Tesi: "Medical Association of South Africa"

1

Van, Vuuren Annemari. "The association between influenza vaccination and hospitalization rates of respiratory and cardiovascular conditions among elderly members of a private medical scheme during the winter season of 2004 in South Africa". Pretoria : [s.n.], 2008. http://upetd.up.ac.za/thesis/available/etd-04302009-134441.

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2

Bloch, Hugh. "The psychological effects of detention with particular reference to the South African political detainee". University of the Western Cape, 1996. http://hdl.handle.net/11394/8369.

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Magister Artium - MA
The intention of this dissertation is to clarify the psychological processes and effects which operate in the political detention situation, and to outline effective treatment and coping strategies. An overview of research literature and theory is provided, and the importance of viewing detention within a broad 'socio-political context is emphasised. In the analysis of the detention situation a number of variables likely to be operative are considered. Solitary confinement, torture, interrogation, reactions to severe stress situation s, and uncertainty, unpredictability and uncontrollability are given separate discussion, interaction situation. prior to an attempt to consider the of these variable s in the detention This projected picture is compared with case material gathered in the area. It is noted that political detention is not a uniform experience with a uniform set of effects. Rather, the effects are seen to be dependent on the particular differences in re-ponse. Nevertheless, political detention is shown to be commonly both objectively and subjectively severely stressful, with a strong likelihood of the detainee developing debilitating psychological sequelae. post-traumatic stress disorder appears to be commonly implicated, and symptom s may persist for many years. Family and community members and organisations to which the detainee belongs suffer not only the effects of the loss of that person, but also the problems of effectively helping him or her to reintegrate. It is shown that detainees have commonly drawn on a number of resources or strategies to counteract the potentially debilitating effects of prior preparation of detention. The for the detention experience to facilitate an accurate appraisal of the situation and better coping is emphasized. Useful strategies that may be learned or fostered are outlined. A multidisciplinary approach to treatment that acknowledges all of the difficulties and needs particular to any specific ex-detainee, and that draws on as broad a recommended. It is shown range of available supports Physiotherapy, psychotherapy, and family involvement are as possible, is medication where stressed. Necessary that much may be learned from Canadian and European units that rehabilitate victims of torture - mainly from South American countries; but that strategies need to be adapted to South African conditions.

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3

Constant, Deborah Ann. "Strengthening medical abortion in South Africa". Doctoral thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/22795.

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Access to safe, legal abortion services is an important public health measure to address morbidity and mortality from unsafe abortion. To expand access and strengthen medical abortion provision in South Africa, evidence is needed on the safety, effectiveness, feasibility and acceptability of task sharing strategies and the implementation of evidence-based regimens. This research aims to: (a) evaluate the safety and acceptability of task sharing gestational age estimation for women seeking abortion, (b) determine the effectiveness and acceptability of text messaging on mobile phones to support women self-managing medical abortion, (c) evaluate the feasibility, safety and acceptability of self-assessment of medical abortion completion using mobile phones alone or in combination with a low-sensitivity pregnancy test, and (d) document clinical outcomes and women's experiences following the introduction of mifepristone into second trimester medical abortion services. Published or submitted papers included in this thesis are from four prospective studies evaluating interventions and interviewing women and health care workers in South African public sector and non-governmental clinics between 2011 and 2015. The first paper establishes that last menstrual period is sufficiently accurate to estimate gestational age in selected women (97%) and has potential to be task shared with community health workers or women themselves. The second paper reports reduced anxiety (p=0.013) and better preparedness (p=0.016) for self-managing abortion symptoms among women receiving automated text messages (compared to those receiving standard care). The third and fourth papers show that mobile phones are a feasible modality for self-assessment for most women (86%), but that clinical history needs to be combined with an appropriate pregnancy test to detect incomplete or failed procedures. Self-assessment using a low-sensitivity pregnancy test is preferred by most women (98%) to in-clinic follow-up, and providing a guided demonstration on the use of a low-sensitivity pregnancy test does not significantly impact on the accuracy of self-assessed abortion outcome compared to simple verbal instructions (88% vs. 85% accuracy; p=0.449). The fifth paper documents successful self-administration of mifepristone, a higher 24-hour abortion rate (93% vs 77%; p<0.001), and greater acceptability following the introduction of mifepristone into second trimester abortion care, compared to historic cohorts receiving misoprostol only. The thesis concludes that supported self-management and task sharing can strengthen medical abortion provision in South Africa. Research evaluating task sharing of medical abortion care has potential to inform similar approaches for other health care services.

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4

Crous, Ilse. "Craniosynostosis in a South Africa population". Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33611.

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Background: Craniosynostosis refers to the premature fusion of calvarial bones which lead to restricted growth potential. Compensatory growth occurs in the dimensions not restricted by fusion and causes progressive distortion in the skull shape. The majority of craniosynostosis cases occur in isolation and are so called non-syndromic craniosynostosis. In about 30 % of all cases, anomalies are noted along with the craniosynostosis, often defining a described and recognised syndrome. The aim is to delineate the phenotype observed in a South African population. Methods: In this descriptive study, hospital records for the preceding five years were retrospectively reviewed to describe the profile of patients with craniosynostosis seen at the Red Cross War Memorial Children's Hospital in Cape Town. In addition to the retrospective review, a sub cohort of patients were prospectively phenotyped. The patients were subdivided into three groups namely: non-syndromic craniosynostosis, syndromic craniosynostosis and craniosynostosis with additional features. The last group included patients who had additional malformations or clinical findings without a syndromic diagnosis. The prevalence of phenotypic findings, teratogen exposure, birth complications, congenital malformations, surgical interventions and results of genetic testing in this cohort is described. Descriptive statistical analysis was used. Results: A total of 47 children with craniosynostosis were included in this study. Twenty-five individuals of the cohort were male, and one patient has a disorder of sexual development. Eighteen patients had non-syndromic synostosis. Twelve of these had sagittal type synostosis and five had metopic type synostosis with one unspecified. Thirteen had syndromic synostosis. Eight were clinically diagnosed with Crouzon syndrome of which three were molecularly confirmed. Four patients had Apert syndrome and one had Pfeiffer syndrome, these were clinically diagnosed without molecular confirmation. Sixteen patients had craniosynostosis with some additional findings but no syndromic diagnosis. The suture involved in the majority of patients was the sagittal suture. Ten patients had an additional structural brain abnormality and 13 had signs of raised intracranial pressure. The average age at confirmation of diagnosis of craniosynostosis by CT scan was 22.5 months (SD = 31.4, range: 0.1 – 140.9). Thirty of the 47 patients had craniosynostosis surgery. The average age of surgery was 22.4 months (SD = 19; range: 5-79). The anthropometric, phenotype and developmental features indicate that this is a highly heterogenous group of disorders. Conclusion: Craniosynostosis has been widely reported worldwide, especially in individuals of European descent with only a few reports on craniosynostosis in South African or African populations. Knowledge of the phenotypic spectrum will aid in understanding and documenting this group of disorders in our local population. This study also highlights that this is a complex condition best managed by a multidisciplinary team that should include a medical geneticist. The recognition of specific craniosynostosis syndromes together with appropriate molecular testing can be cost effective even in a limited resource setting and aid in accurate prognosis and recurrence risk information for families.

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5

Lapere, Jan Noel Romain. "Occupational medical examinations and labour law". Thesis, University of Port Elizabeth, 2003. http://hdl.handle.net/10948/302.

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South Africa’s Constitution and the Employment Equity Act have a major impact on the performance of medical examinations within the employment relationship. Health and safety statutes list a number of occupational medical examinations, which an employer must perform. Other legislation permits the execution of medical examinations. After listing the different statutory references to occupational medical examinations, this treatise examines under which conditions medical testing is required or permissible. The fairness of employment discrimination based on medical facts, employment conditions, social policy, distribution of employee benefits and inherent job requirement is analysed through a study of the legal texts, experts’ opinions and case studies. The particularities of the ethical and legal duties of the medical professional, performing the occupational medical examination, are also examined. Finally, a comprehensive analysis of the different forms of occupational medical examinations is compiled by combining legal and policy-related job requirements and is attached as an annexure. This is the practical result of the research in this treatise combined with the personal experience of the author.

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6

Weich, Lize, Charles Perkel, Zyl Nicolette Van, S. T. Rataemane e Lochan Naidoo. "Medical management of opioid dependence in South Africa". Health and Medical Publishing Group (HMPG), 2008. http://hdl.handle.net/10019.1/7055.

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The original publication is available at http://www.samj.org.za
Medical practitioners in South Africa are increasingly confronted with requests to treat patients with opioid use disorders. Many do not possess the required knowledge and skills to deal with these patients effectively. This overview of the medical treatment of opioid dependence was compiled by an elected working group of doctors working in the field of substance dependence. Recommendations are based on current best practice derived from scientific evidence and consensus of the working group, but should never replace individual clinical judgement.
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7

Boy, Anthony Albert. "Dismissal for medical incapacity". Thesis, Nelson Mandela Metropolitan University, 2004. http://hdl.handle.net/10948/d1016262.

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Labour law in South Africa has evolved over the past century at an ever increasing pace. The establishment of a democratic government in 1995 has been the trigger for a large number of labour law statutes being promulgated, particularly with reference to the laws governing the employment relationship and dismissal. From very humble and employer biased dispute resolution application under the common law of contract, labour law in this country has evolved through the various acts culminating in a labour law system which is highly regulated and codified. Dismissal for medical incapacity in this treatise is reviewed with regard to the applicable statutes and the various codes of good practice as the law has evolved and developed from the period covered by the common law through that covered by the 1995 LRA up to and including the current period. Particular attention is paid to both substantive and procedural requirements as well as the remedies applicable under the different legal regimes and the pertinent tribunals and courts. Regard is also given to the duration and causes of incapacity and the effect this may have on the applicable remedy applied by these tribunals. It will become apparant that the medically incapacitated employee occupied a relatively weak and vulnerable position under the common law as opposed to the current position under the 1995 LRA. The influence of the remedies applied by the tribunals under the 1956 LRA are clearly evident in the current regulations and codes under the 1995 LRA which contain specific statutory provisions for employees not to be unfairly dismissed. Distinctions are drawn between permissible and impermissible dismissals, with medical incapacity falling under the former. Furthermore, a distinction is drawn statutorily between permanent and temporary illhealth/injury incapacity with detailed guidelines for substantive and procedural fairness requirements to be met by employers. The powers of the specialist tribunals (CCMA, Bargaining Councils and Labour Courts) are regulated by statutory provisions and deal with appropriate remedies (reinstatement and/or compensation) a wardable in appropriate circumstances. Certain specific areas nonetheless still remain problematic for these tribunals and hence questions that require clear direction from the drafters of our law are: How to distinguish misconduct in alcohol and drug abuse cases? What degree of intermittent absenteeism is required before dismissal would be warranted? In certain other areas the tribunals have been fairly consistent and prescriptive in their approach and remedies awarded. Included here would be permanent incapacity, HIV cases and misconduct. It will emerge, however, that under the 1995 LRA the position of employees and the protections afforded them have been greatly increased.

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8

Kent, Athol Parkes. "Medical education and the importance of teaching medical teachers about teaching". Master's thesis, University of Cape Town, 1994. http://hdl.handle.net/11427/27044.

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This is an overview of medical education today. It deals with tertiary education matters pertinent to medical schools in South Africa, the forces that will inevitably cause medical education to change and the responses of other countries to similar circumstances. These forces are medical, educational and political. The medical forces bringing about changes are concerned with the explosion in knowledge in the fields of medical facts, technologies, therapies and informatics. It is an ongoing educational problem as to how the burgeoning sciences can be balanced with the present call for the return to the humanities. Medical schools are being required, through their teaching and learning methodologies, to encourage the qualification of empathetic graduates with generalist (holistic) skills and attitudes to best serve their patients. Educational forces, in particular new curriculum strategies, will need to be explored to assist teachers and students to cope with the demands of communities and individuals for care with expertise. In many First World countries these demands have found expression in moves from Traditional to Innovative curricula. Fundamentally, Traditional schools teach normal Anatomy and Physiology first, then move to the abnormal, before students reach the Clinical Years where these "basic sciences" are applied. Innovative schools, on the other hand, employ Problem-Based Learning with Community-Orientation throughout their curricula, with early patient contact, horizontal and vertical integration of disciplines, group work and community interaction as crucial aspects of their students' learning. Supporters of the Innovative philosophy see as progressive the revising of Flexnerian notions of basic science building blocks, the debalkanising of instruction subject by subject and the motivational impetus achieved when learning takes place in context. Political factors can impinge on staff teaching and student learning by Governmental demands through statutory councils or through the power exerted by the universities. Macro politics dictate financial or other resources that are allocated and may in future directly influence what sort of doctor the various medical schools are expected to graduate. The politics of staffing the teaching institutions, the development of teachers, and the demographics of the student population raise important questions of direction and commitment, and may lead to new realignments. The recognition of the importance of teaching at a professional level is a crucial factor in educating students more appropriately. Teachers versed in the medical pedagogic process will be pivotal in producing a new breed of doctors. This new breed will not be expected to "know everything" but have a core knowledge carefully ascertained by each medical faculty and the ability to find information that is further required. Students will not be expected to acquire all the facts to sustain them through the rest of their professional lives, but to have enquiring minds and the motivation to continue their education, to satisfy their curiosity and provide improved patient care. Their skills in mastery of the behavioural sciences will be more pertinent than ever as preventative medicine becomes as important as curative. They will be expected to formulate ethical attitudes and provide leadership in community and individual dilemmas. These are challenges that will need to be faced critically by our medical teachers who are too often experts in content in ever-narrower sub-specialities. For these challenges to be met, teaching cannot be taken for granted, but must be viewed more seriously by the schools and changes made where appropriate. The University of Cape Town (UCT) has a considerable reputation in the quality of its medical graduates. However, for its medical faculty to remain in the forefront of medical education, it needs to reconsider the knowledge required, the skills and attitudes embodied in its graduates but, as importantly, it must take the lead in undergraduate training. The need for renewing strategies and the action required are the themes of this dissertation.

