Health Sciences Faculty Day Posters

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Posters presented on Health Sciences Faculty Day by undergraduate and postgraduate students and lecturers.

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Now showing 1 - 20 of 46

Computer-based testing (CBT) for assessment of medical and dental students on the higher levels of Bloom’s taxonomy.
(2009-12-09T06:23:00Z) De Bruyn, E.; Meiring, J.H.; Creative Studios, Dept of Education Innovation, University of Pretoria; Van Schoor, Albert-Neels
This study reflects on a new Computer-based testing (CBT) system implemented at the School of Medicine, Faculty of Health Sciences at the University of Pretoria (UP) in South Africa. This CBT model was used in different innovative ways for assessing medical and dental students on the higher levels of Bloom’s taxonomy. The students showed an overall positive feel for using this CBT system of assessment. Compliance amongst the students was established and the learning experience was also enhanced due to immediate feedback available after each assessment. The lecturers involved with designing the questions agreed that the new CBT system can be used for testing on higher levels of Bloom’s taxonomy and are positive with regards to its application. A favourable relationship between the cost, resources and logistics was also established when using this format of assessment. Taking into account the scope and versatility of this new system, its potential to be used by any discipline in a tertiary institution, and its potential to test students on higher levels of Bloom’s taxonomy, makes the new system an ideal assessment tool that allows for valid and reliable assessment of large groups of students
Anatomical considerations of the neonatal ilio-inguinal/ iliohypogastric nerve block
(2009-12-09T06:22:10Z) Bosenberg, A.T.; Creative Studios, Dept of Education Innovation, University of Pretoria; Van Schoor, Albert-Neels; Bosman, Marius C.
The ilioinguinal/ iliohypogastric nerve block is an effective technique that provides analgesia for a variety of inguinal surgical procedures in children. However, a relatively high failure rate of between 20-30% has been reported. The aim of this study was to determine the exact anatomical position of the ilio-inguinal and iliohypogastric nerves in relation to an easily identifiable bony landmark, the anterior superior iliac spine (ASIS), in neonates. Dissections were performed on a sample of 54 neonatal cadavers (51 left and 53 right sides; mean length: 0.43m ± 0.06m; mean weight: 1.64kg ± 0.72kg) and the distance from the ASIS to both these nerves, on a line connecting the ipsilateral ASIS to the umbilicus, was measured using a mechanical dial sliding calliper (accuracy: 0.01mm). No significant difference was found when comparing the left and right sides of the sample. The data for the left and right sides were therefore combined, i.e., a total of 104 ilio-inguinal and 103 iliohypogastric nerves were examined. The nerves were found to be much closer to the ASIS than was previously thought. The ilio-inguinal nerve was between 1.98mm-2.43mm from the ASIS, while the iliohypogastric nerve was approximately 3.56mm-4.07mm from the ASIS. The data obtained from this study suggest that the high failure rate of the ilio-inguinal/ iliohypogastric nerve block could be due to lack of spatial knowledge regarding the anatomy of these nerves in neonates. An improved needle insertion site was therefore developed, one that aims to block these nerves at a point closer to the ASIS.
The anatomical basis of the submandibular gland and its clinical importance. a cadaver study
(2009-12-09T06:20:47Z) Basson, N.; Creative Studios, Dept of Education Innovation, University of Pretoria; Bosman, Marius C.
The submandibular gland can be involved in a variety of different diseases. Although tumours of the gland are rare, it is difficult to distinguish whether it is malignant or benign and a final diagnosis is often only possible after excision of the diseased gland. Anterior surgery of the upper cervical spine often necessitates removal of the gland to enable access the vertebrae. As the gland has many functions, excision may cause numerous clinical complications and side-effects. The aim of this study was to identify and evaluate the anatomy of the submandibular gland and its relations in terms of differences between males and females as well as left and right sides. Fifty-six glands were dissected. A Vernier caliper was used to measure the distance from the symphysis mentis to the anterior and posterior ends of both glands to determine the length and the width was determined perpendicular to the length. The average distance from the symphysis mentis to the gland was greater on the right than the left side in both males and females (L=33.01„b1.49mm, R=34.13„b1.46mm). Although the measurements for males were greater, it was not significant (T-test, p>0.05). The glands¡¦ length (l) and width (w) was slightly larger in males than in females (males l=34.12¡Ó1.58mm w=31.36¡Ó1.23mm; females l=33.95¡Ó1.38mm w=30.02¡Ó1.32mm). There was no significant difference between the sexes in this regard (T-test, p>0.05). The normal practice to remove the submandibular gland during surgery to the upper cervical spine that involves the anterior retropharyngeal approach should be discouraged, since it may lead to xerostomia in the elderly. The gland¡¦s superficial anatomy allows for quick and easy mobilisation, even in patients with short necks, and resection of healthy glands should be avoided at all costs.
