Prevalence and Causes of Elective Surgical Cancellations: Findings from a Rural Tertiary Hospital in the Eastern Cape, South Africa
- Sukwana, Abongile, Mrara, Busisiwe, Oladimeji, Olanrewaju
- Authors: Sukwana, Abongile , Mrara, Busisiwe , Oladimeji, Olanrewaju
- Date: 2023/01
- Subjects: prevalence , cancellation , elective surgical procedure , rural tertiary hospital
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13271 , vital:78418 , DOI: https://doi.org/10.3390/healthcare11020270
- Description: Background: Cancellations of elective surgeries adversely affect the patient, hospital staff, facility, and health system. Cancellations potentially result in hospital financial losses, theatre inefficiency, and substandard patient care. A common benchmark for the cancellation rate of elective surgeries is less than five percent, and most operating rooms fall short of this standard. There is a paucity of data on the rates and causes of elective surgical cancellations in rural, resource-limited settings. This study aimed to determine the prevalence of elective surgery cancellations, the causes for such cancellations, and the surgical disciplines most affected at Nelson Mandela Academic Hospital (NMAH). Methodology: This was an observational, descriptive, cross-sectional review of operating theatre records from January 2019 to July 2019. The prevalence and main causes of elective case cancellations were determined. The causes were classified, and the most affected surgical departments and patient characteristics were identified. Results: The prevalence of elective surgical case cancellations was 14.4% in our hospital, higher than the international benchmark of 5%. Patient-, facility-, and surgical-related factors were the leading causes of cancellations, and avoidable cancellations were mostly surgical- and anaesthetic-related. Ophthalmology was the most affected, followed by gynaecology and general surgery, with plastic surgery being the least affected. The most common patient-related factors were nonattendance and uncontrolled medical conditions, while overbooking was the most common surgical reason. Abnormal investigatory results and unfit status were the most common anaesthetic reasons. Facility-related issues included the lack of theatre time, equipment scarcity or malfunction, and staff unavailability. Most cancellations were unavoidable, but with careful planning, could be avoided. Conclusion and recommendations: This study identified challenges with theatre efficiency in a rural, resource-limited setting that call for the cooperation of multidisciplinary teams of surgeons, anaesthetists, nursing staff, and health care policymakers.
- Full Text:
- Authors: Sukwana, Abongile , Mrara, Busisiwe , Oladimeji, Olanrewaju
- Date: 2023/01
- Subjects: prevalence , cancellation , elective surgical procedure , rural tertiary hospital
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13271 , vital:78418 , DOI: https://doi.org/10.3390/healthcare11020270
- Description: Background: Cancellations of elective surgeries adversely affect the patient, hospital staff, facility, and health system. Cancellations potentially result in hospital financial losses, theatre inefficiency, and substandard patient care. A common benchmark for the cancellation rate of elective surgeries is less than five percent, and most operating rooms fall short of this standard. There is a paucity of data on the rates and causes of elective surgical cancellations in rural, resource-limited settings. This study aimed to determine the prevalence of elective surgery cancellations, the causes for such cancellations, and the surgical disciplines most affected at Nelson Mandela Academic Hospital (NMAH). Methodology: This was an observational, descriptive, cross-sectional review of operating theatre records from January 2019 to July 2019. The prevalence and main causes of elective case cancellations were determined. The causes were classified, and the most affected surgical departments and patient characteristics were identified. Results: The prevalence of elective surgical case cancellations was 14.4% in our hospital, higher than the international benchmark of 5%. Patient-, facility-, and surgical-related factors were the leading causes of cancellations, and avoidable cancellations were mostly surgical- and anaesthetic-related. Ophthalmology was the most affected, followed by gynaecology and general surgery, with plastic surgery being the least affected. The most common patient-related factors were nonattendance and uncontrolled medical conditions, while overbooking was the most common surgical reason. Abnormal investigatory results and unfit status were the most common anaesthetic reasons. Facility-related issues included the lack of theatre time, equipment scarcity or malfunction, and staff unavailability. Most cancellations were unavoidable, but with careful planning, could be avoided. Conclusion and recommendations: This study identified challenges with theatre efficiency in a rural, resource-limited setting that call for the cooperation of multidisciplinary teams of surgeons, anaesthetists, nursing staff, and health care policymakers.
- Full Text:
A single centre study evaluating adherence to methotrexate monitoringguidelinesin patients with rheumatoid arthritis
- Authors: Genevieve, Olivier
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9690 , vital:74612
- Description: Introduction: Methotrexate (MTX) is considered a first-line agent for the treatment of rheumatoid arthritis (RA) and regular blood test monitoring is advised in treatment guidelines to identify potential toxicity. Failure to adhere to monitoring guidelines for methotrexate use may compromise patient care. Identifying and correcting variability in care may optimise the safe use of this medication and improve patient outcomes. Aims: This study aimed to evaluate adherence to guidelines on methotrexate safety monitoring in rheumatoid arthritis patients at an Eastern Cape hospital and to establish whether a dedicated rheumatology outpatient department (OPD) performs this task more effectively than a general medical outpatient department (MOPD). Method: This retrospective cross-sectional single-centre study was conducted at Frere Hospital in the Eastern Cape over one year from 1 January 2019 to 31 December 2019. Adult patients over the age of 18 years who received methotrexate for rheumatoid arthritis during the study period and attended either the rheumatology OPD or the MOPD at Frere Hospital were included in the study population. Permission to undertake this study was obtained through the Faculty of Health Sciences Research Ethics and Bio-safety Committee at Walter Sisulu University and the Cecilia Makiwane and Frere Hospitals Research and Ethics Committee. The random sample generator tool on Microsoft Excel was used to select patients from the Frere Hospital Pharmacy Database who was prescribed methotrexate for rheumatoid arthritis. Laboratory test results were accessed through the Labtrak system of the National Health Laboratory Service (NHLS). The number and type of blood test done as recommended in a South African Methotrexate use guideline by Hodkinson et al, was documented on a data collecting sheet. Two or more blood tests done within a three-to six month period was considered adherent to the guideline. The hospital management system version two (HMS2) was used to see which clinic the patient attended. iii Results: There was 53% adherence (95% Confidence Interval 42-65%) overall to guideline. In the study sample, 64% of patients were from Rheumatology OPD and the remainder were from MOPD. There was 78% (95% CI 62-89%) adherence in the Rheumatology OPD compared to 22% (95% CI 11-38%) in MOPD. No significant association was found between the number of FBC tests and the site of testing (p-value = 0.346) or for Creatinine tests (p-value = 0.078). However, a significant association was found with ALT tests and the site of testing (MOPD or rheumatology OPD) with p-value = 0.010, although this is likely a chance finding. Conclusion: Adherence to a South African guideline for methotrexate safety monitoring was found to be suboptimal at the study centre. Adherence was better in the dedicated Rheumatology OPD compared to a general medical OPD. Education regarding the correct use of guidelines in different health settings by medical professionals is advised. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
- Full Text:
- Authors: Genevieve, Olivier
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9690 , vital:74612
- Description: Introduction: Methotrexate (MTX) is considered a first-line agent for the treatment of rheumatoid arthritis (RA) and regular blood test monitoring is advised in treatment guidelines to identify potential toxicity. Failure to adhere to monitoring guidelines for methotrexate use may compromise patient care. Identifying and correcting variability in care may optimise the safe use of this medication and improve patient outcomes. Aims: This study aimed to evaluate adherence to guidelines on methotrexate safety monitoring in rheumatoid arthritis patients at an Eastern Cape hospital and to establish whether a dedicated rheumatology outpatient department (OPD) performs this task more effectively than a general medical outpatient department (MOPD). Method: This retrospective cross-sectional single-centre study was conducted at Frere Hospital in the Eastern Cape over one year from 1 January 2019 to 31 December 2019. Adult patients over the age of 18 years who received methotrexate for rheumatoid arthritis during the study period and attended either the rheumatology OPD or the MOPD at Frere Hospital were included in the study population. Permission to undertake this study was obtained through the Faculty of Health Sciences Research Ethics and Bio-safety Committee at Walter Sisulu University and the Cecilia Makiwane and Frere Hospitals Research and Ethics Committee. The random sample generator tool on Microsoft Excel was used to select patients from the Frere Hospital Pharmacy Database who was prescribed methotrexate for rheumatoid arthritis. Laboratory test results were accessed through the Labtrak system of the National Health Laboratory Service (NHLS). The number and type of blood test done as recommended in a South African Methotrexate use guideline by Hodkinson et al, was documented on a data collecting sheet. Two or more blood tests done within a three-to six month period was considered adherent to the guideline. The hospital management system version two (HMS2) was used to see which clinic the patient attended. iii Results: There was 53% adherence (95% Confidence Interval 42-65%) overall to guideline. In the study sample, 64% of patients were from Rheumatology OPD and the remainder were from MOPD. There was 78% (95% CI 62-89%) adherence in the Rheumatology OPD compared to 22% (95% CI 11-38%) in MOPD. No significant association was found between the number of FBC tests and the site of testing (p-value = 0.346) or for Creatinine tests (p-value = 0.078). However, a significant association was found with ALT tests and the site of testing (MOPD or rheumatology OPD) with p-value = 0.010, although this is likely a chance finding. Conclusion: Adherence to a South African guideline for methotrexate safety monitoring was found to be suboptimal at the study centre. Adherence was better in the dedicated Rheumatology OPD compared to a general medical OPD. Education regarding the correct use of guidelines in different health settings by medical professionals is advised. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
