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Fundal pressure during the second stage of labour

  • Authors: Hofmeyr, Georges Justus , Vogel, Joshua. P , Cuthbert, Anna , Singata, Mandisa
  • Date: 03-2017
  • Subjects: South Africa Pregnancy Computer File
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/11260/5766 , vital:44640 , https://DOI:10.1002/14651858.CD006067.pub3
  • Description: Background Fundal pressure during the second stage of labour (also known as the 'Kristeller manoeuvre') involves application of manual pressure to the uppermost part of the uterus directed towards the birth canal, in an attempt to assist spontaneous vaginal birth and avoid prolonged second stage orthe need for operative birth. Fundal pressure has also been applied using an inflatable belt. Fundal pressure is widely used, however methods of its use vary widely. Despite strongly held opinions in favour of and against the use of fundal pressure, there is limited evidence regarding its maternal and neonatal benefits and harms. There is a need for objective evaluation of the eGectiveness and safety of fundal pressure in the second stage of labour. Objectives To determine if fundal pressure is eGective in achieving spontaneous vaginal birth, and preventing prolonged second stage or the need for operative birth, and to explore maternal and neonatal adverse eGects related to fundal pressure. Search methods We searched Cochrane Pregnancy and Childbirth's Trials Register (30 November 2016) and reference lists of retrieved studies. Selection criteria Randomised and quasi-randomised controlled trials of fundal pressure (manual or by inflatable belt) versus no fundal pressure in women in the second stage of labour with singleton cephalic presentation. Data collection and analysis Two or more review authors independently assessed potential studies for inclusion and quality. We extracted data using a pre-designed form. We entered data into Review Manager 5 soAware and checked for accuracy. Main results Nine trials are included in this updated review. Five trials (3057 women) compared manual fundal pressure versus no fundal pressure. Four trials (891 women) compared fundal pressure by means of an inflatable belt versus no fundal pressure. It was not possible to blind women and staG to this intervention. We assessed two trials as being at high risk of attrition bias and another at high risk of reporting bias. All other trials were low or unclear for other risk of bias domains. Most of the trials had design limitations. Heterogeneity was high for the majority of outcomes. Manual fundal pressure versus no fundal pressure Manual fundal pressure was not associated with changes in: spontaneous vaginal birth within a specified time (risk ratio (RR) 0.96, 95% confidence interval (CI) 0.71 to 1.28; 120 women; 1 trial; very low-quality evidence), instrumental births (RR 3.28, 95% CI 0.14 to 79.65; 197 women; 1 trial), caesarean births (RR 1.10, 95% CI 0.07 to 17.27; 197 women; 1 trial), operative birth (average RR 0.66, 95% CI 0.12 to 3.55; 317 women; 2 studies; I2 = 43%; Tau2 = 0.71; very low-quality evidence), duration of second stage (mean diGerence (MD) -0.80 minutes, 95% CI -3.66 to 2.06 minutes; 194 women; 1 study; very low-quality evidence), low arterial cord pH in newborn babies (RR 1.07, 95% CI 0.72 to 1.58; 297 women; 2 trials; very low-quality evidence), or Apgar scores less than seven at five minutes (average RR 4.48, 95% CI 0.28 to 71.45; 2759 infants; 4 trials; I2 = 89%; Tau2 = 3.55; very low-quality evidence). More women who received manual fundal pressure had cervical tears than in the control group (RR 4.90, 95% CI 1.09 to 21.98; 295 women; 1 trial). No neonatal deaths occurred in either of the two studies reporting this outcome (very low-quality evidence). No trial reported the outcome severe maternal morbidity or death. Fundal pressure by inflatable belt versus no fundal pressure Fundal pressure by inflatable belt did not reduce the number of women havinginstrumental births (average RR 0.73, 95% CI 0.52 to 1.02; 891 women; 4 trials; I2 = 52%; Tau2 = 0.05) or operative births (average RR 0.62, 95% CI 0.38 to 1.01; 891 women; 4 trials; I2 = 78%; Tau2 = 0.14; very low-quality evidence). Heterogeneity was high for both outcomes. Duration of second stage was reported in two trials, which both showed that inflatable belts shortened duration of labour in nulliparous women (average MD -50.80 minutes, 95% CI -94.85 to -6.74 minutes; 253 women; 2 trials; I2 = 97%; Tau2 = 975.94; very low-quality evidence). No data on this outcome were available for multiparous women. The inflatable belt did not make any diGerence to rates of caesarean births (average RR 0.56, 95% CI 0.14 to 2.26; 891 women; 4 trials; I2 = 70%; Tau2 = 0.98), low arterial cord pHin newborn babies (RR 0.47, 95% CI 0.09 to 2.55; 461 infants; 1 trial; low-quality evidence), or Apgar scores less than seven atfive minutes (RR 4.62, 95% CI 0.22 to 95.68; 500 infants; 1 trial; very low-quality evidence). Third degree perinealtears were increased in the inflatable belt group (RR 15.69, 95% CI 2.10 to 117.02; 500 women; 1 trial). Spontaneous vaginal birth within a specified time, neonatal death, andsevere maternal morbidity or death were not reported in any trial. Authors' conclusions There is insuGicient evidence to draw conclusions on the beneficial or harmful eGects of fundal pressure, either manually or by inflatable belt. Fundal pressure by an inflatable belt during the second stage of labour may shorten duration of second stage for nulliparous women, and lower rates of operative birth. However, existing studies are small and their generalizability is uncertain. There is insuGicient evidence regarding safety for the baby. There is no evidence on the use of fundal pressure in specific clinical settings such as inability of the mother to bear down due to exhaustion or unconsciousness. There is currently insuGicient evidence for the routine use of fundal pressure by any method on women in the second stage of labour. Because of current widespread use of the procedure and the potential for use in settings where other methods of assisted birth are not available, further good quality trials are needed. Further evaluation in other groups of women (such as multiparous women) will also be required. Future research should describe in detail how fundal pressure was applied and consider safety of the unborn baby, perineal outcomes, longer-term maternal and infant outcomes and maternal satisfaction.
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  • Date Issued: 03-2017