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9

Van, Heerden Andries Johannes. "Medical practitioners and medical specialists : profile and key factors for South Africa". Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/5536.

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Thesis (MBA (Business Management))--Stellenbosch University, 2008.
ENGLISH ABSTRACT: Recent years have been witness to the co-existence of incredible advances in human well-being and healthcare development on the one hand and extreme deprivation and a significant drop in numerous health indicators on the other. Central among this paradox lies the key to accessible, comprehensive and dedicated healthcare - the health workforce and the numerous factors impacting on health professionals and health professional data. Key to health care human resource planning is a comprehensive understanding of the environment and demands that health professionals are faced with. This must be supported by knowledge of the profile of health professionals in a specific country and should lead to detailed health resource planning, based on benchmarks and analytical interpretation of the factors that both determine and influence the number of health professionals. This research report provides an abbreviated background to the local and international health sectors, profiles the current number and distribution of medical practitioners and selected medical specialists in the country and internationally, identifies the key factors for consideration in projecting the number of medical practitioners and medical specialists required for South Africa and proposes a framework for taking the process forward. The research showed that, while there are positive aspects to the South African health professional environment, the country faces dire regional disparities and does not compare favourably to many of its international peers in terms of health professional resources. The key aspects that influence health human resources were identified and it became clear that sustainable and comprehensive health resource planning is not a mere matter of ratios, but is indeed dependent on a number of critical success factors. It is critical that health human resource planning in South Africa requires urgent and comprehensive attention. Failure to address this urgently will result in a health care system continuing to struggle to meet the health care needs of the population. A structured approach is possible, but requires dedication and careful planning.
AFRIKAANSE OPSOMMING: Die laaste paar jare is gekenmerk deur die kontras van indrukwekkende vooruitgang in lewenskwaliteit en gesondheidsorg aan die een kant en ekstreme tekortkominge en die verswakking van gesondheidstatistieke aan die ander. Sentraal tot hierdie paradoks is die sleutel tot toeganklike, omvattende en toegewyde gesondheidsorg - die gesondheidswerkers en die vele faktore wat gesondheidswerkers en - data beinvloed. Die kern van gesondheidsorg menslike hulpbronne beplanning is 'n omvattende begrip van die omgewing en vereistes waaraan gesondheidswerkers blootgestel word. Dit moet ondersteun word deur in diepte kennis van die gesondheidswerker profiel binne in 'n spesifieke land en behoort te lei tot gedetaileerde gesondheidsorg menslike hulpbronne beplanning, na aanleiding van toepaslike verwysingsraamwerke en 'n analitiese interpretasie van die faktore wat die aantal gesondheidswerkers beide bepaal en noodwendig beinvloed. Hierdie navorsingsverslag verskaf 'n sinoptiese agtergrondskets van die nasionale en internasionale gesondheidsektore, gevolg deur die profiel (getalle en verspreiding) van die algemene praktisyns en geselekteerde mediese spesialiste, beide in Suid Afrika en internasionaal. Dit identifiseer die belangrikste faktore vir oorweging in die projeksie van die aantal algmene praktisyns en mediese spesialiste benodig en sluit af met 'n voorgestelde raamwerk vir voortgesette omvattende beplanning. Die navorsing het getoon dat, alhoewel die Suid Afrikaanse gesondheidswerker omgewing deur positiewe aspekte gekenmerk word, die land steeds onderworpe is aan daadwerklike streeks ongelykhede en boonop nie besonder positief vertoon teenoor ander soortgelyke lande nie. Die kern kwessies wat gesondheidswerkers beinvloed is geidentifiseer en dit is duidelik dat onderhoudende en omvattende gesondheidsorg beplanning nie bloot die toepassing van ratios is nie, maar dat dit onderhewig is aan 'n groot verskeidenheid kritiese sukses faktore. Dit is van kritiese belang dat gesondheid menslike hulpbronne beplanning in SA daadwerklike aandag geniet. Die nalaat van hierdie verantwoordelikheid, sal lei tot 'n gesondheidsisteem wat nie in staat is om aan die behoeftes van die land te voldoen nie. 'n Gestruktureerde benadering is moontlik, maar verdien toewyding en beplanning.

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10

Jekwa, Mandisi. "The Port Elizabeth Land and Community Restoration Association project in Fairview". Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/17712.

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The purpose of the research is to assess how the Port Elizabeth Land and Community Restoration project has been perceived by the beneficiaries with regard to spatial transformation.The study is about land restitution programme in Port Elizabeth; with specific emphasis on those land claims which were lodged through a community based organization called Port Elizabeth Land and Community Restoration Association (PELCRA) for the restitution of Fairview, South End, Salisbury Park and Korsten. Such land claims were subsequently part of the PELCRA project for the restitution of Fairview. The study looks specifically at claimants who were dispossessed of their land rights as a result of the implementation of Group Areas Act in the 1960s. The claimants were forcefully removed from Fairview, Korsten, South End and Salisbury Park to their respective race group areas, such as Bloemendal for coloureds, Malabar for Indians and Kwa-Zakhele for Africans.However, before the general objectives of the study could be discussed, it is important to provide a brief historical context that brought about racial segregation in the South African urban setting, and how the post-apartheid government sought to re-integrate, restructure the towns and cities, as well as healing the boundaries set by racial zoning through land reform. This will then followed by the discussion on how the various communities of Port Elizabeth responded to the introduction of the Land Restitution Act 22 of 1994. The post-apartheid government in South Africa faces serious challenges in undoing the legacy of apartheid. One such product of apartheid system is the ‘apartheid city’. It stands out as an extreme example of social engineering. According to Freund (2001, 537) urban segregation was pervasive across the colonial world, some other cities in colonial and even post-colonial Africa were subject to massive forced removals or urbanisation that were comparable to South Africa under the apartheid regime. Urban segregation is therefore not unique to South Africa. It has to be said though that the South African apartheid city was distinctive in a number of ways.

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11

Gater, Thomas. "Pharmaceutical Security in South Africa: Law and Medical Geopolitics". Thesis, University of the Western Cape, 2008. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_5273_1274376650.

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The study focuses on the political and economic geographies of pharmaceutical delivery. In 1997 the South African government passed the Medicines and Related Substances Control Amendment Act, sparking outrage from both the local and international pharmaceutical industry, and resulting in court action in 2001. The industry believed that South Africa was in breach of its obligations under international intellectual property law. Those fighting for pharmaceutical security hoped the court case would be a &lsquo
landmark&rsquo
in the global campaign for equitable access to medicines. This investigation seeks to analyse the domestic and international legacy of the court action. The inquiry takes its significance from the high prevalence rates of treatable diseases and the need for pharmaceutical security in South Africa and its neighbouring African countries. The absence of a sustainable international medicines delivery system is a global political, economic and moral failure. A solution is required that balances the positive productive forces of the market with a philosophy of justice and equity.

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12

Nwedamutsu, Tsepo. "Alternative dispute resolution in medical malpractice in south Africa". University of the Western Cape, 2020. http://hdl.handle.net/11394/7634.

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Magister Legum - LLM
South Africa has seen a spike in medical malpractice litigation, including the number and size of claims instituted against healthcare practitioners. This has led to a backlog in medical malpractice court cases throughout South Africa and a strain on both the public and private healthcare sectors, affecting an already burdened healthcare system. The surge in medical malpractice litigation is not a new phenomenon in developed countries. Most have curbed this through alternative dispute resolution (ADR). This has been facilitated by effectively introducing efficient legal frameworks that promote ADR. Unfortunately, this is not the case in a developing country such as South Africa. To date, much research and literature has attributed blame for the large-scale increase in medical malpractice litigation to legal practitioners. This has been aided by comments made by the former Minister of Health, Dr Aaron Motsoaledi (Dr Motsoaledi). In as much as this may be the common perception, there appears, to the contrary, to be systematic problems in the South African healthcare system. The legal profession is only a minor contributing factor to the increase in medical malpractice litigation. The strained financial resources and shortage of healthcare staff in public hospitals contributes to the increased risk of medical malpractice cases. Furthermore, when considering the South African legal system, contingency fee arrangements have, in certain circumstances, increased vexatious litigation and, as such, it is on this basis that medical malpractice litigation has been on the increase in South African courts. This study seeks to analyse the current state of the South African healthcare system, and in light of the increasing number of medical practice claims and litigation, propose ADR mechanisms that offer efficient, cost effective, and expeditious channels to resolving these issues and to ensure that parties recognise the full benefits of ADR. This study proposes legal reform in medical malpractice litigation in South Africa. This thesis compares the experiences, legislative and policy frameworks in Australia and the United States of America (USA), in order to learn lessons that could assist South Africa in framing legislation and best practices for ADR. It contends that, in order to effectively develop and implement ADR to address medical malpractice litigation, it requires the involvement of the government, legislature, judiciary, legal profession and the public. It has identified court- iv annexed mediation as the appropriate ADR mechanism in addressing medical malpractice litigation.

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13

Mahlati, Malixole Percival. "The medical profession in a transforming South Africa society : ideals, values and role". Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51996.