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An audit of patients with new onset stroke and associated barriers to thrombolysis of hyperacute strokesat a tertiary level hospital in the Eastern Cape
- Authors: Pasio, Roswyn Claire
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9891 , vital:74639
- Description: Globally and in South Africa stroke is a leading cause of morbidity and mortality. In 2006, the Joint World Congress of Stroke declared stroke a ‘catastrophic illness’ in South Africa. This declaration aims to focus the attention of policymakers on the impact of stroke and engage with them to intervene. Local stroke data is needed to make informed and relevant policy changes. Data is also required to start multi-level initiatives regarding stroke prevention and care. This study aims to analyse the demographic profile of stroke and assess the quality of stroke care using time-based performance measures at Livingstone Tertiary Hospital in the Eastern Cape. Methodology The study is a descriptive, retrospective chart review of patients presenting with an acute stroke to Livingstone Tertiary Hospital Emergency Department over a 12 month period. Demographic data, stroke risk factors, patient comorbidities and mode of transport were collated and analysed. Time parameters were used to ascertain delays within the stroke care pathway of patients and factors precluding patients from thrombolysis were identified. Results The study included 403 eligible patients, 54% of the patients of whom were female. The majority of those were of Mixed-race ethnicity (49%) and aged between 50 and 79 years. Hypertension (71%) was the most common comorbidity followed by smoking (31%) and diabetes mellitus (24%). The median time from onset of symptoms to presentation to hospital was 12 hours 23 minutes (I.Q 20hrs 34min). The average time from arrival to being III seen by a doctor was 1 hour 57 minutes (I.Q 1hr 59min) and the time from arrival to radiological imaging was 17 hours 6 minutes (I.Q. 8hrs 28min). 375 patients had radiological imaging, 58% (n=217) had evidence of an ischaemic stroke compared to 21% (n=80) who had signs of an intracranial haemorrhage. Of the study cohort, 99 (25%) of all stroke patients presented within the 4.5hr thrombolytic window, 68 (32%) of which were ischaemic strokes. However, in-hospital time delays precluded 35% of these patients from thrombolysis. A further 33% of patients had other contraindications to thrombolysis and 32% were not offered thrombolysis based on the clinical discretion of the doctor. Conclusion This study highlights the burden of stroke within Port Elizabeth, located in the Western Region of the Eastern Cape. Risk factor modification and disease control is imperative in reducing the prevalence and impact of stroke. The major precluding factor in stroke patients not being offered thrombolysis is a delay in arrival to hospital. Public education and awareness initiatives need to focus on addressing this issue. The clinical discretion of the treating physician significantly influences the decision to thrombolyse patients with an acute stroke. In-service training can address physicians’ perceptions regarding the benefits of thrombolysis as a treatment option. , Thesis (Masters) -- Faculty of Medicine and Health Sciences in brach of emergency medicine, 2023
- Full Text:
- Authors: Pasio, Roswyn Claire
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9891 , vital:74639
- Description: Globally and in South Africa stroke is a leading cause of morbidity and mortality. In 2006, the Joint World Congress of Stroke declared stroke a ‘catastrophic illness’ in South Africa. This declaration aims to focus the attention of policymakers on the impact of stroke and engage with them to intervene. Local stroke data is needed to make informed and relevant policy changes. Data is also required to start multi-level initiatives regarding stroke prevention and care. This study aims to analyse the demographic profile of stroke and assess the quality of stroke care using time-based performance measures at Livingstone Tertiary Hospital in the Eastern Cape. Methodology The study is a descriptive, retrospective chart review of patients presenting with an acute stroke to Livingstone Tertiary Hospital Emergency Department over a 12 month period. Demographic data, stroke risk factors, patient comorbidities and mode of transport were collated and analysed. Time parameters were used to ascertain delays within the stroke care pathway of patients and factors precluding patients from thrombolysis were identified. Results The study included 403 eligible patients, 54% of the patients of whom were female. The majority of those were of Mixed-race ethnicity (49%) and aged between 50 and 79 years. Hypertension (71%) was the most common comorbidity followed by smoking (31%) and diabetes mellitus (24%). The median time from onset of symptoms to presentation to hospital was 12 hours 23 minutes (I.Q 20hrs 34min). The average time from arrival to being III seen by a doctor was 1 hour 57 minutes (I.Q 1hr 59min) and the time from arrival to radiological imaging was 17 hours 6 minutes (I.Q. 8hrs 28min). 375 patients had radiological imaging, 58% (n=217) had evidence of an ischaemic stroke compared to 21% (n=80) who had signs of an intracranial haemorrhage. Of the study cohort, 99 (25%) of all stroke patients presented within the 4.5hr thrombolytic window, 68 (32%) of which were ischaemic strokes. However, in-hospital time delays precluded 35% of these patients from thrombolysis. A further 33% of patients had other contraindications to thrombolysis and 32% were not offered thrombolysis based on the clinical discretion of the doctor. Conclusion This study highlights the burden of stroke within Port Elizabeth, located in the Western Region of the Eastern Cape. Risk factor modification and disease control is imperative in reducing the prevalence and impact of stroke. The major precluding factor in stroke patients not being offered thrombolysis is a delay in arrival to hospital. Public education and awareness initiatives need to focus on addressing this issue. The clinical discretion of the treating physician significantly influences the decision to thrombolyse patients with an acute stroke. In-service training can address physicians’ perceptions regarding the benefits of thrombolysis as a treatment option. , Thesis (Masters) -- Faculty of Medicine and Health Sciences in brach of emergency medicine, 2023
- Full Text:
Appraising the sustainability of groud water quantity and quality
- Authors: Mkosana, Kululwa
- Date: 2023-00
- Subjects: Geography
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9398 , vital:73516
- Description: South Africa is a semi-arid region that suffers from water scarcity. With a changing climate, incidents such as droughts and human migration will exacerbate the water scarcity already experienced. Thus, the assessment of groundwater quality and quantity is a major step toward ensuring a viable sustainable water argumentation for general use and to serve as one of the most basic needs of human beings. Hence, this study appraises the sustainability of groundwater resource availability and assesses its water quality at the King Sabatha Dalindyebo Local Municipality within the Mthatha River Catchment (MRC). The objectives were to: i) examine the extent of groundwater potential in the area ii) investigate the determinant factors that characterized the groundwater and surface water interaction and assess the impacts of climatic variables on yield iii) compare the physico-chemical and microbial concentration samples collected at different boreholes in the MRC with respect to South African and World Health Organization (WHO) standards and iv) develop the temporal variation trend in modeling the groundwater quality parameters. Using a systematic sampling method, a preliminary survey was carried out to identify the location and selection of the appropriate boreholes’ representation. Thereafter, reconnaissance map and characterisation of the 10 selected borehole's location was made to spatially represent the sites. The water samples were made thrice per site (totally 30 samples). The collected samples were transported to Talbot and Talbot Laboratory, where they were analysed for their physico-chemical and bacteriological parameters using established procedures. Other parameters such as depth of hole, water level, borehole yield, abstraction rate, the screen length, drawdown, morphometry, geological, land-use variables, were generated after rigorous geographical information system (GIS) analysis in QGIS environment and Excel in achieving the study aims. The Soil and Water Assessment Tool (SWAT) model was used for the estimation of the groundwater flow or baseflow drawing strength from the hydraulic conductivity of the aquifer flow (Ksat) (mm/day), sub-basin divide for the groundwater system to the main channel Lgw (m), and the water table height (m). Thereafter, the principal iv component analysis, multiple linear regression analysis, and correlation analysis were used to assess the controlling factors for the spatial variation of recharge in the watershed characteristics and assess the impacts of climatic variables on groundwater yield. The simulated results revealed a mean monthly water yield range of 2.7-14.8 m3/s for groundwater over the study years (2000-2019). The development of temporal variation trend modeling of the physico-chemical composition of the groundwater varied from one borehole to another despite their proximity, thus, making it difficult to generalise the water quality parameters fluctuation. The water quality results showed that the majority of the variables are not within acceptable standards. Ammonia and total coliform levels depict a range between 1.5 mg/l minimum to 10 mg/l maximum with to 1000 counts/mL for total coliform. Also, there was no clear relationship between the location of the boreholes and the borehole yield among the selected samples. However, there was a significant difference between the borehole yield and the risk description matrix for the various water quality parameters. Most of the borehole water quality depicts a non-health aesthetic, acute health, and disinfectant status for the area. Keywords: Water scarcity, groundwater, seasonal variability, aquifer scale , Thesis (Masters) -- Faculty of Natural Sciences, 2023
