Thesis (MA (Psychology))--University of Stellenbosch, 2006. / The aims of the present study were to inquire into the origins of middle childhood South African children’s fears. In order to do this as precisely as possible it was determined to what extent Rachman’s (1977, 1991) three pathways played a role in the experience of the selected sample’s fears; in intensifying their fears; and finally in the actual onset of their fears. The results were examined across the independent variables age, gender, socio-economic status (SES), and culture. In addition, Rachman’s (1977; 1991) hypothesis that stronger, more intense fears originate through Conditioning experiences, while less intense, everyday fears originate through the indirect pathways, namely Modeling and Negative Information/Instruction was tested. The participants consisted of a sample of 660 children aged between 10 and 14 years, attending grades 5 and 7, representing the three main cultural groups found in the Western Cape, South Africa, and residing in low, middle and high socio-economic residential areas. Participants completed a short biographical questionnaire and the Fear Option List (FOL). Data analysis revealed that the majority of participants reported Modeling experiences in connection to their greatest fear, followed by Information and Conditioning experiences. Significant gender, SES, and cultural differences were found. The majority of participants reported that Information experiences were responsible for intensifying their greatest fear, and thus playing a role in maintaining it, followed by Modeling and Conditioning experiences. Significant gender, SES, and cultural differences were found. With regard to the actual onset of participants fears, the majority of participants reported that they had no clear idea of how their fear began, followed by Information, Conditioning, and Modeling. Only significant SES and cultural differences were found. The first half of Rachman’s (1977; 1991) hypothesis was confirmed in that stronger, more intense fears were found to be strongly related to Conditioning experiences. However, the second part of his hypothesis that less intense, everyday fears are likely to originate through the indirect pathways was not confirmed. The implications of the present study’s findings within a South African context are discussed, as well as the limitations of the study and suggestions for future research.

Thesis (MTech (Biomedical Technology))--Peninsula Technikon, Cape Town, 2004 / Introduction and Background: The prevalence of obesity amongst both the adult and paediatric population has assumed almost epidemic proportions in many developed and developing countries. A recent study by the Medical Research Council found that a disturbing 20% of all South African children could be categorized as being obese. Limited data is currently available on the prevalence of obesity in South African children, particularly from the previously disadvantaged population. Given the global epidemic of paediatric obesity, hypertension and type-2-diabetes and the limited available data relating to obese South African children, further studies to enhance the understanding of the risk factors associated with the epidemic are imperative. Aims and Objectives of the Study: The objectives of the study were to: 1. Determine the prevalence of overweight and obesity amongst leamers attending schools in the communities of Belhar, Delft and Mfuleni within the City of Cape Town, South Africa. 2. Determine the prevalence of diabetes and hypertension amongst learners attending school in the communities of Belhar, Delft and Mfuleni in the City of Cape Town. 3. To investigate the association of overweight and obesity with diabetes and hypertension in children and adolescents, and • To determine the risk factors associated with overweight, obesity, diabetes and hypertension Sample Population: Excluding learners that did not meet the inclusion criteria, the final sample consisted of 338 learners aged 10 - 16 years attending the government funded primary and secondary schools and residing in the target communities.

This thesis investigated the education support services provided by occupational therapists, physiotherapists and speech and language therapists in the Western Cape Province of South Africa. Changes in the education policy in South Africa to an inclusive education system have major implications for the way therapists provide support. Therapists have been challenged to move from a medical model of support with a focus on highly specialised treatment for a small number of individual learners with disabilities, to a system, including all learners, teachers and parents. The aim of this research was to develop an appropriate and integrated approach for therapists to support schools within an inclusive and health promoting schools framework in South Africa.

This thesis investigated the education support services provided by occupational therapists, physiotherapists and speech and language therapists in the Western Cape Province of South Africa. Changes in the education policy in South Africa to an inclusive education system have major implications for the way therapists provide support. Therapists have been challenged to move from a medical model of support with a focus on highly specialised treatment for a small number of individual learners with disabilities, to a system, including all learners, teachers and parents. The aim of this research was to develop an appropriate and integrated approach for therapists to support schools within an inclusive and health promoting schools framework in South Africa.

