A Comparison of Inflation Expectations and Inflation Credibility in South Africa: Results from Survey Data

This paper reports a comparison of South African household inflation expectations and inflation credibility surveys undertaken in 2006 and 2008. The objective is to test for possible feed-through between inflating credibility and inflation expectations. It supplements similar earlier research that focused only on the 2006 survey results. The single most important difference between the survey results of 2006 and 2008 is that female and male respondents reported inflation expectations at the same level in 2006, while female respondents expected higher inflation than male respondents in the 2008 inflation expectations survey. More periodic survey data will be required for developing final conclusions on the possibility of feed-through effects. A very large percentage of respondents in the inflation credibility surveys indicate that they 'don't know' whether the historic rate of inflation is an accurate indication of price increases. It will be necessary to reconsider the structure of credibility surveys to increase the number of respondents providing views on the accuracy of historic inflation data.Inflation; inflation credibility; inflation expecttaions; inflation surveys; multinomial analysis

outcomes of neonates with perinatal asphyxia at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) from 2007-2011

A Research Report submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Medicine in Paediatrics. 8 May 2014Background: Perinatal asphyxia is a significant cause of death and disability. Aim: To determine the outcomes (survival to discharge and morbidity post discharge) of neonates with perinatal asphyxia at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Methods: This was a descriptive retrospective study. Patient information was obtained from the computerised neonatal database of neonates admitted to CMJAH within 24 hours of birth between 1 January 2006 and 31 December 2011 with a birth weight of >1800 grams and a 5 minute Apgar score <6. Results: 450 babies were included in the study; 185 females (41.1%). Mean birth weight was 3034.80 grams (SD 484.936) and mean gestational age was 39.11 weeks (SD 2.2). Most babies were inborn 391/450 (86.9%) and most were delivered by normal vaginal delivery 270/450 (60%). The overall survival was 390/450 (86.6%). There were 42 babies admitted to ICU. The ICU survival was 37/42 (88.1%). Significant predictors of survival were place of birth (p value 0.006), mode of delivery (p value 0.007) and bag mask ventilation at birth (p value 0.040). The duration of stay (p value 0.000) was significantly longer in survivors (6.49 days SD 6.6). The remaining factors were not significantly different between the two groups. The rate of perinatal asphyxia (Apgar score <6) was 4.68 per 1000 live births; while 3.61 per 1000 live births had evidence of hypoxic ischaemic encephalopathy (HIE). Of the 390 babies discharged from CMJAH, 113 had follow up records (28.97%) to a mean corrected age of 5.88 months (SD 5.03). The majority (90/113 – 79.64%) had normal development. Conclusion: i) The high overall survival and survival after ICU admission provides a benchmark for further care. ii) Obtaining adequate data for long term follow up was not possible with the existing resources and surrogate early markers of outcome and / or more resources to ensure accurate follow-up are needed and iii) the high incidence of HIE suggest that a therapeutic hypothermia service including long-term follow-up component would be beneficial

Whole-system change: case study of factors facilitating early implementation of a primary health care reform in a South African province

BACKGROUND: Whole-system interventions are those that entail system wide changes in goals, service delivery arrangements and relationships between actors, requiring approaches to implementation that go beyond projects or programmes. METHODS: Drawing on concepts from complexity theory, this paper describes the catalysts to implementation of a whole-system intervention in the North West Province of South Africa. This province was an early adopter of a national primary health care (PHC) strategy that included the establishment of PHC outreach teams based on generalist community health workers. We interviewed a cross section of provincial actors, from senior to frontline, observed processes and reviewed secondary data, to construct a descriptive-explanatory case study of early implementation of the PHC outreach team strategy and the factors facilitating this in the province. RESULTS: Implementation of the PHC outreach team strategy was characterised by the following features: 1) A favourable provincial context of a well established district and sub-district health system and long standing values in support of PHC; 2) The forging of a collective vision for the new strategy that built on prior history and values and that led to distributed leadership and ownership of the new policy; 3) An implementation strategy that ensured alignment of systems (information, human resources) and appropriate sequencing of activities (planning, training, piloting, household campaigns); 4) The privileging of ‘community dialogues’ and local manager participation in the early phases; 5) The establishment of special implementation structures: a PHC Task Team (chaired by a senior provincial manager) to enable feedback and ensure accountability, and an NGO partnership that provided flexible support for implementation. CONCLUSIONS: These features resonate with the deliberative, multi-level and context sensitive approaches described as the “simple rules” of successful PHC system change in other settings. Although implementation was not without tensions and weaknesses, particularly at the front-line of the PHC system, the case study highlights how a collective vision can facilitate commitment to and engagement with new policy in complex organisational environments. Successful adoption does not, however, guarantee sustained implementation at scale, and we consider the challenges to further information.Web of Scienc