Beneficial effects of medicinal plants in fish diseases

  • Authors: Stratev, Deyan , Zhelyazkov, Georgi , Noundou, Xavier Siwe , Krause, Rui W M
  • Date: 2008
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/123487 , vital:35447 , https://doi.org/10.1007/s10499-017-0219-x
  • Description: Fish are constantly in contact with pathogens inhabiting water. High population density as well as poor hydrodynamic conditions and feeding lead to an increased sensitivity towards infections. In order to prevent major economic losses due to diseases, various medications are used for treatment and prevention of infections. The use of antimicrobial drugs in aquacultures could lead to emergence of resistance in pathogenic microorganisms. Alternatives are being sought over the last few years to replace antibiotics, and medicinal plants are one of available options for this purpose. These plants are rich in secondary metabolites and phytochemical compounds, which have an effect against viral, bacterial, and parasitic diseases in fish. Their main advantage is their natural origin and most of these plants do not represent threat for human health, the fish, and the environment. The goal of this review is to present information on the treatment of viral, bacterial, and parasitic diseases in fish through medicinal plants, with focus on the mechanisms of action of the identified secondary metabolites, fractions, or plant extracts.
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  • Date Issued: 2008

Exploratory mathematics talk in a second language: a sociolinguistic perspective:

  • Authors: Graven, Mellony , Robertson, Sally-Ann
  • Date: 2009
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/69907 , vital:29594 , https://doi.org/10.1007/s11858-018-0952-2
  • Description: This paper illuminates challenges confronting teachers and students at the literacy/numeracy interface in contexts where students have not developed sufficient English language proficiency to be learning mathematics through English but, due to socio-politically and economically driven perceptions are being taught in English. We analyse transcript data of classroom talk in a South African grade 4 mathematics lesson on fractions. Together with interview data, the lesson data highlight some of the consequences students’ diminished access to their home language appear to have on their access to mathematical meaning-making.
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  • Date Issued: 2009

Using a transdisciplinary framework to examine mathematics classroom talk taking place in and through a second language

  • Authors: Graven, Mellony , Robertson, Sally-Ann
  • Date: 2009
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/69838 , vital:29586 , https://DOI: 10.1007/s11858-018-0952-2
  • Description: This paper proposes a transdisciplinary framework to allow for a multifocal exploration of classroom talk practices. It draws on data from a broader study of talk in South African Grade 4 mathematics classrooms where the language of teaching and learning (English) was the home language for neither the teachers nor their students. Lesson transcript data from one teacher’s lessons on fractions are used to demonstrate how working with three strands of conceptual insight from the disciplines of psychology, sociology and linguistics conduces to a potentially richer understanding of a teacher’s use of classroom talk in mediating her students’ mathematical understanding. By drawing on elements of Vygotsky’s sociocultural psychology, we make visible in the lesson data the ways in which this teacher used the ‘everyday’ in trying to navigate her students’ towards more ‘scientific’ conceptualizations of unit fractions. By then taking up aspects of Bernstein’s sociological work, we articulate, and make visible, how societal circumstances impinge on students’ access to exploratory mathematical discourse needed for epistemological access to abstract and generalized mathematical concepts. Finally, through Halliday’s work on the power of particular linguistic registers for meaning-making, we highlight challenges in learning mathematics in and through a second language and reveal the constraints placed on students’ opportunity to maximally exploit the distinct forms of meaning contained within the mathematics register.
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  • Date Issued: 2009

A moderate elevation in [CO 2] results in potential hypervirulence on SABBIErica

  • Authors: Gallagher, Sean , Hill, Jaclyn M , Murugan, N , Botha, Christiaan E J
  • Date: 2017
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/68835 , vital:29329 , https://doi.org/10.1016/j.sajb.2017.10.010
  • Description: The Russian Wheat Aphid (Diuraphis noxia Kurdjumov, 1913) (RWA) is a serious pest of grain crops and is of considerable concern in South Africa, particularly in terms of barley grown specifically for the brewing industry. This paper highlights the effect of a small (50 ppm) increase in [CO2] on the growth rate of the four South African RWA biotypes on the SABBIErica barley cultivar. Controlled environment experiments revealed that the colony growth rate for RWASA4 was significantly lower than SA1 under ambient conditions as well as significantly lower than SA1, SA2 or SA3 under elevated CO2 conditions. The unexpected difference suggested an atypical, non-preferential feeding habit on SABBIErica, for RWASA4. The small RWASA4 colonies inflicted similar morphological damage to the significantly larger RWASA1 – RWASA3 biotype populations — indicative of potential hypervirulence under elevated CO2. The continuous feeding of RWASA biotypes causes damage to the transport system as well as substantial, catastrophic damage to mesophyll chloroplasts as well as mitochondria within the host plant's leaves. The TEM study revealed evidence of sequential/systematic degeneration of chloroplasts and mitochondria with continued aphid feeding, which we suggest is an indication of potential emergent hypervirulence under elevated CO2 conditions.
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  • Date Issued: 2017