Thesis (MScSportSc)--University of Stellenbosch, 2002. / ENGLISH ABSTRACT: Postural deformities are a commonly encountered problem among children. Most of the aches and pains of adults are the result, not of injuries, but of the long-term effects of distortions in posture or alignment that have their origins in childhood or adolescence. Television, video entertainment, motorized transportation, fast food and lack of regular physical activity contribute to the poor physical condition of children. School screening for scoliosis is mandated in schools in 26 states of the United States (US) for children between 10 and 16 years of age. Previous studies conducted in the US found that 160 out of 1000 people suffer from scoliosis. This means that scoliosis is as prevalent as hypertension or diabetes mellitus (Boachie-Adjei & Lonner, 1996). Identification of postural deformities at an early stage makes early treatment possible, which may, in future, prevent serious postural abnormalities. The American Academy of Orthopedic Surgeons approved the implementation of screening programs in schools in 1974 (Lonstein, 1988). Few studies have included the entire musculoskeletal system. The purpose of this study was to determine the prevalence of postural deformities among children aged 11 to 13 years in selected primary schools in the Western Cape. The study also proposes to investigate factors that may influence the prevalence rate of postural deformities. These factors included age, gender, school district, weight, height, BMI (Body Mass Index), fat%, waist-hip ratio, and physical activity. Letters were sent to 15 primary schools within a 30km radius of Stellenbosch. This region included Stellenbosch, Strand, and Kuilsrivier. Four schools replied, giving permission to conduct the study at their schools. The sample (N=288, mean age=12.36, SD=0.92) consisted of 78 scholars from grade five; 104 scholars form grade six; and 106 scholars from grade seven. Of the total number of scholars examined (288), 154 were boys, and 134 were girls. Only children with parental consent were allowed to participate in the study. Anthropometric measures included stature, mass, skinfoids (two-site skinfoid), waist- and hip circumferences and trochanterion leg length. Level of physical activity and family history of deformities were obtained by means of a questionnaire. The New York Posture Test was used for postural evaluation (Bloomfield et aI., 1994:320; Reedeo Inc., 2001. This Posture Test was designed for the screening of 13 categories of deformities. Using a "see-through" posture grid, lateral and posterior examinations were performed. The "Adam's position" (forward bending) was used for further scoliosis evaluation. Quantitative data was analyzed, using Statistica (Statsoft, 2001) and classification tree methodology (Breiman et aI., 1993). The anthropometric results indicated that the subjects had a mean stature of 1.54m, mass of 47.48kg, BMI of 19.75, waist-hip ratio of 0.79 and fat% (Lohman, 1987) of 21.35%. The prevalence of postural deformities was as follows: Lordosis, 70%; Kyphosis, 57%; Uneven shoulders, 55%; Inclined trunk, 43%; Winged scapulae, 42%; Pronated feet, 30%; Flat feet, 30%; Flat chest, 29%; Forward head, 28%; Protruding abdomen, 28%; Uneven hips, 11%; Scoliosis, 10%; and Twisted head, 1%. Uneven hips, scoliosis and twisted head were not considered for statistical purposes, because of their low incidence compared to the other deformities. The factors that influenced the prevalence rate of deformities the most were BMI and fat%. A higher BMI and fat% resulted in a higher prevalence rate in most deformities. The prevalence rate of postural deformities in this study was considerably high. Sedentary lifestyles of children (watching television, computer games, junk food and physical inactivity) were a contributing factor in the high prevalence rate of postural deformities. It is known that overweight and sedentary behavior of children is increasing and this could pose an alarming concern to the health of a child. Also, if a significant correlation does exist between the prevalence of postural deformities and conditions such as back pain, the high prevalence rate reported in this study is a matter of concern. / AFRIKAANSE OPSOMMING: Postuurafwykings