Infraclavicular brachial plexus blocks. Comparison of neonatal and adult anatomy
(2009-12-09T06:19:54Z) Bosenberg, A.T.; Creative Studios, Dept of Education Innovation, University of Pretoria; Van Schoor, Albert-Neels; Bosman, Marius C.
The infraclavicular (IC) block has been designed to effectively block all the cords and branches of the (BP). However, the majority of paediatric research available uses techniques designed employing adult samples. Although the success rates of these procedures are acceptable, a nerve stimulator is used to identify the BP. Even with the aid of nerve stimulators, no regional anaesthetic technique can be considered safe and consistent until the anatomy has been examined. This study aims to describe the anatomy of the paediatric BP, to determine an improved needle insertion site for the IC block using constant bony landmarks and, finally, to compare the data obtained from the paediatric study to that obtained from a similar adult study. A sample of 52 neonatal (52 left and 50 right axillae; mean length: 0.43m±0.08m; mean weight: 1.94kg±1.62kg) and 75 adult (74 left and 70 right axillae; mean length: 1.70m±0.09m; mean weight: 57.57kg±14.95kg) cadavers were used in the study. No significant difference was found when comparing the left and right sides of either sample. The data for the left and right sides of both samples were therefore combined, i.e., a total of 102 neonatal and 144 adult axillae were examined. The distances of the lateral and medial cords of the BP were measured from the coracoid process (CP) on a line between the CP and the xiphisternal joint (XS). The ideal point of needle insertion (a point halfway between the lateral and medial cords of the BP) was also determined for both samples. These measurements were then converted to a percentage of the CP to XS line distance on both sides. Statistical analysis of the data showed that there was a significant difference between the percentages obtained when comparing the neonatal and adult samples. Two distinct regression formulae were therefore developed in order to predict the ideal point of needle insertion (dependant variable) with the CP to XS line distance as the independent variable. It is clear from this study that children are not small adults and caution is advised when performing paediatric blocks that were developed for adult populations.
A comparison of the palmaris longus and plantaris muscles employed as flaps in reconstructive surgery
(2009-12-09T06:18:46Z) Venter, G.; Creative Studios, Dept of Education Innovation, University of Pretoria; Van Schoor, Albert-Neels; Bosman, Marius C.
Tendon grafts are often needed in reconstructive surgery. A donor tendon is usually selected for transfer because it is thought to be nonessential in its original location. This is the case with the palmaris longus (PL) and plantaris muscles (P) that are found to be frequently missing without any adverse effects. The literature reports that plantaris should be present in about half of those who do not have the PL muscle, and further states that the absence of the PL appears to be related with the absence of plantaris. Both remain the key choices for tendon harvest. Although the frequency, structure and function of these muscles have been well described in the literature, little attention has been given to the description of their simultaneous occurrence. The aim of this study was to compare the macroscopic structures of PL and P in a South African population and to compare the data found to that reported in the literature. Secondly,to determine if an absence of PL correlates with an absence of P, in a cadaver population. The muscles were dissected out along the entire course in a sample of 150 cadavers. Information regarding the length and width of these muscles’ fleshy belly and tendons were measured, as well as the demographic information for each cadaver was recorded. Preliminary results show that the length of the P tendon is longer than tendon of the PL muscle, and the width of the PL tendon is wider than the P. The absence of the PL muscle does not correlate with an absence of the P muscle in the same individual. If tendon length is favoured for grafting in reconstructive surgery, the P is used, and the PL is preferred when width is important.