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Thesis (MPhil)--Stellenbosch University, 2000.
Some digitised pages may appear illegible due to the condition of the original hard copy.
ENGLISH ABSTRACT: Medicine in our country is under severe stress, brought about by internal and external forces that need a response from the medical profession. The profession's attempts and response will fall short unless the profession itself is aligned with the new social ethos and the responses are based on the profession's inherent values. Problem Statement: Medical doctors have always been highly valued in society because of the duty they have when illness and disease set in. As individuals, doctors have fulfilled other important roles in the communities where they work. These include giving advice to young people on career choices, counseling on various matters and provision of material help where there is need. This profession has for a long time been shrouded in mystery, being a trade learnt by a few. All these factors contributed to their social standing increasing phenomenally. There is a view that this has also led to public perceptions that doctors are the rich untouchable elite who have no interest or are unconcerned about problems faced by society. The medical profession faces a challenge that is more significant because of the value placed on it by society. The numerous submissions by the victims of human rights abuses to the Truth and Reconciliation Commission have cast a shadow of doubt on the medical profession for its complicity in these acts. The present government has declared transformation of health care as one of its top priorities. The response of the medical profession to this initiative has so far not led to any significant changes of public perception that the profession is unwilling to participate in the transformation of our society. The challenge and subject of discussion in this thesis therefore is: "What is the ideal role of the medical profession in a transforming South African society?" The medical profession, being the nerve centre of health care, has a big responsibility in social transformation. Doctors stand accused as a collective for failing to protect the human rights of patients and not living up to the standards of ethics required of them when patients' rights were violated. The Truth and Reconciliation Commission record of the hearings into the role of the professional organisations in health is used in this thesis to illustrate how serious society views the medical profession's role in the human rights abuses of the past. Based on the T. R. C's report and the assumption that society traditionally places high value on the medical profession, I conducted a survey among South African doctors to test their attitudes towards a range of policy and transformational issues. The unit of analysis was the medical doctors who are in active practice in South Africa in whatever mode of practice. The survey sought to explore the awareness of the respondents about a range of transformation policy changes and invite their comments on the role that they envisage for the medical profession in the process of transformation of society. There is unfortunately scarcity or a lack of applicable South African literature on this topic thus limiting local material for referencing. The search of international literature only yielded the subject of the study of professional values and not necessarily the role of a medical profession in a transforming society. The medical profession has to re-visit its foundations, analyse its history and map out its future in the context of the South African realities. It must find a way of aligning itself with the new ethos and diverse cultures South Africa possesses. Medicine has its own traditional goals and values derived and adapted from society's diverse cultural value systems. With its national and international networks, the inherent knowledge and skills that it possesses, guided by an ethical code, the Hippocratic Oath that serves as a public promise, it influences policy on the country's health care system - a mechanism that government uses to provide a basic human need. The medical profession therefore has to be responsive to the needs of society as much as society needs to support the profession. This thesis explores the role that the profession should play in a transforming South African society. The argument is that this can only be done through the profession examining its values and aligning itself with broader societal value systems, the moral and social norms. It is further argued that visible realistic commitment by the profession to public health will lead to an improvement in its public image. It is the actions or non-actions of the majority that the public notices. The majority of respondents to the survey have indicated that they approve of the transformation policies in health but that they may differ in the way they were introduced.
AFRIKAANSE OPSOMMING: Die geneeskunde in ons land is onder geweldige druk as gevolg van interne en eksterne faktore en dit is nodig dat die mediese beroep reageer. Dit sal die beroep egter nie help om te reageer indien sy lede hulle nie met die nuwe maatskaplike etos vereenselwig nie en die reaksie op die inherente waardes van die mediese beroep geskoei word nie. Probleemstelling Mediese dokters is nog altyd baie hoog geag deur die gemeenskap as gevolg van die verpligting wat hulle het om na mense om te sien wanneer hulle siek word. In hulle individuele hoedanigheid het dokters ook ander belangrike bydraes tot hulle gemeenskappe gelewer. Dit sluit in: advies aan jong mense oor loopbaankeuses, berading en die verskaffing van finansiele hulp waar nodig. Die beroep as sulks was egter vir baie lank ietwat van 'n misterie omdat dit 'n vakrigting is waarin baie min mense hulle kon bekwaam. Al hierdie faktore het die maatskaplike aansien/waarde van dokters geweldig verhoog. Daar is ook diegene wat van mening is dat hierdie faktore aanleiding gegee het tot die openbare mening dat dokters 'n ryk en onaantasbare elite is en glad nie in die probleme van die gemeenskap belangstel nie. Die etlike voorleggings deur die slagoffers van menseregtevergrype aan die Waarheids- en Versoeningskommissie het ook vrae rondom die beroep se betrokkenheid by sodanige gevalle laat ontstaan. Die huidige regering het die transformasie van gesondheidsorg as een van sy grootste prioriteite verklaar. Die reaksie van die beroep hierop het tot dusver nie tot enige noemenswaardige veranderinge in die openbare mening dat dokters nie bereid is om aan die transformasie van ons gemeenskap deel te neem gelei nie. Wat is die ideale rol van die mediese beroep in die transformasie van die Suid- Afrikaanse gemeenskap? As die senusentrum van gesondheidsorg het die mediese beroep 'n groot verantwoordelikheid in maatskaplike transformasie. Dokters word kollektief beskuldig dat hulle nagelaat het om die menseregte van pasiente te beskerm en nie voldoen het aan die nodige etiese standaarde wat van hulle verwag word in die tyd toe pasienteregte geskend is nie. Die rekord van die verhore van die Waarheids- en Versoeningskommissie oor die rol van professionele gesondheidsorganisasies is vir die doeleindes van hierdie tesis gebruik om te illustreer hoe ernstig die gemeenskap voeloor die mediese beroep se rol in die menseregte vergrype van die verlede. Gegrond op die WVK-verslag en die aanname dat die gemeenskap die mediese beroep hoog ag, het ek 'n meningsopname onder 300 Suid-Afrikaanse dokters gedoen om hulle houding jeens 'n aantal beleids- en transformasiekwessies te toets. Die eenheid van analise was mediese dokters wat in die aktiewe praktyk staan, ongeag hulle praktykgebied. Die opname het gepoog om te bepaal wat die vlak van bewustheid by die respondente oor 'n aantal beleidsveranderinge gerig op transformasie is, en hulle uit te nooi om kommentaar te lewer op die rol wat hulle meen die mediese beroep behoort in die proses te speel. Ongelukkig is daar nie toepaslike Suid-Afrikaanse literatuur oor die onderwerp beskikbaar me. 'n Internasionale literatuursoektog het net studies rondom waardes opgelewer, en nie oor die rol van 'n mediese beroep in die transformasie van 'n gemeenskap nie. Die mediese beroep moet die grondslag van sy wese in oenskou neem, die geskiedenis analiseer en sy toekoms in die konteks van die Suid-Afrikaanse realiteite uitstippel. Die beroep moet 'n manier vind om homself met die nuwe etos en uiteenlopende kulture van Suid-Afrika te vereenselwig. Die geneeskunde het sy eie tradisionele doelwitte en waardes gekry en aangepas vanuit die uiteenlopende kulturele waardestelsels van die gemeenskap. Deur middel van sy nasionale en internasionale netwerke, inherente kennis en vaardighede, die leiding van 'n etiese kode, die Eed van Hippokrates wat as 'n belofte aan die publiek dien, beinvloed die mediese beroep die land se gesondheidsorgstelsel - 'n meganisme van die regering om in 'n basiese menslike behoefte te voorsien. Die mediese beroep moet daarom ingestel wees op die behoeftes van die gemeenskap in dieselfde mate as wat die gemeenskap die beroep behoort te ondersteun. Hierdie tesis ondersoek die rol wat die mediese beroep behoort te vervul in 'n Suid-Afrikaanse gemeenskap waar transformasie besig is om plaas te vind. Daar word geargumenteer dat dit net gedoen kan word indien die beroep sy waardes ondersoek en hom met die breer maatskaplike waardestelsels vereenselwig. Daar word verder geargumenteer dat 'n sigbare realistiese verbintenis van die mediese beroep tot openbare gesondheid tot die verbetering van sy openbare beeld sal lei. Dit is die optrede of nie-optrede van die meerderheid wat die publiek raaksien. Die meerderheid respondente in die meningsopname het aangedui dat hulle die transformasiebeleid vir gesondheid ondersteun, maar dat hulle verskil van die wyse waarop dit in werking gestel is.

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14

Mohlakoana, Keneuoe. "Antimicrobial activity of selected Eastern Cape medical plants". Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1199.

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Bacterial resistance to antibiotics has been a great problem for many years. The degree of resistance and the speed with which resistance develops varies with different organisms and different drugs. Enzymes called β-lactamases are produced by bacteria and are one mechanism in which bacteria develop antimicrobial resistance. Gram-negative bacteria producing enzymes called ESBLs because of their wide substrate range are of a particular concern in nosocomial infections. In many countries people still use traditional medicine derived from plants as an alternative to the Western medicine due to increased cost of Western medicine and microbial resistance of antibiotic treatments. Biologically active compounds isolated from plants species are used in herbal medicine. Because of the high prevalence of the ESBLs and their increasing resistance to the antibiotics, this research study was done to test the antimicrobial activities of selected medicinal plants of the Eastern Cape; G. incanum, D. angustifolia and E. autumnalis which were traditionally used to treat various infections. The in vitro antimicrobial activity of three different extracts (acetone, methanol & distilled water) and the traditional preparations of the three plants were tested against the selected strains of ESBL-producing bacteria, non β-lactamase producers and the different fungal species. The extracts were screened against 26 Gram-positive bacterial strains, 53 Gram-negative bacterial strains and 15 fungal strains. The Gram-positive bacteria included strains from S. aureus, B. cereus and E. faecalis. The Gram-negative bacteria included strains from E. ii coli, E. cloacae, K. pneumoniae, P. aeruginosa and Acinetobacter spp. The fungal strains included 9 strains of Candida albicans and a single strain of each of the following opportunistic fungi, Mucor sp, Geotrichium sp, Penicillium sp, Fusarium sp and Rhizopus sp. The agar dilution assay was used for the antimicrobial screening of the plants extracts and for the determination of the MICs. The Ames test was performed for the determination of probable carcinogenicity of the extracts of G. incanum and D. angustifolia. The distilled water extracts followed by acetone extracts of the plants revealed the highest antimicrobial activity against the different microbial strains. The extracts of G. incanum followed by the extracts of D. angustifolia inhibited the highest number of microbial strains. The extracts of E. autumnalis did not show any antimicrobial activity against all the pathogens in this study. More of the Gram-positive bacteria were inhibited by the plant extracts. The lowest MIC was obtained with Gram-positive bacteria. The bacterial strains of E. faecalis and P. aeruginosa were not inhibited by any of the plants extracts in the agar dilution assay yet Acinetobacter species which are MDR were inhibited by the distilled water and methanol extracts of G. incanum. A single strain of Mucor sp was the only spore forming fungi that was inhibited by the distilled water extracts of G. incanum. None of the plants extracts showed any mutagenic effects on the TA100 S. typhimurium strains incorporated on the Ames test. Apart from revealing of new antimicrobial agents that may be used against resistant organisms, the proper use of antimicrobial agents should be recommended. The study has highlighted a need for further investigations on the properties of the medicinal plants used in this study.

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15

Valentine, Nicole Britt. "An evaluation of expenditure in the private health care sector and its reporting in the national accounts of South Africa". Master's thesis, University of Cape Town, 1997. http://hdl.handle.net/11427/17539.

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Bibliography: pages 94-102.
There is currently much work underway internationally to improve the accuracy and to refine the detail of accounting for health care expenditures. This research was initiated by the increasing activity in the field of national health accounting, as well as by previous research indicating that the Reserve Bank might be underestimating private health care expenditure in the national accounts. The Reserve Bank estimate of health care expenditure is important as it is the only complete and regularly produced estimate of private sector health care expenditure for South Africa. It was posited that an independent estimation of private health care expenditure would show that its magnitude is underestimated in the expenditure estimates published by the Reserve Bank for the national accounts. This thesis was upheld by the results of the research. The thesis estimate of private health care expenditure was R15 billion, 39% higher than the Reserve Bank estimate available at the time. It was also 21% higher than the final Reserve Bank estimate published in December 1995. The methodology used to derive the thesis estimate involved a survey of national income accounting concepts and guidelines embodied in the internationally used publication, the 1993 System of National Accounts. Primary data was collected from a wide range of institutions in the South African health sector. Secondary data sources were also consulted in several instances. In particular, the Registrar of Medical Schemes was consulted for medical scheme expenditure estimates as they constitute the largest portion of private sector health care expenditure in South Africa. The thesis estimate was then calculated for a single year according to the 1993 System of National Accounts guidelines. The year chosen was the government financial year from April 1992 to March 1993. The year was chosen to coincide with the year chosen for a national health expenditure review. In the presentation of the results, the estimate was broken down in separate "sources" and "uses" matrices, which are being used internationally to present national health accounting information. From the comparison of the Reserve Bank and thesis expenditure estimates, one of the most important recommendations that emerged was that the Reserve Bank should consult a wider range of expenditure data sources, more timeously and regularly. In particular, it was suggested that the Reserve Bank should negotiate earlier access to the data held by the Registrar of Medical Schemes, as well as cross-check household survey data with independent estimates of out-of-pocket and statutory scheme health care expenditure. In addition to providing a new benchmark estimate for private sector health care expenditure in the government financial year 1992/93, the breakdown of the estimate into matrices provides a framework that could be used as the basis for the development of more detailed satellite national health accounts, in accordance with 1993 SNA standards.

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Doman, Alicia Jane. "The Association of Spirituality and Well-Being in South African and Ugandan Samples". BYU ScholarsArchive, 2019. https://scholarsarchive.byu.edu/etd/8626.

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Literature has shown a correlation between spirituality and well-being, but this has not been thoroughly studied outside North America, with very few studies conducted in Africa. This study compared data from two sub-Saharan African nations, Uganda and South Africa, that differ markedly in terms of multiple factors that affect well-being, such as mortality rates and access to healthcare, as well as educational and personal growth opportunities. Survey data were collected using the measures of The Spiritual Involvement and Beliefs Scale and Ryff's Personal Well-Being Scale. There were four racial groups represented in the data: Black South Africans, Coloureds, White South Africans, and Black Ugandans. The results showed both similarities and differences among the racial groups in regard to spirituality and well-being. White South Africans had the lowest levels of spirituality, but the groups were fairly equivalent in terms of overall well-being, which finding was surprising, given the fact that the South Africans have much better material conditions and survival rates than Ugandans. Group differences were also observed in terms of the positive and negative aspects of well-being, which were highly correlated in the data from White South Africans but weakly correlated for the other groups. The correlations between the measures of spirituality and well-being were positive for all groups, with that association explaining a remarkable 32% of the variance in the Black Ugandan sample but only 4% of the variance in the White South African sample. These data confirm the salience of spirituality to well-being, particularly among the samples indigenous to sub-Saharan Africa.