A dedicated vascular access clinic for children on haemodialysis: Two years' experience

BACKGROUND: Arteriovenous fistula (AVF) formation for long-term haemodialysis in children is a niche discipline with little data for guidance. We developed a dedicated Vascular Access Clinic that is run jointly by a transplant surgeon, paediatric nephrologist, dialysis nurse and a clinical vascular scientist specialised in vascular sonography for the assessment and surveillance of AVFs. We report the experience and 2-year outcomes of this clinic. METHODS: Twelve new AVFs were formed and 11 existing AVFs were followed up for 2 years. All children were assessed by clinical and ultrasound examination. RESULTS: During the study period 12 brachiocephalic, nine basilic vein transpositions and two radiocephalic AVFs were followed up. The median age (interquartile range) and weight of those children undergoing new AVF creation were 9.4 (interquartile 3-17) years and 26.9 (14-67) kg, respectively. Pre-operative ultrasound vascular mapping showed maximum median vein and artery diameters of 3.0 (2-5) and 2.7 (2.0-5.3) mm, respectively. Maturation scans 6 weeks after AVF formation showed a median flow of 1277 (432-2880) ml/min. Primary maturation rate was 83 % (10/12). Assisted maturation was 100 %, with two patients requiring a single angioplasty. For the 11 children with an existing AVF the maximum median vein diameter was 14.0 (8.0-26.0) mm, and the median flow rate was 1781 (800-2971) ml/min at a median of 153 weeks after AVF formation. Twenty-two AVFs were used successfully for dialysis, a median kt/V of 1.97 (1.8-2.9), and urea reduction ratio of 80.7 % (79.3-86 %) was observed. One child was transplanted before the AVF was used. CONCLUSIONS: A multidisciplinary vascular clinic incorporating ultrasound assessment is key to maintaining young children on chronic haemodialysis via an AVF

Manganese oxide- based gold catalysts for low temperature CO conversion

Thesis ( M.Sc)--University of the Witwatersrand, Faculty of Science, 2003Initial investigations at Mintek, into the addition of gold to commercial hopcalite (CuxMnyOz), showed that it improved the activity of hopcalite. So this study was initially focused on investigating Aulhopcalite catalysts further. Also, since according to literature, MnxOy has catalytic potential, the study of AulMnxOy catalysts was included. Au/hopcalite and Aul/nxOy catalysts were made by means of deposition-precipitation, colloidal gold deposition and co-precipitation. Only one catalyst-type was highly active at room temperature - the co-precipitated Au/MnxOy catalysts. The optimised co-precipitated Au/MnxOy catalysts were more active than all the other catalysts by at least an order of magnitude. So the study focus changed, to make the optimisation of AulMnxOy catalysts a priority. Cerium is a well-known promoter on MnxOy catalysts, and so was also added to the co-precipitated Au/MnxOy catalysts. However, even small amounts of cerium had an adverse effect on the catalysts' activities. The compaction and crushing of a co-precipitated Au/MnxOy catalyst to obtain granules of larger particle size than the powders, was also carried out. The activities and surface areas of the catalysts were found to be comparable. This augers well for industrial purposes, since the use of powdered catalysts in industry is not viable

The myths and realities of Generational Cohort Theory on ICT Integration in Education: A South African Perspective

There is an assumption that the younger cohort of teachers who are considered to be digital natives will be able to integrate technology into their teaching spaces with ease. This study aims to determine if there is a difference between generational cohorts with respect to ICT (Information Communication Technology) integration in classrooms among South African teachers. There is a paucity of research on ICT integration in education with respect to generational cohorts. This study involved a secondary analysis of two primary data sets, which contained qualitative and quantitative data. The quantitative data revealed that there are few statistical differences between the generations with respect to their ICT usage in the classroom. However, the qualitative data revealed that younger cohorts of teachers appear to be highly concerned about classroom management, while a recurring theme amongst all cohorts was the lack of access and time

Developing a conceptual model to improve patient experience as a strategy to engage public health sector reform in South Africa.