A cadaver study on the anatomical variation and branching of the anterior cerebral artery
(2009-12-09T06:18:15Z) Odendaal, C.W.; Creative Studios, Dept of Education Innovation, University of Pretoria; Briers, Nanette
The cortical branches of the distal anterior cerebral artery (ACA) are responsible for the primary blood supply of the corpus callosum. Anatomical variation in these arteries leads to difficulty in defining a standard vascularisation pattern for the distal ACA, which in turn complicates the task of neurovascular surgeons operating on these structures. The particular aim of this study was to investigate the vascularisation of the corpus callosum by studying the anatomical variations and branching of the ACA. The diameter of the ACA at specific landmarks, its course and branches were studied in 34 embalmed brains. The study revealed that the diameter of the distal ACA was the largest (2.46±0.1mm) at the start of the A4-1 segment. At the start of the A4-2 segment, the ACA was significantly smaller (1.61±0.09mm), while being the smallest (1.31±0.1mm) at the start of the A4-3 segment. Therefore, the artery becomes thinner as it proceeds posteriorly over the corpus callosum. In 29.4% of subjects, 4 branches of the A4-2 segment were found to supply the body of the corpus callosum, causing it to be the most vascular portion. The A4-1 segment had 3 branches in 29.4% of subjects, supplying the genu of the corpus callosum. In 38.2% of subjects, 1 supplying branch of the A4-3 segment was found. Although the most supplying branches were expected to be from the A4-1 segment of the distal ACA, the shorter length of this segment, compared to that of the A42 segment, could possibly be the reason for the fewer number of supplying branches. In conclusion, the blood supply of the corpus callosum differs in the various segments of the distal ACA. Knowledge of this vascular anatomy will aid pre-operative planning and avoidance of complications during neurosurgical procedures
A bioarchaeological investigation into the human remains discovered in the chloorkop area
(2009-12-09T06:16:53Z) Creative Studios, Dept of Education Innovation, University of Pretoria; Meyer, Anja; Nienaber, Willem C.; Keough, Natalie
In November 2008 human skeletal remains were discovered during construction works undertaken by Carlop Properties in the Chloorkop industrial area, Kempton Park, Gauteng. The University of Pretoria’s Forensic Anthropology Unit, FARC (Forensic Anthropology Research Centre), was notified and rescue excavations of both the exposed and undisturbed remains were undertaken. The skeletonized remains of at least 18 individuals were recovered and sent to the Department of Anatomy at the University of Pretoria for standard anthropological analysis. The identity and time period of these human remains are unknown and during social consultation no relatives could be identified. Excavations revealed a formal burial pattern which suggests a formal cemetery, probably associated with a historic institution. All individuals were buried in wooden coffins in an extended, supine position. The remains consist of both adult and juvenile remains. Some of the remains were found in a commingled state due to disturbance caused by construction work. MNI was determined by visual pair matching of skeletal elements based on similarities observed in bone morphology, age and sex, trauma and pathology, and taphonomic alterations. Bioarchaeological techniques were employed and the following preliminary results were obtained. Of the possible 18 individuals at least 15 were identified to be male, one possibly female, and two juveniles. At least five of the adult male individuals presented with cut marks associated with standard autopsy procedures. No reference to the individuals’ identity or to the context of the cemetery within the historical span of the Chloorkop area has been located. However, the burial pattern observed, as well as the demographic profile and pathology observed on the skeletal remains suggests that these individuals could possibly be linked to one of two large industrial companies in the area. The Modderfontein Dynamite Factory (circa 1895-1950s) and the Klipfontein Organic Products Factory (circa 1941-1970s) both employed large numbers of labourers, the majority of which lived in compounds on the factory premises.
The skeletal remains of Du Preezhoek, Pretoria, South Africa: a bioarchaeological investigation of a 19th-century pioneer family
(2009-12-09T06:14:32Z) Ouzman, Sven; Creative Studios, Dept of Education Innovation, University of Pretoria; Meyer, Anja; Steyn, Maryna; Steyn, Maryna
The assessment of human skeletal remains can provide valuable insight into health and lifestyle of past populations. Skeletal remains of 11 individuals were exhumed, as part of a Heritage Impact Assessment, from the Du Preezhoek cemetery located on the western banks of the Apies River, next to the Old NZASM Bridge. The excavated cemetery dates to the latter half of the 19th century and contained the remains of early Pioneers. The aim of this study was to assess them for health indicators and also to try and establish their identity taking into account existing archaeological and archival data. Standard physical anthropological techniques were used to analyse these skeletons to determine their age, sex, ancestry, health, and diet. The remains consisted of three adult females, one adolescent individual of unknown sex between the age of 12-16 years, one child between the ages of 7-8 years, and six infants ranging between birth and 3 years of age. One of the adult females presented attributes associated with a mixed ancestry. Skeletal pathology observed included subperiosteal bone growth, Schmorl nodes on the lumbar vertebrae, and osteophytic lipping of the elbow and knee joints. Dental pathology included dental caries, dental calculus and enamel hypoplasia. The demographic and pathological information gathered through the physical anthropological analyses used in combination with archival sources, provided insight into these individuals’ lifestyles and a glimpse into pioneer life in 19th century Pretoria. The demographic profile suggested that this was a typical 19th century Pioneer family, possibly related to the Du Preez family. The presence of mixed ancestry is reflective of the early interaction of various South African populations, whereas pathological markers reveal some of the hardships associated with Pioneer life. The high death rate amongst infants along with the presence of enamel hypoplasia, subperiosteal bone growth, and high caries rates in adults is suggestive of a stressful lifestyle, possibly due to malnutrition and or disease. Degenerative pathology further reveals the strenuous physical activities engaged by early Pioneers on a daily basis. Overall the Du Preezhoek remains provides a glimpse into the life of one of Pretoria’s first Pioneer families.