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Dalmeyer, Johannes Paulus Franciscus. "A business model for medical subspecialty training in South Africa". Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/3508.

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The shortage of healthcare workers and doctors in the developing world compared to the developed world is a problem, and will continue to be so, due to the continual migration of qualified professionals and the inability of the state to remedy these shortfalls. A shortage of healthcare workers and specialist doctors will seriously hamper the Government’s National Health Insurance (NHI) plan, as well as the sustainability of the private health care sector. In addition, the duration of medical training in South Africa is exceptionally long. The three major hospital groups and other private corporates have over the last number of years taken limited initiative to fund education projects in conjunction with the academic institutions. However, these projects have been poorly focused and have been managed in an unstructured and detached manner. There is a desire from the private sector to get involved in these projects on a much larger scale through more formalised structures. Given this background, the primary objective of this research is to develop a business model for medical subspecialty training to complement the current academic subspecialty training in South Africa. A trial model for training subspecialists in reproductive medicine was developed as a first attempt to address the threatening shortages and training duration. This trial programme is the basis of this research. A two-phased process was used in collecting data. In Phase 1 data was collected from stakeholder groups. The results of this survey assisted in generating variables to include in the measuring instrument for the survey in Phase 2. In Phase 2 the perceptions and expectations of sub-specialists (reproductive subspecialists and cardiologists) regarding sub-specialty training was collected. The results of the demographic variables confirm the aging profile of subspecialist and the need to ensure succession. The results further showed that cardiologists and reproductive subspecialist expectations of the training of subspecialists are very similar except for their expectations on the training duration. Reproductive subspecialist respondents agreed more than cardiology subspecialist respondents that the training duration is too long. The biggest gap between perceptions and expectations is also with the factor training. The results showed that the expectations of subspecialists are not met for training. From these results a business model for the training of medical subspecialists is proposed. This proposed business model can play a complementary role to the existing state controlled system and form the bases of Public Private Partnerships (PPP) in medical training. This proposed business model will fit a developing country were the focus is on primary healthcare, with financial and capacity constraints. The proposed model would require role players to bring about change to accommodate a larger scale Public Private Partnership (PPP) to ensure the implementation of the model. The proposed decentralised business model for training subspecialists would allow the trainee subspecialist to practise as a specialist thus maintaining an acceptable income, and enable an expedited completion and lead to a wider dissemination of medical expertise that can be delivered in a wider national foot print. It further will provide for a structured Public Private Partnership.

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18

Jansen, van Vuuren Arno. "The implementation of the water release module of the WAS program at the Vaalharts Water Users' Association". Thesis, Bloemfontein : Central University of Technology, Free State, 2008. http://hdl.handle.net/11462/112.

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Thesis (M. Tech) - Central University of Technology, Free State, 2008
Food and water are two basic human needs. International projections indicate that water shortages will be prevalent among poorer countries where resources are limited and population growth is rapid, such as the Middle East, parts of Asia and Africa. Provisional estimates are that South Africa will run out of surplus usable water by 2025, or soon thereafter. Urban and peri-urban areas will therefore require new infrastructure and inter-basin transfers to provide safe water and adequate sanitation. Due to the high cost of these developments, such water is seen as being used for industrial and public needs only and not for irrigation. Currently, the agricultural water users consume the majority of the water used by humans. Taking cognisance of the before mentioned it is a reality that in the future the irrigation sector will have to sacrifice some of its water for public and industrial usage. This suggests growing conflict between the different water users and the agricultural water users. An attempt by the Department of Water Affairs and Forestry (DWAF) to address this conflict has been the implementation of pilot studies to determine the steps Water User Associations (WUAs) could take to ensure more effective water use in the future by the agricultural sector. These steps include an increase in irrigation efficiency according to the benchmarks of crop irrigation requirements and more efficient dam and canal management. The Water Administration System (WAS) has been developed to fulfill this exact requirement as it ensures optimal delivery of irrigation water on demand. The program is designed as a management tool for irrigation schemes, WUAs and water management offices to manage their accounts, and also to manage water supply to clients more efficiently through canal networks, pipelines and rivers. The WAS program consists of four modules that are integrated into a single program. Three modules of the WAS program have already been implemented at the Vaalharts irrigation scheme. This scheme has been transformed from a government controlled scheme to a privately owned scheme, and is now known as the Vaalharts Water User’s Association (VHWUA). The main purpose of this study was to implement the fourth module of the WAS program at the VHWUA as only full functionality of the complete program will ensure effective water use at the scheme. The fourth module calculates the volume of water to be released for all the canals (main canal and all its branches), allowing for lag times, water losses and accruals in order to minimise waste and thus save water. The methodology followed in this study was to first of all develop an understanding of the distribution cycle and the current calculation procedure of the VHWUA. The fourth module was then applied on a typical feeder canal and used to calculate the release volumes in order to compare these results with the current values. The next step was then to verify all data abstracted from the database used by the WAS program to calculate the release volumes. The database consists of information like cross-sectional properties, positioning of the sluices, canal slope, as well as canal capacities. The verification of data was done by field work, by studying existing engineering design drawings, through meetings and consultations with all parties involved in the VHWUA as well as by mathematical calculations. Cross-checking and verification, if necessary, of all above mentioned data were done. After the verification process, the database was updated and another cycle of calculations were run to do the final calibrations. Accurate calibrations were done to the seepage and the lag time coefficient. Some final adjustments were also made to the canal geometry in the database. This was an important part of the study as only a trusted and verified database will deliver correct results, irrespective of the software program used. After calibration of the database, the fourth module was again applied, but this time water losses were included in the calculations and the results revealed trustworthy and accurate real-time release volumes. The study therefore succeeded in the implementation of the fourth module on a typical feeder canal at the VHWUA. The study was concluded by the compilation of a checklist, which the VHWUA can use to implement the module on the whole scheme. This would enable the VHWUA to implement and apply the complete WAS program, which offers all the benefits and answers in every need of any water management office. Sustainable water resource utilisation can only be achieved through proper management. Applying this most effective management program will ensure a cost effective and optimised process at the VHWUA.

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19

Mills, Elizabeth Anne. "Embodied precarity : the biopolitics of AIDS biomedicine in South Africa". Thesis, University of Sussex, 2014. http://sro.sussex.ac.uk/id/eprint/48911/.

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This thesis centres on the lives of women who live in Khayelitsha and who receive AIDS biomedicines through South Africa's public health system. It is tiered across five ethnographic chapters to elucidate a single overarching argument: biopolitical precarity is networked into the permeable body. This argument is based on ethnographic research and seeks to challenge the discursive construction of distance that divorces women's lives and bodies from the governance of AIDS biomedicines as life-giving technologies. The multi-sited ethnography underpinning this thesis was configured to follow the networked threads that weave women's embodied precarity into the governance of technologies and the technologies of governance. To this end, fieldwork was conducted in South Africa from October 2010 – July 2011 in order to understand the embodied and political dimensions of access to AIDS biomedicine. Thereafter, fieldwork was conducted in Brazil from August 2011 – September 2011 to explore the networked connections spanning activist organisations, government coalitions and economic blocs to move out from the intimate spaces of women's lives and bodies to locate them in the regional and global spaces of biomedical developments and health policy dynamics. This thesis argues that although it is crucial to anchor technologies in people's lives, it is also analytically and politically necessary to link people's lives - and the technologies that sustain them - back into the global assemblage that is networked around the governance of medicine. Therefore, I locate biomedical technologies in social and political contexts of lives of the people with whom I worked in Khayelitsha, and I argue further that their lives also need to be understood as part of a complex network of actors (spanning international organisations, regional coalitions and national governments) and actants (HIV and ARVs) that assemble in dynamic configurations and that are woven into and through the body.

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20

Van, den Heever Alexander Marius. "The distribution and redistribution of health resources in South Africa". Master's thesis, University of Cape Town, 1991. http://hdl.handle.net/11427/18291.

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This thesis is intended as a broad examination of the distribution of health resources in South Africa. Issues both macro and micro in nature have been covered to provide a perspective that would be Jacking in a narrower study. Although the title refers to a redistribution of resources, the intention of this thesis is to stress the importance of providing appropriate health measures rather than merely apportioning existing facilities evenly. This realization is insufficient, however, if it is not accompanied by the introduction and utilization of analytical approaches for identifying resource selection priorities. The influences on health status are many. In defining appropriate measures to improve health status it is important to be aware of the limitations of medical-care. Chapter three involves a cross-sectional regression analysis of various countries in order to examine the influences certain variables have on health status. This study suggests the need for an integrated approach to improving the health of a population. Merely focusing on medical care will only have a limited affect. However, this does not mean that medical-care is not important. It must just be provided in an appropriate manner. The rest of the thesis evaluates health-care resource distribution in South Africa. The existing distribution of health-care resources in South Africa is ill-suited to the existing health status of the population. There is a bias toward urban based curative facilities. Furthermore, the location of facilities has been based on racial criteria, whereby some areas have sufficient resources for their needs while others do not. Two methods of identifying how these issues should be dealt with are produced in this thesis. The first deals with a method for adjusting the broad distribution of funds toward those areas where need is greatest. The suggestion put forward by this thesis is that a formula be developed that would be able both to define need on a geographical basis, and to allocate resources based on that need. The formula would be used to allocate government health expenditure. This section is based on a formula that was developed in the United Kingdom. The second deals with a method for defining appropriate medical interventions on the micro level. It is called cost-effectiveness analysis (CEA). CEA is used for micro-economic decision-making where a choice has to be made between at least two alternatives for attaining a particular objective. Furthermore, CEA evaluates projects or programmes that are on-going in nature. It should be noted that CEA can also evaluate non-medical interventions to solve a particular health problem. In order to indicate the type of information that a CEA can provide, an investigation into cervical cancer procedures used on black females was produced. The entire black female population of South Africa was examined. A computer simulation of incidence and mortality rates of the disease was used to evaluate various scenarios. The results indicate that significant gains can be made by introducing cervical cancer screening on a large scale in South Africa. A major priority of this thesis was to stress the importance of using economic criteria to assist in making decisions concerning health-care resource allocations. Very little work of this nature is produced in South Africa. Hopefully this will not always be the case.

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21

Enoch, Annabel. "Hepatitis A seroprevalence in South Africa: Are we in epidemiological transition?" Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/27817.

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Hepatitis A virus (HAV) is the most common cause of viral hepatitis worldwide. Infection with HAV is vaccine preventable, however, a vaccine against HAV is not included in the Expanded Programme on Immunization in South Africa (SA). South Africa was considered to be a high endemic country for hepatitis A in the past, hence there was no need for routine immunization against the virus. Our hypothesis is that SA is changing from high to intermediate endemic setting for hepatitis A. To test our hypothesis, we conducted a cross-sectional seroprevalence study in the 1-7 year age group in the Western Cape Province. Our samples for this study were from specimens, collected between August and October 2015, sent for routine diagnosis to referral hospitals in the Western Cape Province. We tested remaining serum of 482 samples sent for routine tests. A Siemens enzyme immunoassay was used to test for hepatitis A antibodies. We also analysed hepatitis A test results from the National Health Laboratory Services (NHLS) Disa*Lab database at Groote Schuur hospital from 2009-2014, as well as hepatitis A surveillance data from the National Institute for Communicable Diseases (NICD) from 2009-2014, to look at the past hepatitis A prevalence trend. Our cross-sectional study showed the seroprevalence to be 44.1% in the 1-7 year age group. The NHLS data showed a seroprevalence of <90% up to age 10 years, indicating intermediate endemicity. The NICD data showed that a substantial number of symptomatic hepatitis A infections occurred in the 7-40 year age group, suggesting an increasing proportion of a susceptible population to HAV infection. Taken together, these results indicate the need for further studies designed to aid the development of vaccination policies against HAV infection in South Africa.

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22

Hoffmann, Rena. "Ready of not? Perceptions of the strengths and weaknesses of newly qualified medical microbiologists entering practise in South Africa". Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71927.