- Full Text:
- Authors: Mkosana, Kululwa
- Date: 2023-00
- Subjects: Geography
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9398 , vital:73516
- Description: South Africa is a semi-arid region that suffers from water scarcity. With a changing climate, incidents such as droughts and human migration will exacerbate the water scarcity already experienced. Thus, the assessment of groundwater quality and quantity is a major step toward ensuring a viable sustainable water argumentation for general use and to serve as one of the most basic needs of human beings. Hence, this study appraises the sustainability of groundwater resource availability and assesses its water quality at the King Sabatha Dalindyebo Local Municipality within the Mthatha River Catchment (MRC). The objectives were to: i) examine the extent of groundwater potential in the area ii) investigate the determinant factors that characterized the groundwater and surface water interaction and assess the impacts of climatic variables on yield iii) compare the physico-chemical and microbial concentration samples collected at different boreholes in the MRC with respect to South African and World Health Organization (WHO) standards and iv) develop the temporal variation trend in modeling the groundwater quality parameters. Using a systematic sampling method, a preliminary survey was carried out to identify the location and selection of the appropriate boreholes’ representation. Thereafter, reconnaissance map and characterisation of the 10 selected borehole's location was made to spatially represent the sites. The water samples were made thrice per site (totally 30 samples). The collected samples were transported to Talbot and Talbot Laboratory, where they were analysed for their physico-chemical and bacteriological parameters using established procedures. Other parameters such as depth of hole, water level, borehole yield, abstraction rate, the screen length, drawdown, morphometry, geological, land-use variables, were generated after rigorous geographical information system (GIS) analysis in QGIS environment and Excel in achieving the study aims. The Soil and Water Assessment Tool (SWAT) model was used for the estimation of the groundwater flow or baseflow drawing strength from the hydraulic conductivity of the aquifer flow (Ksat) (mm/day), sub-basin divide for the groundwater system to the main channel Lgw (m), and the water table height (m). Thereafter, the principal iv component analysis, multiple linear regression analysis, and correlation analysis were used to assess the controlling factors for the spatial variation of recharge in the watershed characteristics and assess the impacts of climatic variables on groundwater yield. The simulated results revealed a mean monthly water yield range of 2.7-14.8 m3/s for groundwater over the study years (2000-2019). The development of temporal variation trend modeling of the physico-chemical composition of the groundwater varied from one borehole to another despite their proximity, thus, making it difficult to generalise the water quality parameters fluctuation. The water quality results showed that the majority of the variables are not within acceptable standards. Ammonia and total coliform levels depict a range between 1.5 mg/l minimum to 10 mg/l maximum with to 1000 counts/mL for total coliform. Also, there was no clear relationship between the location of the boreholes and the borehole yield among the selected samples. However, there was a significant difference between the borehole yield and the risk description matrix for the various water quality parameters. Most of the borehole water quality depicts a non-health aesthetic, acute health, and disinfectant status for the area. Keywords: Water scarcity, groundwater, seasonal variability, aquifer scale , Thesis (Masters) -- Faculty of Natural Sciences, 2023
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Arterial stiffness in pregnant women with preeclampsia and HIV infection at Nelson Mandela Academic Hospital
- Authors: Flatela, Mlungisi
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9832 , vital:74631
- Description: Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
- Full Text:
- Authors: Flatela, Mlungisi
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9832 , vital:74631
- Description: Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
- Full Text:
Attitudes and barriers towards HIV testing services among males aged between 15-49 years at Mzamomhle Township: Buffalo City Metropolitan Municipality
- Authors: Mantashe, Zintle
- Date: 2023-00
- Subjects: Public Health
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9753 , vital:74617
- Description: This study delves into the attitudes and obstacles surrounding HIV Testing Services (HTS) among males aged 15 to 49 in Mzamomhle Township, Buffalo City Metropolitan Municipality, South Africa. HIV/AIDS prevalence remains a significant concern, especially in sub-Saharan Africa. Employing a mixed-methods approach with questionnaires and interviews, data was gathered from 106 participants. The findings highlight a range of challenges that impede the accessibility of HTS. These challenges include stigma, concerns about privacy, fears related to testing, limited knowledge, and negative attitudes of staff towards HTS. Despite these challenges, the study reveals that participants generally hold positive attitudes towards HTS. However, there are doubts regarding the efficacy of testing in preventing the transmission of HIV. Privacy concerns emerge prominently, with participants fearing that their status might be disclosed. Stigma also acts as a barrier, as individuals fear potential embarrassment if their status becomes known. To address these issues, several recommendations are proposed. These include the establishment of robust support systems, educational campaigns to empower individuals with knowledge about HTS benefits, and community initiatives to combat negative attitudes towards testing. Furthermore, enhancing healthcare worker training and raising political awareness can contribute to creating a more favourable environment for HTS utilisation. By implementing these recommendations, South Africa can work towards dismantling the barriers that hinder HIV testing and promoting a proactive culture of health-seeking behaviour among men. This effort is essential for reducing HIV transmission rates and achieving global health targets. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
- Full Text:
- Authors: Mantashe, Zintle
- Date: 2023-00
- Subjects: Public Health
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9753 , vital:74617
- Description: This study delves into the attitudes and obstacles surrounding HIV Testing Services (HTS) among males aged 15 to 49 in Mzamomhle Township, Buffalo City Metropolitan Municipality, South Africa. HIV/AIDS prevalence remains a significant concern, especially in sub-Saharan Africa. Employing a mixed-methods approach with questionnaires and interviews, data was gathered from 106 participants. The findings highlight a range of challenges that impede the accessibility of HTS. These challenges include stigma, concerns about privacy, fears related to testing, limited knowledge, and negative attitudes of staff towards HTS. Despite these challenges, the study reveals that participants generally hold positive attitudes towards HTS. However, there are doubts regarding the efficacy of testing in preventing the transmission of HIV. Privacy concerns emerge prominently, with participants fearing that their status might be disclosed. Stigma also acts as a barrier, as individuals fear potential embarrassment if their status becomes known. To address these issues, several recommendations are proposed. These include the establishment of robust support systems, educational campaigns to empower individuals with knowledge about HTS benefits, and community initiatives to combat negative attitudes towards testing. Furthermore, enhancing healthcare worker training and raising political awareness can contribute to creating a more favourable environment for HTS utilisation. By implementing these recommendations, South Africa can work towards dismantling the barriers that hinder HIV testing and promoting a proactive culture of health-seeking behaviour among men. This effort is essential for reducing HIV transmission rates and achieving global health targets. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
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Critical analysis of the role played by izidlalo zabafazi in amaXhosa women’s psycho-socio health
- Authors: Wayise, Siphenkosi
- Date: 2023-00
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10913 , vital:75665
- Description: African tribes have found that traditional songs are one of the most crucial factors in fostering cohesion, solidarity and communication between physical and non-physical entities as well as knowledge of culture and cultural activities. Traditional women's songs, or izidlalo zabafazi, are amongst the most potent tools utilized by the AmaXhosa tribe. Women mostly use these songs to communicate their emotions about various situations. Before Westernization had an impact, women used izidlalo zabafazi to talk about and deal with terrible times and challenging circumstances, such as verbal, emotional, physical and all other forms of abuse experienced by them. This indicates that these songs were especially important in providing a platform for women to express themselves by singing, acting and reacting to their many struggles. Since women today also experience many difficulties, particularly those that have an emotional impact on them, this prompted the researcher to investigate whether the significance of these songs can be exposed as a traditional platform where women can express themselves about their marital matters and be viewed as traditional therapeutic systems to be used by AmaXhosa women even in our day and age. The study employs two theoretical frameworks to accomplish this investigation: the psychoanalytic theory, which examines the psychological effects of izidlalo zabafazi on amaXhosa women; and the African feminism theory, which emphasizes the equalization of power and authority between the sexes and asserts that women should not be subservient to men and that they have a voice, even in patriarchal societies. Using a textual analysis approach, a selection of songs from various available sources, including books, papers, YouTube, tik-tok and Facebook, have been examined. Their therapeutic effect has unraveled the influence on the psychological well-being of women. The study indicates that it is highly effective in promoting mental recuperation, especially for adherents of izidlalo zabafazi. This has led to the notion that izidlalo zabafazi have an impact on the psychological well-being of amaXhosa women. , Thesis (Masters) -- Faculty of Law, Humanities and Social Science, 2023