Neonatal anatomy relevant for lumbar and caudal epidural blocks
(2009-12-09T06:14:14Z) Bosenberg, A.T.; Creative Studios, Dept of Education Innovation, University of Pretoria; Van Schoor, Albert-Neels; Bosman, Marius C.
Many anaesthesiologists not used to working with paediatric patients may lack the knowledge of relative depths or position of key anatomical structures, as it is known that the anatomy of children differ to some degree from that of adults. A thorough knowledge of the anatomy of paediatric patients is therefore essential for safe and successful performance of epidural blocks. The aims of this study were to observe and quantify the important landmarks and structures, associated with both the lumbar and caudal epidural blocks. The vertebral column of 40 neonatal cadavers were dissected and measurements were taken in both a prone and flexed (between 40o-50o) position. Information regarding Tuffier’s line (TL), the surface area of the L1/L2 to L5/S1 interlaminar spaces, and the vertebral level and distance from the apex of the sacral hiatus (ASH) to the conus medullaris (CM) and the dural sac (DS), were then obtained. It was found that, when prone, the L2/L3 and L3/L4 interlaminar spaces have the largest surface areas, 9.61-12.68mm2 and 9.73-12.54mm2, respectively. Flexion caused the greatest change (approximately 23.52%) at the L3/L4 interlaminar space. On average, the CM was found to be at the middle third of the L2 vertebra. The distance from the ASH to the CM was between 36.05-41.61mm when prone and 40.99-48.88mm when flexed. TL was found to be at the L4/L5 interlaminar space when prone. When flexed, this level moved caudally, ending at the upper third of L5. In all cases the DS was found to be within the caudal space. On a prone cadaver the distance from the ASH to the DS was between 8.88-11.79mm. This increased to 10.45-12.99mm when flexed. This study hopes to complement what is already known of the neonatal vertebral column and to shed some light on the changes that occur when the neonate is flexed during the conduction of either single-shot lumbar or caudal epidural blocks, or for the insertion of a continuous epidural catheter via the caudal or lumbar route.
Sexing accuracies using proximal and middle phalanges of the hand in a modern south african sample
(2009-12-09T06:13:58Z) Navsa, Nadia; Iscan, M.Y.; Creative Studios, Dept of Education Innovation, University of Pretoria; Steyn, Maryna
Forensic anthropologists include sex determination as part of their analyses. Hand bones were previously excluded from such studies due to their relatively small size and poor preservation. Scheuer and Elkington (1993) were able to show that metacarpals and the first proximal phalanx are sexually dimorphic, with accuracies ranging from 78.0% - 92.0% and 74.0% - 78.0% respectively. The aim of this study was to determine sexing accuracies using the proximal (PP) and middle (MP) phalanges of the human hand in a South African sample. A total skeletal sample of 200 individuals (100 males and 100 females) was used. Seven measurements were recorded on each bone to an accuracy of 0.01mm. Data were analyzed using SPSS version 11.5. Statistically significant differences (p<0.01) were found between males and females for all variables. In the stepwise discriminant function analysis, the variables selected for proximal phalanges were the antero-posterior midshaft diameter for the first proximal phalanx, the medio-lateral midshaft measurement of the second and fifth proximal phalanges and the antero-posterior base diameter of the third and fourth proximal phalanges. Variables selected for the middle phalanges were the antero-posterior base diameter for the second middle phalanx and the medio-lateral midshaft measurement for the third, fourth and fifth middle phalanges. Classification accuracies for proximal phalanges using the stepwise analysis ranged between 80.6% and 84.0% (males) and 85.9% to 88.8% (females), with the highest accuracies obtained for PP1 (males and females) and PP3 (females). Direct analyses for proximal phalanges using single variables produced accuracies ranging from 74.5% to 85.0% (males) and 86.6% to 88.9% (females). Classification accuracies for middle phalanges using the stepwise analysis, ranged between 77.6% and 85.0% (males) and 85.4% to 86.7% (females), with the highest accuracies obtained for MP3. Direct analyses for middle phalanges using single variables produced accuracies ranging from 71.7% to 79.2% (males) and 83.3% to 85.4% (females). In conclusion, these results compare with those of previous studies indicating that these bones can be used to determine sex
A possible phylogenetic degeneration of the palmaris longus muscle
(2009-12-09T06:13:40Z) Venter, G.; Creative Studios, Dept of Education Innovation, University of Pretoria; Van Schoor, Albert-Neels; Bosman, Marius C.