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Thesis (MPhil)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Purpose of the Research: To obtain more comprehensive data on the perceptions of strengths and weaknesses in Medical Microbiological Pathology training against the background of rapidly changing pathology services. Methods: On-line surveys were conducted of potential employers and recent graduates of Medical Microbiology and Clinical Pathology. Results: There were 15 employer respondents and 19 newly trained pathologist respondents out of the 88 pathologists that were identified to participate in the study. From the employers’ standpoint, the majority expressed overall satisfaction with newly trained pathologists. Specific areas of deficiency were Administration, Management and Research. In addition, almost a half of employers agreed that the same amount of guidance and support for newly trained pathologists is needed now than was required a decade ago. Newly trained pathologists did not appear to be inappropriately overconfident in their abilities. In selecting new pathologists, employers perceived ability to work in a team, academic knowledge and interpersonal skills as the most important applicant characteristics. When newly trained pathologists were asked why they thought they were offered their position, the responses were very varied, ranging from academic background to contractual obligations. Conclusion: We believe that with this study some insights were obtained into the perceived strengths and weaknesses of newly trained pathologists entering Microbiology Pathology Services and that the results of the study can be used as input for further discussions and training of pathology registrars.
AFRIKAANSE OPSOMMING: Doel van die Navorsing: Om meer omvattende data te bekom oor die tekortkominge en sterk punte in Mediese Mikrobiologiese Patologie opleiding in ag genome huidige vinnig veranderende patologie dienste. Metodes: Internet-gebasseerde vraeboë is gerig aan potensiële werkgewers van patoloeë asook nuut gekwalifiseerde graduanti van Mediese Mikrobiologie en Kliniese Patologie. Resultate: Van die 88 patoloeë wat uitgenooi is om deel te neem aan die studie het 15 werkgewers en 19 nuut gekwalifiseerde patoloeë deelgeneem. Die meerderheid van die werkgewers was oor die algemeen tevrede met nuwe aanstellings. Spesifieke areas waaraan meer aandag behoort te gee word, is Administrasie, Bestuur en Navorsing. Bykans die helfde van die werknemers het saamgestem dat nuut gekwalifiseerde patoloeë nou dieselfde hoeveelheid bystand en ondersteuning benodig as patoloeë ‘n dekade gelede. Dit wil voorkom asof die nuut gekwalifiseerde patoloeë nie oormatige selfvertroue in hulle eie vermoëns het nie. Werkgewers het die volgende eienskappe as die belangrikste ge-ag as hulle nuwe patologeë aanstel: vermoë om in ‘n span te werk, akademiese kennis en interpersoonlike vaardighede. Toe nuut gekwalifiseerde patoloeë gevra is hoekom hulle dink hulle is aangestel was die antwoorde baie uiteenlopend en het gewissel van akademiese prestasie tot kontrakturele verpligtinge. Gevolgstrekking: Ons glo dat met die resultate van hierdie studie ons beter insigte bekom het oor die tekortkominge en sterk punte van nuut gekwalifiseerde patoloeë wat Mikrobiologiese Patologie Dienste betree. Hopelik sal hierdie studie ‘n bydrae kan maak tot die toekomstige beplanning van nagraadse patologie opleiding.

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23

Stein, Dan J., Stacey L. Williams, Pamela B. Jackson, Soraya Seedat, Landon Myer, Allen Herman e David R. Williams. "Perpetration of Gross Human Rights Violations in South Africa: Association With Psychiatric Disorders". Digital Commons @ East Tennessee State University, 2009. https://dc.etsu.edu/etsu-works/8024.

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Abstract (sommario):

Background. A nationally representative study of psychiatric disorders in South Africa provided an opportunity to study the association between perpetration of human rights violations (HRVs) during apartheid and psychiatric disorder. Prior work has suggested an association between perpetration and post-traumatic stress disorder (PTSD), but this remains controversial. Methods. Subjects reported on their perpetration of human rights violations, purposeful injury, accidental injury and domestic violence. Lifetime and 12-month prevalence of DSM-IV (Diagnostic and Statistical Manual, 4th edition) disorders were assessed with Version 3.0 of the World Health Organization Composite International Diagnostic Interview (CIDI 3.0). Socio-demographic characteristics of these groups were calculated. Odds ratios for the association between the major categories of psychiatric disorders and perpetration were assessed. Results. HRV perpetrators were more likely to be male, black and more educated, while perpetrators of domestic violence (DV) were more likely to be female, older, married, less educated and with lower income. HRV perpetration was associated with lifetime and 12-month anxiety and substance use disorders, particularly PTSD. Purposeful and DV perpetration were associated with lifetime and 12-month history of all categories of disorders, whereas accidental perpetration was associated most strongly with mood disorders. Conclusion. Socio-demographic profiles of perpetrators of HRV and DV in South Africa differ. While the causal relationship between perpetration and psychiatric disorders deserves further study, it is possible that some HRV and DV perpetrators were themselves once victims. The association between accidental perpetration and mood disorder also deserves further attention.

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24

Chiwandire, Desire. "Conscientious objection and South African medical practitioners' constructions of termination of pregnancy and emergency contraception". Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1017863.

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Abstract (sommario):

Aim: The 1996 Choice on Termination of Pregnancy Act decriminalized abortion in South Africa and the South African Medicines Control Council in 2000 approved the dispensing of emergency contraceptive methods by pharmacists to women without a doctor's prescription. This legislation has been hailed as among the most progressive in the world with respect to women's reproductive justice. However the realisation of these rights in practice has not always met expectations in part due to medical practitioners' ethical objections to termination of pregnancy and the provision of related services. The aim of this study was to interpret the varying ways in which medical practitioners frame termination of pregnancy and emergency contraceptive services, their own professional identities and that of their patients/clients. Methods: Sample of 58 doctors and 59 pharmacists drawn from all nine provinces of South Africa. Data collected using an anonymous confidential internet-based self-administered questionnaire. Participants were randomly recruited from online listings of South African doctors and pharmacists practicing in both private and public sectors. Data were analysed using theoretically derived qualitative content analysis. Results: Participants drew on eight frames to justify their willingness or unwillingness to provide termination-of-pregnancy related services: the foetal life frame, the women's rights frame, the balancing frame, the social justice frame, the do no harm frame, the legal and professional obligation frame, the consequences frame and the moral absolutist frame. Conclusion: Health professionals' willingness or unwillingness to provide termination of pregnancy related services is highly dependent on how they frame or understand termination of pregnancy, and how they understand their own professional identities and those of their patients/clients.

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25

Du, Toit Willem Johannes. "The development of an integrated management model for occupational health and safety in medical institutions". Thesis, Nelson Mandela Metropolitan University, 2005. http://hdl.handle.net/10948/1300.

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Abstract (sommario):

Health and safety management forms part of the overall risk management of medical institutions, and deals with the responsibility of an organisation to provide a risk free environment for all who are exposed to the activities of such medical institutions. Affected people include health care workers, contractors, visitors, and patients. Medical institutions, and hospitals specifically, are uniquely distinct from other industries in that they employ highly skilled staff with specific specialised knowledge. These institutions are also increasingly making use of complex technology that requires specialist staff to operate medical machines and equipment. These specific aspects are accounted for in this research. The overall purpose of this research is to determine the need for an alternative approach to the management of health and safety in medical institutions. An appropriate model will be developed that can be integrated into the existing health and safety management system. The research methodology for this study comprises the following steps: Firstly, the health and safety environment was researched in relation to all stakeholders, external and internal, that are affected by medical institutions’ activities. The effect of these activities, and how it influences health and safety management, was evaluated in a South African context. Secondly, the overall risk management approach of medical institutions and the effect of organisational culture were researched to determine the effect on health and safety performance. Thirdly, a questionnaire was sent to selected staff of five hospitals in the Eastern and Western Cape to determine their perception and experience of health and safety management. Quantitative data on incidents in Netcare Hospitals were obtained, and a comparison of the questionnaire studies was done to determine the need for a health and safety model. The final step of this study entailed the development of a health and safety model using legislative requirements and the needs identified in the research. A proposal is made to integrate specialist functions and departments into the existing health and safety management system, in order to strengthen the managerial capabilities of such a system. The importance of improving the safety and compliance culture is indicated.

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26

Burch, Vanessa Celeste. "Medical education in South Africa assessment practices in a developing country /". Rotterdam : Rotterdam : Erasmus Universiteit ; Erasmus University [Host], 2007. http://hdl.handle.net/1765/10152.

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27

Loubser, Petrus Abel. "The future and sustainability of private medical care in South Africa". Thesis, Stellenbosch : Stellenbosch University, 2007. http://hdl.handle.net/10019.1/21186.

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Abstract (sommario):

Thesis (MBA)--Stellenbosch University, 2007.
ENGLISH ABSTRACT: This study provides an overview of the medical aid industry in South Africa and highlights the impact of the formation of the Council for Medical Schemes through the implementation of the Medical Schemes Act of 1998. The regulatory framework that governs the medical aids in South Africa is analysed. In this study. different medical aid funds are compared in terms of administration costs, required solvency levels and membership numbers relative to the acceptable industry averages. The main cost drivers of medical aid funds that could also threaten the future of private medical care are identified, as these services may not be affordable to most South Africans in the future. The new vision of government in terms of healthcare is outlined, and the regulations that will be implemented to transform the healthcare sector into a Social Health Insurance system, and ultimately into a National Health Insurance system. are analysed. The proposed mechanisms, such as the Risk Equalisation Fund, the Government Employees Medical Scheme and lowincome medical schemes, are discussed, highlighting all their advantages as well as the associated risks for the sustainability of private medical care. The proposed new legislation and the potential negative financial impact on the private medical industry are analysed with detailed reference to the Medical Schemes Act of 1998 and the Medicines and Related Substance Control and Amendment Act of 1997. The implications of fundamental changes proposed in private health insurance, such as community risk rating versus the traditional individual risk rating, are discussed. The negative impact of prescribed minimum benefits (which include HIV/Aids) on the financial sustainability of the medical aid industry is highlighted. The impact of HIV/Aids on the sustainability of the medical aid industry is discussed and some conclusions and recommendations are made regarding the financial sustainability of the medical aid industry and hence the future of private medical care in South Africa.
AFRIKAANSE OPSOMMING: Hierdie studie is 'n oorsig van die mediesefondsbedryf in Suid·Afrika, en beklemtoon die impak van die totstandkoming van die Raad van Mediese Skemas deur die impJementering van die Wet op Mediese Skemas van 1998. Hierdie regulatoriese raamwerk, wat mediese fondse in SuidAfrika tans reguleer, word in die studie ondersoek. In hierdie studie word van die grootste mediese fondse in tenne van administratiewe koste, voorgeskrewe fondsreserwes en lidmaatskapgetalle relatief tot die aanvaarde bedryfsnonne met rnekaar vergelyk. Die belangrikste koste-items vir mediese fondse wat die voortbestaan van privaat gesondheidsorg kao bedreig, word ontleed cmdat hierdie dienste in die toekoms vir die rneeste Suid-Afrikaners onbekostigbaar kan word. Die regering se nuwe visie vir gesondheidsorg word uiteengesit. asook die regulasies wat germplementeer sal word om die gesondheidsektor na 'n sosiale gesondheidsversekeringstelsel en uiteindelik na tn nasionale gesondheidstelsel te transfonneer. Die voorgestelde meganismes, seos die Risiko-egalisasiefonds, GEMS en laeinkomste-mediesefondse word bespreek, met al die relevante voor- en nadele, tesame met die geassosieerde risiko's vir die voortbestaan van privaat mediese dienste. Die voorgestelde wetgewing en die gevolglike negatiewe finansiele impak op die privaat gesondheidsbedryf, met spesifieke verwysing na die Wet op Mediese Skemas van 1998 asook die Wet op die Beheer van Medisyne en Verwante Middels van 1997, word ondersoek. Die implikasies van fundamentele veranderinge wat in terme van gesondheidsversekering voorgestel word, soos gemeenskapsrisikogradering teenoor individuelerisikogradering, word bespreek. Voorgeskrewe minimum voordele (wat MIV insluit) wat nou ingevolge wetgewing ten volle deur fondse betaal moet word, se potensiele negatiewe impak op die finansiele lewensvatbaarheid van mediese fondse word beklemtoon. Die potensiele negatiewe impak van die MIV-epidemie op die lewensvatbaarheid van die mediesefondsbedryf word bespreek en gevolg deur aanbevelings om die fmansiele lewensvatbaarheid en toekoms van die privaat gesondheidsbedryf in Suid-Afrika te verseker.

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28

Liountris, Demitri. "Exploring rape myth acceptance among general medical practitioners in South Africa". Master's thesis, Faculty of Law, 2021. http://hdl.handle.net/11427/32782.

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Abstract (sommario):

Rape myths have several negative effects on society, and can affect those who come into contact with victims of sexual assault on a professional level. One group of professionals that assist victims are general medical practitioners and in a country like South Africa, that has a high rate of rape, it is not uncommon for general medical practitioners to find themselves assisting victims. Previous research has suggested that professionals who assist victims such as police officers and lawyers are susceptible to rape myth acceptance. In South Africa, research suggests that medical health professionals can have negative views of victims, depending on a number of factors such as the victim's behaviour and alcohol consumption. Presenting data collected using the Illinois Rape Myth Acceptance Scale (IRMAS) from a sample of 44 general medical practitioners in South Africa, it was found that the participants had low levels of rape myth acceptance. The findings indicated that not only were rape myths not strong influences within the sample, myths that related to the concept of ‘real rape' were the least likely to be supported. Furthermore, additional questions in the survey revealed that general medical practitioners are not well-equipped to provide care to victims of sexual assault and more effort is needed with regards to service provision.

