4. Electronic Theses and Dissertations (ETDs) - Faculties submissions
Permanent URI for this communityhttps://hdl.handle.net/10539/37773
For queries relating to content and technical issues, please contact IR specialists via this email address : openscholarship.library@wits.ac.za, Tel: 011 717 4652 or 011 717 1954
Browse
699 results
Search Results
Item Perceptions of Mental Health in low-middle- income South Africa(University of the Witwatersrand, Johannesburg, 2024) Ndlazi, Simphiwe; Harvey, ClareMental health is an important contributing factor to well-being. Understanding mental health is crucial in influencing an individual’s help-seeking behaviour. This study aimed to explore and discover perceptions of mental health in Low-Middle income (LMI) communities in the South African context, as well as gain an in-depth understanding of what informs the perceptions of mental health. Furthermore, the aim was to establish information on the role of perceptions of mental health. Finally, the aim was to contribute to the current scope of knowledge on perceptions of mental health and improve the academic research attention given to perceptions of mental health in the South African context. The study employed a qualitative approach and used one-on-one, semi-structured interviews as a method of data collection. Seven individuals above the age of eighteen years were invited to be participants. Based on the findings, mental health is recognised in LMI communities however, it is also stigmatised. It has been discovered that financial strain and joblessness are major contributors to mental health issues among LMI communities. Additionally, individuals have reported insufficient mental health resources and care within these communities, including a shortage of qualified professionals in public clinics. This study has the potential to improve the awareness on the prevalent perspectives and stigma surrounding mental health and other significant mental health issues in LMI communities, such as resource allocation. The study also highlights the urgency of developing effective policies and tailored interventions that are context-sensitive to address the disparities in quality mental health care in LMI communities.Item Intersecting Epidemics: The implications of COVID-19 in the utilisation of HIV treatment services among people living with HIV on antiretroviral treatment (ART) in Zimbabwe(University of the Witwatersrand, Johannesburg, 2024) Tapera, Talent; Odimegwu, CliffordZimbabwe has been working towards the last mile of controlling the Human Immunodeficiency Virus (HIV) epidemic where keeping people that are living with HIV on antiretroviral therapy (ART) is primarily important. Ensuring they are virally suppressed and can thwart opportunistic infections is key. The advent of COVID-19 potentially posed a threat of derailing or reversing the gains attained in the fight against HIV. Zimbabwe has more than one million people living with HIV (United Nations Programme on HIV and AIDS [UNAIDS], 2020). The question of whether the COVID-19 pandemic intensified barriers and redefined the utilisation of HIV treatment services by people who are living with HIV on ART in Zimbabwe has remained largely unanswered in the literature currently available. Thus, the main purpose of this research was to examine the implications of COVID-19 in the utilisation of HIV care treatment services among people who are living with HIV on ART in Zimbabwe and the factors associated with it. This study defined, the utilisation of HIV treatment services as accessing and taking up a package of services expected to be received by people who are living with HIV on ART such as scheduled ART drug refill collections, viral load monitoring, Tuberculosis (TB) preventative therapy and TB screening. In addition, the study investigated the predisposition of people who are living with HIV in using the COVID-19 vaccine and the reasons behind not getting vaccinated. The study was anchored in the fifth revision of the Andersen behavioural model of healthcare utilisation. This model argues that the use of health services is a based on of three factors classified as (1) predisposing, (2) enabling and (3) need factors. The fifth model version of the model allowed the addition of environmental factors. The dependent variable was the utilisation of HIV treatment services and also COVID-19 vaccination among people living with HIV. As such, it was critical to anchor the study in this framework as it sought to identify the critical factors of utilisation of HIV treatment services and COVID-19 vaccination among people living with HIV. Therefore, following the Anderson model, the