Variations in the human muscular system are common and may vary with the side of the body or sex of the subject. The palmaris longus muscle (PL) is subject to variability. PL is frequently found to be missing without any adverse effects. This makes the PL appear to be vestigial and has also been described to be phylogenetically degenerative. The PL is occasionally absent in vertebrates who do not use their forelimbs in ambulation. It is suggested that the function of this muscle have been taken over by the other flexors in the limbs. This has yet to be determined in a South African population The aims of this study are therefore to firstly determine the prevalence of PL in a South African population and, secondly, to determine whether there exists a phylogenetic degenerative trend for the PL. A sample of 600 participants was randomly selected from various age groups. The prevalence of the PL muscle was determined with a 95% confidence interval. Further statistical analysis included comparisons of the prevalence of the muscle between males and females and left and right sides using a student t-test. A Chi-squared test was used to determine a possible trend in phylogenetic degeneration of the PL muscle within the six groups. The ages of the participants ranged from 5 to 99 years. Preliminary results have shown that the PL muscles is unilaterally absent in about 10% of individuals that there is possibly no phylogenetic degenerative trend of the PL muscle in a South African population. In a South African population the prevalence of the PL muscle differs from studies done in the past. But like previously mentioned prevalence of this muscle does not guarantee the usefulness in reconstructive surgery, rather the morphology of this muscle
Femoral nerve blocks : a comparison of neonatal and adult anatomy
(2009-12-09T06:12:53Z) Bosenberg, A.T.; Creative Studios, Dept of Education Innovation, University of Pretoria; Van Schoor, Albert-Neels; Bosman, Marius C.
The femoral nerve (FN) block is regarded as the quickest and most effective method of pain relief for femoral shaft fractures when general anaesthesia is contra-indicated. Correct placement of the needle relies heavily on the pulse of the femoral artery (FA) however, and in times where this pulse is absent, a lack of well-defined and constant bony landmarks increases the chance of a failed block. This study aimed to determine the position of the FN using constant bony landmarks, the anterior superior iliac spine (ASIS) and pubic tubercle (PT). Dissections were performed on both sides of a sample of 54 neonatal (50 left and 50 right sides; mean length: 0.44m±0.08m; mean weight: 1.96kg±1.57kg) and 77 adult (70 left and 68 right sides; mean age: 61.6±20.1 years; mean length: 1.69m±0.09m; mean weight: 56.43kg±15.53kg) cadavers. No significant difference was found when comparing the left and right sides of either sample. The data for the left and right sides of both samples were therefore combined, i.e., a total of 100 neonatal and 138 adult femoral triangles were examined. The distances from the ASIS to the PT (ASIS-PT) were measured as well as the distance of the FN and FA to the ASIS and the FN to the FA. These measurements were converted to a percentage of the ASIS-PT distance and the neonatal and adult data was compared using a paired t-test. In neonates the FN lies between 33.38% and 36.30% of the ASIS-PT distance from the ASIS. In adults it lies between 48.06% and 49.96% from the ASIS. A significant difference was also found between the distances of the ASIS to the FN (p=0.000) and FA (p=0.000) when comparing the two samples. Two separate linear regression models, both with a strong correlation to the ASIS-PT distance (R=0.806 for the neonatal and R=0.784 for the adult sample), was developed for the two samples. The data also proves that neonatal and adult anatomy differs appreciably from each other. It is also important to have proper knowledge of neonatal anatomy before attempting to perform regional nerve blocks on paediatric patients.
The size, branching pattern and anatomical relationships of the dorsal pedal aretery on the dorsum of the foot: a cadaver study
(2009-12-09T06:12:28Z) Van der Merwe, L.; Creative Studios, Dept of Education Innovation, University of Pretoria; Briers, Nanette; Bosman, Marius C.