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29

Van, Huyssteen Nina. "A legal analysis of the emergency medical services in South Africa". Diss., University of Pretoria, 2016. http://hdl.handle.net/2263/60108.

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Abstract (sommario):

The purpose of this dissertation is to analyse the Emergency Medical Services (EMS) in South Africa from a legal point of view. The researcher has practical experience in the EMS and this has given her insight as to how the EMS operates, the grey areas in this unique profession and how the EMS is regulated by the South African law. A brief background of the EMS is given as well as how the system operates now and what EMS providers deal with on a day-to-day basis. This provides a clear picture of how diverse and unpredictable the EMS profession truly is. How the law regulates the EMS is discussed and all the grey areas from a medico-legal point of view are pointed out and analysed. During this discussion, the researcher makes use of her practical experience to explain why certain situations EMS providers have to deal with on a regular basis are so complex and why the EMS is in need of a better regulatory framework. The grounds of justification in medical law are also discussed and applied to the pre-hospital environment. The researcher made use of the EMS of the United States of America (USA) and the EMS of Australia in the comparative section, analysed how their respective EMS systems operates and how it is regulated by the law. This is ultimately compared to the EMS of South Africa and recommendations were made as to how the regulation of the EMS system, as a whole, can improve in the future.
Dissertation (LLM)--University of Pretoria, 2016.
Public Law
LLM
Unrestricted

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30

Mupfumira, Rudo. "An assessment of African traditional medicines in pregnancy and on birth outcomes: pharmacists' perceptions of complementary medicines in pregnancy". Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1003256.

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Abstract (sommario):

Increasing numbers of medicines are being used by pregnant South African women in the public sector during pregnancy, for the treatment of different biomedical and supernatural disease states and conditions. The motivation for the research is to support the development of more local pregnancy registries in order to strengthen evidence for the safety and efficacy of medicines used in pregnancy. A mixed methods approach was used. Women in their ninth month of pregnancy in a public sector setting, and four community pharmacists were identified. The women who met the inclusion criteria were recruited. One in-depth semi-structured interview was conducted with each woman before giving birth and data on their pregnancy outcomes were collected after labour. Coincidentally, the mother of one of the participants was found to be a traditional healer. She was also interviewed on the topic. A structured questionnaire was administered to the pharmacists. Ten pregnant women between the ages of 19 to 39 who had used or were using a traditional medicine during the pregnancy were recruited. All the participants had had at least one antenatal check up during their pregnancy with one having attended five times. No abnormal results were reported from any of the check ups or tests done during the visits. All of them had been to school and had at least Standard 8/Grade 10 education. Ten babies were seen between one and four days postpartum and no birth defects were obvious or were reported for any of them. The traditional healer did not provide additional information to what the women had said and confirmed that some of the practices the women reported were known to her as traditional medicine practices. All four pharmacists indicated that they considered complementary and alternative medicines (CAMs) to be “somewhat effective” and sold them at their pharmacies although none of them were aware of whether or not they were registered with the MCC. None of the pharmacists appeared to have an in-depth knowledge of traditional, complementary and alternative medicines (TCAMs). All four pharmacists said that it is important to have a basic understanding of TCAMs before using them, although they did not agree on the reasons for this. All of them felt that pharmacists have a professional responsibility to provide information on TCAMs (especially herbal preparations) and two felt that providing this information is part of a medical doctors’ responsibility. No harm from taking TCAMs could be shown. However herbal medicines have numerous ingredients some of which are unknown and taking these medicines is risky. The pharmacists in this sample were unsure whether they were accessing unreliable CAM information. Reliable sources of information and reference materials on CAMs to assist pharmacists and other healthcare professionals are needed. The apparent widespread use of TCAM in pregnancy indicates a need for documentation about its efficacy and safety. The establishing of TCAM pregnancy registries should seriously be considered. Due to the increase in CAM use, CAM education during pharmacists’ training as well as continuing professional development (CPD) in CAM for pharmacists in practice should be encouraged.

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31

Maesela, Matlou Tlakale. "The analysis of public and private healthcare in South Africa". Diss., University of Pretoria, 2019. http://hdl.handle.net/2263/73473.

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Abstract (sommario):

The Bill of Rights enshrines the rights of all people in our country and affirms the democratic values of human dignity, equality and freedom. The state must respect, protect, promote and fulfil the rights in the Bill of Rights. Every human being on earth has the right to life. In general, the state's positive and negative duties are set out in section 7(2) of the Constitution of South Africa, which requires the state to respect, protect, promote and fulfil all human rights. The Constitution of the Republic of South Africa adopted and in 1996 is the supreme law of the land and supersedes all other laws in the country. The main key to having a more eloquent and fulfilling governing system is to align it with the Constitution. This is empirical to developing and implementing health law and policy, which regulates in at least five important ways: • It regulates the structure of government. • It regulates the way in which various branches of government operate. • It sets out the framework for raising taxes and allocating revenue. • It guides the content of all laws and policies, primarily through the Bill of Rights. • It regulates the role of government and non-state actors such as private corporations in realising the right of access to health care services. Furthermore, it emphasizes that every person has the right “to have access to health care services, including reproductive health care”.
Mini Dissertation (LLM)--University of Pretoria, 2019.
Public Law
MPhil
Restricted

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32

Ramaloko, Thomas Tshwantshi. "The effect of different land uses on household livelihoods in Tale Ga-Morudu Communal Property Association". Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/14146.

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Abstract (sommario):

This study is about a population of 235 households in Blouberg municipality, Limpopo Province, that constituted itself in 2004 into a Communal Property Association. The Tale Ga-Morudu CPA was formed in order to own, manage and control a total of seventeen farms which were progressively restituted to them during 2004 by the Commission on Restitution of Land Rights. Tale Ga-Morudu households were dispossessed and forcefully removed from a number of fertile, arable and irrigable farms1in the 1960s due to racially discriminatory laws or practices. These households were then relocated by the then apartheid regime on the eastern part of Mogalakwena River. They were distributed in the arid communal areas of Laanglagte/Vergelegen, Matekereng; Ga- Mankgodi; Letswatla and Mamoleka under the traditional leadership of Kgoshi Maleboho of BabinaTšhwene. (Map one). It is the aim of this study to find out how Tale Ga-Morudu CPA currently uses these restituted farms for the households who have said to have benefited from restituted land. The researcher used his own observations, lessons and analysis of perspectives from case studies conducted from Limpopo in order to pursue this aim. This study adopted a descriptive household survey design that used a predominantly quantitative approach, and the use of qualitative methods to complement contextual details. A quantitative questionnaire was used on a sample unit of (20%) 45 households obtained by simple random sampling from a population of 235 households of the CPA. Other qualitative methods include focus group discussion, document review and observation. From the results it is clear that land claimants, prefer to retain existing practices of land use, than risk changes in land use in order to meet their socio-economic needs. Thus, instead of investing in commercial agriculture or wildlife farming, people follow subsistence agriculture and remain dependent on social grants and pensions for their livelihood. The general study findings show that the CPA planned to implement different types of land use including those of direct land use value. These include food gardens, resettlement; game farming; poultry enterprises and livestock grazing, and also of indirect use value. The latter refers to contract crop cultivation, rentals and strategic partnerships. The study found that despite income being generated from indirect types of land use, the majority of these intended beneficiaries never benefited from accrued financial dividends of land rental and development. However, households were still able to take advantage of employment opportunities created by contract crop cultivation and in the process they acquired crop cultivation skills. Furthermore the harvesting of natural resources such as wood and poles also contribute to the wellness of households. Households, also derived cultural wellness and a sense of satisfaction by accessing their restored farms to perform rituals. The general conclusion of the study is that the CPA is underutilizing its properties, including arable and irrigable fields, rentable recreational facilities, game farming and its tourism potential.

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33

Grobler, Chazanne. "A regulatory framework for psycho-legal assessments in South Africa". Thesis, University of Pretoria, 2020. http://hdl.handle.net/2263/78604.

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Abstract (sommario):

The study demonstrates that mental health professionals, more specifically psychiatrists and psychologists, conducting psycho-legal assessments in South Africa, play a pivotal role in assisting the courts in ensuring that justice is done. Mental health professionals are involved in numerous matters, ranging from criminal cases, such as conducting psycho-legal assessments regarding criminal capacity, civil proceedings concerning care and contact evaluations, personal injury claims, and many more. In reviewing case law and the complaints lodged with, and rulings made by, the Health Professions Council of South Africa, it is evident that psycho-legal assessments are often problematic. The problems relate to an inadequate level of performance in evaluations and testimony and unethical behaviour. It is argued that the lack of regulation of psycho-legal assessments is one of the main contributing factors in the increasing challenges experienced. The study examines the current regulatory framework regarding psycho-legal assessments in South Africa by first examining the procedural and evidentiary rules that control the admissibility and evaluation of expert testimony, and secondly, the self-regulation by the mental health professions. To address the shortcomings, the regulatory mechanisms in the international context is analysed by turning to the United Kingdom as well as the United States of America. Both jurisdictions have strong ties to South Africa and a rich history concerning regulating psycho-legal assessments and psychological and psychiatric evidence in general. Drawing from the regulatory frameworks in the comparator countries recommendations for the South African context is made. The recommendations take a multi-level approach, focusing on the rules of evidence and other procedural rules within the legal system and self-regulation of mental health professions.
Thesis (LLD)--University of Pretoria, 2020.
Public Law
LLD
Unrestricted

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34

Mullah, Moonira. "A survey of the working environment of medical technologists in South Africa". Thesis, Cape Peninsula University of Technology, 2018. http://hdl.handle.net/20.500.11838/3081.

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Abstract (sommario):

Thesis (MSc (Health and Wellness Sciences))--Cape Peninsula University of Technology, 2018
Biomedical Laboratory Technologists play a fundamental role in the diagnosis of disease in patients. Their role in South Africa is currently undergoing profound changes with an emphasis placed on a four-year professional degree that will replace the National Diploma in Biomedical Technology at most Universities of Technology and Comprehensive Universities (UJ and NMU) by 2020. Training and competency programs, along with the retention of experienced staff, remain key in providing accurate laboratory results. It is therefore imperative to investigate this field in factors related to training, work experience and job satisfaction. This study aimed to evaluate the perceptions of Medical Technologists and Medical Technicians with regards to salary, interpersonal relationship, continuing professional development (CPD), work ethic and scope of practice within the profession. A mixed methods study was conducted to evaluate salary, career choice happiness and CPD compliance of Medical Technologists and Medical Technicians, as well as their perceptions around interpersonal relationships, work ethic and scope of practice. In sampling, a convenience sample was identified, after which a snowballing method was used. A link to a web-based survey was distributed to a group of Medical Technologists and Medical Technicians who attended the Society of Medical Laboratory Technology of South Africa (SMLTSA) Medical Laboratory Professionals congress. This congress was held in 2015 in Port Elizabeth, South Africa. A sample of 144 Medical Technicians and Medical Technologists was obtained, of which 98.6% were registered with the Health Professions Council of South Africa (HPCSA). Only 54.2% were active members of the Society of Medical Laboratory Technologist of South Africa. Age (r = 0.674, p < 0.05) and years worked at current employer (r = 0.533, p < 0.05) proved to have stronger relationships with salary than education (r = 0.195, p < 0.05). Those employed in the public sector earned significantly lower salaries than those in any other sector (p < 0.05), with the exception of those working in independent practice. Both Medical Technologists (44.2%) and Medical Technicians (34.4%) perceived that they did not receive the respect they deserved from Pathologists in their working relationship. In addition, 31.3% of Medical Technicians perceived that their roles were regarded as of lesser value, and that their knowledge, training and attained qualifications were not recognised by the Pathologists. Despite this, this study concluded respondents were generally happy with their career choice, as 71.9% of respondents reported. Findings of this study serve as a strong foundation for additional research on the topic of career happiness versus job satisfaction and retention of staff in medical diagnostic laboratories.

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35

Grové, Gertruida le Roux. "A Framework for Legal Enforceability of Living Wills in South Africa". Thesis, University of Pretoria, 2019. http://hdl.handle.net/2263/76363.