- Full Text:
- Authors: Wayise, Siphenkosi
- Date: 2023-00
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10913 , vital:75665
- Description: African tribes have found that traditional songs are one of the most crucial factors in fostering cohesion, solidarity and communication between physical and non-physical entities as well as knowledge of culture and cultural activities. Traditional women's songs, or izidlalo zabafazi, are amongst the most potent tools utilized by the AmaXhosa tribe. Women mostly use these songs to communicate their emotions about various situations. Before Westernization had an impact, women used izidlalo zabafazi to talk about and deal with terrible times and challenging circumstances, such as verbal, emotional, physical and all other forms of abuse experienced by them. This indicates that these songs were especially important in providing a platform for women to express themselves by singing, acting and reacting to their many struggles. Since women today also experience many difficulties, particularly those that have an emotional impact on them, this prompted the researcher to investigate whether the significance of these songs can be exposed as a traditional platform where women can express themselves about their marital matters and be viewed as traditional therapeutic systems to be used by AmaXhosa women even in our day and age. The study employs two theoretical frameworks to accomplish this investigation: the psychoanalytic theory, which examines the psychological effects of izidlalo zabafazi on amaXhosa women; and the African feminism theory, which emphasizes the equalization of power and authority between the sexes and asserts that women should not be subservient to men and that they have a voice, even in patriarchal societies. Using a textual analysis approach, a selection of songs from various available sources, including books, papers, YouTube, tik-tok and Facebook, have been examined. Their therapeutic effect has unraveled the influence on the psychological well-being of women. The study indicates that it is highly effective in promoting mental recuperation, especially for adherents of izidlalo zabafazi. This has led to the notion that izidlalo zabafazi have an impact on the psychological well-being of amaXhosa women. , Thesis (Masters) -- Faculty of Law, Humanities and Social Science, 2023
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Effects of the timing of initiation of maternal anti-retroviral therapy, cd4 count and viral load on birth out comes in South Africa
- Authors: Siqithi, Sisanda
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9849 , vital:74633
- Description: Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
- Full Text:
- Authors: Siqithi, Sisanda
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9849 , vital:74633
- Description: Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
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Efffectiveness of using the strategy instructions approach (SIA) in teaching reading comprehension: A stud of selected schools in the Amathole East District
- Authors: Senye-Awudi, Patrick Kwabla
- Date: 2023-00
- Subjects: Direct Marketing
- Language: English
- Type: Strategy instructions approach (SIA) , text
- Identifier: http://hdl.handle.net/11260/10747 , vital:75216
- Description: This study sought to explore the effectiveness of using the strategy instructions approach (SIA) to teaching reading comprehension. This research was necessitated by the fact that most South African children do not perform well when it comes to reading comprehension. Many researchers from the literature, such as Rule (2017) and Pretorius and Klapwijk (2016), revealed that most language teachers, especially English First Additional Language teachers, do not have adequate skills to teach learners reading comprehension effectively. Even though in the Curriculum and Assessment Policy Statement (CAPS) document, which should serve as the ultimate guide for teaching English, some strategies are clearly spelt out to be used to teach reading comprehension, the teachers do not use them. This study used the SIA, which contains some of those strategies in the CAPS documents to teach the reading comprehension to grade 8 learners in Elliotdale CMC in the Amathole East District of the Eastern Cape of the Republic of South Africa. The study also sought to find out if SIA could develop positive attitudes and autonomy in the learners towards reading comprehension. The constructivist theory of learning and the schema theory of teaching reading comprehension were the two theories that underpinned the study. A control group and an experimental group (sampled from three schools) were used to determine the effectiveness of SIA when compared to the traditional teaching approaches used by teachers to teach reading comprehension. The study revealed that the use of SIA to teach reading comprehension developed positive attitudes and autonomy in reading comprehension. Finally, SIA has become effective to increase the performance of learners in reading comprehension. The study recommends that teachers should be trained in the higher institutions to use SIA to teach reading comprehension and teachers in the field should be developed to learn how to use the strategies to teach reading comprehension. In addition, more hours should be allocated on the school timetables for teaching reading comprehension. Finally, more reading materials, together with more reading activities, should be given to learners in the schools, especially schools in the rural areas. , Thesis (Masters) -- Faculty of Education, 2023
- Full Text:
- Authors: Senye-Awudi, Patrick Kwabla
- Date: 2023-00
- Subjects: Direct Marketing
- Language: English
- Type: Strategy instructions approach (SIA) , text
- Identifier: http://hdl.handle.net/11260/10747 , vital:75216
- Description: This study sought to explore the effectiveness of using the strategy instructions approach (SIA) to teaching reading comprehension. This research was necessitated by the fact that most South African children do not perform well when it comes to reading comprehension. Many researchers from the literature, such as Rule (2017) and Pretorius and Klapwijk (2016), revealed that most language teachers, especially English First Additional Language teachers, do not have adequate skills to teach learners reading comprehension effectively. Even though in the Curriculum and Assessment Policy Statement (CAPS) document, which should serve as the ultimate guide for teaching English, some strategies are clearly spelt out to be used to teach reading comprehension, the teachers do not use them. This study used the SIA, which contains some of those strategies in the CAPS documents to teach the reading comprehension to grade 8 learners in Elliotdale CMC in the Amathole East District of the Eastern Cape of the Republic of South Africa. The study also sought to find out if SIA could develop positive attitudes and autonomy in the learners towards reading comprehension. The constructivist theory of learning and the schema theory of teaching reading comprehension were the two theories that underpinned the study. A control group and an experimental group (sampled from three schools) were used to determine the effectiveness of SIA when compared to the traditional teaching approaches used by teachers to teach reading comprehension. The study revealed that the use of SIA to teach reading comprehension developed positive attitudes and autonomy in reading comprehension. Finally, SIA has become effective to increase the performance of learners in reading comprehension. The study recommends that teachers should be trained in the higher institutions to use SIA to teach reading comprehension and teachers in the field should be developed to learn how to use the strategies to teach reading comprehension. In addition, more hours should be allocated on the school timetables for teaching reading comprehension. Finally, more reading materials, together with more reading activities, should be given to learners in the schools, especially schools in the rural areas. , Thesis (Masters) -- Faculty of Education, 2023
- Full Text:
Exploring teachers’ classroom management strategies to enhance teaching and learning in Gauteng Province
- Authors: Mamaila, Dineo
- Date: 2023-00
- Subjects: Education
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10556 , vital:75187
- Description: Classroom management strategies in teaching and learning are still a challenge in most high schools. The study investigates how classroom management strategies can be enhanced towards effective teaching and learning in Gauteng Province, South Africa. The research is lenses within an interpretive paradigm and was conducted using a qualitative approach, and a case study research design was employed. The study employed purposive sampling to select relevant participants from high schools. The participants consisted of twelve teachers from three chosen schools in Gauteng Province in the Ekurhuleni North District. Each school had four teachers as participants, making a total of twelve participants. Semi-structured interviews were conducted to elicit information from the participants. Content analysis was applied to analyze and evaluate the data from the conducted semi-structured interviews. The findings were as follows: teachers' ineffectiveness affects classroom management, especially when there is a lack of planning, poor time management, and poor relationship between the learners and teachers. It is suggested that teachers need to take charge of knowing what roles to play, such as being the controller, assessor, and organizer in the classroom setting. Recommendations were made to address the implementation of classroom management strategies in the classroom, whereby active teaching and learning need to take place in the schools. Therefore, it is possible for teachers to successfully implement classroom management by always being flexible, such as being able to read the classroom environment, implementing necessary discipline measures without attracting attention to themselves or interrupting the class session, and prioritizing professionalism always. , Thesis (Masters) -- Faculty of Education, 2023
- Full Text:
- Authors: Mamaila, Dineo