"Our Voice of Africa": it is less than our voice without a woman's voice

  • Authors: Tumusiime, Amanda
  • Date: 2018
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/145687 , vital:38458 , https://0-muse.jhu.edu.wam.seals.ac.za/article/695397/pdf
  • Description: In her poem Our Voice (Chipasula and Chipasula 1995: 166–67) Noémia de Sousa (1926–2002) speaks about “our voice of Africa” as that voice that is liberative; that voice which opens “up new ways” and “lights up remorse … and burns glimmers of hope in the dark souls of desperate people” who cry out for emancipation from “slavery.” That voice which creates new possibilities by awakening a “cyclone of knowledge.” That voice which can persistently and effectively represent the aspirations of “millions of voices that shout, shout and shout!” for freedom and self-actualization.
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  • Date Issued: 2018

'We pledge to improve the health of our entire community'

  • Authors: Grant, Carolyn , Nawal, Dipty , Guntur, Sai Mala , Kumar, Manish , Chaudhuri, Indrajit , Galavotti, Christine , Mahapatra, Tanmay , Ranjan, Kunal , Kumar, Gangesh , Mohanty, Sunil , Alam, Mohammed Aftab , Das, Aritra , Jiwani, Safia
  • Date: 2018
  • Subjects: To be catalogued
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/281179 , vital:55699 , xlink:href="https://doi.org/10.1371/journal.pone.0203265"
  • Description: Background: Motivation is critical to health worker performance and work quality. In Bihar, India, frontline health workers provide essential health services for the state’s poorest citizens. Yet, there is a shortfall of motivated and skilled providers and a lack of coordination between two cadres of frontline health workers and their supervisors. CARE India developed an approach aimed at improving health workers’ performance by shifting work culture and strengthening teamwork and motivation. The intervention—“Team-Based Goals and Incentives”—supported health workers to work as teams towards collective goals and rewarded success with public recognition and non-financial incentives. Methods: Thirty months after initiating the intervention, 885 health workers and 98 supervisors completed an interviewer-administered questionnaire in 38 intervention and 38 control health sub-centers in one district. The questionnaire included measures of social cohesion, teamwork attitudes, self-efficacy, job satisfaction, teamwork behaviors, equitable service delivery, taking initiative, and supervisory support. We conducted bivariate analyses to examine the impact of the intervention on these psychosocial and behavioral outcomes. Results: Results show statistically significant differences across several measures between intervention and control frontline health workers, including improved teamwork (mean = 8.8 vs. 7.3), empowerment (8.5 vs. 7.4), job satisfaction (7.1 vs. 5.99) and equitable service delivery (6.7 vs. 4.99). While fewer significant differences were found for supervisors, they reported improved teamwork (8.4 vs. 5.3), and frontline health workers reported improved fulfillment of supervisory duties by their supervisors (8.9 vs. 7.6). Both frontline health workers and supervisors found public recognition and enhanced teamwork more motivating than the non-financial incentives. Conclusions: The Team-Based Goals and Incentives model reinforces intrinsic motivation and supports improvements in the teamwork, motivation, and performance of health workers. It offers an approach to practitioners and governments for improving the work environment in a resource-constrained setting and where there are multiple cadres of health workers.
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  • Date Issued: 2018

0 Representation of South African "tribal" culture in soap operas : a content and audience analysis of the series Generations : The Legacy

  • Authors: Onyenankeya, Oluwayemisi Mary
  • Date: 2018
  • Subjects: Television criticism Mass media and culture Mass media--Social aspects
  • Language: English
  • Type: Thesis , Doctoral , Communication
  • Identifier: http://hdl.handle.net/10353/15430 , vital:40407
  • Description: Commercial media entertainment offerings in South Africa especially mainstream soap operas, are progressively infusing dominant social values and ideas which are alien to South African tribal societies. In most of the commodified television drama series, people who hold tight to traditional beliefs and values are often characterised as traditionalists, while those who have imbibed the western defined dicta and ideology of modernity are seen as progressives. This study therefore, sought to ascertain how South African tribal language, traditional institutions, values, social norms and ancestral beliefs are portrayed through the television drama, Generations: The Legacy and what the viewers think about those constructions and the implication for cultural identity. The mixed methods approach was employed involving the administration of questionnaire to 350 participants selected through random sampling and a content analysis of 20 episodes of Generations: The Legacy. The findings suggest that Generations: The Legacy tends to portray South African tribal culture negatively (p-value > 0.05). More than half of the respondents (52percent) strongly believe such negative portrayals may erode the cultural identity of black South Africans, 68.6% were of the opinion that Generations: The Legacy gives preference to western culture as against South African tribal culture. The findings further showed that the African values and traditions represented in Generations: The Legacy do not significantly reflect the South African tribal tradition and values (p-value > 0.05). In the few occasions that African traditional values are represented Generations: The Legacy, they tend to be portrayed as old fashioned (p-value > 0.05), and inferior and backward (p-value > 0.05). In addition, the findings indicate that Generations: The Legacy is a vehicle for promoting dominant culture. Nearly, 59percent of the respondents stated that watching Generations: The Legacy affect the way they view South African tribal culture, while 59.1percent indicated that watching Generations: The Legacy has somehow affected their perception of their own cultural identity. In all, participants rated the representation of South African tribal culture as poor. The study concludes that while South African tribal culture is increasingly finding expression on mainstream soap opera, tribal South African values and beliefs are often depicted as old-fashioned, and inimical to modernisation, and individual’s freedom.
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  • Date Issued: 2018

