Thesis (Mnutr)--Stellenbosch University,2003. / ENGLISH ABSTRACT: Most of the risk factors for coronary heart disease (CHD) such as hypertension, dyslipidaemia, smoking, non-insulin dependent diabetes mellitus (NIDDM), obesity, physical inactivity and heredity are common in South African populations, with Indians ranking among those with the highest prevalence in the country. Little published literature is available on eating patterns in pre-school children in the Indian population. Therefore, this study a ims to assess the nutritional status of a group of Indian pre-school children in Howick West (a small suburb in the Kwa-Zulu Natal Midlands). Methods: This was a cross-sectional study of 50 Indian pre-school children between the ages of 1-5 years, randomly selected from a total of 632 available Indian households in Howick West. Written, informed consent was obtained from the mother/caregiver of each child that participated in the study. Standardized and validated 24-hour-recall (24-H-R) and quantitative food frequency questionnaires (QFFQ), used in the National Food Consumption Survey (NFCS) of 1999, were adapted and used to assess habitual intake and eating patterns of the 50 Indian pre-school children. Height and weight measurements using standardized methodology were used to assess the anthropometric status of the children. Results: The prevalence of underweight was 14%. Stunting affected only 8% of the children, and 2% were at risk of overweight. The mean energy intakes of the children were above that recommended for age. A high fat intake was observed, with total fat contributing 42% to the daily total energy (TE) intake. The contributions of total carbohydrate and protein to TE intake were 45% and 10%, respectively. Low mean intakes of the following micronutrients were observed (less than 67% of the RDA): Calcium (22% of the children), Vitamin D (90%), Zinc (56%) and Iodine (90%), respectively. Based on the 24-H-R, the intakes of the remaining micronutrients were either above or equivalent to that recommended for age when compared to the 1989 RDAs. Conclusions: Despite a relatively high prevalence of underweight compared to overweight in these preschoolers, dietary analysis has indicated adequate dietary intakes in terms of total energy recommended for the age groups studied. However, total fat intake which represented 42% of TE, was high, with saturated fat (SF) contributing 15% to TE intake. This finding is cause for concern as excessive consumption of dietary fat has been implicated in the aetiology of CVD, obesity and some forms of cancer, and CHD is one of the main causes of morbidity and mortality in South Africa, especially among the Indian segment of the population. / AFRIKAANSE OPSOMMING: Meeste van die risikofaktore vir koronêre hartsiektes (KHS) soos hipertensie, dislipidemie, rook, nie-insulien afhanklike diabetes (NIADM), vetsug, fisiese onaktiwiteit en oorerflikheid, kom algemeen onder Suid-Afrikaanse bevolkingsgroepe voor, met Indiërs onder dié met die hoogste voorkoms in die land. Min gepubliseerde inligting is beskikbaar oor die eetgewoontes van voorskoolse kinders onder die Indiër bevolking. Die doel van hierdie studie was dus 0 m die voedingstatus van 'n groep Indiër voorskoolse kinders in Howick Wes ('n klein voorstad in die Kwa-Zulu Natal Middellande) te bepaal. Metodes: Dit was 'n dwarssnit studie van 50 voorskoolse Indiër kinders tussen die ouderdomme van 1-5 jaar, ewekansig geselekteer uit 632 beskikbare Indiër huishoudings in Howick Wes. Geskrewe en ingeligte toestemming is ontvang van die moeder/versorger van elke kind wat aan die studie deelgeneem het. Gestandaardiseerde en gevalideerde 24-uur herroep (24-H-R) en voedsel frekwensie vraelyste (QFFQ) soos gebruik in die Nasionale Voedsel Inname Studie (NFCS) van 1999, is aangepas en gebruik om gewoontelike inname en eetgewoontes van die 50 Indiër voorskoolse kinders te bepaal. Lengte en gewig is m.b.v. standaad tegnieke bepaal om die antropometriese status van die kinders te evalueer. Resultate: Die voorkoms van ondergewig was 14%. Dwerggroei het slegs 8% van die kinders geaffekteer en 2% het 'n risiko vir oorgewig getoon. Die gemiddelde energie inname van die kinders was hoër as wat aanbeveel word vir hierdie ouderdomsgroep. 'n Hoë vetinname is gevind, met 'n totale vet bydrae van 42% tot die daaglikse totale energie (TE) inname. Die bydrae van koolhidrate en proteïen tot TE was 45% en 10% respektiewelik. Lae gemiddelde innames van die volgende mikrovoedingstowwe is gevind (minder as 67% van die RDA): kalsium (22% van die kinders), vitamien D (90%), sink (56%) en jodium (90%), respektiewelik. Gebasseer op die 24-H-R, was die inname van die oorblywende mikrovoedingstowwe óf hoër óf gelyk aan wat aanbeveel word vir die betrokke ouderdomsgroep wanneer vergelyk word met die 1989 RDA. Gevolgtrekkings: Ten spyte van 'n relatiewe hoë voorkoms van ondergewig in vergelyking met oorgewig in hierdie voorskoolse kinders, was dieetinname voldoende in terme van totale aanbevole energie vir die ouderdomsgroep. Totale vetinname, wat 42% van TE uitgemaak het, was egter hoog en versadigde vette het 15% van TE bedra. Hierdie verskynsel is 'n rede tot kommer aangesien oormatige vetinname reeds geïmpliseer is in die etiologie van KHS, vetsug en sommige vorms van kanker, en KHS is een van die belangrikste oorsake van morbiditeit en mortaliteit in Suid Afrika, veralonder die Indiër bevolking.

