The chemistry of AlF and CaF production in buffer gas sources.

In this work, we explore the role of chemical reactions on the properties of buffer gas cooled molecular beams. In particular, we focus on scenarios relevant to the formation of AlF and CaF via chemical reactions between the Ca and Al atoms ablated from a solid target in an atmosphere of a fluorine-containing gas, in this case, SF6 and NF3. Reactions are studied following an ab initio molecular dynamics approach, and the results are rationalized following a tree-shaped reaction model based on Bayesian inference. We find that NF3 reacts more efficiently with hot metal atoms to form monofluoride molecules than SF6. In addition, when using NF3, the reaction products have lower kinetic energy, requiring fewer collisions to thermalize with the cryogenic helium. Furthermore, we find that the reaction probability for AlF formation is much higher than for CaF across a broad range of kinetic temperatures.

Hyperfine-resolved optical spectroscopy of the A2Π â† X2Σ+ transition in MgF.

We report on hyperfine-resolved laser spectroscopy of the A2Π â† X2Σ+ transition of magnesium monofluoride (MgF), relevant for laser cooling. We recorded 25 rotational transitions with an absolute accuracy of better than 20 MHz, assigned 56 hyperfine lines, and determined precise rotational, fine, and hyperfine structure parameters for the A2Π state. The radiative lifetime of the A2Π state was determined to be 7.2(3) ns, in good agreement with ab initio calculations. The transition isotope shift between bosonic isotopologues of the molecule is recorded and compared to predicted values within the Born-Oppenheimer approximation. We measured the Stark effect of selected rotational lines of the A2Π â† X2Σ+ transition by applying electric fields of up to 10.6 kV cm-1 and determined the permanent electric dipole moments of 24MgF in its ground X2Σ+ and first excited A2Π states to be µX = 2.88(20) D and µA = 3.20(22) D, respectively. Based on these measurements, we caution for potential losses from the optical cycling transition due to electric field induced parity mixing in the excited state. In order to scatter 104 photons, the electric field must be controlled to below 1 V cm-1.

'It depends on how the relationship was before you became ill': black South African women's experiences of life partner support through the trajectory of cervical cancer.

Spouses are the primary source of support for married patients and patients suffering from gynaecological cancers and play a major role in the positive, or negative, management of the disease and treatment. The purpose of the study was to explore the experiences of life partner support among hospitalised women receiving treatment for cervical cancer at an academic hospital in Tshwane, South Africa. An exploratory, qualitative study was conducted using a convenience sampling method. Seventeen (n = 17) women were interviewed. The data were analysed using open coding and a template analysis style. The support women treated for cervical cancer received from their life partner varied. Some were fully supported while others received limited support and some were even abandoned. Both the women and their life partners were challenged in terms of giving and receiving support. How the support they received from their life partners influenced their quality of life is not known and should be the next exploratory step before designing and testing a support intervention to maximise the outcomes for these patients.

Combining breast and cervical screening in an attempt to increase cervical screening uptake. An intervention study in a South African context.

During 2008-2009, only 4% of women targeted for cervical screening were screened in Tshwane, South Africa. The purpose of the study was to determine whether cervical screening uptake could be improved when breast and cervical screening are combined. An intervention research design was used. The intervention was assessed in terms of two outcomes, namely cervical screening uptake and the findings of the screening. The study was conducted in a resource poor environment in Tshwane. Convenience sampling was used to recruit the sample (n = 299) and a baseline survey was conducted before delivering the intervention. Only 14% of the sample (n = 299) reported having been screened for cervical cancer previously. The total sample (n = 299) were willing to have a clinical breast examination; however, only 65.4% of those eligible for cervical screening (n = 283) used the opportunity to be screened. The majority of the sample screened (n = 185) using acetic acid for visual inspection (VIA) were VIA negative; 12.4% were VIA positive and 4.4% were VIA positive, invasive cancer; the screening of 8.7% failed. Despite women's lack of knowledge of cervical cancer and the screening thereof, combining cervical screening and breast screening lead to an increase in cervical screening uptake.