is "n algemene probleem wat dikwels onder kinders voorkom. Baie van die skete en pyne by volwassenes spruit nie uit beserings nie, maar vanuit langtermyn gevolge van swak postuur wat huloorsprong uit die kinderjare het. Televisie, videospeletjies, vervoer per motor, kitskos en gebrek aan fisieke aktiwiteit dra by tot die swak fisieke kondisie van kinders. Evalueringsprogramme in skole word in 26 state in die Verenigde State van Amerika (VSA) toegepas vir kinders tussen die ouderdomme van 10 en 16 jaar. Vorige studies in die VSA het getoon dat 160 uit 1000 mense skoliose het (Boachie-Adjei & Lonner, 1996). Dit beteken dat skoliose net so veel voorkom soos hipertensie of diabetes mellitus. Identifikasie van postuurafwykings op "n vroeë stadium maak vroeë behandeling moontlik, wat in die toekoms ernstige postuurafwykings kan voorkom. Die "American Academy of Orthopedie Surgeons" het reeds in 1974 die implementering van assesseringsprogramme goedgekeur (Lonstein, 1988). Volgens navorsing het slegs "n beperkte aantal studies die hele spierskeletale stelsel geëvalueer. Die doel van hierdie studie was om die voorkoms van postuurafwykings by kinders tussen die ouderdomme van 11 en 13 jaar in geselekteerde Wes-Kaapse skole te bepaal. Die studie het ook faktore wat "n invloed op die voorkoms van postuurafwykings kan hê, ingesluit. Hierdie faktore het onder andere ouderdom, geslag, skool, gewig, lengte, LMI (Liggaamsmassa-indeks), vet%, middel-heup-ratio en fisieke aktiwiteit ingesluit. Uitnodigingsbriewe is na 15 laerskole binne "n 30km radius vanaf Stellenbosch gestuur. Dit het ingesluit Stellenbosch, Strand, en Kuilsrivier. Vier skole het toestemming verleen om die studie by die betrokke skole te loods. Die steekproef (N=288, gemiddelde ouderdom = 12.36, SD=0.92) het bestaan uit 78 leerlinge uit graad vyf; 104 leerlinge uit graad ses en 106 leerlinge uit graad sewe. Uit die totale aantal leerlinge wat geëvalueer is, was daar 154 seuns en 134 dogters. Antropometriese metings het die volgende ingesluit: lengte, gewig, velvoue (twee-velvou meting), middel- en heupomtrekke en trochanterion beenlengte. Fisieke aktiwiteitsvlak en familiegeskiedenis van postuurafwykings is bepaal met behulp van "n vraelys. Die "New York Posture Tesf' is gebruik vir postuurevaluasie (Bloomfield et al., 1994:320; Reedco Inc., 2001). Hierdie toets is ontwerp vir die evaluering van 13 deformiteite. Die kinders is vanuit 'n posterior en anterior aansig ge-evalueer met behulp van 'n "deurskynende" postuurruitnet (grid). Die "Adam's-" toets (vooroorbuig-toets) is gebruik vir verdere evaluering van skoliose. Statistica (StatSoft, 2001) en klassifikasieboom-metodologie (Breiman et al., 1993) is gebruik vir statistiese ontleding. Die proefpersone het 'n gemiddelde lengte van 1.54m, gewig van 47.48kg, LMI van 19.75, middel-heup-ratio van 0.79 en vet% (Lohman, 1987) van 21.35% gehad. Die voorkoms van die onderskeie postuurafwykings was as volg: Lordose,70%; Kifose, 57%; Ongelyke skouers, 55%; Romp na posterior gebuig, 43%; Gevleuelde skapulas, 42%; Voetpronasie, 30%; Plat voete, 30%; Plat bors, 29%; Protraksie: skedel, 28%; Uitstaan buik, 28%; Ongelyke heupe, 11%; Skoliose, 10%; en Gekantelde hoof, 1%. Ongelyke heupe, skoliose en gekantelde hoof het minder voorgekom in vergelyking met die ander deformiteite, daarom is die deformiteite nie vir statistiese analise in aammerking gebring nie. LMI en vet% was die faktore wat die voorkoms van postuurafwykings die meeste beïnvloed het. 'n Hoër LMI en vet% het 'n toenemende voorkoms in meeste deformiteite veroorsaak. Die voorkoms van postuurafwyking in hierdie studie was hoog. Sedentêre leefwyses van kinders (TV, rekenaarspeletjies, gemorskos, en fisieke onaktiwiteit) het bygedra tot die hoë voorkoms. Die voorkoms van oorgewig en sedentêre leefwyses is besig om te verhoog by kinders en kan ernstige gevolge vir die gesondheid van die kind inhou. Indien daar 'n betekenisvolle korrelasie tussen die voorkoms van postuurafwykings en kondisies soos rugpyn is, dan blyk die hoë voorkoms, wat in hierdie studie gevind is, 'n bron van bekommernis te wees. Postuurevalueringsprogramme is 'n effektiewe metode vir die vroeë identifikasie van postuurafwykings, aangesien dit vroeë identifikasie en konserwatiewe behandeling moontlik maak.