Doctoral Degree. University of KwaZulu-Natal, Durban.Patient Experience is well recognized in health quality improvement initiatives within developed countries due to the reforms that result thereof. Developing a conceptual model to improve patient experience in South Africa is undertaken in this study. The study consists of a qualitative (nine nursing service managers participated in semi-structured interviews) and quantitative component (three hundred patients were included in a survey). A one hundred percent response rate was noted for the qualitative interviews and a 93.3 percent response rate was noted for the surveys that were conducted. Data for the quantitative study was analyzed using the Statistical Package for Social Sciences and a thematic analysis using NVIVO was applied to the qualitative data. The results from the qualitative component highlight the need for patient experience to be incorporated in the drive for quality improvement and stress the value of a patient experience model. Nursing managers support that the patient experience is positive in the primary health clinic but the survey findings reveal that the majority of respondents reported a negative patient experience. The overall patient experience satisfaction variable indicates that more than 50% of the respondents are dissatisfied with the overall patient experience. The Kruskal-Wallis analysis reveals a significant association with age and race on the overall patient experience satisfaction. Older patients are more accepting of health service delivery as compared to younger patients who are more critical. Patients show agreement with more than 50% of respondents indicating that the fifteen domains as per the Conceptual Framework are influencers of their patient experience. Nursing managers showed support for all fifteen domains. A latent factor analysis revealed that Information, Communication, Management Effectiveness towards Producing Positive Outcomes and Patient Centered Care were not statistically significant towards influencing the patient experience. The conceptual model was developed by incorporating the remaining eleven domains that influence the patient experience and the positive reforms that result thereof. Given the changing landscape in SA, it was necessary to develop a model to improve patient experience in order to improve the quality of service delivery thus engaging sustainable positive reform

A systematic review of the efficacy and safety of Saccharomyces boulardii in the treatment of acute gastroenteritis in the pediatric population