Surgical techniques such as ankle arthroscopy and reconstructive flap surgery have made detailed knowledge of the dorsal pedal artery (DPA) and the deep fibular nerve (DFN) on the foot dorsum essential. The aims of this study were to determine the size, branching pattern of the DPA and its relations to the DFN and inferior extensor retinaculum (IER). Forty cadaver ankles were dissected to expose the contents of the anterior tarsal tunnel. The size of the DPA and branches were measured with a Vernier caliper and the branching pattern and relationship of the DPA to the DFN and IER were noted. The size of the DPA were 3.90 mm +/- 0.2 mm (n=40). No significant difference were seen between the sexes (T-test, p>0.05). The branching pattern of the DPA can be described in 3 categories. In 27.5% the DPA had branches above the IER, 62.5% underneath IER and 10% below the IER. No significant difference was noted between the sexes (T-test, p>0.05). The bifurcation of the DPA was mostly underneath IER (57.5%), followed by 37.5% below the IER. In 2.5% the distal branching was above the IER or absent. The bifurcation of DFN is similar as the majority (55.0%) was located underneath the IER, while 27.5% was located above the IER and 17.5% of bifurcations were observed below the IER. A distance of 7.79 +/- 2.9mm was recorded between the bifurcation of DPA and DFN. No significant difference was observed when comparing male and female as well as age groups (T-test, p>0.05). In some cases, the arterial branching lead to the formation of trunks, while 'loops' were observed in the branching pattern of the DFN. The measurements and patterns noted increases the awareness of the possible variations and should assist surgeons during vascular and reconstructive surgery
Imaging of neuromyelitis optica (Devic's syndrome/disease)
(2009-04-07T06:45:14Z) Roux, M.J.; Ismail, Farzanah; Lockhat, Zarina I.
Neuromyelitis optica (NMO) is also known as Devic’s disease. It is a demyelinating disease affecting the spinal cord and the optic nerves resulting in paraplegia and blindness. The disease is characterized by acute, severe transverse myelitis followed by simultaneous or sequential bilateral optic neuropathy. MRI is the investigation of choice, thus we present the MRI findings in a patient with NMO. (Case Study)
Development of a criterion-based assessment form for clinical radiographic practice
(2009-04-07T06:12:44Z) mable.kekana@up.ac.za; Creative Studios, Dept for Education Innovation, University of Pretoria; Kekana, R.M. (Mable)
The presentation focuses on the pros and cons of engaging relevant stakeholders in the development of the assessment form. The assessment form was used in assessing learners’ competency in clinical radiographic practice. The objective behind the development of the form was to improve consistency among the various assessors who conduct assessments on radiography learners in the clinical environment. Practitioner action research was identified as the appropriate design for the study. I was the researcher and lecturer (practitioner). As a lecturer I had the responsibility of coordinating the clinical radiographic program between the university and the clinical training centres. I also had the responsibility of ensuring that clinical training at the various centres complied with the university policies and professional standards. As a researcher, I was the main driver of the study, with learners and assessors acting as information providers and validation groups. Literature review included consistency in the way assessments are conducted with more emphasis being placed on the clinical training of diagnostic radiography learners. Assessment instruments described in most of the literature consulted were among others, rubrics and scoring guides. The instruments used in collecting research data were questionnaires, focus group interviews, workshops as well as observations. Constant analysis method was used to analyse the collected data. Active engagement of both the learners and assessors seemed to have contributed positively to the development of the criterion-based assessment form. There were however some challenges due to this active engagement. Some of the challenges related to focus group interviews, like poor attendance, conducting the interviews and ensuring that as a researcher, I stay focused on the interview and do not allow the participants to deviate from the main objective of the research. Based on the research findings and my experience as a researcher, active engagement of the stakeholders, resulted in positive attitude which is essential for the implementation phase.
Modelling clay as portion size estimation aid
(2008) friede.wenhold@up.ac.za; Creative Studios, Dept for Education Innovation, University of Pretoria; Pohorski, A.; Schlenther, C.; Spalovsky, L.; Van Huysteen, A.; Wenhold, Friedeburg Anna Maria
Modelling clay, in contrast to measuring cups, appears to be a valid portion size estimation aid.