Men's lack of knowledge adds to the cervical cancer burden in South Africa.

The purpose of the study was to determine the level of knowledge regarding cervical cancer among Black men living in Ga-Rankuwa, South Africa. A quantitative survey was conducted. The population consisted of 980 (n = 980) convenience sampled men. Self-reported data were gathered using a structured interview and a pre-tested questionnaire served as data gathering instrument. The study provided evidence that men living in Ga-Rankuwa did not have knowledge of cervical cancer. None of the sample mentioned the HPV as risk factor while some knew that having multiple sexual partners add to a woman's risk. It is, however, doubtful whether the respondents experienced themselves as those with the multiple partners. More than 90% of the sample (n = 963) reported to have had more than one sexual partner in the previous 5 years while less than a quarter indicated that they would have to change their sexual behaviour to prevent cervical cancer. Men add to the cervical cancer burden in South Africa as their knowledge would not enable them to protect their partners from HPV infections, motivate them to be screened or allow them to protect themselves against this dreadful disease.

Knowledge related to nutrition and hypertension management practices of adults in Ga-Rankuwa day clinics.

Hypertension is a global, non-communicable chronic disease being asymptomatic and known as the silent killer with signs and symptoms only occurring when a target organ is damaged. Being a condition common in South Africa, hypertension is also a risk factor for cerebro-vascular incidents, myocardial infarction, left ventricular hypertrophy, renal disease and retinopathy. Black adults in an urban environment appear to be especially vulnerable to excessive increases in blood pressure. The research question explored was what was the knowledge of hypertensive adults attending day clinics in Ga-Rankuwa regarding nutrition and hypertension management practices. An exploratory strategy was used as no similar research had previously been conducted in Ga-Rankuwa. A cross sectional survey design was used to investigate hypertensive adults attending the three primary health clinics in Ga-Rankuwa. The sampling method was convenient and the sample size 101 participants. Two data gathering methods were used, these being physical measurements and self-report. For the self-report, a structured interview was conducted. The data were analysed using descriptive statistics. The results indicated a lack of knowledge regarding nutrition and management of hypertension. The proportion of participants with uncontrolled hypertension was high (58.6%) and non-compliance with medication occurred frequently (58.1%). A third (28.7%) of the sample lacked knowledge of the complications of hypertension (28.7%). A community-based intervention, based on the results of the study, is recommended.

Adaptation of the Rapid Estimate of Adult Literacy in Medicine Revised (REALM-R) to the South African Context: Part 1

Literacy levels are increasingly important in health care because professional nurses and other health care professionals often use written health education materials as a major component in patient education. In South Africa; no current instrument is available to assess the literacy levels of patients in the primary health care setting; though several instruments have been developed and validated internationally. The purpose of this paper was to adapt and validate the Rapid Estimate of Adult Literacy in Medicine Revised (REALM-R) to the South African context. The REALM-R is a short instrument that is designed to rapidly screen clients in the primary health care setting for low health literacy. A modified Delphi-technique was used to measure the judgement of a group of experts for the purpose of making a decision. Eight experts in the field of Nursing Science were selected purposively to obtain the most reliable consensus. Data was collected by means of a self-report whereby participants responded to a series of questions posed by the researcher. Descriptive statistics was used for analysing data. The REALM-R was adapted to the South African context to ensure that the literacy level of South African clients is measured with an appropriate instrument

Assessment of the eng Literacy Level of Patients in Primary Health Care Services in Tshwane; Gauteng Province: Part 2