predisposing factors for this study were age, sex, marriage, religion, education and COVID-19 vaccination. The enabling factors were COVID-19 lockdown restrictions, COVID- 19 transport stoppages, distance to a health facility, transport cost to a health facility, fear of contracting COVID-19, non-availability of community healthcare services, and COVID-19 related stigma among healthcare workers. The need factors were opportunistic infection during the COVID- 19 period, COVID-19 infection, and contact with a COVID-19 case, while environmental factors were residence and type of health facility.Item A Qualitative Exploration of People Living with Chronic Pain in Rural South Africa(University of the Witwatersrand, Johannesburg, 2024) Ramoshai, Tebatso; Wadley, Antonia; Mulaudzi, MamakiriChronic pain is a highly prevalent global health concern. While much research has been conducted on the prevalence, treatment, and management of chronic pain, few studies have explored the experiences of people living with chronic pain, particularly in the South African context. This study aimed to explore and interpret how HIV-negative people living with chronic pain perceive their personal experiences with chronic pain and the impact it has on their lives. Part of a larger study that investigated the factors that influence the experience, daily activity, and disclosure of pain in people living with and without HIV in rural South Africa, this study conducted a qualitative exploration and interpretation of pre-collected interview data on a purposively selected sample of 16 HIV-negative individuals living with chronic pain from the Limpopo province of South Africa. Thematic analysis was used to analyse the data. Seven main themes emerged from the data: The nature of pain, participants’ typical physical activity, pain interference, disclosure of chronic pain, reactions to pain disclosure, benefits of disclosing pain, and social support. The findings suggest that for HIV-negative people living with chronic pain, the impact of pain is multidimensional. All participants experienced pain interferences; however, there was little to no difference in participants' physical activity levels regardless of interferences. The findings suggest that economic stressors may be an influential factor in how pain is experienced between any two pain cohorts, determining whether there will be a change in physical activity levels or not. Furthermore, contrary to previous concerns in a South African cohort with chronic pain, pain disclosure was high in this cohort; therefore, participants were able to recruit different types of social support from close others. This research, therefore, contributes to the qualitative knowledge of the relationships between pain, physical activity, and the seeking of social support by people living with chronic pain in a South African contextItem Hearing function of paediatric patients with cancer in Johannesburg, South Africa: relationships and influences explored(University of the Witwatersrand, Johannesburg, 2024) Chauke, Tlangelani Nyeleti; Khoza-Shangase, K.According to the World Health Organization (WHO), there are about 466 million people living with a disabling hearing loss globally, with almost 34 million of them being children, and approximately 7 million of these children are living in Sub-Saharan Africa (SSA). In South Africa, the incidence of childhood cancer represents approximately 1% of all cancers in the population. The standard treatment in South Africa consists of platinum compounds such as cisplatin and carboplatin. Morbidity factors amongst childhood cancer survivors include hearing loss. Between 20% and 70% of patients suffer from cisplatin and carboplatinum-related ototoxicity. In any context including the South African context, for preventive audiology, it is important to describe and characterise the hearing function of paediatric patients with cancer. Aim: The main aim of the current study was to investigate the hearing function of paediatric patients with cancer in Johannesburg, South Africa. Methodology: A descriptive retrospective record review design was adopted in this study. The patient records were reviewed from Chris Hani Baragwanath Academic Hospital and Charlotte Maxeke Johannesburg Academic Hospital oncology and audiology units. Non- proportional quota sampling was used in this study. Data was reviewed from 47 patient records from the Chris Hani Baragwanath Academic Hospital and Charlotte Maxeke Johannesburg Academic Hospital audiology and oncology units. Analysis: In this current study, descriptive and inferential statistics were used in order to indicate any patterns the data may have