingsprogram wat deur empiriese navorsing ontwikkel is, 'n positiewe bydrae tot optimale ondersteuning kan maak, aangesien daar geen gepubliseerde Suid-Afrikaanse verpleegkundige begeleidingsprogram in die literatuur gevind kon word nie. Dit is dus die doel van die studie om 'n begeleidingsprogram vir persone wat HIV infektering vermoed, te ontwikkel wat hulle in staat stelom: - feitelike kennis oor VIGS te bekom, - die psigologiese gevolge van HIV infektering te begryp, en - die nodige gedragsverandering te begryp en te bemeester. 'n Beskrywende studie met 'n nie-eksperimentele navorsingsontwerp is gebruik. Na 'n omvattende, intensiewe literatuurstudie is 'n voorlopige begeleidingsprogram vir persone wat hoë risikogedrag openbaar, saamgestel. Daarna is dit aan domeinkundiges, wat oor spesiale kennis op die gebied van VIGS beskik, vir evaluering volgens die Delphi-tegniek voorgelê. Beskrywende statistieke is gebruik in die ontleding van die data wat verkry is. Uit die bevindinge is dit duidelik dat die domeinkundiges met die afdelings sowel as items van die voorlopige program saamstem. Die finale program is na 'n herorganisasie van die items ten einde 'n logiese geheel te verkry, saamgestel. Vir die volgende afdelings en inhoud is voorsiening gemaak: - Inligting oor VIGS -- Oorsprong -- Patogenese -- Epidemiologie -- Spektrum -- Kliniese tekens en simptome -- Oordraging van HIV -- Hoë risikogedrag - Psigososiale reaksies van persone wat mv infektering vermoed - Verpleegsorg -- Ondersteuning -- Motivering tot gedragsverandering Die verpleegkundige wat die program gebruik moet deurentyd bewus wees van die kliënt se uniekheid en slegs toepaslike gedeeltes gebruik. Die program is dus as hulpmiddel vir die verpleegkundige ontwikkel en nie as 'n inligtingstuk vir persone wat HIV infektering vermoed nie. Item Open Access'n Verpleegkundige ondersteuningsprogram vir vroue met primêre karsinoom van die mammae(University of the Free State, 1995-11) Nel, Elizabeth Cornelia; Van Wyk, N. C.; Van Rhyn, L.English: All women with breast cancer need support to deal with the combined impact of the diagnosis of cancer, breast loss, adjuvant treatment and the possible recurrence of the disease. The women need to adjust to live with and accept these factors. As discussed in the literature, nursing staff do not always give the necessary emotional support. Research results show that there is a difference between women's need for support and that which is given by the nursing staff. The aim of the study is to develop a nursing support program for women with primary breast cancer. A descriptive study was done using a qualitative research design. Free attitude interviews were used to collect data from women with primary breast cancer who are being treated by private oncologists and radiation oncologists in the Pretoria area. The phenomenalogical perspective of Haase and Van Kaam were used in combination for data analysis. According to the data it clearly appears that the support of the nursing 'staff consists of direct nursing support initiated by the nursing staff with the woman, in order to assist the woman to adjust to her illness, and the effects thereof. The core of the direct nursing support is communication, accompaniment and information. The woman's external environment is involved during indirect nursing support. Although the women's needs can be generalised, each woman requires specific and individual care. These support needs vary at times. A nursing support program for women with primary breast cancer was developed after comparing the collected data with the literature. By following this program, the nursing staff can teach the women to adjust to and to accept the emotional as well as the social impact of the diagnosis, breast loss and the adjuvant treatment. The women learn to live with a diagnosis of cancer despite a fear for recurrence. Item Open AccessA problem-based education programme for registered nurses in advanced midwifery and neonatology(University of the Free State, 1996-05) Fichardt, Anna Elizabeth; Viljoen, M. J.It is the aim of the current government that primary health care should be established in South Africa to address the health care needs of the entire South African population. In this regard midwives are seen as the key figures to establish comprehensive perinatal health care. The altered focus of the delivery of health care from curative to primary health care demands expertise from midwives to enable them to meet the needs of the community. This requires an alternative approach to nursing education. Various researchers expressed a concern regarding continuing professional education for midwives. To address these problems, grass root involvement by practising midwives is proposed, in order to prepare them for continuing education. A proposal was made that continuing professional education should be implemented in the regions. The Perinatal Committee of the Free State supported the need for an education programme for midwives in the region. In response, the learning needs of the registered nurses were formally assessed and the Advanced University Diploma in Midwifery and Neonatology was developed and implemented. The community's perinatal health care problems and the learning needs of the potential students played a significant role in the development of the objectives and the selection of the content. An innovative teaching methodology, namely problem-based learning was chosen. With the development and implementation of the Advanced University Diploma in Midwifery and Neonatology the researcher not only tried to prepare graduates who can function in clinical context with the demands placed on them are constantly changing, where problems and situations are not easily defined or solved and where the body of knowledge is rapidly changing. The researcher also aimed to prepare health workers who will contribute maximally to the improved health of the individuals and communities they serve