Low literacy can be described as the inability to read; write or use numbers effectively. The limited ability to read and understand health care instructions directly translates into poor health outcomes. The aim of this study was to assess the eng literacy levels of primary health care patients using the Learning Ability Battery (LAB) and the adapted Rapid Estimate of Adult Literacy; Revised (REALM-R) and to determine how the results of the adapted REALM-R correlate with those of the LAB. Data were collected by means of a self-report whereby the participants had to answer the questions that were posed in the LAB and read the words out loud for the adapted REALM-R. The data analysis was performed by means of descriptive and inferential statistics; including the chi-square test and Spearman's rho. The result of the study indicated that in South Africa; school grades achieved and the reading levels of primary health care patients differ with four grades. In terms of the correlation between the results of the adapted REALM-R and those of the LAB; a correlation of r = 0.43 (p 0.001) could be established. Depending on the cut-off point used for the adapted REALM-R; 67of the participants had low literacy levels. The study provides evidence of the importance of a validated; quick and easy-to-administer literacy screening tool. The effective assessment of patients' literacy levels will assist registered professional nurses to provide health education on an appropriate level to improve patients' health literacy

Mortality and drug exposure in a 5-year cohort of patients with chronic liver disease.

BACKGROUND: Chronic liver diseases are common in the general population. Drug treatment in this group may be challenging, as many drugs are hepatically metabolised and hepatotoxic. OBJECTIVES: We aimed to assess the mortality of patients with chronic liver disease according to specific drug exposures and the three laboratory parameters creatinine, bilirubin and International Normalised Ratio (INR). METHODS: We conducted a multicentre, 5-year retrospective cohort study in two tertiary university referral hospitals and a secondary referral hospital, using a research database to evaluate the crude and adjusted mortality. RESULTS: Of 1159362 individual patients 1.7% (n = 20158) had chronic liver disease and in this group 36.8% had unspecified chronic non-alcoholic liver disease, 30.1% chronic hepatitis C and 11.9% cirrhosis of the liver. 8.4% of patients presented a diagnosis associated with alcohol. The 4-year survival rates were significantly higher in the group with the most normal laboratory values (94.3%) versus 34.5% in the group with elevated parameters (p <0.001). Overall, drug exposure was not associated with higher mortality; in adjusted multivariate analysis the hazard ratio for anti-cancer drugs was 2.69 (95% CI 1.32-5.46). Of individual drugs, mortality hazard ratios for amiodarone, morphine oral, acetazolamide, sirolimus and lamivudine were 2.46 (95% CI 1.68-3.61), 2.26 (95% CI 1.78-2.86), 2.10 (95% CI 1.19-3.70), 1.81 (95% CI 1.02-3.21) and 1.72 (95% CI 1.17-2.53) respectively. CONCLUSIONS: Drug exposure in general was not associated with higher mortality except for a few categories. Mortality in patients with chronic liver disease was high and is associated with simple laboratory values.

Treatment of oral thrush in HIV/AIDS patients with lemon juice and lemon grass (Cymbopogon citratus) and gentian violet.

PURPOSE: The purpose of the study was to investigate the safety and efficacy of lemon juice and lemon grass (Cymbopogon citratus) in the treatment of oral thrush in HIV/AIDS patients when compared with the control group using gentian violet aqueous solution 0.5%. Oral thrush is a frequent complication of HIV infection. In the Moretele Hospice, due to financial constraints, the treatment routinely given to patients with oral thrush is either lemon juice directly into the mouth or a lemon grass infusion made from lemon grass (Cymbopogon citratus) grown and dried at the hospice. These two remedies have been found to be very efficacious therefore are used extensively. Gentian violet, the first line medication for oral thrush in South Africa, is not preferred by the primary health clinic patients due to the visible purple stain which leads them to being stigmatized as HIV-positive. Cymbopogon citratus and Citrus limon have known antifungal properties. METHODS: The study design was a randomised controlled trial. Ninety patients were randomly assigned to one of three groups: gentian violet, lemon juice or lemon grass. Inclusion criteria included being HIV-positive with a diagnosis of oral thrush. The study period was 11 days and patients were followed up every second day. International ethical principles were adhered to during the study. RESULTS: Of the 90 patients, 83 completed the study. In the intention-to-treat analysis, none of the p-values were significant therefore the null hypothesis could not be rejected. In the analysis of the participants who actually completed the trial, the lemon juice showed better results than the gentian violet aqueous solution 0.5% in the treatment of oral thrush in an HIV-positive population (p<0.02). The null hypothesis in terms of the lemon grass and gentian violet could also be rejected on the basis of the Chi-square test and the likelihood ratio test (p<0.05). CONCLUSIONS: Though the patient population was small, the use of lemon juice and lemon grass for the treatment of oral candidiasis in an HIV population was validated by the randomised controlled trial.