- Date: 2023-00
- Subjects: Education
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10556 , vital:75187
- Description: Classroom management strategies in teaching and learning are still a challenge in most high schools. The study investigates how classroom management strategies can be enhanced towards effective teaching and learning in Gauteng Province, South Africa. The research is lenses within an interpretive paradigm and was conducted using a qualitative approach, and a case study research design was employed. The study employed purposive sampling to select relevant participants from high schools. The participants consisted of twelve teachers from three chosen schools in Gauteng Province in the Ekurhuleni North District. Each school had four teachers as participants, making a total of twelve participants. Semi-structured interviews were conducted to elicit information from the participants. Content analysis was applied to analyze and evaluate the data from the conducted semi-structured interviews. The findings were as follows: teachers' ineffectiveness affects classroom management, especially when there is a lack of planning, poor time management, and poor relationship between the learners and teachers. It is suggested that teachers need to take charge of knowing what roles to play, such as being the controller, assessor, and organizer in the classroom setting. Recommendations were made to address the implementation of classroom management strategies in the classroom, whereby active teaching and learning need to take place in the schools. Therefore, it is possible for teachers to successfully implement classroom management by always being flexible, such as being able to read the classroom environment, implementing necessary discipline measures without attracting attention to themselves or interrupting the class session, and prioritizing professionalism always. , Thesis (Masters) -- Faculty of Education, 2023
- Full Text:
Health capital and labour productivity in selected Southern African Development Community (SADC) Countries
- Authors: Mafunda, Lihle Andiswa
- Date: 2023-00
- Subjects: Masters of commerce
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10116 , vital:74937
- Description: Health plays a critical role in economic development, as it directly affects productivity and ultimately leads to higher per capita income. Within the Southern African Development Community (SADC) countries, health capital has immense significance for labour productivity, serving as a catalyst for growth. This study investigated the relationship between health capital and labour productivity in selected SADC countries from 2000 to 2020, with the chosen period primarily based on data availability and coverage for the selected countries during this timeframe. To accomplish this, the study employed the panel autoregressive distributed lag (ARDL) models and techniques, which leverage the advantages of panel data and ARDL models, enabling the analysis of both short-run and long-run relationships, providing a comprehensive understanding of the dynamics between variables over time. The data for the study period was obtained from a single reliable source, The Global Economy, ensuring credibility. The primary finding from the pooled mean group (PMG) estimator indicates a positive and significant relationship between health capital and labour productivity in the short run, suggesting that investments in healthcare can boost productivity. However, contrary to the expected theory and prior assumptions, the long-run findings reveal a negative and significant relationship. This discrepancy highlights the complexity of the health-productivity relationship and necessitates further investigation to comprehend the underlying mechanisms and design effective policy interventions. Policymakers must carefully consider these mixed findings and tailor their strategies accordingly to promote both health and productivity in the long term. It is crucial to strike a balance between immediate gains and sustainable long-term outcomes. , Thesis (Masters) -- Faculty of Economics and Financial Sciences, 2023
- Full Text:
- Authors: Mafunda, Lihle Andiswa
- Date: 2023-00
- Subjects: Masters of commerce
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10116 , vital:74937
- Description: Health plays a critical role in economic development, as it directly affects productivity and ultimately leads to higher per capita income. Within the Southern African Development Community (SADC) countries, health capital has immense significance for labour productivity, serving as a catalyst for growth. This study investigated the relationship between health capital and labour productivity in selected SADC countries from 2000 to 2020, with the chosen period primarily based on data availability and coverage for the selected countries during this timeframe. To accomplish this, the study employed the panel autoregressive distributed lag (ARDL) models and techniques, which leverage the advantages of panel data and ARDL models, enabling the analysis of both short-run and long-run relationships, providing a comprehensive understanding of the dynamics between variables over time. The data for the study period was obtained from a single reliable source, The Global Economy, ensuring credibility. The primary finding from the pooled mean group (PMG) estimator indicates a positive and significant relationship between health capital and labour productivity in the short run, suggesting that investments in healthcare can boost productivity. However, contrary to the expected theory and prior assumptions, the long-run findings reveal a negative and significant relationship. This discrepancy highlights the complexity of the health-productivity relationship and necessitates further investigation to comprehend the underlying mechanisms and design effective policy interventions. Policymakers must carefully consider these mixed findings and tailor their strategies accordingly to promote both health and productivity in the long term. It is crucial to strike a balance between immediate gains and sustainable long-term outcomes. , Thesis (Masters) -- Faculty of Economics and Financial Sciences, 2023
- Full Text:
Infuence of green marketing mix on sustainable consumption and customer loyalty in Polokwane, South Africa
- Authors: Chiwenga, Lillian
- Date: 2023-00
- Subjects: Retail Green Marketing
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9948 , vital:74929
- Description: Marketers throughout all industries are investing enormously towards developing and promoting green products and the retail sector is not exempted from this growing trend. The study aimed to investigate the influence of green marketing mix elements (green product, green price, green promotion and green distribution or place) on sustainable consumption and customer loyalty. To achieve the objective, the research study employed a positivist research paradigm anchored by a quantitative approach using descriptive research design. A structured self-administered survey questionnaire was randomly distributed to retail customers of a sample size of 265 respondents. The data was analysed using SPSS for descriptive statistics and Smart PLS for Structural equation modelling. The key findings reveal that all five hypothesised relationships are positive, however, only four are significant. The strongest relationship was found between sustainable consumption and customer loyalty (β=0.432) while the weakest (yet positive) relationship was between green place and sustainable consumption (β=0.078). The study equips the retailers about the key predictors of consumers’ green sustainable consumption behaviour enabling them to tailor their product offerings and formulate marketing strategies to encourage green buying behaviour. The current study can further assists policymakers to ground their discussions when developing regulations that govern how retail industries should promote, price and distribute their green products. , Thesis (Masters) -- Faculty of Economics and financial Sciences, 2023
- Full Text:
- Authors: Chiwenga, Lillian
- Date: 2023-00
- Subjects: Retail Green Marketing
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9948 , vital:74929
- Description: Marketers throughout all industries are investing enormously towards developing and promoting green products and the retail sector is not exempted from this growing trend. The study aimed to investigate the influence of green marketing mix elements (green product, green price, green promotion and green distribution or place) on sustainable consumption and customer loyalty. To achieve the objective, the research study employed a positivist research paradigm anchored by a quantitative approach using descriptive research design. A structured self-administered survey questionnaire was randomly distributed to retail customers of a sample size of 265 respondents. The data was analysed using SPSS for descriptive statistics and Smart PLS for Structural equation modelling. The key findings reveal that all five hypothesised relationships are positive, however, only four are significant. The strongest relationship was found between sustainable consumption and customer loyalty (β=0.432) while the weakest (yet positive) relationship was between green place and sustainable consumption (β=0.078). The study equips the retailers about the key predictors of consumers’ green sustainable consumption behaviour enabling them to tailor their product offerings and formulate marketing strategies to encourage green buying behaviour. The current study can further assists policymakers to ground their discussions when developing regulations that govern how retail industries should promote, price and distribute their green products. , Thesis (Masters) -- Faculty of Economics and financial Sciences, 2023
- Full Text:
Investigating the determinants of economics growth in South Africa
- Authors: Dudumashe, Nomsindisi
- Date: 2023-00
- Subjects: Economic growth determinants in South Africa
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9986 , vital:74931
- Description: Economic growth is regarded as one of the prime macroeconomic objectives of any economy. The study aimed to investigate the determinants of economic growth in South Africa for the period 1994 to 2021 using yearly data obtained from World Bank and IMF. The analysis of all the variables has been provided to show the relationship that the variables have with economic growth in the South African economy. The independent variables used were capital stock, financial development, employment and inflation. In achieving this aim, an Autoregressive Distributive Lag (ARDL) was used since it examines both the short-term and the long-term dynamics of the determinants of economic growth. In addition, Granger causality was used to determine whether the explored variables were causally related to one another. In the long run, the results point out that financial development was significant at 5%, while capital stock and employment were significant at 10%. In the short run, all variables were significant at 1%. The study recommends employment stimulation, investment in capital stock and financial development in order to boost economic growth. , Thesis (Masters) -- Faculty of Economics and Financial Sciences, 2023