Thesis (MPhil)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: The central focus of this thesis is Youth Leadership Development programs in Africa. These programs are viewed within the context of the circumstances the youth currently face in their lives, and also the important role the youth in Africa have to play in the future of the continent. It is argued that leadership development holds the key to addressing the social, economic and political challenges Africa currently experiences. The Youth capacity building program in Uganda and the Joint Enrichment Project in South Africa were chosen as two case studies of Youth Leadership Development programs in Africa. The two case studies were benchmarked against the assessment tool that the International Youth Foundation (IYF) has created for making youth programs work. The above two programs differ greatly in their cultural, economic, social and political contexts. The aim of this study is to determine whether a single set of criteria for Youth Leadership Development programs in the African context is possible, despite the aforementioned differences inherent in the programs. To this end separate qualitative comparisons have been conducted on both the case studies. Shortcomings with regard to the assessment tool as well as the chosen youth programs were also identified. This study highlights that community development includes youth development, and therefore also the training of future leaders. Africa cannot rely on previous models of leadership development for today's youth. Further research in this field is needed, but this study confirms that Youth Leadership Development is vital in Africa. / AFRIKAANSE OPSOMMING: Die sentrale fokus van die tesis is jeug leierskapsontwikkelingsprogramme in Afrika. Hierdie programme word benader binne die konteks van die omstandighede wat die jeug se lewens beinvloed, asook diebelangrike rol wat die jeug in Afrika speel in die toekoms van die kontinent. Die uitgangspunt is dat leierskapsontwikkeling die sleutel is tot die verbetering van sosiale, ekonomiese en politieke uitdagings in Afrika. Die "Youth capacity building" program van Uganda, en die "Joint Enrichment Project" van Suid-Afrika is twee gevallestudies wat gekies is as voorbeelde van jeug leierskapsontwikkelingsprogramme in Afrika. Hierdie twee gevallestudies is gemeet aan die "International Youth Foundation" (IYF) se riglyne vir die bepaling van suksesvolle jeugprogramme. Die twee gekose programme verskil grootliks ten opsigte van die kulturele, ekonomiese, sosiale en politieke konteks waarbinne hulle plaasvind. Die doel van hierdie studie is om die moontlikheid te bepaal van 'n enkele stel kriteria vir jeug leierskapsontwikkelingsprogramme binne die Afrika konteks. Vir hierdie doel is afsonderlike kwalitatiewe vergelykings getref tussen die gevallestudies en die bepaalde riglyne van die IYF. Verder is tekortkominge van beide die riglyne asook die jeugprogramme bepaal. Volgens hierdie studie vonn jeugontwikkeling 'n integrale deel van gemeenskapsontwikkeling, en daarom behels gemeenskapsontwikkeling ook die opleiding van toekomstige leiers. Daar kan nie op vorige modelle van leierskapsontwikkeling gesteun word vir die huidige jeug in Afrika nie. Daar is verdere navorsing in hierdie rigting nodig, maar hierdie studie bevestig dat jeugleierskapsontwikkeling in Afrika van kardinale belang is.

