SUNScholar

SUNScholar is a leading digital archive for the preservation and promotion of the research output of Stellenbosch University.

 

Recent Submissions

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An Evaluation of High‑Risk HPV in Squamous Cell Carcinomas of the Lip in a South African Cohort
(Springer Nature, 2024-05-06) Harbor, Sharon N.; Schneider, Johann W.; Solomons, Nadine; Sanderson, Micheline; Afrogheh, Amir H.
Background To determine the prevalence of HR-HPV in a series of lip SCC from South African patients, using currently accepted HPV-testing methodologies and to define the clinical and histomorphologic features of HPV-associated lip SCC. Methods Fifty SCC of lip and 50 control cases were tested for HR-HPV using p16 and HR-HPV DNA PCR. p16-equivocal/positive and HPV DNA PCR-positive SCC were further evaluated for the expression of HPV-16 and HPV-18 mRNA transcripts using reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) to confirm transcriptionally active HPV. Results p16 was positive in 22% (n = 11) and equivocal in 4% (n = 2) of the SCC. One p16-positive case showed positivity for both HPV-16 DNA and HPV-16 E6/E7 mRNA transcripts (HPV prevalence rate of 2%). The HPV-positive case was non-keratinizing and occurred in an 80-year-old female. The two p16-equivocal cases were HR-HPV DNA positive and mRNA PCR negative. p16 was found to have a positive predictive value of 9%. Conclusion Findings from our cohort of lip SCC suggest that HR-HPV may have an insignificant role in the pathogenesis of SCC at this site. Due to its low ppv, p16 is insufficient to establish HR-HPV infection in SCC of the lip. The combination of p16 and DNA PCR appears to correlate with the presence of transcriptionally active virus. HPV E6/E7 mRNA detection is the gold standard for identifying HR-HPV. mRNA testing is not widely available in sub-Saharan Africa due to technical and financial constraints; however, the test appears to be of great value in p16-equivocal lip SCC.
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Rehabilitation and primary care treatment guidelines, South Africa
(World Health Organization, 2022-08-22) Conradie, Thandi; Charumbira, Maria; Bezuidenhout, Maryke; Leong, Trudy; Louw, Quinette
The World Health Organization recognizes rehabilitation as an essential component of universal health coverage (UHC). In many countries, UHC builds on a standard benefits package of services that is informed by the country’s essential medicines list, standard treatment guidelines and primary health care essential laboratory list. In South Africa, primary health care is largely provided and managed by primary health-care nurses and medical officers in accordance with primary health care standard treatment guidelines. However, rehabilitation is mostly excluded from these guidelines. This paper describes the 10-year process that led to rehabilitation referral recommendations being considered for inclusion in South Africa’s primary health care standard treatment guidelines. There were five key events: (i) a breakthrough moment; (ii) producing a scientific evidence synthesis and formulating recommendations; (iii) presenting recommendations to the national essential medicines list committee; (iv) mapping rehabilitation recommendations onto relevant treatment guideline sections; and (v) submitting revised recommendations to the committee for final consideration. The main lesson learnt is that, by working together, rehabilitation professionals can be of sufficient number to make a difference, improve service delivery and increase referrals to rehabilitation from primary health care. A remaining challenge is the lack of a rehabilitation representative on the national essential medicines list committee, which could hamper understanding of rehabilitation and of the complexities of the supporting evidence.
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Teaching as Epistemic Mistrust
(Springer Nature, 2024-08-19) Davids, Nuraan
Long portrayed as a virtuous profession, teaching has always been embedded in notions of trust and trustworthiness. Alongside expectations of epistemic cultivation and development, is an implicit handing over of discretionary powers to ‘the trusted teacher’. At the height of #blacklivesmatter protests in 2020, however, high school learners all over South Africa took to social media—@yousilenceweamplify—to express their hurt and anger at their dehumanising experiences at some of the country’s leading schools. Their accounts not only exposed some schools as intense sites of racial, religious, cultural, ethnic, and linguistic tension and conflict, but shattered presumptions about ‘the trusted teacher’. Following a consideration of what trust infers, and the potential harms that arise from epistemic mistrust, the paper considers what might be gained from philosophical engagements in the espousal of teaching as a relationship of epistemic trust, and which ensures the flourishing of both learner and teacher? How might philosophy of education assist teacher education programmes in attuning students to an understanding that being trustworthy as teachers resides in self-knowledge as well as knowledge of the differences of, and among others?