Thesis (MBA)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Childhood tuberculosis is an infectious disease that can cause serious illness and mortality in especially young children. Following contact with an infectious adult tuberculosis case, the disease is easily preventable through preventive isoniazid treatment, yet very few exposed and at-risk children currently access this healthcare service in most high-burden settings. Previous research pointed out the multifactorial and complex nature of the barriers to accessing preventive care. Specifically, the lack of a formalised recording and reporting tool, such as the universally used tuberculosis treatment registers, possibly contribute to the operational barriers of preventive care delivery to these children. The purpose of this research was to evaluate the cost-effectiveness of an isoniazid preventive treatment register tool used at community level. The study utilised previously reported data from the study population and other high-burden settings to construct a decision analysis model that included varying probabilities of isoniazid preventive treatment across three high risk age groups (<1 year of age, 1 – 2 years of age, 3 – 5 years of age), coupled with disease probabilities and associated treatment costs. The scenarios simulated included 1) the routine isoniazid preventive treatment service (3% started on treatment, 17% identified as eligible); and 2) an isoniazid preventive treatment service supported by a recording register (15% (adherent to six months of treatment) and 38% (started on IPT treatment)). In addition, two hypothetical simulations were included for 76% and 100% isoniazid preventive treatment uptake; these hypothetical simulations required additional community based healthcare worker resources in addition to the register tool. The observations from the literature indicated that more children were identified (24(17%) vs. 54(38%)) and started (4(3%, base case) vs. 54) on isoniazid preventive treatment following the implementation of the register. As expected, the mean number of tuberculosis cases prevented, increased as the proportion of eligible children that received isoniazid preventive treatment, improved; the change in the number of cases prevented per simulation showed incremental improvements which were all significantly better (p<0.01) than the base case.. The incremental cost-effectiveness ratios incurred savings for each of the scenarios simulated since the mean costs for each of the simulations were significantly less (p<0.01) than the costs associated with the base case. The current evidence suggests that the proposed isoniazid preventive treatment register tool is a cost-effective alternative to the current standard of care in place at community level for at-risk children exposed to tuberculosis. It is therefore recommended that the tool be used incrementally on a bigger scale, until such time that sufficient evidence has been generated to support widespread implementation.

Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The long waiting lists for general anaesthesia and sedation services for children with Early Childhood Caries (ECC) at the Tygerberg Oral Health Centre highlighted the problem of ECC in this area. This was confirmed by a retrospective study of patient records at the Centre. ECC is largely caused by a combination of lifestyle factors, especially feeding and oral hygiene practices. Socio-economic status and parental factors such as education and employment have also been shown to play a role in the development of ECC. In order to address this problem, a study was designed to determine the prevalence of ECC in children from the lower socio-economic communities which drain to the Tygerberg Oral Health Centre and assess the knowledge of the caregivers of these children. A total of 659 children were examined at crèches and schools as well as community health clinics. The children examined at the clinics accompanied others and did not have any health reason for the visit themselves. As the aetiology is largely behaviour-driven and children are dependent on their caregivers to meet their basic needs, 366 caregivers attending the community health clinics with their children, were interviewed to determine their practices and knowledge of oral health. A total of 83 health care workers at these clinics were also interviewed to assess their knowledge of oral health matters and determine the role that they can play in the prevention of this disease. A cross-sectional community survey was carried out by means of clinical assessments and structured interviews with the aid of questionnaires. The survey was divided into 3 parts: 1. Prevalence of ECC amongst the children 2. Knowledge of the caregivers about oral health care 3. Knowledge of health care workers at the clinics in these communities about ECC The prevalence study revealed that 71.6% of children in the study population presented with caries. This is extremely high and highlights the need for serious interventions. Parents/ caregivers were shown to be ill-informed regarding their children’s oral health care needs which include dietary and oral hygiene practices as well as how this disease can be prevented. It is clear that caregivers need to be educated regarding feeding practices, weaning time, dietary content and the importance of basic oral health. The importance of preserving the primary dentition and regular dental attendance also needs to be emphasized in this community where dental health does not seem to be a priority. Health care workers such as nurses who come into contact with children from an early age would be the ideal vehicle to impart this information. However, as revealed from the results of this study, there is a serious lack of knowledge amongst these professionals regarding oral health matters. Time and resources therefore have to be invested to improve their knowledge and lessen their load so that more emphasis can be placed on prevention. Small changes can make a big difference towards addressing the burden of this disease on the health care system. / AFRIKAANSE OPSOMMING: Die lang waglyste vir algemene narkose en sedasiedienste vir kinders met Vroeë Kinderkaries (VKK) by die Tygerberg Mondgesondheid Sentrum het die probleem van VKK in die area uitgelig. Dit is bevestig deur 'n retrospektiewe studie van pasiënterekords by die Sentrum. VKK word grootliks veroorsaak deur 'n kombinasie van lewenstyl- faktore, veral voeding en mondhigiëne praktyke. Daar is ook aangetoon dat sosio-ekonomiese status en ouerlike faktore soos opvoeding en werkstatus 'n rol speel in die ontwikkeling van VKK. In 'n poging om hierdie probleem aan te spreek is 'n studie onderneem om die prevalensie van VKK in kinders van laer sosio-ekonomiese gemeenskappe wat van die Tygerberg Mondgesondheid Sentrum gebruikmaak te bepaal. Die kennis van mondgesondheid van die vernaamste toesighouers van die kinders in die studie is ook bepaal. 'n Totaal van 659 kinders is by crèches en skole sowel as gemeenskapsklinieke ondersoek. Die kinders wat by die klinieke ondersoek is, het nie self 'n gesondheidsrede vir die besoek gehad nie maar het saam met ander mense gekom. Die etiologie van VKK word hoofsaaklik deur gedrag gedryf en kinders is van hulle toesighouers afhanklik vir hulle basiese behoeftes. Dus is 366 toesighouers wat gemeenskapsklinieke besoek het ondervra oor hulle praktyke en kennis rakende mondgesondheid. 'n Totaal van 83 gesondheidswerkers by die klinieke is ook ondervra oor hulle kennis van mondgesondheid om die rol wat hulle kan speel in die voorkoming van hierdie siekte te ondersoek. 'n Dwarsdeursnit gemeenskaps-opname is uitgevoer deur middel van kliniese ondesoeke en gestruktureerde onderhoude met behulp van vraelyste. Die opname is in drie dele aangepak: 1. Prevalensie van VKK onder die kinders 2. Kennis van die toesighouers oor mondgesondheidsorg 3. Kennis van gesondheidsorgwerkers by die klinieke in hierdie gemeenskappe oor VKK Die prevalensiestudie het getoon dat 71% van kinders in die studiepopulasie karies gehad het. Dit is baie hoog en het die behoefte aan ernstige ingryping beklemtoon. Ouers/ toesighouers het geblyk om baie swak ingelig te wees oor hulle kinders se mondgesondheid-behoeftes wat dieet- en mondhigiëne praktyke ingesluit het, asook hoe die siekte voorkom kan word. Dit is duidelik dat versorgers onderrig moet word oor voedingspraktyke, die beste tyd vir soog, dieetinhoud en die belang van basiese mondgesondheid. Die belang van die behoud van primêre dentisie en gereelde tandsorgafsprake behoort ook in hierdie geneemskappe beklemtoon te word, gesien in die lig van die lae prioriteit wat hierdie gemeenskappe op mondgesondheid plaas. Gesondheidsorgwerkers soos verpleegpersoneel wat reeds in kontak kom met hierdie kinders op 'n jong ouderdom is die ideale persone om sulke inligting te versprei. Dit het egter uit die studie geblyk dat daar 'n ernstige gebrek aan kennis by hierdie professionele persone bestaan oor mondgesondheid. Tyd en hulpbronne sal belê moet word en hulle werkslading verlig moet word om hulle kennis te verbeter sodat meer klem op voorkoming gelê kan word. Klein veranderinge kan 'n groot verskil maak om hierdie siektelas op die gesondheidsorgstelsel te verlig.