Prevalence of ESBL and MBL antibiotic resistance genes in Klebsiella pneumoniae in Pretoria Academic Hospital
(2008-12-09T08:06:31Z) Maningi, Nontuthuko Excellent; Makgothlo, E.; Kock, Marleen M.; Creative Studios, Dept of Education Innovation, University of Pretoria; Ehlers, Marthie Magdaleen; Hoosen, Anwar Ahmed; Omar, Shaheed Vally
Extended-spectrum-beta-lactamases (ESBL) have been recovered from medical centres in South Africa since the late 1980’s but little is known about the various types of ESBLs present and their prevalence. Metallo-beta-lactamase is an emerging class of broad-spectrum beta-lactamases in non-fermenting Gram-negative bacteria worldwide. Klebsiella pneumoniae strains producing ESBLs and MBLs have been responsible for failure of therapy with extended-spectrum cephalosporins in healthcare settings. Multi-drug resistant K. pneumoniae is mostly transmitted from patient to patient, via hands of healthcare workers and contaminated care items. This study investigated the prevalence of ESBL and MBL antibiotic resistance genes in K. pneumoniae isolates from Pretoria Academic Hospital. A Multiplex Polymerase Chain Reaction (PCR) assay was used for the detection of four genes blaCTX-M, blaSHV, blaTEM and VIM genes in 97 K. pneumoniae isolates. Preliminary results indicated 90% (74/82) of K. pneumoniae isolates were positive for one or more of these ESBL genes. A total of 39% (32/82) of the isolates were positive for all three ESBL genes. In 4% (3/82) of the isolates blaSHV and blaTEM were detected and in another 4% (3/82) of the isolates blaCTX-M and blaSHV were detected, while blaCTX-M and blaTEM were detected in 20% (17/82) of the isolates. Only the blaSHV gene was detected in 14% (12/82) of the isolates, while only blaTEM was detected in 5% (4/82) and only blaCTX-M detected in 4% (3/82) of the K. pneumoniae isolates. The VIM gene was not detected in any of the isolates analysed in this study. The results obtained from this study emphasised the need to address the emergence and spread of ESBL-producing K. pneumoniae in clinical settings. Appropriate infection control measures should be implemented for all patients who are infected with ESBL-producing K. pneumoniae. The 90% prevalence of ESBL-producing K. pneumoniae isolates collected in this study reflects the overuse of the newer extended-spectrum cephalosporins. This high ESBL prevalence limits the therapeutic options of physicians treating patients, since carbapenems are the only beta-lactam drugs that are still active against ESBL-producing K. pneumoniae.
Trends in the dental caries prevalence and severity in South Africa
(2008-12-05T09:49:40Z) Van Wyk, Candice; candice.vanwyk@up.ac.za; Van Wyk, Philippus J.
OBJECTIVES: Purpose of this study was to determine trends in dental caries prevalence and severity amongst South African children in terms of dimensions of time, person and place. METHODOLOGY: During the past 25 years, 3 national surveys were conducted in 1982, 1988/89 and 1999/2002 to determine the prevalence and severity of dental caries in South Africa. Data obtained from these surveys was used to determine trends in dental caries prevalence and severity amongst South African children. In all surveys the WHO methods with regard to dental caries were followed. RESULTS: In terms of variable time, results of the survey show a decrease in the prevalence of dental caries amongst 12-year-old children, from 64.38% (1982), 54.88% (1988/89) to 41.72% (1999/2002) - total of 22.66% over 20 year period or 1.13% per year. A significant decrease (p<0.05) was also observed in the DMFT from 2.54 (1982), 1.73 (1988/89) to 1.17 (1999/2002). The percentage untreated caries in 12-year-old children increased from 70.47% (1982), 72.25% (1988/89) to 75.21% (1999/2002). The South African population comprises of four main population groups, namely: Asians, 2.5%; Blacks, 79%; Coloureds, 8.9% and Whites, 9.5%. Statistically significant decreases (p<0.05) were recorded in the DMFT (1982-2002) in the White, 75.3%; Asian, 64.1%; Black, 49.8%; and Coloured groups, 44.8%. High levels of untreated caries (D) and very low levels of treatment (M and F) were also recorded in all groups. In 2002 in terms of variable place the highest mean dmft/DMFT for 6- and 12-year-olds respectively were recorded in the coastal areas of the Metro Cape (5.1/1.86); followed by Port Elizabeth (3.86/1.37) and Durban (3.42/1.33); and the lowest in the interior - Bloemfontein (2.47/0.73). CONCLUSIONS: 1. Dental caries reduced significantly during the past twenty years. 2. Dental caries is more prevalent and severe amongst Coloured and Black population groups. 3. Higher dental caries prevalence and severity rates were recorded in coastal regions compared to the interior region. 4. Percentage of untreated caries in 12- and 15-year-old children increased, indicating a decrease in dental services rendered to schoolchildren. 5. More than 70% of dental caries in 6-, 12- and 15-year-old children go untreated.
