Browsing by Author "Schneider, M."

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    Access to health care for persons with disabilities in rural South Africa
    (BioMed Central, 2017-11-17) Vergunst, R.; Swartz, L.; Hem, K.-G.; Eide, A. H.; Mannan, H.; MacLachlan, M.; Mji, G.; Braathen, S. H.; Schneider, M.
    Background: Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a paucity of research in South Africa looking at “triple vulnerability” – poverty, disability and rurality. This study explored issues of access to health care for persons with disabilities in an impoverished rural area in South Africa. Methods: The study includes a quantitative survey with interviews with 773 participants in 527 households. Comparisons in terms of access to health care between persons with disabilities and persons with no disabilities were explored. The approach to data analysis included quantitative data analysis using descriptive and inferential statistics. Frequency and cross tabulation, comparing and contrasting the frequency of different phenomena between persons with disabilities and persons with no disabilities, were used. Chi-square tests and Analysis of Variance tests were then incorporated into the analysis. Results: Persons with disabilities have a higher rate of unmet health needs as compared to non-disabled. In rural Madwaleni in South Africa, persons with disabilities faced significantly more barriers to accessing health care compared to persons without disabilities. Barriers increased with disability severity and was reduced with increasing level of education, living in a household without disabled members and with age. Conclusions: This study has shown that access to health care in a rural area in South Africa for persons with disabilities is more of an issue than for persons without disabilities in that they face more barriers. Implications are that we need to look beyond the medical issues of disability and address social and inclusion issues as well.
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    Addressing the intersection between alcohol consumption and antiretroviral treatment : needs assessment and design of interventions for primary healthcare workers, the Western Cape, South Africa
    (BioMed Central, 2016) Schneider, M.; Chersich, M.; Temmerman, M.; Parry, C. D.
    ENGLISH SUMMARY : Background: At the points where an infectious disease and risk factors for poor health intersect, while health problems may be compounded, there is also an opportunity to provide health services. Where human immunodeficiency virus (HIV) infection and alcohol consumption intersect include infection with HIV, onward transmission of HIV, impact on HIV and acquired immunodeficiency syndrome (AIDS) disease progression, and premature death. The levels of knowledge and attitudes relating to the health and treatment outcomes of HIV and AIDS and the concurrent consumption of alcohol need to be determined. This study aimed to ascertain the knowledge, attitudes and practices of primary healthcare workers concerning the concurrent consumption of alcohol of clinic attendees who are prescribed antiretroviral drugs. An assessment of the exchange of information on the subject between clinic attendees and primary healthcare providers forms an important aspect of the research. A further objective of this study is an assessment of the level of alcohol consumption of people living with HIV and AIDS attending public health facilities in the Western Cape Province in South Africa, to which end, the study reviewed health workers’ perceptions of the problem's extent. A final objective is to contribute to the development of evidence-based guidelines for AIDS patients who cons ume alcohol when on ARVs. The overall study purpose is to optimise antiretroviral health outcomes for all people living with HIV and AIDS, but with specific reference to the clinic attendees studied in this research. Methods: Overall the research study utilised mixed methods. Three group-specific questionnaires were administered between September 2013 and May 2014. The resulting qualita tive data presented here supplements the results of the quantitative data questionnaires for HIV and AIDS clinic attendees, which have been analysed and written up separately. This arm of the research study comprised two, separate, semi-structured sets of interviews: one face-to-face with healthcare workers at the same primary healthcare clinics from which the clinic attendees were sampled, and the other with administrators from the local government health service via email. The qualitative analysis from the primary healthcare worker interviews has been analysed using thematic content analysis. Results: The key capacity gaps for nurses include the definition of different patterns and volumes of alcohol consumption, resultant health outcomes and how to answer patient questions on alcohol consumption while on antiretroviral treatment. Not only did the counsellors lack knowledge regarding alcohol abuse and its treatment, but they were also they were unclear on their role and rights in relation to their patients. Docto rs highlighted the need for additional training for clinicians in diagnosing alcohol use disorders and information on the pharmacological interventions to treat alcoholism. Conclusion: Pertinent knowledge regarding patient alcohol consumption while taking ARVs needs to be disseminated to primary healthcare workers.