- Full Text:
- Authors: Dudumashe, Nomsindisi
- Date: 2023-00
- Subjects: Economic growth determinants in South Africa
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9986 , vital:74931
- Description: Economic growth is regarded as one of the prime macroeconomic objectives of any economy. The study aimed to investigate the determinants of economic growth in South Africa for the period 1994 to 2021 using yearly data obtained from World Bank and IMF. The analysis of all the variables has been provided to show the relationship that the variables have with economic growth in the South African economy. The independent variables used were capital stock, financial development, employment and inflation. In achieving this aim, an Autoregressive Distributive Lag (ARDL) was used since it examines both the short-term and the long-term dynamics of the determinants of economic growth. In addition, Granger causality was used to determine whether the explored variables were causally related to one another. In the long run, the results point out that financial development was significant at 5%, while capital stock and employment were significant at 10%. In the short run, all variables were significant at 1%. The study recommends employment stimulation, investment in capital stock and financial development in order to boost economic growth. , Thesis (Masters) -- Faculty of Economics and Financial Sciences, 2023
- Full Text:
Knowledge, Attitudes and Perceptions of Breaking Bad News Among Paediatric Doctors in a South African Hospital
- Authors: Thaver, Linesri
- Date: 2023-00
- Subjects: Paediatrics and Child Health
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/12709 , vital:76151
- Description: Breaking bad news to patients is a difficult but regular task for doctors in clinical practice (Alshami et al. 2020). In paediatrics, doctors have the additional complexity of communicating difficult information with their young patients and their families (Mǎrginean et al. 2017). Despite this essential skill, clinicians are inadequately prepared, which can contribute to poor patient satisfaction and outcomes, litigation and negatively impact the treating clinician (Brown et al. 2009; Alshami et al. 2020). Aim: The study aimed to assess the knowledge regarding breaking bad news, as well as the attitude and perceptions towards breaking bad news among doctors working in the paediatric department at Dora Nginza Hospital, a regional teaching hospital in Gqeberha, South Africa, and compare the findings to the international literature. Approach: A mixed methods knowledge, attitudes and perceptions study using a self-administered questionnaire was conducted at the paediatric department at Dora Nginza Hospital. The survey population ranged from junior doctors to senior specialist paediatricians in the department. Data were analysed using descriptive statistics and compared to literature available from similar international studies. Impact of study: Despite the importance of this topic, there are limited studies based in South Africa and specifically in paediatrics, which creates a unique context for this study. The setting of Dora Nginza Hospital, with its diverse cultural background of both doctors and patients, provides vital insight into the local 3 challenges of breaking bad news in this context. The further impact of the predominantly junior staff in an overburdened system and the strategies implemented to break bad news in this context provided useful information to adapt protocols to be utilised in this setting. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
- Full Text:
- Authors: Thaver, Linesri
- Date: 2023-00
- Subjects: Paediatrics and Child Health
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/12709 , vital:76151
- Description: Breaking bad news to patients is a difficult but regular task for doctors in clinical practice (Alshami et al. 2020). In paediatrics, doctors have the additional complexity of communicating difficult information with their young patients and their families (Mǎrginean et al. 2017). Despite this essential skill, clinicians are inadequately prepared, which can contribute to poor patient satisfaction and outcomes, litigation and negatively impact the treating clinician (Brown et al. 2009; Alshami et al. 2020). Aim: The study aimed to assess the knowledge regarding breaking bad news, as well as the attitude and perceptions towards breaking bad news among doctors working in the paediatric department at Dora Nginza Hospital, a regional teaching hospital in Gqeberha, South Africa, and compare the findings to the international literature. Approach: A mixed methods knowledge, attitudes and perceptions study using a self-administered questionnaire was conducted at the paediatric department at Dora Nginza Hospital. The survey population ranged from junior doctors to senior specialist paediatricians in the department. Data were analysed using descriptive statistics and compared to literature available from similar international studies. Impact of study: Despite the importance of this topic, there are limited studies based in South Africa and specifically in paediatrics, which creates a unique context for this study. The setting of Dora Nginza Hospital, with its diverse cultural background of both doctors and patients, provides vital insight into the local 3 challenges of breaking bad news in this context. The further impact of the predominantly junior staff in an overburdened system and the strategies implemented to break bad news in this context provided useful information to adapt protocols to be utilised in this setting. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
- Full Text:
Load shedding and performance of small-scale resturants in Mthatha, South Africa
- Authors: Matangayi, Lelethu
- Date: 2023-00
- Subjects: Economics and commerce
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10346 , vital:74969
- Description: Small businesses in South Africa are recognized for creating jobs and increasing economic growth. Ever since South Africa experienced load shedding in 2008, small businesses, especially those in the restaurant sector, have been hugely affected by load shedding as they heavily rely on electricity for most of their business operations. Load shedding results in a loss of sales and a decrease in productivity, which reduces their profitability and eventually, sustainability. The purpose of the study was to establish the extent to which load shedding affects the performance of small-scale restaurants in Mthatha, South Africa. A positivist research paradigm was adopted for the study, which was anchored on a quantitative approach using an explanatory research design. A fully structured self-administered questionnaire was sent to 53 small-scale restaurant owners or managers and 51 responded. Data analyzed using SmartPLS4 revealed that load shedding has a negative but insignificant impact on both the profitability and productivity of small-scale restaurants. Based on the results load shedding does not impact the performance of small-scale restaurants in Mthatha as both performance proxies showed a statistically insignificant impact. Looking at the current situation of electricity in South Africa, things are getting worse as it is common for Mthatha people to go the entire day without electricity. This study helps in identifying the extent of the effects load shedding has on small-scale restaurants. This study adds to the findings of prior research on the effects of load shedding on the performance of small-scale restaurants and the study contributed to the body of iii knowledge on the effects of load shedding on the performance of small-scale restaurants and mitigates on existing literature gap where the populace is not aware of the extent to which load shedding has affected the performance of small-scale restaurants. , Faculty of Economics and Financial Sciences, 2023
- Full Text:
- Authors: Matangayi, Lelethu
- Date: 2023-00
- Subjects: Economics and commerce
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10346 , vital:74969
- Description: Small businesses in South Africa are recognized for creating jobs and increasing economic growth. Ever since South Africa experienced load shedding in 2008, small businesses, especially those in the restaurant sector, have been hugely affected by load shedding as they heavily rely on electricity for most of their business operations. Load shedding results in a loss of sales and a decrease in productivity, which reduces their profitability and eventually, sustainability. The purpose of the study was to establish the extent to which load shedding affects the performance of small-scale restaurants in Mthatha, South Africa. A positivist research paradigm was adopted for the study, which was anchored on a quantitative approach using an explanatory research design. A fully structured self-administered questionnaire was sent to 53 small-scale restaurant owners or managers and 51 responded. Data analyzed using SmartPLS4 revealed that load shedding has a negative but insignificant impact on both the profitability and productivity of small-scale restaurants. Based on the results load shedding does not impact the performance of small-scale restaurants in Mthatha as both performance proxies showed a statistically insignificant impact. Looking at the current situation of electricity in South Africa, things are getting worse as it is common for Mthatha people to go the entire day without electricity. This study helps in identifying the extent of the effects load shedding has on small-scale restaurants. This study adds to the findings of prior research on the effects of load shedding on the performance of small-scale restaurants and the study contributed to the body of iii knowledge on the effects of load shedding on the performance of small-scale restaurants and mitigates on existing literature gap where the populace is not aware of the extent to which load shedding has affected the performance of small-scale restaurants. , Faculty of Economics and Financial Sciences, 2023
- Full Text:
Monitoring strategies used for teaching and learning in selected scondary schoolsof OR Thambo Inland Education District, Eastern Cape Provice, South Africa
- Tswane, Patience Nomampondomise
