Browsing by Author "Paterson, Marie."

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The prevalence and degree of dehydration in rural South African forestry workers.
(2008) Biggs, Chara.; Maunder, Eleni Maria Winifred.; Paterson, Marie.
South African forestry workers are predisposed to dehydration due to the heavy physical activity they perform in impermeable regulation safety clothing in hot and often humid environments where the availability of a variety of suitable fluids at reasonable temperatures is limited. As dehydration reduces both physical and mental capacity the potential consequences include decreased productivity and an increased risk for injury. The aim of this cross sectional observational study was to determine the prevalence and severity of dehydration in rural forestry workers in both winter (minimum and maximum daily temperatures 3-22°C) and autumn (minimum and maximum daily temperatures 14-27°C). The convenience sample included 103 workers in autumn (Nelspruit, n=64 males, n=39 females, mean age 37.32 years, mean BMI 22.3 kg/m2) and 79 in winter (Richmond, n=68 males, n=11 females, mean age 25.85 years, mean BMI 22.2 kg/m2). The sample included chainsaw operators, chainsaw operator assistants, debarkers and stackers. The risk of heat illness was moderate in Nelspruit (average daily temperature 21.1°C 67% rh) and low in Richmond (average daily temperature 17.0°C 39% rh). The prevalence of dehydration was determined by urine specific gravity (USG) measurements. Percent loss of body weight in the course of the shift was used to determine the severity of dehydration. In Nelspruit 43% (n=43) and in Richmond 47% (n=37) of the forestry workers arrived at work dehydrated (USG>1.020 g/ml). Pre break this had increased to 49% (n=49) in Nelspruit and 55% (n=33) in Richmond. By the end of shift the number of dehydrated forestry workers had significantly increased to 64% (n=64, p≤0.001) in Nelspruit and 63% (n=42, p=0.043) in Richmond. A minimum of 21% (n=2) in Nelspruit and 23% (n=15) in Richmond of the forestry workers had lost more than 2% of their body weight which could significantly decrease work capacity and work output as well as mental and cognitive ability. Dehydration was not related to season (winter/autumn), gender or job category. In Nelspruit 23% (n=23) and in Richmond 13% (n=10) arrived at work overhydrated (USG<1.013 g/ml). Pre break this had decreased to 14% (n=14) in Nelspruit and 10% (n=6) in Richmond. By the end of shift 4% (n=4) in Nelspruit and 2% (n=1) in Richmond had remained overhydrated and without correcting for fluid and food intake, 5% (n=5) had gained over 2% of their body weight in Nelspruit while none had gained weight in Richmond. Overhydration was not related to season (winter/autumn), gender or job category. Physical symptoms at the end of shift included tiredness (24%), toothache (13%) and headaches (10%) although these did not correlate to end of shift USG readings (p=0.221). The fluid requirements for male workers (n=8) who did not eat or drink across the shift was 439 ml per hour. The contractors were unaware of how much fluid should be supplied to workers and how much fluid they actually supplied. The only fluid provided by the contractors was water at the ambient air temperature which was the main source of fluid for the majority. Some forestry workers brought a limited variety of other fluids including amahewu, tea and cold drinks to work. At least 40% of the work force investigated, started their shift already compromised to work to capacity (USG>1.020 g/ml). The prevalence of dehydration had increased by the break emphasizing the need to begin drinking early on in the shift. The majority of forestry workers were dehydrated at the end of the shift. A significant proportion was dehydrated to the extent (>2%) that both work capacity and mental ability would be significantly compromised. A select group of forestry workers were drinking excessive amounts of fluid and were therefore susceptible to potentially fatal dilutional hyponatremia especially as water was the primary source of fluid. Dehydration in both autumn and winter was identified as being a significant but preventable risk. As a consequence of overhydration, a small group of forestry workers may be susceptible to dilutional hyponatremia. Fluid intake guidelines for males of 450 ml per hour appeared to be safe and were within the recommendations of the American College of Sports Medicine. Fluid guidelines for females need investigation.
Professional development of dietitians completing compulsory community service in South Africa with special focus on KwaZulu-Natal.
(2006) Paterson, Marie.; Green, Jannette Maryann.; Maunder, Eleni Maria Winifred.
Introduction: The aim of this research was to establish the attitudes, knowledge, job satisfaction and professional development of community service dietitians because negative attitudes, poor knowledge, low levels of job satisfaction and poor professional development would be detrimental to the process of community service and ultimately to the provision of health services. Methodology: Three distinct annual intakes of qualified dietitians completing compulsory community service were the subjects of an analytical cross sectional survey conducted biannually for the period 2003-2005. Data collection methods included telephone interviews, mail, emailed questionnaires and focus group discussions. Individual factors: sex, population group, language, university attended; institutional factors: organisation of community service, mentorship rating, hospital manager support type of facility, rural allowance, hospital location, access to resources, working and living conditions and personal safety and other factors: attitude, community nutrition knowledge, job satisfaction and professional development were included in the data set. Management of data: Data were divided into 2003 cohort (n=20) and 2004-2005 cohorts (n=26). Analysis of the demographic details for 2003 and 2004-2005 cohorts were, respectively: mean ages 23.6 (±0.99) and 24.05(±4.96) years, 60 percent and 73 percent white, 90 percent and 96 percent female, 35 percent and 73 percent University of KwaZulu-Natal graduates and 65 percent of both cohorts were placed in rural facilities. Results: Community nutrition knowledge of the 2003 cohort was unacceptable but improved in the 2004-2005 cohort. Subjects had a generally positive attitude towards community service. Community nutrition levels of knowledge of the 2003 ranged between 60 percent at entry and 67 percent at exit and for the 2004-2005 between 72.8 percent and 78.42 percent. The job satisfaction level of the 2003 cohort at exit was 13.65 (±3.573). In the 2004-2005 cohort job satisfaction was 15.75(±3.360) at entry and 15.75 (±3.360) at exit. 85 percent of the 2003 cohort rated their professional development positively whereas 65 percent of the 2004-2005 cohort rated theirs' positively. This decline and associated problems were to some extent shown in the interview responses. The 2004-2005 cohort did however show a tendency for improvement in the professional practitioner ranking (p=0.088). The majority (95%) of the 2004-2005 cohort rated the dietetic services positively. Focus group discussions highlighted problems that the community service dietitian (CSD) encountered such as lack of supervision and support, lack of basic facilities, poor hospital administration, problems with transport, work overload and problem with their professional role in the community and health facility. A model showing the results of the research indicated that the objectives of the Department of Health for improved service in rural areas were obtained but the retention of health professionals and capacity was lost due to annual rotation of subjects. Community service as a strategy to overcome service delivery has merit provided identified problems are addressed.