and tried to help students to learn how to learn, that is to create independent learners who will assume active responsibility for a lifetime of continuing education and who will be able to keep up with advances in their field. Item Open AccessA problem-based education programme for registered nurses in advanced midwifery and neonatology(University of the Free State, 1996-05) Fichardt, Anna Elizabeth; Viljoen, M. J.English: It is the aim of the current government that primary health care should be established in South Africa to address the health care needs of the entire South African population. In this regard midwives are seen as the key figuires to establish comprehensive perinatal health care. The altered focus of the delivery of health care from curative to primary health care demands expertise from midwives to enable them to meet the needs of the community. This requiires an alternative approach to nursing education. Various researchers expressed a concern regarding continuing professional education for midwives. To address these problems, grass root involvement by practising midwilves is proposed, in order to prepare them for continuing education. A proposal was made that continuing professional education should be implemented in the regions. The Perinatal Committee of the Free State supported the need for an education programme for midwives in the region. In response, the learning needs of the registered nurses were formally assessed and the Advanced University Diploma in Midwifery and Neonatolog1y was developed and implemented. The community's perinatal health care problems and the learning needs of the potential students played a significant role: in the development of the objectives and the selection of the content. An innovative teaching methodology, namely problem-based learning was chosen. With the development and implementation of the Advanced University Diploma in Midwifery and Neonatology the researcher not only tried to prepare graduates who can function in clinical context with the demands placed on them are constantly changing, where problems and situations are not easily defined or solved and where the body of knowledge is rapidly changing. The researcher also aimed to prepare health workers who will contribute maximally to the improved health of the individuals and communities they serve and tried to help students to learn how to learn, that is to create independent learners who will assume active responsibility for a lifetime of continuing education and who will be able to keep up with advances in their field. Item Open AccessVerpleegsorgbehoeftes van HIV positiewe pasiënte(University of the Free State, 1996-05) Basson, Petro Magdalena; Van Rhyn, W. J. C.; Viljoen, M. J.English: HIV infection causes AIDS, a communicable, stigmatised and terminal disease. It leads to the progressive deterioration of the immune system that ends in death. HIV infection affects the total human being. Never in history were health care workers so drastically challenged to look beyond an illness and to take on a holistic approach to health, as in the case with AIDS. The research was done in two phases. The first phase was the reconnaissance and description of HIV positive patients' nursing care needs as well as nurses' view thereof. The selection of nurses and patients were done by purposiveness selection. The researcher has established the nursing care needs of the HIV positive patient in the study by in-depth interviews. Nurses' views of the nursing care were also obtained through in-depth interviews. Interviews were recorded on tape and were transcribed afterwards. Data analysis was done according to Giorgi's model. After data analysis had been done, the results were controlled and verifted with the literature. The abovementioned processes were completed according to the philosophic foundation of the researcher, namely the Christian anthropology. Several needs and problems of the HIV positive patients with regard to their nursing care were identified. Nurses also experienced problems in the delivery of their nursing care. The primary problems that nurses experienced were, a lack of information about HIV and AIDS as well as limited time to deliver quality nursing care. Phase two: From the gathered information from HIV positive patients, nurses and literature, a nursing care model was compile to provide in the needs of the HIV positive patients. The model makes provision for application in any stage of AIDS. The family, community, resources and the multi-disciplinary team fugerate in this model. The nurse is the key role player in the model. The model is framed by the 15 aspects of Dooyeweerd and therefore shows that the HIV positive patient is nursed according to the holistic approach. The description and reconnaissance of the concepts applicable to the model were done according to the theory generated by Marriiler-Tomey,(1989:5), Woods and Catenzaro (1988:20), Walker and Avant (1988: 10) and Kim (1983: 131). This middle range theoretical model was compiled to ease the task of the nurse in practice and also to deliver quality nursing care to HIV positive patients. Item Open AccessThe identification of community needs for AIDS health education(University of the Free State, 1997-09) Khokho, Sylvia Rejoice Olebile; Basson, P. M.; Visser, L.English: AIDS is a fatal disease which mostly affects the economically productive age-group (25-50 years). It therefore adversely affects the economy of the country. It is also expensive to treat as it affects the immune system of the body, thereby rendering the person critically ill and requiring intense and expensive nursing and medical care. AIDS is also seen as a disease of attitude and behaviour, as it is closely associated with sexual behaviour, where a person has more than one sexual partner. This practice, in the form of polygamy (as seen today) and concubinage, is still accepted as normal cultural practice in most black communities in spite of the