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Abstract (sommario):

This thesis investigates the legal validity of living wills (advance directives) in South Africa. The study explores the current status of living wills in South Africa and contains recommendations on how legal enforceability of living wills can be improved in the South African context. The Constitution of the Republic of South Africa, 1996, the common law and the National Health Act, 61 of 2003, serve as basic points of departure for this investigation. Shortcomings in the current South African legislation and proposed draft legislation including the Law Commission’s Draft Bill on End of Life Decisions, 1998, and The National Health Amendment Bill, 2019, as well as shortcomings in the common law, the field of medical ethics and medical practice are indicated and recommendations for an improved framework are made. For purposes of a legal comparative methodology, the legal frameworks of living wills in the Netherlands, England and Canada are investigated. Specific circumstances which could potentially hamper the legal enforcement of living wills are discussed, including: emergency situations, do-not-resuscitate orders, permanent vegetative states, dementia, cessation of artificial hydration and feeding, pregnancy, euthanasia, assisted suicide, palliative care, pain relief and organ donation. It is argued that a living will could be an important tool in enhancing the doctor-patient relationship, not only to the benefit of the autonomous patient whose dignity and other fundamental human rights should be protected, but also to the benefit of the doctor as the medical care provider.
Thesis (LLD)--University of Pretoria, 2019.
Public Law
LLD
Unrestricted

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36

Coetzee, Francois. "A survey of wound care knowledge in South Africa". Thesis, Stellenbosch : University of Stellenbosch, 2015. http://hdl.handle.net/10019.1/97230.

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Abstract Chronic wounds afflict millions worldwide, incurring significant health care costs and chronic suffering. Clinicians are often unsure about treatment, resulting in poor outcomes. Objective To determine the scope of knowledge possessed by fifth year medical students, general practitioners (GP’s) and surgical registrars, concerning chronic wound management. Design Cross sectional study Methods Deans of eight South African medical schools received letters requesting information regarding time devoted to wound-care training. Knowledge-based questionnaires were distributed to final-year students at two universities, surgical registrars at three universities and general practitioners attending refresher courses. Result. Four medical schools replied, of whom only two offered formal teaching. 162 medical students, 45 GP’s and 47 surgical registrars completed questionnaires. The overall median (25th–75th percentiles) knowledge scores for registrars, GP’s and students were 65%;(55%–70%), 55%;(45%–65%) and 45%;(35%–50%) respectively. Whereas the scores of registrars and GP’s did not differ, the student scores were significantly less. Only 32% of registrars and 18% of GP’s attained scores of 70% or more. 96% considered training to be inadequate. Interest in wound-care was only mild to moderate, with more GP’s than registrars requesting literature. Conclusions Very little, if any training on chronic wounds is offered in South Africa. The levels of knowledge cannot be considered adequate for successful treatment, nor for teaching to undergraduates. This preliminary study cannot reflect the attitudes and knowledge throughout the country; however it is clear that there is a need for improved education about these conditions that have huge clinical and economic consequences.

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37

Calmeyer, Sean. "Building long-term customer loyalty in the South African Medical Scheme industry". Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/21432.

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Abstract (sommario):

Thesis (MBA)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: The medical scheme industry of South Africa has been exposed to fundamental changes during the last decade. We have been witness to various amalgamations and scheme closures as a result of financial pressure and changes to legislation. Never before has it been more important for medical scheme administrators to become more customer focused and find solutions for medical schemes to stay viable into the future. Relationship marketing, a widely acknowledged concept, has been recognised as an appropriate tool to manage relationships and improve customer loyalty over a long-term period. A number of studies have investigated the viability of relationship marketing strategies across different industries. No such studies have however been performed for the medical scheme industry of South Africa. The study therefore aims to investigate how loyalty between medical schemes and their respective administrators is currently maintained. It further aims to determine if the medical scheme industry would benefit from relationship marketing initiatives to encourage long-term loyalty. An in-depth literature study was performed. The underlying aspects under investigation include relationship marketing, customer relationship management (CRM) and customer loyalty. It is thus important to investigate the influence of these three components on the strength of relationships and customer retention. The second phase of the study consisted of in-depth semi-structured interviews with various scheme representatives from the industry. This study is based on an exploratory case and the qualitative data was analysed using pattern finding techniques and qualitative content analysis. The study investigated the factors that have an impact on loyalty in the medical scheme industry. It was determined that relationships between administrators and medical schemes are multilevel and although relationship marketing literature indicates that key account managers are essential for the successful use of relationship based strategies, it was evident that expertise needs to extend beyond only those in key customer management positions. It is evident from the findings of this study that the medical scheme industry of South Africa could benefit hugely from correctly implemented and well researched relationship marketing strategies. This study may therefore be useful to the medical scheme industry in that it provides insight into relationship marketing in the South African context.

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38

Lachman, Peter Irwin. "Referral patterns to the Red Cross War Memorial Children's Hospital". Master's thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/26634.

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This prospective descriptive study describes the referral patterns to the Red Cross War Memorial Children's Hospital. The study was conducted from 1st July to 31st December 1987 and entailed the collection of all referral letters presented (9288) to the hospital and the analysis of a sample of these letters (4702). The results indicated: * The patients are similar in terms of age and sex to those attending the Outpatients Department except that relatively fewer referred patients are Black. * The private sector, i.e. general practitioners, is the largest referral agency followed by Day Hospitals. * Most patients were ref erred to the Outpatients Department without an appointment. * Of the specialist clinics, the surgical clinics, i.e. Ophthalmology and Ear, Nose and Throat Clinics, were utilised the most. * The majority of patients (84,90%) were not admitted. * The contact made by the hospital with referral agents was poor (only in 30,30%). * The quality of information in referral letters was generally poor and did not contribute to patient care. Recommendations are made to the hospital and relevant health authorities.

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39

Yusuff, Toyeeb. "Retention strategies for medical doctors in a Port Elizabeth Hospital complex". Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/8856.

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The aim of this research is to investigate the factors identified as significant in increasing the retention of medical doctors employed in Port Elizabeth hospital complex (PEHC) in the Eastern Cape, South Africa. Medical practitioners of PEHC are providing the needed critical clinical services and are believed to be the strength of tertiary health services in the Eastern Cape, providing world class treatment to the public. Recruitment and retention of talented medical practitioners, then, is in the best interests of the Department of Health. Demotivated staffs are more likely to leave their jobs for better opportunities, and therefore efforts must be geared towards retaining them. This research investigates the independent factors identified. They include the management style, risk exposure, the working environment, the work overload, and the benefits associated with retaining of medical practitioners in PEHC. The results of this study revealed that the following factors influence the talent management and retention of doctors in the hospital complex: a management style that appreciates and recognises staff, a risk-free work environment, a flexible and balanced life, a reasonable work load, and the attitude of immediate supervisors. The results of this study will add to the guidelines and retention strategies already in place by the Department of Health, Eastern Cape. The senior management and policy makers could use the recommendations revealed in this study for an efficient human resources policy. However, future research still needs to be done in the area of providing employment for spouses of members of staff especially on the reward system and the recognition of employees in the organization.

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40

Brand, Catharina Elizabeth. "A continuing professional development framework for medical laboratory technologists/technicians in South Africa". Thesis, Bloemfontein : Central University of Technology, Free State, 2006. http://hdl.handle.net/11462/57.

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Thesis (D.Tech) - Central University of Technology, Free State, 2006
Since 2002 all medical technologists and technicians have been obliged to participate in the compulsory continuing professional development (CPD) programme implemented by the Health Professions Council of South Africa (HPCSA). It was foreseen that CPD would not be equally accessible to medical technologists and technicians in urban and rural areas. The reason for this survey was to identify obstacles that might prevent medical technologists and technicians, especially those in rural areas from participating in CPD activities and to identify ways to overcome these obstacles. The survey was conducted in three phases. During the first phase quantitative information, concerning the profession of medical technology in South Africa, and CPD in general was obtained from registered medical technologists and technicians by means of a questionnaire. Information obtained from the questionnaire as well as that obtained from the literature led to the second phase in which an interview questionnaire was compiled. Structured interviews were conducted with medical technologists and technicians employed throughout South Africa, gathering mainly qualitative information regarding medical technology and CPD. Lack of time and financial constraints and to a lesser extent travelling were identified as the major obstacles to participating in CPD activities. The obstacles were an even bigger problem to those employed in rural areas. It was also confirmed that everybody involved in medical technology should be positively motivated to create and participate in CPD activities. A method suggested was to practise CPD activities during working hours which is cost effective but restricted, because of the workload. In addition medical technologists and technicians should participate in activities offered by the Society of Medical Laboratory Technologists of South Africa (SMLTSA) and attempt formal further qualifications. Being involved in research projects and identifying case studies could result in publishing in accredited journals. During the third phase of the survey a concept CPD framework was compiled. According to the framework all role players involved in the profession of medical technology must collaborate and contribute to making CPD activities accessible to all registered medical technologists and technicians and create a positive attitude to CPD. The role players include the HPCSA, employers and top management, the SMLTSA, medical companies, other health professionals, higher education institutions and the individual. It must be emphasised that the task of collecting CPD credits remains the responsibility of the medical technologist or medical technician. The framework offered suggestions for CPD activities whereby medical technologists and technicians could accumulate CPD credits. One major concern indicated in the framework, was that CPD should not only be measured by CPD credits but the outcomes of CPD should be reflected in the profession and the workplace and a system must be implemented to measure CPD outcomes. The CPD framework was evaluated by a panel of experts familiar with the profession of medical technology and the CPD programme, using the Delphi technique. This final CPD framework will be referred to the HPCSA for implementation in all South African pathology laboratories and the blood transfusion services. The aim of the framework is to assist the CPD guidelines currently under revision in establishing a usable CPD programme.

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41

Cilliers, Liezel. "Critical success factors for user acceptance of telemedicine in South Africa". Thesis, University of Fort Hare, 2010. http://hdl.handle.net/10353/384.

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The World Health Organization has recommended Telemedicine to improve health care in developing countries. The objective of this study was to produce Critical Success Factors that will investigate and identify factors that influence the acceptance and continued use of Telemedicine in the Eastern Cape Department of Health, and to suggest ways to sustain this technology from initial adoption (the pilot programme) to full adoption. Sub questions investigated which other facilitating factors, such as management support or previous Information Technology exposure must be present in order for the technology to be adopted successfully. The study made use of a questionnaire to investigate the user acceptance and behaviour of health care workers. A return rate of 76% was achieved. The data was analysed making use of Statistical Package for the Social Sciences (SPSS), specifically the Chi Square test. From these results Critical Success Factors where then formulated to address the problems identified. The Critical Success Factors that were identified include: Implement and disseminate best practice within a legislative framework; Find a champion; Change management strategies; Training; Sustainable finance; Technical issues and Project management principles If these CSFs are addressed before and during the implementation of Telemedicine it will increase the acceptance and use of the technology among health care workers. Critical Success Factors for User Acceptance of Telemedicine in South Africa.

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Mostert-Phipps, Nicolette. "Health information technologies for improved continuity of care: a South African perspective". Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/1619.

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The fragmented nature of modern health care provision makes it increasingly difficult to achieve continuity of care. This is equally true in the context of the South African healthcare landscape. This results in a strong emphasis on the informational dimension of continuity of care which highlights the importance of the continuity of medical records. Paper-based methods of record keeping are inadequate to support informational continuity of care which leads to an increased interest in electronic methods of record keeping through the adoption of various Health Information Technologies (HITs). This research project investigates the role that various HITs such as Personal Health Records (PHRs), Electronic Medical Records (EMRs), and Health Information Exchanges (HIEs) can play in improving informational continuity of care resulting in the development of a standards-based technological model for the South African healthcare sector. This technological model employs appropriate HITs to address the problem of informational continuity of care in the South African healthcare landscape The benefits that are possible through the adoption of the proposed technological model can only be realized if the proposed HITs are used in a meaningful manner once adopted and implemented. The Delphi method is employed to identify factors that need to be addressed to encourage the adoption and meaningful use of such HITs in the South African healthcare landscape. Lastly, guidelines are formulated to encourage the adoption and meaningful use of HITs in the South African healthcare landscape to improve the continuity of care. The guidelines address both the technological requirements on a high level, as well as the factors that need to be addressed to encourage the adoption and meaningful use of the technological components suggested. These guidelines will play a significant role in raising awareness of the factors that need to be addressed to create an environment conducive to the adoption and meaningful use of appropriate HITs in order to improve the continuity of care in the South African healthcare landscape.

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43

Yen, Jeffery. "Healing at the margins: discourses of culture and illness in psychiatrists', psychologists' and indigenous healers' talk about collaboration". Thesis, Rhodes University, 2000. http://hdl.handle.net/10962/d1002600.