assumed and to help summarise the collected data. Findings: Demographic and diagnostic factors were thought to have an influence on the hearing function of the paediatric population with cancer. When establishing if a relationship existed between age of diagnosis, gender, race, type of cancer, treatment duration, and type of treatment and hearing function, all the objectives were found to be statistically non-significant, except for the type of cancer which was found to have a statistically significant association. The researcher was 95% 8 confident that the true prevalence of hearing loss in the paediatric population with cancer would fall between 23.5% and 51.2%. The prevalence of hearing loss was found to be 36.2%. Conclusion: The participants who were found to have a hearing impairment, had a hearing impairment due to ototoxicity. As evident from all the audiological assessments administered, there was an evident change in the hearing function of participants from session one to two. Implications: It was recommended by the researcher that audiological monitoring as well as screening protocols be implemented in the oncology and audiology units. Current findings could contribute towards identifying risk factors that are associated with hearing loss in the paediatric population with cancer. These findings could possibly help guide future researchers, audiologists, pharmacists, oncologists, or policy makers in in developing treatment protocols, policies and interventions that may help minimize the effects and risks of cancer treatment on the hearing function of this population without having to compromise the effectiveness of their treatment. Implications for future research are also raised by current findings.Item Optimization of Prostate Plan in a Pelvic Prosthesis Phantom(University of the Witwatersrand, Johannesburg, 2024-09) Dumela, Khombo Eunice; Oderinde, Oluwaseyi M.; Usman, IyaboT.Background: An increasing number of elderly prostate cancer patients with high-density material hip prosthesis are referred for external beam Radiotherapy (EBRT). Radiation treatment of pelvis cancer patients with high-density hip prosthesis needs special attention because of the artifacts created in the computed tomography (CT) field of view and the radiotherapy dosimetry challenges. The accuracy of the treatment planning dose calculation algorithms determines the accuracy of the dose delivered to the patient during radiation therapy. However, the most available algorithms do not accurately model the absorption of high-density metals’ scattering properties and underestimate the resulting dose perturbations. Aim: This study aims to optimize the dose distribution of prostate 3D conformal treatment, intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) in an in-house metallic hip prosthesis phantom. Methods and materials: In this study, an ionization chamber and Gafchromic (EBT3) films were used to physically measure the prostate point dose in an in-house pelvic phantom. The pelvic phantom was irradiated on the Linac with four static fields, namely, (1) anterior field, (2) posterior field, (3) right lateral field passing through the bone of the normal hip and (4) left lateral passing through the hip prosthesis. IMRT and VMATs plans were also generated on the phantom. The phantom was also irradiated with IMRT and VMATs plan. The use of single arc versus two arcs with avoidance sector were also evaluated. The phantom consists of different materials; Nylon-12 (a solid water-equivalent material) to simulate the prostate with a central cavity to accommodate an ionization chamber and film, superflab gel bolus to simulate human soft tissue, dental wax to simulate human soft tissue, bone anatomy for the right hip and a titanium implant to replace the bony structure of the left hip. For the static fields, an in-house pelvic phantom was simulated using the EGSnrc Monte Carlo code, and 6 and 15 MV photon energies were employed as in an experimental setting. The prostate point doses computed by the Treatment Planning System (TPS), measured using ionisation chamber, and Gafchromic EBT3 film were compared with the prostate point doses simulated by Monte Carlo code. Results and discussion: The novel phantom was constructed using superflab gel bolus, Nylon-12, dental wax, pig bone insert and a titanium alloy hip replacement. The radiological equivalence of the superflab gel bolus and dental wax was determined employing linear attenuation coefficients and then compared to an RW3 Solid water phantom. EGSnrc Monte Carlo (MC) code was used in this study. Before using Monte Carlo codes, they need to be validated by comparing the Linear accelerator