effect of social change on many tribal customs. There is a drastic increase in the number of persons infected with AIDS in spite of existing efforts to combat the disease. This increase is not specific to a particular racial group, country, community or town. It is a worldwide problem. However, most new cases of AIDS are found among the black population. Health education seems to be the only strategy available as a measure for controlling the spread of AIDS in the absence of a cure. There is therefore a definite need to investigate the requirements for the development of a health education program for the control of AIDS. The aim of this study was to identify the needs of the community for AIDS health education. This entailed eliciting their perceptions of AIDS, establishing their preference regarding the AIDS educator, identifying topics/aspects to be addressed in the educational program, as well as establishing principles with which ethnicspecific health educational programs should comply to be acceptable to communities. Interviews were conducted with clients visiting health services In Mangaung. Trained fieldworkers were used to help with the implementation of the structured interview schedule. The data were analysed and the findings were compared and discussed in terms of the literature review. Reliability of the data collection instrument was ensured by training fieldworkers to ask questions correctly. The conduction of a pilot study to identify possible problems and address these before the major study helped to ensure reliability. For the purpose of validity, the interview schedule was submitted to experts in research. This ensured face validity. Content validity was ensured by submitting the measuring instrument to a domain expert. It was also handed to an expert working at the AIDS Training, Information and Counselling Centre (ATICC) for evaluation. These experts were asked to evaluate the interview schedule in terms of whether the questions were correctly and objectively worded and whether they matched the objectives of the study. Conclusions and recommendations were made and guidelines, based on findings, were set for the development of a health education program for the control of AIDS. Item Open AccessAssessment of different methods of determining confidence intervals for the difference of binomial proportions(University of the Free State, 1998-05) Nel, Mariette; Joubert, G.; Schall, R.; Nel, D. G.Abstract not available Item Open AccessThe assessment of potential radiation hazards from gold mines in the Free State Goldfields to members of the public(University of the Free State, 1998-11) Ellis, Jozua Francois; Botha, J. C.; Van Aswegen, A.The gold mines In the Free State Goldfields extract and process ore from underground, which contains naturally radioactive uranium and its associated decay products. This assessment aimed to cost effectively determine the major potential radiation hazards to the public from the gold mines in the area. The potential exposure sources from the mines are radon gas, radioactive dust, contaminated water and external gamma radiation. The assessment focussed mainly on the public's potential exposure to radon gas emanating from tailings dams, waste rock dumps and upcast shafts from underground workings. The rate of radon emanation from the dams was measured using several different techniques, and the potential dispersion of the radon was modelled using internationally accepted modelling codes and local weather data for the Free State Goldfields. A maximum potential contribution to the natural background radon levels of 6 Bq m-3 was calculated. This is a small increment to the background levels in the order of 25 to 35 Bq m-3". Environmental measurements of outdoor radon concentrations confirmed the modelling results to the extent that no significantly high radon concentration could be detected in the environment. Background radon levels in towns outside the Free State Goldfields are in the same order as those measured around the mines. Similar environmental measurements of airborne dust and water sources around the mines indicated relatively low levels of radiation. A conservative estimate of the total potential exposure of the public in the Free State Goldfields is in the order of 130 to 250 µSv/a. This can be interpreted as well within the internationally accepted public dose limit of 1000 µSv/a. Item Open AccessIdentification and confirmation of the presence of some steroid-like growth promoters in the urine of cattle and swine(University of the Free State, 1998-11) Pieterse, Jacobus Wilhelmus; Van der Merwe, P. J.English: Anabolic steroids and/or growth promoters are used to improve growth rate and feed conversion efficiency of livestock. The residues of these anabolics, which are present in the meat, may have a pharmacological activity due to oral bioavailability, and pose a risk to the consumer. Certain anabolics can be given legally to farm animals in some countries, but are banned in most others because of their proved or alleged toxic and/or carcinogenic properties. The use of these substances is completely forbidden within the European Community (EC). Before meat products can be exported to any member state of the EC, it is compulsory for the exporting country to have a monitoring programme to test for illegal use of these anabolic substances. The necessity to test for illegal use or to determine residue levels after legal use, has led to a strong interest in developing analytical methods for the identification and confirmation of anabolic agents in biological samples. The objectives of this study were to develop suitable analytical methods with a view to identify residues of some growth-promoting veterinary drugs in the urine of cattle and/or swine, to confirm the presence of these veterinary drugs unequivocally in the urine and to examine the stability of these drugs in urine under different environmental storing conditions. The excretion