Palliative care: a positive outcome for cancer patients?

The development of palliative care in terms of recognizing the needs of the dying, palliative care becoming a nursing and medical speciality, the involvement of the World Health Organization in palliative care and the continuous development of treatment modalities available to cancer patients creates the expectation that the outcomes for the patient should also be positively influenced. The purpose of the study was to determine the most common symptoms of advanced cancer patients treated in a public and private hospital in Tshwane, and whether advances in palliative care improved the outcomes for these patients by decreasing the prevalence of symptoms experienced. The design of the study was a quantitative survey. The population consisted of patients with advanced cancer receiving palliative treatment as out patients in radiation and medical oncology clinics in a public and private hospital the Tshwane Metropolitan area. The sampling method was convenient and the sample size was 148 participants (n = 148). Data was gathered by means of an interview and self report. Data analysis was done by means of descriptive statistics. The results of the study indicated that a high number of patients still experience problems that could have been prevented. Pain was found to be the biggest problem for patients (76.4%) followed by weakness and fatigue (65.5%), nausea and vomiting (65.5%) and a dry mouth (46.6%). Thirst was reported by 41.2% of the sample. The study provides evidence that the development of palliative care did not have a positive outcome for patients by reducing the prevalence of symptoms experienced.

Lifestyle risk factors in an urban South African community.

The research question addressed in the study was to determine the prevalence of the following lifestyle risk factors: obesity, waist-hip ratio, physical inactivity, high blood glucose, and hypertension in an urban community. The research objective for the study was to determine the prevalence of specific risk factors in an urban community. Based on the results, a health intervention could be planned and implemented to reduce the prevalence of the risk factors and the possibility of chronic non-communicable diseases in later life. The design was a quantitative survey using physical measurement and a structured questionnaire. The target population of the study was black urban adults (n=218). The sampling method was convenient and purposive. The results of the study indicated that the prevalence of hypertension and obesity were higher than the national prevalence for South Africa. The waist-hip ratio revealed that 20% of the men and 49.7% of the women were at risk for cardiovascular disease. High blood glucose levels were demonstrated for 21.6% of the group. Physical activity was also shown to be inadequate. In conclusion, the potential for cardiovascular and metabolic health problems in future is high. It is recommended that an intervention, based on the results of the study, should and must be developed and implemented. The more challenging question is to know what to do and how to do it. A framework is suggested to guide the development of an intervention.

Health care practices influencing health promotion in urban black women in Tshwane.

Health promotion is a multifaceted activity. Women and children are particularly vulnerable regarding access to quality health care, with young African women reportedly the poorest and most economically marginalised and least educated sector in South Africa. Understanding the context within which a person lives is an essential component in the health educator's teaching strategy. Understanding urban black women's health care practices will enable health promoters to develop interventions that are successful. The problem investigated was to gain an understanding of the health care practices of urban black women that could influence health promotion activities. The design was qualitative exploratory. The respondents were women living in an urban township in Tshwane, South Africa. The sampling method was convenient and purposive and the sample size was determined by saturation of the data. Data was gathered through semi-structured interviews using six specific themes and the analysed using open coding. The results indicated that the social environment created by the registered nurses in the primary health influenced the health care practices of the women negatively. Practices regarding the seriousness of a health problem suggest a possible reason for late admission of a person with a serious health problem.