A baseline survey of channel geomorphology with particular reference to the effects of sediment characteristics on ecosystem health in the Tsitsa River, Eastern Cape, South Africa

  • Authors: Huchzermeyer, Nicholaus Heinrich
  • Date: 2018
  • Subjects: Fluvial geomorphology -- South Africa -- Eastern Cape , Stream health -- South Africa -- Eastern Cape , River sediments -- South Africa -- Eastern Cape , Watershed management -- South Africa -- Eastern Cape , Dams -- Environmental aspects -- South Africa -- Eastern Cape , Tsitsa River (South Africa) , Ntabelanga Dam (South Africa)
  • Language: English
  • Type: text , Thesis , Masters , MSc
  • Identifier: http://hdl.handle.net/10962/58056 , vital:27040
  • Description: Fluvial systems are dynamic systems in which variables in a catchment and river channel affect the morphology of river reaches. South African rivers are increasingly being exposed to stresses from a combination of factors, one of the most prevalent being the impacts of damming rivers which result in varying downstream sediment fluxes and flow regimes. The sediment load combined with flow characteristics for respective river channels provides the physical habitat for aquatic ecosystems. The damming of the Tsitsa River, through the construction of the Ntabelanga Dam, will change the overall downstream geomorphology. This creates an opportunity for research in the preconstruction window. The current condition of the Tsitsa River was monitored by completing a baseline survey of the channel geomorphology with specific reference to the influence of sediment on river habitats and ecosystem health. Five sites were established in variable reaches of the Tsitsa River, with Site 1 located above the proposed Ntabelanga Dam inundation and Sites 2-5 below the proposed dam wall. Each site included a range of features that can be monitored for their response to the dam. Physical variables, water quality and biota were monitored seasonally to note changes in habitat quality. A baseline survey of the present geomorphology and associated instream habitats of the selected reaches was set up by conducting cross-sectional surveys of channel topography, water slope surveys, discharge measurements and visual and quantitative assessments of substrate. Level loggers were installed at each site to collect continuous data on variations in depth and temperature. Monitoring surveys, in terms of fine sediment accumulation, were conducted to characterise dynamic habitat arrangements and macroinvertebrate community composition. A taxa related physical habitat score for the Tsitsa River was created. The relationship between water quality, physical and ecological characteristics of the Tsitsa River will aid further research in the area as well as create a better understanding of the influence of sediment on river habitats and ecosystem health. Monitoring sites can be used to monitor the impact of catchment-wide rehabilitation on river health prior to the dam being built. After dam construction, the top site above the dam inundation can still be used as a point to monitor the impact of catchment rehabilitation on ecosystem health in terms of fine sediment accumulation.
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  • Date Issued: 2018

A best practice guideline for a healthy work environment for professional nurses working in the South African Military Health Service

  • Authors: Mabona, Jean Fezeka Madi
  • Date: 2018
  • Subjects: Nurses -- Employment -- South Africa , Medicine, Military -- South Africa South Africa -- National Defence Force -- Medical care , Work environment -- National Defence Force -- Medical care
  • Language: English
  • Type: Thesis , Doctoral , DCur
  • Identifier: http://hdl.handle.net/10948/30811 , vital:31146
  • Description: Governments, internationally and nationally, are becoming aware of the importance of healthy work environments within their health departments, environments that are caring and supportive to health professionals. This awareness is brought about by the mounting evidence that healthy work environments are critical to recruiting and retaining health professionals. On the other hand, unhealthy work environments can contribute to medical errors, ineffective delivery of care, and conflict and stress among health professionals in the clinical setting and faculty shortage that can compromise academic excellence in the academic setting. The professional nurses working in the South African Military Health Service (SAMHS), a branch of the South African National Defence Force (SANDF) could experience the military environment as unhealthy because it is rigid and controlled. The hierarchical rank structure could deprive them of their autonomy as the decision-making powers are directly proportional to the rank. Stressful conditions could be experienced when these professional nurses are taken away from the well equipped hospital environment to the deployment areas away from home. There was, however, no evidence found on the work environment of professional nurses in the SAMHS during literature review. The aim of the study is therefore to explore and describe the experiences of professional nurses working in the SAMHS and their understanding of a healthy work environment and the scope and nature of a best practice guideline, then to integrate the evidence generated to the evidence emanating from the critical appraisal of the existing best practice guidelines from other health settings in order to develop a best practice guideline for a healthy work environment for nurses in the SAMHS. The study adopted a qualitative, exploratory, descriptive and contextual research design. The research study was made up of three phases. In Phase 1, semi-structured interviews were conducted with professional nurses to collect information on their experiences of working in the SAMHS and their understanding of evidence-based best practice guidelines. The interviews were transcribed by an independent transcriptionist and data analyzed using the eight steps of data analysis as suggested by Tesch. Themes were identified and grouped together to form new categories. The process of coding was supported by an independent coder. Lincoln and Guba’s model of Page | vii trustworthiness consisting of credibility, transferability, dependability and confirmability was used to ensure the validity of the study. An integrative literature review was conducted where the existing evidence-based best practice guidelines for healthy work environment for nurses were searched for, appraised, had data extracted and were synthesized in Phase 2. In Phase 3, evidence generated in Phase 1 and Phase 2 was triangulated, forming recommendations that were utilized to develop a best practice draft guideline for a healthy work environment for professional nurses working in the SAMHS. The draft guideline was sent to five expert reviewers for their comments and recommendations. These were considered in the development of the final guideline. The final guideline consists of several recommendations in four themes: the need for effective leadership to create an empowering environment; effective communication amongst members of the health team; a culture that supports team work, and; the need for an environment that promotes professional autonomy. Further recommendations were made to address factors that impact negatively on enhancement of a healthy work environment. The guideline is intended for use by SAMHS’ leadership, at Levels 2, the strategic level, Level 3, the formation level and Level 4, the unit level (hospitals, sickbays and clinics and nursing college) and all professional nurses working in all the military health institutions of the SAMHS, including the military clinics, sickbays and hospitals irrespective of positions. However, the guideline may also be adapted by nursing institutions outside the military such as public and private hospitals and clinics where they find it applicable. Results
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  • Date Issued: 2018