- Authors: Tswane, Patience Nomampondomise
- Date: 2023-00
- Subjects: Monitoring strategies
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10769 , vital:75218
- Description: This study was meant to investigate monitoring strategies used for teaching and learning in selected secondary schools of OR Tambo Inland Education District in Eastern Cape Province of South Africa. The study mainly concentrated on collecting the analysed data from principals, deputy principals and heads of departments of secondary schools of Qumbu magisterial district on the basis of my proximity to their schools. A case study research design was adopted as only principals, deputy principals and HODs officially employed by the Department of Education to teach in geographically located secondary schools in Qumbu magisterial district were used as subjects to collect data. The qualitative research approach was employed in this study. A sample of 15 participants who were chosen using purposive sampling were interviewed face-to-face adopting semi-structured interviews to gather data for this study. The findings supported SMTs' use of monitoring curriculum implementation methodologies, but their actual implementation was characterised by a lack of rigour and decisiveness. Evidently, a number of contextual circumstances influenced to what extent the methods that had been decided upon were carried out. It emerged that in some SMTs’ strategies to manage and monitor the quality of teaching and learning in their secondary schools, teacher unions disrupts such systems. This implies that the teacher unions play a detrimental role in limiting effective intervention strategies by management. As long as teacher unions plays a powerful role in tying the hands of management in quality control oversight, management will find it very difficult to make inroads into improving commitment by teachers and progress of learners. The Department of Basic Education and government need to review and revise the powers of teacher unions. , Thesis (Masters) -- Faculty of Education, 2024
- Full Text:
- Authors: Tswane, Patience Nomampondomise
- Date: 2023-00
- Subjects: Monitoring strategies
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10769 , vital:75218
- Description: This study was meant to investigate monitoring strategies used for teaching and learning in selected secondary schools of OR Tambo Inland Education District in Eastern Cape Province of South Africa. The study mainly concentrated on collecting the analysed data from principals, deputy principals and heads of departments of secondary schools of Qumbu magisterial district on the basis of my proximity to their schools. A case study research design was adopted as only principals, deputy principals and HODs officially employed by the Department of Education to teach in geographically located secondary schools in Qumbu magisterial district were used as subjects to collect data. The qualitative research approach was employed in this study. A sample of 15 participants who were chosen using purposive sampling were interviewed face-to-face adopting semi-structured interviews to gather data for this study. The findings supported SMTs' use of monitoring curriculum implementation methodologies, but their actual implementation was characterised by a lack of rigour and decisiveness. Evidently, a number of contextual circumstances influenced to what extent the methods that had been decided upon were carried out. It emerged that in some SMTs’ strategies to manage and monitor the quality of teaching and learning in their secondary schools, teacher unions disrupts such systems. This implies that the teacher unions play a detrimental role in limiting effective intervention strategies by management. As long as teacher unions plays a powerful role in tying the hands of management in quality control oversight, management will find it very difficult to make inroads into improving commitment by teachers and progress of learners. The Department of Basic Education and government need to review and revise the powers of teacher unions. , Thesis (Masters) -- Faculty of Education, 2024
- Full Text:
Natural resource rents and public debt in selected resource in rich Sub-Saharan AfricanCountries
- Authors: Chizengeya, Elisha
- Date: 2023-00
- Subjects: Rents and Public debt
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9970 , vital:74930
- Description: Many Sub-Saharan African countries are endowed with natural resources and yet their public debts are keeping on ballooning. The skyrocketing of these debts can cause a public debt crisis which can further bite on the poor who are already living miserable lives in resource-rich countries. This study examines the impact of natural resource rents on public debt in Sub-Saharan African (SSA) countries from 2000 to 2020, utilising the panel ARDL technique. The main objective of this research work was to investigate the relationship between natural resource rents and public debt in selected resource-rich Sub-Saharan African countries. The panel ARDL technique employed in this study strengthens the analysis by considering both short-run and long-run dynamics. In the short run, a significant and negative relationship is observed between natural resource rents and public debt, aligning with the theoretical expectations of resource-rich economies benefiting from increased revenues. However, in the long run, a contrasting pattern emerges, indicating that natural resource rents contribute to an increase in public debt, highlighting the challenges associated with the resource curse phenomenon. The empirical analysis reveals noteworthy findings with implications for theory, practice, and policy. The findings underscore the need for careful fiscal management and prudent policies in resource-rich countries to avoid excessive debt accumulation over the long term. This highlights the importance of implementing effective governance mechanisms, transparency, and accountability frameworks to manage natural resource revenues responsibly. In conclusion, this study contributes to the understanding of the relationship between natural resource rents and public debt in SSA countries. It emphasizes the importance of balancing short-term fiscal benefits with long-term sustainability and provides valuable insights for policymakers to design and implement effective resource management strategies. , Thesis (Masters) -- Faculty of Economics and Financial Sciences, 2023
- Full Text:
- Authors: Chizengeya, Elisha
- Date: 2023-00
- Subjects: Rents and Public debt
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9970 , vital:74930
- Description: Many Sub-Saharan African countries are endowed with natural resources and yet their public debts are keeping on ballooning. The skyrocketing of these debts can cause a public debt crisis which can further bite on the poor who are already living miserable lives in resource-rich countries. This study examines the impact of natural resource rents on public debt in Sub-Saharan African (SSA) countries from 2000 to 2020, utilising the panel ARDL technique. The main objective of this research work was to investigate the relationship between natural resource rents and public debt in selected resource-rich Sub-Saharan African countries. The panel ARDL technique employed in this study strengthens the analysis by considering both short-run and long-run dynamics. In the short run, a significant and negative relationship is observed between natural resource rents and public debt, aligning with the theoretical expectations of resource-rich economies benefiting from increased revenues. However, in the long run, a contrasting pattern emerges, indicating that natural resource rents contribute to an increase in public debt, highlighting the challenges associated with the resource curse phenomenon. The empirical analysis reveals noteworthy findings with implications for theory, practice, and policy. The findings underscore the need for careful fiscal management and prudent policies in resource-rich countries to avoid excessive debt accumulation over the long term. This highlights the importance of implementing effective governance mechanisms, transparency, and accountability frameworks to manage natural resource revenues responsibly. In conclusion, this study contributes to the understanding of the relationship between natural resource rents and public debt in SSA countries. It emphasizes the importance of balancing short-term fiscal benefits with long-term sustainability and provides valuable insights for policymakers to design and implement effective resource management strategies. , Thesis (Masters) -- Faculty of Economics and Financial Sciences, 2023
- Full Text:
Prevalence and risk factors of imaging confirmed neurological complication amongst patients withhypertensive disorders in pregnancy admitted at Nelson Mandela Academic Hospital
- Authors: Sabona, Ncumisa
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9868 , vital:74635
- Description: Hypertensive disorders in pregnancy (HDP) are the world's second leading cause of maternal mortality and morbidity, with sub-Saharan Africa taking the lead. The prevalence of HDP in Africa is 10%, remarkably higher than the reported global range of 5.2-8%. This study aimed to determine the prevalence and associated risk factors of CT-confirmed neurological complications in patients managed at the labour ward at Nelson Mandela Academic Hospital (NMAH) over two years. Methodology: A retrospective cross-sectional study was conducted on obstetric patients with clinical files at NMAH from January 2018 to December 2020. We tracked and merged hospital admission data and radiological (brain CT) findings in patients managed for HDP at the labour ward at NMAH within the specified period. Descriptive analysis, bivariate and multivariate logistic regression analysis was performed to identify associated clinical risk predictors of neurological complications. Major findings: Of the 5119 patients with HDP, 153 underwent CT scans. Our study found that 78.2% of the scanned patients with HDP were between 18 and 34 years old. Patients younger than 18 years accounted for 10% of the 154 patients who underwent CT-scan. We found that 81.1% had abnormal CT-brain findings, while 18.9% were normal. The most common abnormal finding was posterior reversible encephalopathy syndrome (PRES) (25.1%), followed by cytotoxic oedema (16,5%), neurocysticercosis (15.1%), and dural sinus thrombosis (7.9%). The most common neurological findings on admission were headache (82%), low GCS (60.1%), fits (55.6%), blindness (28.8%), and focal signs (11.5%). In addition, the following risk predictors were statistically associated with PRES: post-partum onset ( aOR=6.26,95% CI 1.02-38.83, p-value0.049 ), blindness (aOR=3.19, 95% CI; 1.07-9.59, p=0.038) and fits (aOR=0.20, 95% CI: 0.64-0.63, p-value=0.006. Recommendations and clinical implications: The most common radiological finding among obstetric patients with HDP in this study is PRES. The most significant risk predictors for PRES are the post-partum onset of symptoms and blindness. As PRES is | 3 associated with significant morbidity and mortality, vigilance and aggressive management should be continued and include the post-partum period. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