Monte Carlo simulated dose distribution with the experimental data measured in a Linear accelerator using water and ionization chamber for 6 MV and 15 MV photon beams of different field sizes. The EGSnrc dose distributions were compared with the experimental measurements using a gamma analysis, employing a 2 %/2 mm distance-to-agreement criterion. The EGSnrc Monte Carlo calculated dose distribution agreed well with experimental measurements within 2 %. The MC beam model was then used to compute the dose distribution in an in-house pelvic phantom. The comparison of the measurements between the TPS calculated prostate point dose and ionization chamber for the 6 MV and 15 MV photon beams was: anterior (gantry 0°) 1.8 % and -0.5 %; posterior (gantry 180°) 1.7 % and -0.2 %; left lateral (gantry 90°) 6.3% and 4.2 %; right lateral (gantry 270°) -2.2 % and -2.1 % respectively. Results obtained for Gafchromic EBT3 film measured doses were: anterior 2.3 % and 1.3 %; posterior -0.9 % and 0.2 %, left lateral 4.5 % and 3.5 %; right lateral -2.1 % and -2.5%, for the 6 MV and 15 MV photon beams, respectively. Consequently, results obtained for comparison of TPS, ion chamber and Film with MC simulated doses were: anterior 3.9 %, -2.1 and -1.6% %; posterior 1.8 %, -0.1% and -2.7 %; left lateral -0.2 %, 6.5 % and 4.7 %; right lateral 0.4 %, -2.6% and -2.5 %, for the 6 MV photon beam. And for 15 MV photon beam the results were: anterior 1.9 %, -3.8 and -0.6%; posterior 2.0 %, -2.3 % and -2.2 %; left lateral 0.5 %, 3.7 % and 2.9 %; right lateral 0.4 %, -2.4 % and -2.9 %. Monte Carlo simulations and film measurements have a statistically significant difference of p<0.001, with the film measurements having a higher value than MC simulations except on the left lateral field. Monte Carlo simulations and ionization chamber measurements also show a significant difference of p<0.001, with the ionization chamber having a higher value than the MC simulation, except for the left lateral field passing through the hip prosthesis. The comparison of the measurements between the TPS calculated prostate point dose with ionization chamber and Gafchromic EBT3 film for the 6 MV IMRT plan of the beam passing through the prosthesis was 2.2 % and 3.3%, respectively. While the IMRT plan with avoided beam was 1.9 % and 3.1% for ionization chamber and Gafchromic EBT3 film, respectively. The comparison of the measurements between the TPS calculated prostate point dose for the 6 MV VMAT plan without avoiding for the beam passing through the prosthesis was 1.1 % and 2.2 % for ionization chamber and Gafchromic EBT3 film, respectively. While for VMAT plan with avoided sector as 3.0 % and 4.0% for ionization chamber and Gafchromic EBT3 film, respectively. The test suggested a significant difference of p=0.0001 between the distribution of film measurements and TPS calculated dose. Meanwhile, for ionization chamber measurements and TPS calculated dose; the test indicated a significant difference between ion chamber measurements and TPS calculated dose with a significant level of less than 0.001. in addition, MC simulated dose and TPS calculated dose; the test shows a percentage difference of -0.2 % and 0.5 % for 6 MV and 15 MV photon beams in the lateral field that passes through the prosthesis. The test indicated the significant difference of p=0.001 which is slightly lower compared to the other comparisons. Conclusion: The dual dosimetric pelvic prosthesis phantom is easy to assembly and is more convenient for second dose check for patients with hip prostheses. Through the use of the pelvic phantom, it was possible to measure the prostate point dose using ionization chamber and films. The TPS overestimated the prostate point dose because the treatment planning algorithm could not accurately determine the CT number and the electron density of the prosthesis due to the limitation on the CT scanner. The maximum deviation calculated in this study for TPS, ionization chamber Gafchromic EBT3 films when compared to Monte Carlo simulated dose comes from the lateral fields passing through the prosthesis for both 6 MV and 15 MV photon beams.Item Investigating the performance of South African children from an under-resourced background on selected verbal subtests of the WISC-V and SSAIS-R(University of the Witwatersrand, Johannesburg, 2024) Rampai, Tsholofelo; Vorster, AdriGiven the South African context and the scarcity of valid and reliable individual intelligence measures to assess the intellectual functioning of a broad spectrum of children from different socioeconomic, cultural, and linguistic backgrounds, continued research must be done on the utility, validity, and