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    Estimating the burden of disease attributable to alcohol use in South Africa in 2000
    (Health & Medical Publishing Group, 2007) Schneider, M.; Norman, R.; Parry, C.; Bradshaw, D.; Pluddemann, A.
    Objectives. To make quantitative estimates of the burden of disease attributable to alcohol use by sex and age group in South Africa in 2000. Design. The analysis follows the World Health Organization comparative risk assessment (CRA) methodology. Populationattributable fractions (PAFs) calculated from modelled prevalence estimates and relative risks based on the global review were applied to the burden of disease estimates from the revised South African National Burden of Disease study for 2000. The alcohol-attributable fractions for injuries were directly determined from blood alcohol concentrations (BAC > 0.05 g/ 100 ml) at the time of injury. Monte Carlo simulationmodelling techniques were used to quantify uncertainty in the estimates. Setting. South Africa. Subjects. Adults ≥ 15 years. Outcome measures. Deaths and disability-adjusted life years (DALYs) from ischaemic heart disease, stroke, hypertensive disease, diabetes, certain cancers, liver cirrhosis, epilepsy, alcohol use disorder, depression and intentional and unintentional injuries as well as burden from fetal alcohol syndrome (FAS) and low birth weight. Results. Alcohol harm accounted for an estimated 7.1% (95% uncertainty interval 6.6 - 7.5%) of all deaths and 7.0% (95% uncertainty interval 6.6 - 7.4%) of total DALYs in 2000. Injuries and cardiovascular incidents ranked first and second in terms of attributable deaths. Top rankings for overall attributable burden were interpersonal violence (39.0%), neuropsychiatric conditions (18.4%) and road traffic injuries (14.3%). Interpersonal violence accounted for 42.8% of the injury DALYs attributed to alcohol in males and 25.9% in females. In terms of alcohol-attributable disability, alcohol use disorders ranked first (44.6%), interpersonal violence second (23.2%), and FAS third (18.1%). Conclusions. Particular attention needs to be given to preventing and reducing the burden of alcohol-related homicide and violence, alcohol-related road traffic accidents, alcohol use disorders, and FAS. Multilevel interventions are required to target high-risk drinkers, in addition to creating awareness in the general population of the problems associated with alcohol abuse.
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    Ianus Vitalis : In Christophorum Columbum Portait of a hero
    (Stellenbosch University, Department of Ancient Studies, 2009) Schneider, M.; Van Stekelenburg, A. V.
    The discovery of the New World at the end of the 15th century tested the traditional assumptions, beliefs, and attitudes of Renaissance Europe. Although the literary response during the 16th century showed a great deal of diversity in its appreciation and evaluation of the discovery, the standards and references used were inevitably those derived from an inherited classical and Christian tradition. The discussion below will focus on Ianus Vitalis’ poem In Christophorum Columbum — a literary example of 16th century Italian perceptions and attitudes relating to the discovery of the New World.
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    The Roman coin collection at Stellenbosch, a sequel
    (Stellenbosch University, Department of Ancient Studies, 2005) Schneider, M.
    This paper describes a new selection of ancient coins currently in the possession of the Department of Ancient Studies at the University of Stellenbosch. Discussion will focus mainly on the art and importance of coin portraiture during the Imperatorial, Imperial and Byzantine periods of Roman history, with specific reference to various relevant coin denominations from the respective eras. The original coin collection was begun in the early 1960s with a legacy of about a hundred coins from one A P Richter to the former Department of Latin at the University of Stellenbosch. Most of these coins were purchased from Spinks and Son in London. The late professor Frans Smuts, former head of the Department of Latin, expanded the collection with funds made available by the University, thus procuring a small, comprehensive hand-picked selection of Roman coins ranging in period from about 300 BC to AD 1041. More recently the late professor Bert van Stekelenburg managed the department’s numismatic collection and made a valuable contribution to our knowledge about the historical and artistic aspects of this collection. At present the collection hosts about 170 coins and spans the Republican; Imperatorial; Imperial, and Byzantine periods of Roman history.