Thesis (MNutr)--Stellenbosch University, 2016.ENGLISH SUMMARY : Background: The yeast Saccharomyces boulardii has been classed a probiotic because it is a live microorganism known to confer a health benefit to its host, with one such benefit being in the management of gastrointestinal disturbances like gastroenteritis. Gastroenteritis is known to be the second leading cause of death in the world’s most vulnerable populations, with Rotavirus being the most common causative agent, responsible for 215,000 global child deaths during 2013. Together with a few other probiotics, Saccharomyces boulardii has been considered a potentially viable treatment option having been associated with a decreased duration of diarrhea, decreased number of days to the first formed stool, and decreased duration of hospital stay in individual studies. This systematic review was therefore designed to specifically investigate the effects of Saccharomyces boulardii on acute gastroenteritis caused by Rotavirus in the pediatric hospitalized patient. Objectives: To assess the efficacy and safety of Saccharomyces boulardii in the treatment of acute gastroenteritis in the pediatric population. Secondary objectives of cost-effectiveness in terms of length of hospital stay; optimal dosing and administration routes were also investigated. Methods: Data sources included Medline, CINAHL, Scopus and The Cochrane Library up to and including August 2015. Only randomized controlled trials in a hospital setting and involving subjects less than 16 years were included. Two reviewers independently evaluated studies for eligibility, quality and extracted the data. Data were analyzed using Review Manager 5 (RevMan 2008) software. A random effects model of meta-analysis was used due to the presence of heterogeneity of treatment effects between studies. Results: Out of a pool of 190 articles, 10 studies were selected for final inclusion and analysis. A meta-analysis involving five of the ten included studies showed that Saccharomyces boulardii significantly shortened the duration of diarrhea (in days), compared to the control/placebo group (MD -0.57, 95%CI: -0.83 to -0.30, P < 0.0001). Also, participants were passing solid stools in the Saccharomyces boulardii group compared to the control group on Day 2 (RR 3.00; 95% CI: 0.32 to 27.87), Day 3 (RR 3.17; 95% CI: 1.89 to 5.31), Day 4 (RR 1.63; 95% CI: 1.30 to 2.06) and Day 5 (RR 1.25; 95% CI: 1.08 to 1.44), (P = 0.06). Other outcomes like number of participants having less than three stools per day during the intervention and duration of hospital stay did not produce any statistically significant results. No studies reported on any significant adverse effects associated with the use of Saccharomyces boulardii. Conclusion: The results of the current systematic review appear to indicate there’s a potential benefit with using Saccharomyces boulardii to treat acute gastroenteritis in the pediatric patient. Offering this unique yeast probiotic at a dose of 250mg once to twice per day for up to five days has shown some benefit and appears to be safe. However, larger and more rigorous controlled trials are needed to further investigate the efficacy and safety of individual probiotics, like Saccharomyces boulardii, in order to offer specific treatment guidelines.AFRIKAANSE OPSOMMING : Agtergrond: Die gis Saccharomyces boulardii word beskou as ‘n probiotika aangesien dit ‘n lewendige mikroorganisme is wat gesondheidsvoordele inhou vir die gasheer. Een van die voordele is in die behandeling van gastrointestinale afwykings soos gastroenteritis. Alhoewel gastroenteritis slegs ‘n simptoom is van ‘n toestand, is dit bekend om die tweede mees algemene oorsaak van sterfte te wees onder vatbare populasies in die wêreld. Rotavirus, die mees algemene oorsaak van gastroenteritis, was verantwoordelik vir 215,000 kindersterftes wêreldwyd tydens 2013. Tesame met ‘n paar ander probiotika word Saccharomyces boulardii beskou as ‘n potensiële lewensvatbare behandelingsopsie. Hierdie gis probiotika word in individuele studies geassosieer met ‘n verkorte duurte van diaree, verminderde aantal dae tot die eerste gevormde stoelgang en ‘n verkorte duurte van hospitaal verblyf. Hierdie sistematiese literatuuroorsaak was dus beplan om die effek van Saccharomyces boulardii op akute gastroenteritis veroorsaak deur Rotavirus in pediatriese gehospitaliseerde pasiënte te ondersoek. Doelwitte: Om die effektiwiteit en veiligheid van Saccharomyces boulardii in die behandeling van akute gastroenteritis in die pediatrie populasie te bepaal. Sekondêre doelwitte was om die koste-effektiwiteit in terme van duurte van hospital verblyf, optimale dosering en administrasie roetes te ondersoek. Metodes: Data bronne het Medline, CINAHL, Scopus en die Cochrane Biblioteek tot en met Augustus 2015 ingesluit. Slegs verewekansigde gekontrolleerde proewe in ‘n hospitaal omgewing gedoen op persone jonger as 16 jaar is ingesluit. Twee evalueerders het die studies onafhanklik evalueer vir geskiktheid, kwaliteit en was betrokke by data ekstraksie. Data was ge-analiseer deur gebruik te maak van Review Manager 5 (RevMan 2008) sagteware. Die stogastiese-effekte model van meta-analise was gebruik as gevolg van die teenwoodigheid van heterogeniteit van behandelings-effekte tussen studies. Resultate: Uit ‘n poel van 190 potensiële artikels is 10 studies geselekteer vir finale insluiting en analise. ‘n Meta-analise op vyf van die tien studies het getoon dat Saccharomyces boulardii verantwoordelik was vir ‘n beduidende verkorte duurte van diaree (in dae), vergeleke met die kontrole of plasebo groepe (MD -0.57, 95%CI: -0.83 to -0.30, P < 0.0001). Resultate het ook gedui dat meer deelnemers in die Saccharomyces boulardii groep soliede stoelgane gehad het vergeleke met die kontrole groep op Dag 2 (RR 3.00; 95% CI: 0.32 to 27.87), Dag 3 (RR 3.17; 95% CI: 1.89 to 5.31), Dag 4 (RR 1.63; 95% CI: 1.30 to 2.06) en Dag 5 (RR 1.25; 95% CI: 1.08 to 1.44), (P = 0.06). Ander uitkomste soos die aantal deelnemers met minder as drie stoelgange per dag gedurende intervensie en duurte van hospital verblyf het nie beduidende resultate gelewer nie. Geen studies het enige newe-effekte geassosieer met die gebruik van Saccharomyces boulardii gerapporteer nie. Gevolgtrekking: Die resultate van die huidige sistematiese literatuuroorsig dui op ‘n potensiële voordeel met die gebruik van Saccharomyces boulardii vir die behandeling van akute gastroenteritis in die pediatriese groep. Die inname van hierdie unieke gis probiotika teen ‘n dosis van 250mg een tot twee maal per dag vir tot vyf dae het op sommige voordele gewys en blyk om veilig te wees. Groter en strenger gekontrolleerde proewe word egter aanbeveel om die effektiwiteit en veiligheid van individuele probiotika soos Saccharomyces boulardii verder te ondersoek ten einde spesifieke behandelingsriglyne te kan voorstel.Master