Thesis (MPhil (General Linguistics))—University of Stellenbosch, 2006. / The aim of the present study is to identify the functions of codeswitching in intercultural communication occurring in multilingual high school classrooms. The definition of “codeswitching” adopted here is that of Myers-Scotton (1993: 1), who states that the term is used to refer to alternations of linguistic varieties within the same conversation. The present study considers the use of codeswitching between Afrikaans and English by learners and teachers in the classroom. The study was conducted in a multicultural and multilingual high school in the Western Cape in five classrooms of three different subjects. The nature of the multilingual context of the classrooms is diverse and includes learners form various sociolinguistic backgrounds. Being a predominantly English school meant that most learners have English as an L1 and Afrikaans and/or isiXhosa as an L2. The data for the study were collected by the researcher by means of observations and audio recordings of the lessons and by a questionnaire completed by learners and teachers. The data collection was carried out over a period of three weeks and data were analyzed within the framework of Myers-Scotton (1993) Markedness model for codeswitching. According to Myers-Scotton’s (1998: 4) Markedness Model, markedness relates to the choice of one linguistic variety over other possible varieties. Myer-Scotton (1993) classifies codeswitching into four different types namely marked, unmarked, sequential, and exploratory codeswitching. Within these types a number of functions of codeswitching in the classrooms were identified, for example clarification, expansion, and translation. These functions are discussed in relation to the data from the questionnaire.

Thesis (MPhil)--Stellenbosch University, 2012. / Introduction Under-5 year mortality in South Africa is increasing and effectiveness of primary care is a key factor. Adherence to IMCI guidelines by primary care nurses is critical. The IMCI guidelines provide a standardized integrated approach to delivering quality care. Nurses in South Africa are currently using a paper-based guideline. The automated guideline in the format of a convertible personalised computer tablet aimed to improve training in IMCI and the quality of clinical decision making. The automated guideline was designed to systematically guide the nurse through the algorithms thus reducing errors and making care more effective. This study evaluated the use of automated guidelines in improving the training of nurses. Methods A sample size of thirty Professional Registered Nurses (PNs) was selected from the one year Postgraduate Diploma in Clinical Nursing Science at Stellenbosch University. Observational study design compared 15 PNs who used and 15 who did not use the automated guidelines during training. Nurses were compared in terms of their knowledge of IMCI after classroom based teaching and adherence to IMCI in clinical training practices. Results Both groups improved their knowledge of IMCI, but were not significantly different at the end of the classroom teaching. Nurses in the automated group showed significant improvement in their clinical practice (p<0.05): gathering information on HIV risk (50% vs. 93%) or immunisations (68% vs. 93%); making a complete assessment of the patient (61% vs. 100%), prescribing correct medication (50% vs. 85%), correct dose (42% vs. 85%) and safety netting (78% vs. 96%). Conclusion The use of automated guidelines showed potential for improving adherence to IMCI in the Western Cape. Further research is needed to determine if the widespread use of the automated version by PNs translates into better quality of care and improved health outcomes.

Thesis (MTech (Biomedical Technology))--Peninsula Technikon, 2004. / The prevalence of obesity amongst both the adult and paediatric population has assumed almost epidemic proportions in many developed and developing countries. A recent study by the Medical Research Council found that a disturbing 20% of all South African children could be categorized as being obese. Limited data is currently available on the prevalence of obesity in South African children, particularly from the previously disadvantaged population. Given the global epidemic of paediatric obesity, hypertension and type-2-diabetes and the limited available data relating to obese South African children, further studies to enhance the understanding of the risk factors associated with the epidemic are imperative.