A best practice guideline for clinical teaching at a public college of nursing

  • Authors: Gcawu, Sybil Nyameka
  • Date: 2018
  • Subjects: Nursing -- Study and teaching , Clinical medicine Medicine -- Study and teaching
  • Language: English
  • Type: Thesis , Doctoral , DCur
  • Identifier: http://hdl.handle.net/10948/30194 , vital:30860
  • Description: Clinical teaching is a critical component of the education and training of undergraduate nursing students. It determines the level of clinical competence that nursing students achieve during their studies. It should be informed by current best practice evidence available in the nursing care literature (Emanuel, Day, Diegnan & Prys-Muller, 2011:21-22). Clinical teaching is centred around provision of patient care in clinical practice. It takes place through an interaction between the nurse educator and the nursing students. During this process nursing students are moulded so they can demonstrate minimum competency in order to be registered by the regulatory body. Nursing students learn to become competent nurses in the clinical learning environment (Baxter 2006; Nash, 2007 in Franklin, 2013:35). In South Africa nurse educators are required to be fully responsible for clinical teaching through the use of appropriate teaching approaches and learning facilitation techniques (RSA DoH, 2013:91). The overall purpose of the current research study was to explore and describe the current clinical teaching practices of nurse educators; to search, appraise, extract and synthesise literature related to clinical teaching in nursing; and to develop A Best Practice Guideline for Clinical Teaching at a Public College of Nursing in the Eastern Cape Province. This had to be realized in three phases. In Phase One a quantitative, exploratory, descriptive and contextual study was conducted. A structured questionnaire was used to collect data from the nurse educators involved in clinical teaching within the Diploma in Nursing (General, Community, Psychiatric) and Midwifery programme. The data analysed was used as the basis of Phase Two—namely, an integrative literature review of evidence pertaining to the clinical teaching practices of nurse educators doing clinical teaching within the undergraduate programmes. The evidence from Phases One and Two was used to develop a draft Best Practice Guideline. The draft guideline was reviewed by a group of expert reviewers and their suggestions were incorporated in the final guideline. Ethical considerations were maintained throughout the research study. The rigour of the research process was ensured by cognitive testing of the questionnaire, and by critical appraisal of the literature accessed from an integrative literature review. The v authenticity of critical appraisal was ensured by having the critical appraisal done by the researcher and an independent reviewer.
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  • Date Issued: 2018

A budget and expenditure review of public hospital facilities in the Eastern Cape in transition towards National Health Insurance

  • Authors: Ndlovu, Garfield OG
  • Date: 2018
  • Subjects: Health services administration--South Africa--Eastern Cape Government spending policy--South Africa--Eastern Cape Health services administration
  • Language: English
  • Type: Thesis , Masters , Public Health Leadership
  • Identifier: http://hdl.handle.net/10353/11139 , vital:37174
  • Description: The quest to ameliorate and enhance the equitable allocation of resources in the Health Industry remains a global challenge, in particular the distribution of funding resources in public sector health facilities. The need to analyse and understand the appropriation of budget and utilisation of funds by hospital facilities is important in the in the Eastern Cape. The focus of the study seeks to explore recommendations that can be employed in the provincial budgeting process of Hospital Facilities, in a bid to optimise efficiency and improve the funding process as part of the provincial readiness activities towards the realisation of the NHI System and funding approach, wherein the NHI Fund will be a public entity that is not in business to make profit (NHI Booklet 2012: 05). This fund will introduce new systems of paying hospitals and professionals for the services they provide, aiming to be fair to them but to put a stop to unreasonable profits (NHI Booklet 2012: 05). The research has employed the use of descriptive quantitative techniques in order to undertake an expenditure review of existing financial data with respect to the Eastern Cape public Hospitals. The study followed a quantitative descriptive research design, the purpose of this study is that, quantitative research deals in numbers, logic, and an objective stance (Babbie: 2010). The Quantitative aspect of the study found that the data provided, allowed the researcher to organise, synthesise, prioritise and assign value to specific key performance indicators that would be used for the appraisal of hospital facilities in relation to the expenditure patterns based which would present a glimpse into how the Eastern Cape department of health utilises funding resources.
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  • Date Issued: 2018