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Use of Language By generative AI Tools in Mathematical Problem Solving: The Case of ChatGPT
(Taylor & Francis, 2024-08-18) Daher, Wajeeh; Gierdien, Faaiz
Texts generated by artificial intelligence agents have been suggested as tools supporting students’ learning. The present research analyses the language of texts generated by ChatGPT when solving mathematical problems related to the quadratic equation. We use the functional grammar theoretical framework that includes three meta-functions: the ideational meta-function, the interpersonal meta-function and the textual meta-function. The results indicated that in at least one of six problem-solving tasks ChatGPT provided a mathematically incorrect answer. The processes appearing in ChatGPT texts, aiming at developing students’ understanding of mathematical concepts, included verbal, mental, existential, relational and behavioural processes but no material processes. Specifically, ChatGPT performed a mathematically incorrect existential process. ChatGPT generally used the first plural pronoun ‘we’ when describing the processes of solving mathematical problems, while it generally used the first-person singular pronoun when taking responsibility for a specific mistake or when expressing happiness for the actions of the user. Moreover, generally the text of the solution did not include direct imperatives but used ‘let us do’. The advancement of the ChatGPT textual solution was made usually through steps like ‘first’, ‘second’, etc. The research results indicated that the way ChatGPT responded to the mathematical problems would be useful in supporting learners’ understanding of ways to solve quadratic equations, but only if the teacher critically accompanies the student in the problem-solving process. Self-study with ChatGPT could lead to or confirm students’ mathematical misconceptions.
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Factors influencing Western Cape community service doctors’ choice of whether to seek employment in public, rural practice
(Stellenbosch : Stellenbosch University, 2024-12) Baytopp, Tamryn; Motsohi, Ts'epo; Lomas, Vanessa; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Family and Emergency Medicine. Family Medicine and Primary Care.
ENGLISH SUMMARY: Background: Shortage of staff in rural areas has contributed to long-standing inequitable healthcare access between urban and rural populations. One of South Africa’s strategies to address this is the compulsory community service program.(1) To capitalize on this, doctors need to be encouraged to remain in their facilities beyond their community service periods. Identifying factors that positively or negatively influence their decisions to stay could help to develop more focused strategies to promote the retention of doctors in rural areas.(2) Aim: To describe the important factors influencing Western Cape community service doctors’ choice of whether they will seek employment in public rural practice. Design and setting: This was an observational cross-sectional study with correlational analysis of community service doctors working in the Western Cape in 2022. Method: Western Cape community service doctors were invited to complete an internet-based questionnaire. Results: A total of 86 community service doctors completed the questionnaire, of whom 8% intended to work in public rural practice in 2023 and 21% considered rural practice sometime in the future. Demographic factors associated with the intention to work in rural practice were a rural upbringing (6.5 times more likely to consider rural practice) and rural placement for internship (7.7 times more likely to consider rural practice) and community service (3.5 times more likely to consider rural practice). The most important factors influencing their decision for or against rural practice were issues of personal safety and security (mean likert score of 4.7) followed by job satisfaction (mean likert score of 4.6) and mental health (mean likert score of 4.6). Rural upbringing (mean likert score of 1.8) and exposure in internship (mean likert score of 2.4) were ranked low in importance. Conclusion: This study found the proportion of community service doctors considering working in public rural practice has not significantly increased (20%) compared to previous findings in the literature. Suggestions based on the results include revision of strategy on the part of policy makers, preferential enrolment of medical students with a rural upbringing, and prioritisation of placing community service doctors in rural areas. More focus should be placed upon promoting safe, satisfying work environments which are protective of staff mental and psychological wellbeing.