reliability of available measures. Taking this into consideration, the present study aimed to investigate and compare the performance of a sample of South African children who predominantly speak English as a Second Language (ESL) and who come from an under-resourced background on selected verbal subtests of the Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V) and the Senior South African Individual Scales – Revised (SSAIS-R). In addition, the study investigated the internal consistency reliability and concurrent validity of these subtests in the present sample. The children's biographical information was obtained from a demographic questionnaire. The sample consisted of 58 participants (N= 58) from grades 4 to 7 living and developing in under-resourced contexts. Based on the data spread, parametric statistics in the form of a paired t-test, Pearson’s correlation coefficient, and Spearman-Brown split-half formula were used to address the aims of the study and answer the research questions. The findings highlighted the different factors that might influence assessment results in South Africa, particularly for children from under-resourced contexts. The current study can be a stepping stone for further research into the appropriateness of commonly used individual intelligence measures in under-resourced contexts, given that not all South African contexts have been investigated regarding psychological assessments and individual intelligence measures.Item Work-Family Conflict & Burnout in the face of a Pandemic as moderated by Sensory Processing Sensitivity and Social Support(University of the Witwatersrand, Johannesburg, 2024) Ndlovu, Valerie; Pitman, MichaelRemote working has quickly become a norm in organisations in response to the COVID-19 global pandemic. This shift may have been a tough transition on some individuals as work and family spheres have been obscured by remote working where one environment is used for both leisure, domestic and professional reasons. A quantitative, non- experimental, correlational, cross- sectional study (N = 136) was conducted with employed South African participants using online self- report questionnaires. Correlation results showed a significant relationship between Work-Family Conflict (WFC) and burnout subscales, but not Family-Work Conflict (FWC) and burnout. Hierarchical Moderated regression was used to assess the data and showed that Sensory- Processing Sensitivity and Social Support did not moderate the relationship between WFC and burnout. The results show that females are more burnt out than males and as people get older, the less burnt out they are. Individuals experienced financial and fear of the unknown challenges due to the pandemic. This study offers a contribution to Human Resources on employee wellbeing and post- COVID-19 functioning.Item Psychological Challenges facing Primary School Children in Windhoek, Namibia: Perspectives of Teachers(University of the Witwatersrand, Johannesburg, 2024) Uupindi, Victoria N.; Kasese-Hara, MambweThe study aimed to explore the psychological challenges that primary school children were facing through the perspectives of teachers. The study also investigated the support system that was available to mitigate these challenges both at school and in the community. Urie Bronfenbrenner’s Bio-Ecological Theory of human development was used as a theoretical framework to comprehend and discuss the findings of the study. The study employed a Qualitative Research approach using a phenomenological perspective. The data was collected from three primary schools in Windhoek Namibia, from a total of eight participants using face-to-face recorded interviews. The participants were recruited using a snowball sampling technique that allowed the researcher to network for the next participant. The findings indicated that children are indeed influenced by their surroundings, experiencing many challenges such as those associated with Covid-19, those created by home circumstances, negative behavior, emotional distress and challenges associated with their schooling such as low school performance. The study revealed that various systems like the schools, churches and community members all collaborate to help primary school children navigate through their challenges.Item The Enhancement of the SDLC Methodology utilised in the Delivery of Digital Healthcare Products(University of the Witwatersrand, Johannesburg, 2024) Asamoah-Bekoe, Michael; Sunjka, BernadetteThe digital healthcare industry has experienced significant growth in recent years, resulting in increased competition among companies operating in this market. Company X, a competitor in