A business process management framework for enhancing enterprise resource planning value derived in supply chain optimization

  • Authors: Sahdeo, Viresh
  • Date: 2018
  • Subjects: Reengineering (Management) , Workflow -- Management Performance -- Management Strategic planning
  • Language: English
  • Type: Thesis , Masters , MBA
  • Identifier: http://hdl.handle.net/10948/34833 , vital:33459
  • Description: Enterprise Resource Planning (ERP) systems easily diffuse knowledge and allow good business decisions for Information System (IS) technological and organizational advancement. This research is an investigation of how to improve the strategic management and operational efficiency of Enterprise Information Systems (EIS). A Business Process Management (BPM) framework was designed to integrate varying perspectives of organizational activities for wider collaboration and value derivation. The systematic methodology of Business process management (BPM) enables corporates to be more effective and efficient through continual process improvement. Elements used to build the BPM framework explain how to successfully derive value, inclusive of the performance indicators to measure outcomes. The model was tested with questionnaire data collected from corporates operating in the Southern African region and further refined based on Cronbach alpha reliability tests. The findings improve the interpretation of the determinants for the success of BPM and ERP IS from the user’s perspective. The results show that continuous improvement efforts and organisational support have positive influence on performance and validate the importance of quality, service, information, integration and workflow dependencies. Originality/value – This research extends prior work of BPM frameworks to follow up on customer orientation and servitization. Studies have not investigated relationship commitment between IT and operational business units. The relationship and interdependence of organisational functions is essential for Supply Chain value creation. Industrialization and information technology(IT) integration faces new opportunities. The agility of IT is further explored more into efforts of collaboration, structure, and innovation for future changes, emerging technologies and practices envisioned. This research seeks to propose a framework for the future development of smart supply chain, which can provide theory and case for intelligent operational activities with key technologies, such as RFID, Neural Networks, machine learning and artificial intelligence(AI).
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  • Date Issued: 2018

A case study of emergent environmental pedagogical content knowledge in a Fundisa for Change teacher professional development course

  • Authors: Brundrit, Susan
  • Date: 2018
  • Subjects: Career development -- South Africa , Environmental education -- South Africa , Teachers -- Training of --South Africa , Environmental education -- Study and teaching -- South Africa , Fundisa for Change
  • Language: English
  • Type: text , Thesis , Masters , MEd
  • Identifier: http://hdl.handle.net/10962/62850 , vital:28301
  • Description: This study set out to explore and describe in the form of a qualitative case study, an iteration of a Fundisa for Change teacher professional development programme, in this case the Teaching Life & Living short course presented to seventeen teachers as part of their Advanced Certificate in Teaching (ACT) Senior Phase Natural Sciences, at the University of Cape Town. The focus of the research was on describing how the development of teacher environmental pedagogical content knowledge (PCK) was supported and constructed in the course. The Consensus Model of Teacher Professional Knowledge and Skill, an outcome of the 2012 PCK Summit, was used to define the concept of PCK and also contributed the concept of amplifiers and filters as processes that mediate the development of teacher PCK. The study drew on Borko’s (2004) model of a professional development system, using the elements of course, teachers, facilitators and context as an analytical framework. Data generated included a teacher contextual profile questionnaire, audio-recordings of group work, course outputs and reflection and evaluation forms. Data analysis had two phases: the first phase concentrated on the development of analytic memos based on particular data sources whereas the second phase worked across data sources to present the evidence relating to each of the professional development system elements. The study found that teachers were supported in the development of their environmental PCK by the collaborative learning opportunities afforded by the course. Emergent PCK was organised according to five components: assessment knowledge; pedagogical knowledge; content knowledge; knowledge of learners; and, curricular knowledge. Emergent teacher learning ranged in specificity from general, to subject-specific, to domain-specific, and lastly to topic-specific knowledge. Teacher beliefs and orientations, prior knowledge and contexts brought into the professional development system were described as amplifiers and filters to teacher learning of PCK. In particular there were several contextual factors that emerged as themes from the data that had potentially filtering effects. Recommendations included that facilitators create an atmosphere conducive to collaborative learning, that evidence of learner conceptual understanding be examined during the course, that teachers be exposed to in-depth examples of canonical PCK and that more modelling of formative assessment strategies are presented.
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  • Date Issued: 2018

A case study of the role of leadership behaviour in the formation of organizational culture

  • Authors: Moore, Aminah
  • Date: 2018
  • Subjects: Leadership -- Botswana -- Maun , Corporate culture -- Botswana -- Maun , Strategic planning -- Botswana -- Maun , Critical incident technique , Organizational behavior -- Botswana -- Maun , Tourism -- Management , Belmond Safaris (Botswana)
  • Language: English
  • Type: text , Thesis , Masters , MBA
  • Identifier: http://hdl.handle.net/10962/62061 , vital:28103
  • Description: This case study research on the effect of leadership on organizational culture, is based on a small luxury tourism organization – Belmond Safaris – based in Maun, Botswana. The study set out to determine critical incidents that occurred during the tenure of the current general manager with the intention of uncovering her leadership behaviour and how it has shaped the culture of the organization. The literature review identified quantitative and qualitative approaches to researching organizational culture, but settles on Schein’s theory of organizational culture (Schein, 1992; 2010) as the approach adopted in this study. Furthermore, it reviews the various roles of strategic leaders and how these affect the culture of the organization. The study follows a qualitative methodology and applies the Critical Incident Technique to explore how, as a leader, the behaviour of the general manager shaped the organization’s culture. Data triangulation is achieved through the use of multiple sources – interviews, analysis of company documents and the examination of minutes of management meetings. Following the fieldwork, the evidence within the findings of the study required a theoretical reorientation and a shift from strategic leadership to a new focus on relational leadership, highlighting the prominence of social exchanges between the general manager and employees, as opposed to economic exchanges. The study concludes by acknowledging the limitations and delimitations of the study, which include time constraints as well as the deliberate exclusion of certain participants (e.g. camp managers) from the study. In its conclusion the study also presents recommendations for future studies. The researcher recommends a broader study within the tourism industry, as well as a larger and more inclusive sample size, in order to obtain better insights into the study of culture and leadership within organizations.
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  • Date Issued: 2018