Adolescents' sense of coherence and smoking predicts self-reported gingivitis
(2008-11-13T11:36:09Z) Reddy, Priscilla S.; Van den Borne, Bart W.; Pixart Dynamics; Ayo-Yusuf, Olalekan Abdulwahab
CONTEXT: Smoking, which may be initiated as a response to stress during adolescence, is a risk for periodontal disease among adults. Only limited information is available on the effect of smoking on South African adolescents’ oral health. Given that the sense of coherence (SOC) construct seeks to explain the relationship between coping with life stresses and maintaining health, this study sought to examine the independent influence of smoking and SOC on the gingival health of a cohort of rural black South African adolescents. METHODS: This 18-month longitudinal study involved a three-wave questionnaire survey and clinical oral examination of a representative sample of 8th-graders from 11 randomly selected high schools in Limpopo province, South Africa (n=970). Using a generalized estimating equation (GEE) model, we prospectively examined the correlates of experiencing recent or persistent gingivitis, defined as self-reporting recent or persistent frequent bleeding gums. Explanatory variables included baseline socio-economic status, age, gender, plaque levels, tooth-brushing frequency, smoking and snuff use status and SOC levels (measured on a six-item scale with cronbach alpha=0.63). Results: Among our sample, 74.6% self-reported experiencing gingivitis at some point during follow-up, while 41.9% self-reported gingivitis at the last survey. Factors that were positively associated with recent or persistent gingivitis include living in poor households (odds ratio [OR] = 1.49; p<0.01), having higher plaque levels (OR = 1.18; p=0.04) and smoking regularly (OR = 1.57; p=0.04). Recent or persistent gingivitis was negatively associated with being female (OR = 0.76; p=0.02) and having higher SOC (OR = 0.96; p<0.001). CONCLUSIONS: Our findings support the integration of smoking prevention with oral health promotion programmes. In addition, poverty alleviation and teaching of stress-coping skills may be important interventions for promoting adolescents’ gingival health.
Prevalence of extended-spectrum-ß-lactamase (ESBL) and metallo-ß-lactamase (MBL) antibiotic resistance genes in Enterobacter species in Pretoria Academic Hospital
(2008-11-12T12:29:10Z) Bulane, Atang; Makgotlho, Phuti Edward; Kock, Marleen M.; Creative Studios, Dept of Education Innovation, University of Pretoria; Ehlers, Marthie Magdaleen; Said, Halima Mohammed; Hoosen, Anwar Ahmed
The prevalence of blaCTX-M, blaSHV and blaTEM extended-spectrum beta-lactamases (ESBLs) and VIM metallo-beta-lactamases (MBLs) producing Enterobacter are increasing worldwide. Multidrug resistance due to the presence of these resistance genes in the Enterobacteriaceae family is an important reason for therapy failure during treatment with 3rd generation cephalosporins and carbapenems. Methods for the detection of ESBL and MBL can be phenotypic or genotypic. Molecular techniques such as multiplex polymerase chain reaction (PCR) assays can be used for the simultaneous detection of various resistant genes. This study investigated the prevalence of ESBLs and MBLs antibiotic resistance genes in Enterobacter species in Pretoria Academic Hospital using a multiplex PCR assay, which simultaneously detected the blaCTX-M, blaSHV, blaTEM and VIM genes. Ninety seven (97) consecutive clinical Enterobacter isolates (16 E. aerogenes and 81 E. cloacae isolates) were collected from the diagnostic division of the Department of Medical Microbiology. The following results were obtained in E. aerogenes: blaCTX-M, blaTEM, blaSHV were detected in 13% (2/16) while blaCTX-M, blaTEM were detected in 13% (2/16) of the isolates. A total of 75% (12/16) of the isolates were negative for all three genes. In the E. cloacae isolates: blaCTX-M, blaTEM, blaSHV were detected in 7% (6/81) while blaCTX-M, blaTEM were detected in 28% (23/81) and blaTEM, blaSHV were detected in 20% (16/81). Only the blaTEM gene was detected in 6% (5/81) of the E. cloacae isolates. In 30% (21/81) of isolates none of the genes were identified. None of the Enterobacter isolates analysed in this study were positive for the VIM gene. According to the results obtained in this study, the prevalence of ESBL antibiotic resistance genes in Enterobacter species is 56% (54/97) in this clinical setting. It is therefore essential to include molecular technique as part of the surveillance to monitor the circulation of these resistant genes in a clinical setting.

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