this industry, utilises a mixed set of methodologies across their teams, where some methodologies may be outdated. With the emergence of new software development lifecycle methodologies (SDLC), it is crucial for Company X to adapt their current approach to remain competitive. As part of a research study, 24 participants from various teams in Company X were interviewed to gain insights into the industry, the current methodology being used, and how management could ensure a smooth transition to a new SDLC methodology. According to the study results, 21% of participants from Team A-D were unwilling to change their current methodology, while 37% were willing to make a switch. The remaining 42% were indifferent, with their decision depending on the reason for the transition. Based on the literature review and the findings from the study, a conceptual framework was developed to guide the process of transitioning to a new SDLC methodology.Item Electrocatalytic detection of biomarkers of tuberculosis and cervical cancer(University of the Witwatersrand, Johannesburg, 2024-07) Peteni, Siwaphiwe; Ozoemena, Kenneth IkechukwuThe need for simpler, low cost and efficient diagnostic methods remains a matter of urgency. This has opened numerous streams of research. Electrochemistry is a simple, cost effective and efficient method that has been used for the detection of several diseases such as tuberculosis (TB) and human papilloma virus (HPV). TB has been ranked amongst the most problematic diseases in HIV/AIDS burdened communities, this alone calls for concern. Biomarkers of TB not only indicate mycobacterium infection but can also assist in the early detection of TB which is highly beneficial for the infected person and the health care system. HPV is the causative agent for cervical cancer. Cervical cancer is ranked as the fourth disease that causes mortality amongst women. With that in mind, HPV-16 L1 early detecting means possible early detection of cervical cancer. In this thesis, methyl nicotinate (MN), which is one of TB’s biomarkers was detected in phosphate buffer solution (PBS, pH 6.0) and commercial human serum using cobalt nanoparticles supported on carbon derived from trimesic acid (TMA) (abbreviated as Co-NPs@CTMA) and biphenyldicarboxylic acid (BPDC) abbreviated as Co-NPs@CBPDC) as electrocatalysts. These electrocatalysts were obtained using microwave-assisted metal-organic framework process with TMA and BPDC as ligands. XRD data showed that these electrocatalysts are cobalt nanoparticles with dominant {111} and {200} phase with traces of cobalt oxide (CoO). XPS and Raman data showed that Co-NPs@CBPDC is defect-rich compared to the Co-NPs@CTMA counterpart. BET showed that CoPs@CBPDC has higher surface area and pore size and volume than the Co-NPs@CTMA catalyst. Both electrocatalysts showed reversible cobalt nanoparticle oxidation and reduction reactions, in the absence and in the presence of the MN, thereby allowing for a facile indirect electrochemical detection of this biomarker. The calibration curves showed low limit of detection (LoD) of 0.47 and 0.147 µM for Co-NPs@CTMA and Co-NPs@CBPDC, respectively. The higher performance of the latter is attributed to its enhanced physico-chemical properties compared to the former. Next, HPV-16 L1, which is the conventional high-risk antigen that is present in cervical cancer, was detected using onion-like carbon (OLC) and polyacrylonitrile fibre integrated with OLC (OLC-PAN) as electrode platforms. Two electrode platforms were used; onion-like carbon (OLC) and its polyacrylonitrile (OLC-PAN) composites. Both platforms led to the detection in a wide linear concentration range (1.95 fg/ml to 50 µg/ml), excellent sensitivity (>5.2 µA/log([HPV-16 L1, fg/mL]) and ultra-low detection of ca. 1.0 and 1.4 fg/ml for OLC-PAN and OLC-based immunosensors, respectively. The high specificity of detection was proven by experimenting with an anti-Ovalbumin antibody (anti-Ova) and native Ovalbumin protein (Ova). An immobilized antigenic HPV-16-L1 peptide showed insignificant interaction with anti-OVA in contrast with the excellent interaction with anti-HPV-16 LI antibody. The immunosensors showed satisfactory stability of ~ 3 days of re-usability. The application of the immunosensor as a potential point-of-care diagnostic (PoC) device was investigated with the screen printed carbon electrode which showed the ability to detect ultra-low (~ 0.7 fg/ml) and high (~ 12 µg/ml) concentrations. This study opens the door of opportunity for further investigation with other electrode platforms and realization of PoC diagnostic devicesfor screening and testing of HPV biomarker for cervical cancer.