A Case Study of Two Selected Teachers as they Integrated Dynamic Geometry Software as a Visualisation Tool in Teaching Geometry:

  • Authors: Mavani, Deepak , Mavani, Beena , Schäfer, Marc
  • Date: 2018
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/141076 , vital:37942 , https://doi.org/10.1080/18117295.2018.1522716
  • Description: This paper reports on an aspect of a larger research study conceptualised within a teacher development project in Mthatha, Eastern Cape Province. The project was initiated with the objective to develop appropriate skills to use dynamic geometry software (DGS) effectively and strategically as a teaching and learning tool for mathematics. The study reported in this paper aims specifically to ascertain how selected mathematics teachers integrated co-developed technologically aided visualisation tools in the observed lessons. The case study involved two teachers from different schools. The data sources were the classroom observations followed by stimulated reflective interviews with the teachers. The data were analysed to study the use of DGS visualisation tools in relation to Kilpatrick’s framework of teaching proficiency.
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  • Date Issued: 2018

A case study to explore developing a community of practice to support emergent literacy in preschool children's play

  • Authors: Martin, Tamarynd
  • Date: 2018
  • Subjects: Early childhood education , Children -- Language , Reading (Preschool) , Toddlers -- Books and reading
  • Language: English
  • Type: Thesis , Masters , MEd
  • Identifier: http://hdl.handle.net/10948/31841 , vital:31850
  • Description: In South Africa at present, Literacy is a cause for rising concern, with reading and writing competency in primary school being at an all-time low. It is a widespread belief that part of the problem lies with the lack early childhood education. Only 37% of children under the age of five attend an early childhood development centre. Furthermore, South Africa has a shortage of educators, specifically within the domain of early childhood development. With more research being done in the area of literacy, more educators concur that emergent literacy forms the foundation of formal reading and writing later on. This study is a participatory case study, which reflects on the importance of literacy in the early years, showing the belief that pre-formal schooling, specifically emergent literacy, is directly linked to proficiency in reading and writing in formal schooling. This study also highlights how educators in early childhood development can be involved in ongoing reflective interventions through in-service training and communities of practice. This community of practice was developed as a series of focus groups, which met on a weekly basis to discuss and share thoughts, opinions and experiences surrounding emergent literacy in a preschool context. From multiple focus groups, I found that the participants became more confident in sharing their experiences and building upon each other’s ideas and thoughts. The focus groups, not only added to their understanding of emergent literacy, but enthused them and created more of an awareness in their day to day practices.
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  • Date Issued: 2018

A challenge to conventional wisdom: locating agency in Angola’s and Ghana’s economic engagements with China

  • Authors: Chipaike, Ronald , Bischoff, Paul, 1954-
  • Date: 2018
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/10962/161537 , vital:40636 , https://0-doi.org.wam.seals.ac.za/10.1177/00219096187639223
  • Description: This article makes the point that African states with significant strategic resources and democratic governance systems bargain better in economic and development assistance engagements with China and other partners. In democratic African states, non-state actors play critical complementary roles to the state, leading to multi-faceted forms of African agency. For non-democratic states, a significant limiting factor in their agency is the lack of working relationships between the state and non-state actors. Concomitantly, such states find themselves with weak bargaining and negotiating capacities. If African agency is to be assertive, then state and non-state actors should work together when engaging external partners.
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  • Date Issued: 2018

A characterization of landslide occurrence in the Kigezi Highlands of South Western Uganda