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- Authors: Sabona, Ncumisa
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9868 , vital:74635
- Description: Hypertensive disorders in pregnancy (HDP) are the world's second leading cause of maternal mortality and morbidity, with sub-Saharan Africa taking the lead. The prevalence of HDP in Africa is 10%, remarkably higher than the reported global range of 5.2-8%. This study aimed to determine the prevalence and associated risk factors of CT-confirmed neurological complications in patients managed at the labour ward at Nelson Mandela Academic Hospital (NMAH) over two years. Methodology: A retrospective cross-sectional study was conducted on obstetric patients with clinical files at NMAH from January 2018 to December 2020. We tracked and merged hospital admission data and radiological (brain CT) findings in patients managed for HDP at the labour ward at NMAH within the specified period. Descriptive analysis, bivariate and multivariate logistic regression analysis was performed to identify associated clinical risk predictors of neurological complications. Major findings: Of the 5119 patients with HDP, 153 underwent CT scans. Our study found that 78.2% of the scanned patients with HDP were between 18 and 34 years old. Patients younger than 18 years accounted for 10% of the 154 patients who underwent CT-scan. We found that 81.1% had abnormal CT-brain findings, while 18.9% were normal. The most common abnormal finding was posterior reversible encephalopathy syndrome (PRES) (25.1%), followed by cytotoxic oedema (16,5%), neurocysticercosis (15.1%), and dural sinus thrombosis (7.9%). The most common neurological findings on admission were headache (82%), low GCS (60.1%), fits (55.6%), blindness (28.8%), and focal signs (11.5%). In addition, the following risk predictors were statistically associated with PRES: post-partum onset ( aOR=6.26,95% CI 1.02-38.83, p-value0.049 ), blindness (aOR=3.19, 95% CI; 1.07-9.59, p=0.038) and fits (aOR=0.20, 95% CI: 0.64-0.63, p-value=0.006. Recommendations and clinical implications: The most common radiological finding among obstetric patients with HDP in this study is PRES. The most significant risk predictors for PRES are the post-partum onset of symptoms and blindness. As PRES is | 3 associated with significant morbidity and mortality, vigilance and aggressive management should be continued and include the post-partum period. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
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Prevalence and Risk Factors of Traumatic Lumbar Puncture in Children at Nelson Mandela Central Hospital, Mthatha, Eastern Cape Province, South Africa
- Authors: Ghu, Pumza
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9879 , vital:74636
- Description: Traumatic lumbar puncture signals improper procedural and proceduralist factors working on existing patient attributes. Occurrence is very common though believed to be overestimated and cut-off definitions are vague. Complications that follow incurs economic implications to the hospital setting due to high admission rate, long hospital stay and unnecessary use of antibiotics. None of these concepts around this topic is known in the present setting thus necessitating this research. The findings thereof would cause a fundamental change in the manner in which this procedure is performed in the present setting. Aim To determine the prevalence and risk factors of traumatic lumbar punctures, with the secondary goal of developing a protocol for performing appropriate lumbar punctures in order to reduce the rate of traumatic lumbar punctures. Methods An analytical cross-sectional data using retrospective data of 82 lumbar punctures performed over a four (4) month period from March to June 2022 at the paediatric emergency department of Nelson Mandela Central Hospital. Results Demographics characteristics: The median age was two (2) years (IQR = 0.83 – 3.35 years) and the highest proportion (53.66%) was observed for the age group two years and younger. Males constituted more than half (63.41%) of the population. Clinical features: Most of the children presented with seizures (56.10%) and high fever (46.34%). The top three conditions diagnosed were febrile seizures (40.24%), meningitis (17.07%) and acute gastroenteritis (9.78%). More females (20% p=0.047) suffered from acute gastroenteritis than males (3.8%). , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
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- Authors: Ghu, Pumza
- Date: 2023-00
- Subjects: Medicine
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/9879 , vital:74636
- Description: Traumatic lumbar puncture signals improper procedural and proceduralist factors working on existing patient attributes. Occurrence is very common though believed to be overestimated and cut-off definitions are vague. Complications that follow incurs economic implications to the hospital setting due to high admission rate, long hospital stay and unnecessary use of antibiotics. None of these concepts around this topic is known in the present setting thus necessitating this research. The findings thereof would cause a fundamental change in the manner in which this procedure is performed in the present setting. Aim To determine the prevalence and risk factors of traumatic lumbar punctures, with the secondary goal of developing a protocol for performing appropriate lumbar punctures in order to reduce the rate of traumatic lumbar punctures. Methods An analytical cross-sectional data using retrospective data of 82 lumbar punctures performed over a four (4) month period from March to June 2022 at the paediatric emergency department of Nelson Mandela Central Hospital. Results Demographics characteristics: The median age was two (2) years (IQR = 0.83 – 3.35 years) and the highest proportion (53.66%) was observed for the age group two years and younger. Males constituted more than half (63.41%) of the population. Clinical features: Most of the children presented with seizures (56.10%) and high fever (46.34%). The top three conditions diagnosed were febrile seizures (40.24%), meningitis (17.07%) and acute gastroenteritis (9.78%). More females (20% p=0.047) suffered from acute gastroenteritis than males (3.8%). , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
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Private suplementary tutoring and grade 12 education in Geometry performance
- Authors: Mabhamba, Mfuneko
- Date: 2023-00
- Subjects: Mathematics Education
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10448 , vital:75181
- Description: The primary intention of this study was to explore the extent to which private tutorials relate to Euclidean Geometry performance amongst Grade 12 learners from selected schools in OR Tambo Inland District. The first objective was to examine the correlation between private tutorials and Euclidean Geometry performance. The second research question was to investigate the Euclidean Geometry means scores of students who attend private tutorials as compared to the group of students who do not attend private tutorials. The study had a sample size of 347 participants from four schools. Lev Vygotsky's Socio-cultural Theory was used as a theoretical framework to underpin the study. The study adopted quantitative research methodology to answer the research questions. A questionnaire and a standardised Euclidean Geometry test were administered to collect the data from the participants. Correlational and regression analysis were performed to analyse to data. The outcomes of the study reveal that private tutorials and Euclidean Geometry performance were significantly correlated. Furthermore, private tutorials were found to be the determinant or predictor of performance in Euclidean Geometry. Secondly, students who are attending private tutorials significantly outperformed their counterparts (i.e., students who are not attending private tutorials) in Euclidean Geometry. Recommendations were made to implicate stakeholders to enhance the effective use private tutorials to boost Euclidean Geometry performance while also improvising alternative measures to students who might want to attend private tutorials, but affordability becomes a detrimental hindrance. , Thesis (Masters) -- Faculty of Education, 2023
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- Authors: Mabhamba, Mfuneko
- Date: 2023-00
- Subjects: Mathematics Education
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/10448 , vital:75181
- Description: The primary intention of this study was to explore the extent to which private tutorials relate to Euclidean Geometry performance amongst Grade 12 learners from selected schools in OR Tambo Inland District. The first objective was to examine the correlation between private tutorials and Euclidean Geometry performance. The second research question was to investigate the Euclidean Geometry means scores of students who attend private tutorials as compared to the group of students who do not attend private tutorials. The study had a sample size of 347 participants from four schools. Lev Vygotsky's Socio-cultural Theory was used as a theoretical framework to underpin the study. The study adopted quantitative research methodology to answer the research questions. A questionnaire and a standardised Euclidean Geometry test were administered to collect the data from the participants. Correlational and regression analysis were performed to analyse to data. The outcomes of the study reveal that private tutorials and Euclidean Geometry performance were significantly correlated. Furthermore, private tutorials were found to be the determinant or predictor of performance in Euclidean Geometry. Secondly, students who are attending private tutorials significantly outperformed their counterparts (i.e., students who are not attending private tutorials) in Euclidean Geometry. Recommendations were made to implicate stakeholders to enhance the effective use private tutorials to boost Euclidean Geometry performance while also improvising alternative measures to students who might want to attend private tutorials, but affordability becomes a detrimental hindrance. , Thesis (Masters) -- Faculty of Education, 2023
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