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This dissertation explores discourses about culture and illness in the talk of mental health professionals and indigenous healers. It represents an attempt to situate the issue of indigenous healing in South Africa within a particular strand of critical discourse analytic research. In the context of current deliberations on the value, or otherwise, of indigenous healing in a changing health and specifically mental health system, the talk of both mental health practitioners and indigenous healers as they conceptualise “disorder”, and discuss possibilities for collaboration, is chosen as a specific focus for this study. Disputes over what constitutes “disorder” both within mental health, and between mental health and indigenous healing are an important site in which the negotiation of power relations between mental health professionals and indigenous healers is played out. The results of this study suggest that despite the construction of cogent commendations for the inclusion of indigenous healing in mental health, it remains largely marginalised within talk about mental health practice. While this study reproduces to some extent the marginalisation of indigenous healing discourse, it also examines some of the discursive practices and methodological difficulties implicated in its marginalisation. However, in the context of “cultural pride strategies” associated with talk about an African Renaissance, indigenous healing may also function as a site of assertion of African power and resistance in its construction as an essentially African enterprise. At the same time, it may achieve disciplinary effects consonant with cultural pride strategies, in constructing afflictions in terms of neglect of, or disloyalty to cultural tradition. These results are discussed in terms of the methodological difficulties associated with interviewing and discourse analysis of translated texts, which contributes to difficulties with articulating indigenous healing discourse in a way that challenges the dominant psychiatric discourses implicated in its marginalisation within mental health. It concludes with recommendations for future research which addresses indigenous healing discourse in its own terms, and examines its operation as a disciplinary apparatus in South African society.

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44

Kavaka, Evniki. "Medical students acting as health educators :the influence on adolescents' knowledge about HIV/Hepatitis B transmission, as well as attitudes, beliefs and intentions towards condom use". Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_1268_1194348373.

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The aim of this quasi-experimental study was to examine the impact of a health education intervention on knowledge about HIV/Hepatitis B transmission, attitudes, beliefs and intentions towards condom use. Research has shown tht small group discussion, single sex groups, age proximity of health educators, and HIV prevention integrated in the broader sexual health context, increased the effectiveness of health education with regard to safer sexual practices.

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45

Dachs, Robert. "An assessment of undergraduate musculoskeletal training at Medical Schools in South Africa". Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/2837.

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46

Day, Cascia. "Delirium amongst HIV-infected general medical admissions in Cape Town, South Africa". Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33693.

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Background Delirium is associated with increased mortality and hospital length of stay. Limited data are available from HIV-infected acute hospital admissions in developing countries. We conducted a prospective study of delirium amongst acute medical admissions in South Africa - a developing country with universal ART access and high burdens of TB and noncommunicable disease. Methods Three cohorts of adult acute medical admissions to Groote Schuur and Victoria Hospitals, Cape Town, South Africa were evaluated for prevalent delirium within 24 hours of admission. Reference delirium testing was performed by either consultant physicians or neuropsychologists, using the Confusion Assessment Method (CAM). Findings The study included 1182 acute medical admissions; with 318 (26·9%) HIV-infected Median(IQR) age and CD4 count was 35(30-43) years and 132(61-256) cells/mm3 respectively, with 140/318(44%) using ART on admission. Delirium prevalence was 17·6%(95% CI 13·7-22·1%) amongst HIV-infected patients and was an independent risk factor for inpatient mortality. In multivariable logistic regression, factors associated with delirium were age ≥55 years(AOR 6·95[2·03-23·67], p=0·002) and urea ≥15(AOR 4·83[1·7- 13·44], p=0·003), while ART use reduced risk (p=0·014). Low CD4 count, unsuppressed viral load, and active TB were not predictors of delirium; nor were other traditional risk factors such as non-opportunistic, acute infections or polypharmacy. Interpretation Delirium is common and predicts poor outcome in HIV-infected acute medical admissions in endemic settings despite increased ART use. Older HIV-infected patients with renal dysfunction are at high risk for inpatient delirium while those using ART on admission are protected.

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47

Abor, Patience Aseweh. "Medical waste management at Tygerberg hospital in the Western Cape, South Africa". Thesis, Cape Peninsula University of Technology, 2007. http://hdl.handle.net/20.500.11838/782.

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Thesis (MTech (Environmental Health))--Cape Peninsula University of Technology, 2007
This study examined the medical waste management practices of Tygerberg Hospital. The researcher made use of both primary and secondaiy data. Since this was a is study, the analysis is essentially descriptive.The results of this study revealed that both general and medical wastes are generated in the hospital. Tygerberg Hospital does not quantify medical waste. Segregation of medical wastes into infectious medical waste and non-infectious medical waste is not conducted according to definite rules and standards. The hospital does not label infectious waste with Biohazard symbol. Separation of medical waste and municipal waste is however practiced to a satisfactory extent. Wheeled trolleys are used for on-site transportation of waste from the points of production (different wards) to the temporary storage area. Staff responsible for collecting medical waste use almost complete personal protective equipment. The results of this study indicated that off-site transportation of the hospital waste is undertaken by a private waste management company. Waste is transported daily and small pickups are mainly used by the waste management company for transporting the waste to an off-site area for treatment and disposal. The final disposal of the medical waste is done by the private waste management company. The main treatment method used in the final disposal of infectious waste is incineration. Non-infectious waste is disposed of using land disposal method. The hospital does not recycle medical waste materials except white office paper and mixed office paper and the use of empty containers of antiseptics for the collection and temporary storage of sharps.The hospital does not provide training for staff members on the health and environmental effects of infectious waste. The waste management company's workers have also not received any formal training with regards to medical waste management. The study showed that Tygerberg Hospital does not have a policy and plan in place for managing medical waste. There is no definite policy or plan for purchasing the necessary equipment and for providing the facilities for the correct management of medical waste in the hospital. There are also no policies and guidelines regarding the recycling of medical waste products. There are a number of problems the hospital faces in terms of medical waste management, including; lack of necessary rules, regulations and instructions on the different aspects of collection and disposal of waste, intermingling of hazardous wastes with domestic waste in the hospital sometimes, failure to quantify the waste generated in reliable records, lack of use of coloured bags by limiting the bags to only one colour for all waste, the absence of a dedicated waste manager, the supervisor in charge of general services has waste management as part of his job schedule, and there is no committee responsible for monitoring the management of medical waste. From the results of this study, it is obvious that medical waste management is not practiced according to the World Health Organisation's (WHO's) recommended standards. There are some areas where medical wastes are not properly managed. It is imperative for significant investment in the proper management of medical waste in order to reduce the health risk it poses.

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48

Westwood, Anthony Thomas Read. "Survey of medical, dental and nursing services in centres for intellectually and physically disabled children in Cape Town and its environs". Master's thesis, University of Cape Town, 1992. http://hdl.handle.net/11427/26677.

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This study describes the present medical, dental and nursing services in and used by centres for intellectually and physically impaired children in Cape Town and its environs. The information was gained by means of a structured questionnaire. Thirty three of the 34 centres with a total of 3480 children are included. Twelve are Special Care Centres, 15 Training Centres and 6 are Special Schools. The number of children enrolled ranges from 9 to 400. At the time of the study 9 of the centres were for white children, 17 for coloured children, 5 for black children and 2 were multiracial. Nine of the 11 Special Care Centres were not government supported while only 6 of the other centres were mainly funded from non-government sources. Nurses employed at the centres had worked an average of 8 years at their centres, 23,5% of them having worked with disabled children prior to taking up their present posts. Of the Special Care Centres, only the two residential ones had a nurse on the staff. All the Special Schools had at least one nurse. 57,5% of the centres have a doctor or doctors visiting the centre. Two of the others have regular medical care for the children arranged with local health centres. All the Special Schools are visited while 25% of the Special Care Centres and 33% of the Training Centres receive medical visits. The number of doctors visiting a centre varies from 1 to 7. The doctors come from a variety of services both private and public. Most of the doctors do not receive remuneration for their services. Of the 1 7 centres who have no doctors visiting, the majority depend on parents to take their children to a medical facility if there are problems related to the child's disability. For 7 of them, there is no other option. A similar pattern exists for medical problems unrelated to the child's disability. Six centres make use of medical facilities as a first option in these circumstances. For emergencies only 1 centre can count on a doctor to come to the centre. Ten centres may be able to get a doctor to come. The General Hospitals are the most common facility used in an emergency. Dentists visit 4 of the centres. Twelve of the remaining 29 centres arrange regular dental visits for the children. Eleven of the 13 Special Care Centres do not have regular visits to a dentist arranged. Fifteen centres receive visits from Community Nurses and these are local authority nurses in the main. Their functions are limited in all but one case to contraception, immunisation, Heaf testing or genetic services. There are 10 centres which receive visits from neither doctor, dentist nor nurse (7 Special Care Centres, 3 Training Centres). 32% of the interviewees were satisfied with the services received. The most common improvement sought was to have a doctor visit the centre. Of those with a doctor visiting, 28% wanted the doctors to deal with intercurrent problems as well as the child's disability. The need for paramedical services was also expressed. Further detail is presented and the implications of the findings discussed.

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Amod, Farouk. "Islamic Medical Association of South Africa : activities and projects". Thesis, 1998. http://hdl.handle.net/10413/6165.

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Ackah, Shiroma. "The association of demographics and occupational factors with latent tuberculosis infection in radiology staff at public sector hospitals in the eThekwini health district". Thesis, 2015. http://hdl.handle.net/10321/1422.

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Submitted in fulfillment of the requirements for the degree of Master’s of Technology: Radiography, Durban University of Technology, Durban, South Africa, 2015.
Introduction Tuberculosis remains a leading cause of death, second to the Human Immunodeficiency Virus. The risk of latent tuberculosis infection and active tuberculosis disease is a known occupational hazard. In South Africa, a high tuberculosis burden country, the potential of Mycobacterium tuberculosis transmission to health care workers is high. This includes diagnostic radiographers and other radiology staff working in radiology departments. Purpose of the Study This study aimed to investigate the association of demographic and occupational factors with latent tuberculosis infection in radiology staff in public sector hospitals of the eThekwini Health District. Methodology This cross-sectional study was conducted from 26 February 2013 to 07 June 2013. Quantitative methods were used to test for associations of demographic and occupational factors with latent tuberculosis infection in participants. A sample size of 181 participants for an estimated population of 340 radiology staff was recommended at the proposal stage. The study consisted of two phases; the questionnaire survey (phase one) and the administration of a two-step tuberculin skin test (phase two). Data was obtained with regard to demographics, occupational history, social behaviours, medical history; and family and home histories. Demographic and occupational associations with latent tuberculosis infection were made in relation to the size of the first tuberculin skin test induration. Frequency distributions were developed to describe data categories. Pearson’s and Spearman rho’ correlation coefficients were used to test for correlations between the independent variables. The chi-square test was used to determine associations between the categorical independent variables and the dependent variable. Bivariate analyses were performed using these tests. The multivariate analysis was performed using logistic and linear regression on the dependent variable. Results A total of 182 questionnaires were returned from approximately 280 radiology staff. At the outset, all doctors working in the radiology department had to be excluded due to numerous failed attempts to enlist their participation. Fifty-three (29.12 percent) participants were excluded from phase one of the study and a further thirteen participants were excluded from phase two. The total sample was 116 participants. Of the 116 participants, 86.2 percent tested positive for latent tuberculosis infection at the first step of the two-step testing method used. One (0.86 percent) participant went on to convert at the second step, testing positive at this level. Demographic associations with latent tuberculosis infection included age (older) as an associated factor. A significant demographic association with latent tuberculosis infection was the use of alcohol (p-value 0.033 on the multivariate analysis). Occupational associations with latent tuberculosis infection included longer durations of employment. The annual income (higher income earners) displayed significant associations with latent tuberculosis infection (p-value 0.048 on the multivariate analysis). It is necessary in this study to note that participants include support personnel (lower income earners) making up 37.8 percent of the study, diagnostic radiographers making up 48.3 percent; and radiography managers/assistant managers (highest income earners) making up 13.8 percent of the study. Conclusion and recommendations The risk of transmission of Mycobacterium Tuberculosis to health care workers is a known occupational hazard. This study has described the prevalence of latent tuberculosis infection in radiology staff, at district and regional hospitals within the eThekwini Health District. With 23.62 percent of all participants already having active TB disease and 86.2 percent of the tested group displaying positive results for latent tuberculosis infection, using the tuberculin skin tests, the need for tuberculosis screening is essential. The findings of this study will be used as a health improvement mechanism for stakeholders, having identified potential gaps in medical screening in healthcare in Kwa-Zulu Natal. This study makes recommendations for the early detection of active tuberculosis infection and the monitoring of health care workers that are latently infected, thus assisting in reducing the rate of conversion of latent tuberculosis infection to active tuberculosis disease in radiology staff. This reduces long-term exorbitant costs related to health care associated infections, such as tuberculosis. It also reduces rates of transmission and cross infection to both co-workers and already immunocompromised patients, helping to curb the overall epidemic in South Africa.

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Tesi sul tema "Medical Association of South Africa"

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