  • Authors: Nseka, Denis
  • Date: 2018
  • Subjects: Landslides -- Uganda , Land degradation -- Uganda Earth movements
  • Language: English
  • Type: Thesis , Doctoral , DPhil
  • Identifier: http://hdl.handle.net/10948/33791 , vital:33029
  • Description: The frequency and magnitude of landslide occurrence in the Kigezi highlands of South Western Uganda has increased, but the key underpinnings of the occurrences are yet to be understood. The overall aim of this study was to characterize the parameters underpinning landslide occurrence in the Kigezi highlands. This information is important for predicting or identifying actual and potential landslide sites. This should inform policy, particularly in terms of developing early warning systems to landslide hazards in these highlands. The present study analysed the area’s topography, soil properties as well as land use and cover changes underpinning the spatialtemporal distribution of landslide occurrence in the region. The present study focussed on selected topographic parameters including slope gradient, profile curvature, Topographic Wetness Index (TWI), Stream Power Index (SPI), and Topographic Position Index (TPI). These factors were parameterized in the field and GIS environment using a 10 m Digital Elevation Model. Sixty five landslide features were surveyed and mapped. Soil properties were characterised in relation to slope position. Onsite soil property analysis was conducted within the landslide scars, auger holes and full profile representative sites. Furthermore, soil infiltration and strength tests, as well as clay mineralogy analyses were also conducted. An analysis of the spatial-temporal land use and cover changes was undertaken using satellite imagery spanning the period between 1985 and 2015. Landslides were noted to concentrate along topographic hollows in the landscape. The occurrence is dominant where slope gradient is between 25˚ and 35˚, profile curvature between 0.1 and 5, TWI between 8 and 18, SPI >10 and TPI between -1 and 1. Landslides are less pronounced on slope zones where slope gradient is <15˚ and >45˚, profile curvature <0, TWI <8 and >18, SPI <10 and TPI >1. Deep soil profiles ranging between 2.5 and 7 meters are a major characteristic of the study area. Soils are characterized by clay pans at a depth ranging between 0.75 and 3 meters within the profiles. The study area is dominated by clay texture, except for the uppermost surface horizons, which are loamy sand. All surface horizons analysed had the percentage of sand, silt and clay ranging from 33 to 55%, 22 to 40% and 10 to 30% respectively. In the deeper horizons, sand was observed to reduce drastically to less than 23%, while clay increased to greater than 50%. The clay content is very high in the deeper horizons exceeding 35%. By implication, such soils with a very high clay content and plasticity index are considered as Vertisols, with a profound influence in the occurrence of landslides. The top soil predominantly contains more quartz, while subsurface horizons have considerable amounts of illite/muscovite as the dominant clay minerals, ranging from 43% to 47 %. The liquid limit, plasticity index, computed weighted plasticity index (PIw), expansiveness (ɛex) and dispersion ranging from 50, 22, 17, 10 and 23 to 66, 44,34,54 and 64, respectively also have strong implications for landslide occurrence. Landslides are not normally experienced during or immediately after extreme rainfall events but occur later in the rainfall season. By implication, this time lag in landslide occurrence and rainfall distribution, is due to the initial infiltration through quartz dominated upper soil layers, before illite/muscovite clays in the lower soil horizons get saturated. Whereas forest cover reduced from 40 % in 1985 to 8% in 2015, cultivated land and settlements increased from 16% and 11% to 52% and 25% respectively during the same period. The distribution of cultivated land decreased in lower slope sections within gradient group < 15˚ by 59%. It however increased in upper sections within gradient cluster 25˚ to 35˚ by over 85% during the study period. There is a shift of cultivated land to the steeper sensitive upper slope elements associated with landslides in the study area. More than 50% of the landslides are occurring on cultivated land, 20% on settlements while less than 15 % and 10% are occurring on grassland and forests with degraded areas respectively. Landslides in Kigezi highlands are triggered by a complex interaction of multiple- factors, including dynamic triggers and ground condition variables. Topographic hollows are convergence zones within the landscape where all the parameters interact to cause landslides. Topographic hollows are therefore potential and actual landslide sites in the study area. Characterized by deep soil horizons with high clay content dominated by illite/muscovite minerals in the sub soils and profile concave forms with moderately steep slopes, topographic hollows are the most vulnerable slope elements to landslide occurrence. The spatial temporal patterns of landslide occurrence in the study area has changed due to increased cultivation of steep middle and upper slopes. Characterized by deep soil horizons with high clay content dominated by illite/muscovite minerals in the sub soils and profile concave forms with moderately steep slopes, topographic hollows are the most vulnerable slope elements to landslide occurrence. The spatial-temporal patterns of landslide occurrence in the study area has changed due to increased cultivation of steep middle and upper slopes. A close spatial and temporal correlation between land use/cover changes and landslide occurrence is discernible. The understanding of these topographical, pedological and land use/cover parameters and their influence on landslide occurrence is important in land management. It is now possible to identify and predict actual and potential landslide zones, and also demarcate safer zones for community activities. The information generated about the area’s topographic, pedological and land cover characteristics should help in vulnerability mitigation and enhance community resilience to landslide hazards in this fragile highland ecosystem. This can be done through designating zones for community activities while avoiding potential landslide zones. It is also recommended that, tree cover restoration be done in the highlands and the farmers encouraged to re-establish terrace farming while avoiding cultivation of sensitive steep middle and upper slope sections.
  • Full Text:
  • Date Issued: 2018

A cohort analysis of subjective wellbeing and ageing: heading towards a midlife crisis

  • Authors: Otterbach, Steffen , Sousa-Poza, Alfonso , Moller, Valerie
  • Date: 2018
  • Subjects: Aging -- Social aspects Gerontology
  • Language: English
  • Type: Book , Text
  • Identifier: http://hdl.handle.net/10962/65401 , vital:28782 , ISBN 978086810641
  • Description: In this paper, we analyse how different domains of subjective wellbeing evolve within seven years in three different cohorts born 10 years apart. On average, general life satisfaction – as well as satisfaction with leisure time, social contacts and friends, and family – declines substantially between the ages of 15 and 44, with the most significant decrease taking place at a young age (early 20s). Nevertheless, trajectories among the three cohorts differ markedly, indicating that, ceteris paribus, responses on subjective wellbeing differ greatly between cohorts born just a decade apart. The results further indicate that the two older cohorts assess family life and social contacts more favourably than the youngest cohort.
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  • Date Issued: 2018
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