Knowledge and Awareness of Risk Factors for Cardiovascular Disease in the Ga-Rankuwa Community

Cardiovascular disease causes 30 of deaths globally. By comparison; infectious disease accounts for 10of global mortality. As these statistics indicate; cardiovascular disease is the most common cause of death in the world. In South Africa; through urbanisation and changes in lifestyle and dietary habits; the prevalence of risk factors and; by extension; the resulting morbidity and mortality from cardiovascular disease in black people; are expected to increase. Owing to the natural progression of the disease; the first 'westernised illness' is hypertension; which is very prevalent among the black population. Knowledge and awareness of risk factors are essential components of behaviour change; however; little is known about the knowledge and awareness of cardiovascular disease among the working-age people in the Ga-Rankuwa community. The purpose of the study was therefore to determine the knowledge and awareness of the identified risk factors among the working-age people (18-40 years old) in the Ga-Rankuwa community. The design was a quantitative survey. The study sample (n=604) was selected from zones 1; 2; 4 and 16 of Ga-Rankuwa to determine the prevalence of risk factors for cardiovascular disease. Only people with an identified risk factor were included in the knowledge and awareness survey (n=551). Data was gathered from July to October 2005. The data gathering was self-reported with a structured questionnaire. Data were analysed using descriptive statistics and statistical analysis. The results obtained from the knowledge and awareness survey indicate that knowledge and awareness of the risk factors for cardiovascular disease are low in the Ga-Rankuwa community

Integration of research and nursing experiential learning: a case study.

Teaching research to undergraduates has it own challenges and involving undergraduates in research practical experience is just one of those challenges. As nursing students are in the process of becoming professional nurses, knowledge and skills in research are specific outcomes of the curriculum. One of the outcomes of the B Tech Nursing Science programme offered by the Tshwane University of Technology states that for the baccalaureate nursing programme include analysis, interpretation and utilisation of a range of research findings in scientific nursing and midwifery care as well as the development of a research protocol in a given context. In an effort to ensure that students would experience research as an essential part of their daily activities, an integrated approach is suggested whereby the nursing experiential learning opportunities are also research experiential learning opportunities. Using the integration strategy, research theory come 'alive' for the students. The integration approach is uncomplicated and transferable to any other discipline. The case study presented is the second year nursing students using school nursing experiential learning as a research project. The second year nursing students have a community focus during their second year and one of the experiential learning opportunities is school health nursing in a primary school in Tshwane. The results of the school health survey are presented. The students developed a health education intervention based on the research results.

Exploration of knowledge, attitudes and percepions regarding sexually transmitted infections among patients attending a primary health care clinic in Gauteng--part 1.

Sexually transmitted infections are a major public health problem in South Africa. The high incidence and prevalence of sexually transmitted infections in South Africa pose a serious threat to public health for two main reasons. Firstly, the long-term consequences of these infections are a major cause of loss of health or life, and secondly, sexually transmitted infections are important co-factors in driving the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. The control and prevention of sexually transmitted infections has become an urgent priority. At a primary health care clinic, the nursing personnel experienced an increasing number of persons daily seeking treatment for sexually transmitted infections. The purpose of the study was therefore to investigate the knowledge, attitudes and perceptions of people seeking treatment at Stanza Bopape Clinic regarding sexually transmitted infections. The study was a contextual, quantitative survey. The population was all patients (15 years and older) who visited the clinic for a health-related problem during November 2004 to January 2005. The sampling method was convenient. The data gathering method was self-report using a structured questionnaire basic on current knowledge. The data analysis was done with descriptive statistics.

Guidelines to reduce sexually transmitted infections at primary health care centres--part 2.

Sexually transmitted diseases are the second highest cause of death among women aged 15-44 years. The incidence and prevalence of sexually transmitted diseases is on the increase at many health care centres despite their dreadfulness and many preventative measures. According to the Scope of Practice of registered professional nurses working in a community health clinic, the registered professional nurse has a responsibility to prevent disease and promote health as well as do research. This paper aims to describe guidelines to reduce sexually transmitted infections at primary health care centres based on research done to investigate the community specific knowledge, attitudes and perceptions regarding sexually transmitted infections. Structured interviews were used to collect data from 1694 participants (males and females) who were consulted at a primary health care clinic in Mamelodi, Gauteng province. Existing patients' records were also utilised to calculate the incidence rate of sexually transmitted infections. Data were computerised and analysed quantitatively to reflect the results in frequencies and percentages as reported in Part 1 of this research. Guidelines to direct the practice of registered professional nurse were developed based on the findings of the results. These guidelines must underpin community specific interventions to reduce the incidence of sexually.