of clenbuterol, diethylstilbestrol, nandrolone, trenbolone and zeranol from cattle and/or swine were studied. A thorough literature study was done on the published analytical methods as well as the metabolism and pharmacokinetics of these drugs in cattle and/or swine. Reference standards were used to develop a GC-MS screening method for the identification of these drugs and/or their metabolites in the urine of cattle and/or swine. Recoveries of 61-99% and detection limits of 0.9-2.1 ng/ml were obtained for the different analytes with the developed analytical method. Trials were conducted in which these drugs were administered to cattle and/or swine. Urine samples were collected at regular time intervals and stored immediately at -20°C until time of analysis. Reference standards were also used for the development of GC-MS-MS analytical methods to confirm the presence of these drugs and/or their metabolites in the urine of cattle and/or swine. Confirmation of the substances in urine was done by obtaining a MS-MS spectrum of the extract and comparing this with the MS-MS spectrum of a reference standard. The MS-MS spectra was obtained by using the ion-trap technique. Urine samples are often collected at different farms and transported to the laboratory for residue analysis. Although it is standard procedure to freeze samples immediately after collection, it is not always possible. The results of this study show that the analytes contained in urine samples that were stored frozen remained stable for at least 10 days. If urine samples are stored at ambient temperature, concentrations of the analytes can decrease with as much as 30% after 10 days. Epi-nandrolone (metabolite ofnandrolone in cattle) could however not be detected in the urine samples after 4 days. If urine samples are stored in direct sunlight, concentrations of the analytes can decrease with as much as 90% after 10 days. It can be concluded that a method was developed to identify residues of some growthpromoting veterinary drugs and/or their metabolites in the urine of cattle and/or swine, and to confirm the presence of these drugs unequivocally in the urine. It can further be concluded that urine samples should be frozen as soon as possible after collection to prevent false negative results. Item Open AccessStressors experienced by student nurses during clinical placement in psychiatric units in a hospital(University of the Free State, 1998-11) Gontsana, Maphosa Ruth; Van Rhyn, LilyEnglish: Psychiatric nursing students find themselves in a situation in which they are confronted by stressors in their personal and professional enviromnent, as well as stressors caused by their inexperience in psychiatric nursing. An exploratory study was conducted with the aim of discovering and describing possible stressors experienced by psychiatric nursing students during clinical placement in a psychiatric unit. The study had two objectives: firstly, to identify factors experienced by student nurses as stressful while working in psychiatric units and secondly, to recommend guidelines to minimise stress, for inclusion in the psychiatric clinical nursing curriculum. For the purpose of the study an unstructured interview was conducted with each participant during their first placement in a psychiatric unit to identify the factors experienced as stressful. The results indicated that all eight participants experienced average to high stress. Sources of stress identified included, among others, ineffective teaching and learning programmes, poor managerial governance of the service, detachment of professional nurses from their teaching role, poor relationships among staff, over-reliance on the medical model of care and patient neglect. Psychiatric nursing students sampled indicated universal support for in-service education and training for professional nurses, attitude change of professional nurses towards students, support for student initiatives, student involvement in patient care and adequate allocation of resources for patient care and nurse training. Arising from the findings, guidelines were established for the guidance of psychiatric nursing students. The exploration and description of stressors experienced by the psychiatric nursing students will help nurse educators plan clinical learning opportunities in such a way that they are less stressful, thus ensuring that psychiatric nursing students are equipped to utilise themselves as therapeutic instruments. Item Open AccessDie impak van toubaanprogramme op groepseffektiwiteit(University of the Free State, 1998-11) Herselman, Elizma; Bloemhoff, H. J.; Bester, C. L.English: Little is said in the literature regarding the impact of ropes course programmes in South Africa on the effectiveness of the groups that participate in them. With this powerful experiential learning tool at disposal, it is necessary to give participants in this adventure activity clear proof regarding the impact of ropes course programmes on the personal development of the individual and the effectiveness of the group. A ropes course programme has the potential to improve the functioning of groups and simultaneously the productivity of the organisation in which the group finds itself. A hypothesis was formulated on the grounds of this statement, namely that participation in ropes course programmes in group context stimulates certain components of group effectiveness which further lead to the personal development of the individual within the group. Increased productivity in the corporate market demands the functioning of an effective group. In order to establish the effectiveness of the group, certain variables, that are responsible for this effectiveness, were identified in the literature. A variety of programmes are used to enrich, motivate and build a group into an effective group. A tendency of the nineties is adventure-related team building through experiential learning. Adventure-related experiential learning uses the metaphorical