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Background: Incidence of stroke is increasing in sub-Saharan Africa. People who survive stroke experience disability and require long-term care. Health systems in South Africa (SA) are experiencing important challenges, and services in the public health system for people with stroke (PWS) are fragmented. We aimed to explore the perspectives and experiences of PWS related to stroke care services to inform health system strengthening measures.Methods: In-depth interviews with 16 PWS in urban and rural areas in the Western and Eastern Cape Provinces of SA were conducted between August and October 2020. PWS were recruited through existing research networks, non-government organisations and organisations of persons with disabilities by snowball sampling. Interviews were transcribed, coded, and thematically analysed. We used the conceptual framework of access to health care as proposed by Levesque et al. to map and inform barriers to accessing health care from the user perspective.Results: PWS recognised the need for health care when they experienced signs of acute stroke. Health literacy on determinants of stroke was low. Challenges to accessing stroke care include complex pathways to care, physical mobility related to stroke, long travel distances and limited transport options, waiting times and out of pocket expenses. The perceived quality of services was influenced by cultural beliefs, attitudinal barriers, and information challenges. Some PWS experienced excellent care and others particularly poor care. Positive staff attitude, perceived competence and trustworthiness went in hand with many technical and interpersonal deficits, such as long waiting times and poor staff attitude that resulted in poor satisfaction and reportedly poor outcomes for PWS.Conclusions: Strategic leadership, governance and better resources at multiple levels are required to address the unmet demands and needs for health care of PWS. Stroke care could be strengthened by service providers routinely providing information about prevention and symptoms of stroke, treatment, and services to patients and their social support network. The role of family members in continuity of care could be strengthened by raising awareness of existing resources and referral pathways, and facilitating connections within services. [ABSTRACT FROM AUTHOR]

Persistent upper quadrant musculoskeletal pain and disability are common in female computer workers; they are associated with a complex relationship between individual, work-related and psychosocial factors. Upper quadrant musculoskeletal dysfunction has been associated with reduced work performance. Although there is lack of evidence for an adjustable office chair on computer workers' upper quadrant dysfunction and productivity, an adjustable office chair may provide a platform to change the computer workstation set-up and thereby have an effect on upper quadrant musculoskeletal structures. The aim of this two single-subject (n=1) explorative study was to determine whether an adjustable ergonomic office chair was associated with self-reported improvement in chronic upper quadrant musculoskeletal dysfunction and work productivity among female computer workers, compared to a less adjustable ergonomic office chair. Results found a clinically meaningful short-term reduction in both participants' self-reported upper quadrant pain and perceived muscle tension. One participant's results showed a clinically meaningful reduction in self-reported neck disability and work impairment, resulting from the upper quadrant musculoskeletal dysfunction. The other participants' baseline values for both neck disability and work impairment were too low for a meaningful comparison. Study findings indicated that a height-adjustable ergonomic office chair reduced upper quadrant musculoskeletal dysfunction in two female computer workers. This explorative study forms the foundation for further studies that aim to make office chair recommendations for female computer workers to reduce UQ musculoskeletal dysfunction. [ABSTRACT FROM AUTHOR]

Background. The research methodology module was reviewed as part of the overall revision of the undergraduate physiotherapy curriculum of Stellenbosch University. This created an ideal platform from which to assess how to align the principles of evidence-based practice (EBP) with research methodology. Fostering the principles of EBP provides students with research skills and attributes to be able to seek, evaluate and integrate new knowledge and to apply critical thinking in order to effectively facilitate professional growth and support lifelong learning. Objective. To describe the process of changing the undergraduate research methodology module from a primary research to a secondary research approach. Methods. We consulted international experts and searched the literature for ideas and concepts of how to incorporate the principles of EBP. The overall objective of the new research module was formulated to provide students with lifelong skills in obtaining, evaluating, synthesising and forming clinical recommendations, as well as applying research evidence to the clinical setting. Results. Structuring the research methodology module using an EBP teaching framework prepares students to formulate a research question, effectively search for and critically appraise the evidence and formulate clinical recommendations. The barriers and strategies of implementing the new undergraduate research methodology module, as well as lessons learnt, are presented. Conclusion. Utilising a secondary research approach in the form of a systematic review or meta-analysis in our undergraduate research methodology module provides the opportunity for students, as novice researchers, to be trained in the principles of EBP. [ABSTRACT FROM AUTHOR]