Risk factors for cardiovascular disease in the Ga-Rankuwa community.

Cardiovascular disease is the most common and yet one of the most preventable causes of death in the world. Rapid urbanization in South Africa is accompanied by rapid changes in lifestyle and environmental exposure that increase the burden of chronic cardiovascular diseases. Risk factors, modifiable or nonmodifiable, exist that increases a person's chances of developing cardiovascular disease. Though some knowledge is available about the prevalence of the risk factors in South Africa, no information is available regarding the community of Ga-Rankuwa. The purpose of the study was therefore to investigate the prevalence of risk factors for cardiovascular disease amongst the working-age people (18-40 years) in Ga-Rankuwa community. A quantitative survey was done and the sample was selected from zone 1, 2, 4, and 16 of Ga-Rankuwa from July 2005 to October 2005. The sampling method was census sampling (n=604). The data-gathering was self-report using a structured questionnaire as well as physical measurement. Data were analysed using descriptive statistics. The results indicated that risk factors, specifically obesity, physical inactivity and hypertension, were very prevalent in Ga-Rankuwa community. Different distributions of risk factors exist in the various sex and age groups. This finding again emphasises the importance of not developing health interventions with a single focus, for example hypertension or obesity. The risk factors are interwoven and affect each other. It is important to initiate a comprehensive health project to lower the risk factors of cardiovascular diease in the Ga-Rankuwa community.

A conceptual framework for teaching research in nursing.

Though research is often referred to the lifeblood, hallmark or cornerstone in the development of a profession (Brink, 1996:2), teaching research in nursing is a challenge. The challenge does not just lie in teaching the subject, but in resistance and unwillingness of students to engage in the subject. In the experience of the researcher, registered nurses identify themselves with being a nurse and a caregiver; the role of researcher has never been internalised. The challenge is to achieve the outcome envisaged, namely, nurses who are knowledgeable consumers of research as well as continuous productive scholars in their application of nursing. Research generates knowledge and knowledge is the basis of caring with excellence. Nursing is an art and a science and the science must produce the knowledge upon which the art is based. The purpose of this article is to propose a conceptual framework of how to teach research in order to achieve such a successful outcome. The conceptual framework proposed in this article is based on four pillars, theoretical knowledge of research, scientific writing, psychological support and experiential learning. The importance of the research facilitator, not just as a teacher but also as a positive role model, is also described.

Use of narcotic analgesics in the emergency department treatment of migraine headache.

OBJECTIVE: Treatment of acute migraine headache with narcotics is potentially ineffective and may lead to abuse. The authors examined the treatment practice variation across five linked EDs in one Canadian center, focusing on the use of narcotic analgesics and factors associated with their use. METHODS: Five hundred acute migraine headache patient charts were randomly selected from five Canadian EDs. Charts underwent a structured review to determine medication use. Data were analyzed, comparing those who received narcotics as first-line treatment with those who did not, using chi(2) and t-tests and logistic regression. RESULTS: The majority of patients (59.6%) received narcotics as first-line treatment. Numerous factors were associated with first-line narcotic treatment. Having taken antiheadache medications prior to ED presentation (odds ratio [OR]: 2.63; 95% CI: 1.53, 4.51) and hospital of presentation being other than Hospital A (e.g., Hospital D, OR: 6.32; 95% CI: 2.76, 14.46) increased the odds of receiving first-line narcotics. Having received a more urgent triage score (OR: 0.4; 95% CI: 0.24, 0.65) or having a longer duration of headache (OR: 0.994; 95% CI: 0.99, 0.99) decreased the odds of receiving first-line narcotics. CONCLUSIONS: Acute migraine management in these EDs does not meet current consensus guidelines. Factors associated with narcotic use are predictable, and a concerted effort to replace narcotics with more evidence-based first-line treatments is needed.