transfer between the adventurous experience and the workplace of the individual. For the purpose of this study ropes course programmes as a medium of adventure-related experiential learning were investigated in order to determine what their impact is on the participants as a group and as individuals. As part of the prior investigation questionnaires were sent to the managers of corporations that had already had groups participate in ropes course programmes. This information provided basic guidelines regarding the expectations of the companies and the motivation for participation. As part of the research 150 respondents who had participated in ropes course programmes were involved in the study. Respondents were expected to complete a "before" and "after" questionnaire in order to make a comparative study between the "before" and "after" measurements possible. During the prior investigation respondents listed the various aspects regarding the current state of the group's effectiveness qualities of the group and the individual in terms of the strong and weak points of the group. The respondents were requested to list their expectations with regard to the programme and identify areas the group would like to improve. Respondents rated the individual and group aspects on the five-point Likert scale according to the standing of these aspects prior the participation in the programme. In the follow-up questionnaire the most positive and negative effects derived by respondents from their participation were identified. The variables that determined effectiveness during the prior investigation were again given to participants for rating in order to determine whether their participation had any impact on the variables of group effectiveness. It appears from the results that the expectations of participants with regard to the programme closely correlated with the positive effects they derived from it. The significance between the variables' mean difference shows that 81.3% of the group variables show a highly significant difference (p<0.01) and 18.8% of the group variables a significant difference (p<0.05). Regarding the individual variables 9l.0% showed a highly significant difference (p<0.01) and the remaining 9.0% a significant difference (p<0.05). These variables that were identified in the literature are being directly addressed by participation in ropes course programmes. On these grounds it can be concluded that the significant difference indicates that the effectiveness of groups is increased by participation in ropes course programmes and the formulated hypotheses can be accepted Item Open AccessEvaluation of problem-based learning in an undergraduate nursing education programme(University of the Free State, 1999-05) Becker, Susanna; Viljoen, M. J.; Botma, Y.English: The aim of this study was to evaluate problem-based learning in an undergraduate nursing education programme. The School of Nursing at the University of the Orange Free State implemented problem-based learning as a teaching and learning strategy in the undergraduate programme in 1997. The 1998 course was evaluated to determine the success of this innovative method of instruction. It was done by administration of an audit to determine whether the methodology and process of PBL were followed; all the variables (internal and external) were considered during programme development, and whether requirements for outcomes as required by the South African Qualifications Authority were met. Student satisfaction was determined by means of a perception questionnaire and changes that took place in learning styles were determined by means of a learning style inventory that was developed in Lancaster. The grades students obtained in problem-based learning subjects were compared to the grades they obtained in subjects that were instructed by means of traditional lectures, as well as their grade 12 results secondary schooling. The audit revealed that this course was carefully planned and implemented to be one of exceptional quality. An action research model was used to monitor the integrated curriculum model with an emphasis on the PBL philosophy. This curriculum was found to be successful in portraying the South African health context in a lifelike and comprehensive manner, as the design was community-based. This curriculum addressed the tendency to overload and divided curricula in the disciplines, which bears little resemblance to the reality of the South African health context. A deficiency found is the lack of a formal quality assurance programme, which will enhance the maintenance of the high standard. Students in the course were under a lot of stress as they had to leave the comfort zones of traditional learning and some reacted with anger and resentment. Learning did take place in spite of all the hurdles students were confronted with. Superiority in meaning orientation, intrinsic motivation, deep approaches and comprehension learning was detected by the LAS! when results were compared to the scores of similar studies done in first-world countries (see Appendix J). Unfortunately a decrease in student-centredness took place, which could be ascribed to group sizes that were too large, fear of failure (as bursaries would be forfeited if students did not perform up to certain standards) and a heavy workload. Assessment results of PBL subjects were very positive in spite of students' indications that they found the course difficult. Assessment scores were much higher for PBL subjects than for traditional lecturing subjects, as well as Anatomy, which was instructed by means of video-assisted instruction. Nearly half the students obtained better assessment results in PBL than in their matriculation examinations. The most positive aspect of the first-year nursing course was the fact that students became self-directed learners and that a pattern of lifelong learning was created to equip them for the challenges that lie ahead in the 21st century.