Situational assertiveness of South African registered dietitians.
(2000) Paterson, Marie.; Green, Jannette Maryann.; Basson, Clive James.; Ross, Fiona.
Female dominated professions are lower in status because occupational prestige is higher for men than for women in the science, maths and technology occupations (Farmer, Rotella, Anderson & Wardrop 1998). The female dominated professions are paid less and are viewed as less desirable and less worth (Atwater & Van Fleet 1997). It was hypothesised that the reason why dietetics as a female dominated profession had lower status and the other attributes of a female dominated profession could have been due to decreased levels of assertiveness and increased levels of anxiety when they were dealing with the male dominated professions such as the medical profession. It was theorised that a number of factors affected levels of anxiety and assertiveness and a model, developed from the literature, was presented to describe these effects. A random sample of female dietitians (n=321) and all male dietitians (n=29) who were registered with the Health Professionals Council of South Africa (HPCSA) at the beginning of 1999, were mailed questionnaires which contained questions on demographic information and self-assessment inventories. Of these one hundred and forty-five useable questionnaires from female (n=135) and male (n=10) dietitians were returned. Information received from the HPCSA and analysis of their register revealed that dietetics was a female dominated profession. Of the dietitians registered at the end of 1999(n=1260), 97%(n=1217) were females, and 3% (n= 34) were males. The majority of dietitians in the sample were Afrikaans speaking (n=73), and were from the highest socioeconomic group (n=74). The largest number(n=56) trained at the University of Pretoria. The average age of the dietitians was 32.4(±8.56). Almost a quarter of the sample had post registration qualifications (n=34). The majority had no formal training in assertiveness (n=92). The results of the inventories showed that dietitians had levels of assertiveness and anxiety that were within the norms as noted in the literature. This meant that the lower status of dietetics must be attributable to something else. Levels of self-efficacy were significantly higher than test levels quoted in the literature and this had a positive effect on the levels of assertiveness. Job satisfaction levels were significantly lower than American dentists. This was ascribed to poor pay, and difficulty in obtaining employment as a dietitian. None of the other factors tested for affected the level of assertiveness. An amended model Amended Factors Affecting Assertiveness using the findings of this research project has been presented. This is a simpler concept than the original model.
The use and interpretation of the nutrition information on the food label of selected fat spreads by female consumers aged 25-45 years, living in Pietermaritzburg.
(2006) Wiles, Nicola Laurelle.; Paterson, Marie.; Meaker, Jill.
Aim: To determine the use and interpretation of the nutrition information on the food label of selected fat spreads by female consumers aged 25 to 45 years, living in Pietermaritzburg. Objectives: This study set out to determine the following objectives regarding the food label: what the demographics of the consumers making use of the label were; how these consumers used the label and their motivation behind this label use and did the use of the label alter the purchase of that product? Method: One hundred and fifty women aged 25-45 years were chosen from an accidental, non-probability sample of consumers shopping at selected supermarkets within Pietermaritzburg. Respondents were presented with a four part questionnaire surrounding the purchase of selected fat spreads. Results: The greatest number of respondents were from the white population group (n = 65), followed by black respondents (n = 46), Indian respondents (n = 29) and then coloured respondents (n = 10). Results showed that the respondent who was most likely to use the nutrition information on the food label had a tertiary education; was a primary food purchaser, lived with other people, had more than R1000 a month to spend on food and was conscious of choosing the healthier option. Fifty five percent of this study sample (n = 82) claimed to use the nutrition information on the label to assist with purchases and 68% (n = 102) found the nutrition information important for purchasing a new product. Of the potential factors that have previously been found to impede the use of the nutrition information label:-inadequate print size, lack of education as well as lack of nutrition information on the food label were found to be factors restricting label use in this study. The most commonly used sources of nutrition information were the media as well as friends and family and the most trusted source was the Health Professional. Discussion: If the nutrition information is to be used both correctly and effectively, there must be a major educational campaign that sets out to meet the needs of the population that are most vulnerable, especially those with an inadequate education. Conclusion: The consumer most likely to use the nutrition information on the food label has a tertiary education, is a primary food purchaser with a large amount of money available for groceries and is conscious of choosing a healthier option. The label is most likely to be used when purchasing a fat spread for the first time.