Thesis (M Sport Sc (Sport Science))--University of Stellenbosch, 2006. / INTRODUCTION: The primary aim of this study is to identify the prevalence and nature of injuries sustained by South African schoolboy cricketers. The results will then be used to set possible preventative measures in order to minimize the incidence of first-time and recurrent injuries. METHODS: The population consisted of 196 cricketers representing all 16 provincial teams in the under 19 Coca-Cola Khaya Majola cricket week played in Pretoria from 16 - 20 December 2004. Data were collected retrospectively and the cricket players were asked to recall all injuries from June 2003 to May 2004. The researcher personally guided each cricketer through a questionnaire regarding training and injury. The questionnaire was designed to obtain the following information: i) anatomical site of injury, ii) month of injury, iii) diagnosis of injury, iv) cause of injury, v) whether it was a recurrence of a previous injury and vi) whether the injury recurred during the season. A questionnaire was handed to each of the coaches who then asked if they could complete the questionnaire in their own time. The questionnaire was designed to see the level of coaching qualifications achieved by them and their level of understanding of basic training principles. RESULTS: The results showed that 67 injuries were sustained by 196 cricketers with a seasonal incidence of 34.2. Almost 72% of injuries occurred during matches, 14.9% occurred gradually due to the repetitive stresses sustained during matches and practices, 11.9% occurred during practice and 1.5% of the injuries occurred during other forms of training. Surprisingly, no injuries were sustained to the head, neck and face region while 34.3% were sustained to the upper limbs; 34.3% to the lower limbs and 31.3% to the back and trunk. Bowling accounted for 50.7% of the injuries, while fielding accounted for 32.8%, batting accounted for 14.9% and the remaining 1.5% occurred while warming-up or training. The primary mechanism of injury was the delivery and follow through of the fast bowler (34.3%), direct impact from the cricket ball when attempting to take a catch (10.4%), running after the ball (6.0%), stopping the ball along the ground (6.0%) and landing incorrectly after diving for the ball (6.0%). Fifty eight of the injuries were reported as being first time injuries while only nine injuries were due to the recurrence of a previous injury. The majority of injuries (40.6%) reported were quite severe and took the cricketers more than 21 days to recover. Thirty six percent of injuries allowed the cricketers to return to play within seven days of acquiring the injury. Cricketers were found to be more prone to injury during December and January. CONCLUSION: Potential risk factors for injury have been identified and it has been suggested that coaches and cricketers partake in continuous educational processes that focus on all the physical, training, mental and technical components necessary for success in cricket. Cricketers should undergo regular musculoskeletal evaluations and be given personalized training programs. It is essential that a National database for junior cricketers be implemented.

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 (MScSportSc)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: Physical activity is an integral part of children's lives. It makes an essential contribution to their physical, psychological and social well-being. Often, it is through movement and active play that children learn to discover themselves. This movement and play sometimes serves as a medium for communication. Unfortunately, various research studies show that children are not active enough and lead ever increasing sedentary lifestyles and these lifestyles lead to various types of hypo-kinetic diseases. Technology, as well as the phasing out of structured physical education in schools, are aspects that are responsible for the decrease in activity levels of children. The primary aim of this study was to determine if present-day children's (Grades 1 - 3) physical abilities have improved or worsened over the years. Movement tests from Katzenellenbogen (1976) were used to test movement abilities of these children. Adapted questionnaires from Van Deventer (1999) were used to construct the lifestyle patterns of learners and to get information concerning movement programmes from teachers at schools. The sample population (N=372) was selected from four schools (two previously disadvantaged and two former Model C schools) in the Stellenbosch area. The tests evaluated, inter alia the following, velocity, velocity and power, power, velocity and accuracy, accuracy and precision. Children from the previously disadvantaged and former Model C schools, as well as age and sex were compared. A comparison with the 1976 study of Katzenellebogen was also done. The latter study only involved girls and was undertaken only at White schools. The coding of the variable data was done in a computer format, coded and statistically analysed. Averages are compared through the Analyses of Variance (ANOVA). From the results of the study, it can be concluded that children at the former Model C schools fared better in most of the tests and it is evident that boys generally are more active than girls. As far as the comparison with the 1976 study is concerned, present-day girls fared worse in almost all the tests. The weight of the 9 year old girls increased by as much as 7.2 kg. This study can therefore be a starting point for further study attempting to combat the tendency of inactivity amongst the youth of today. / AFRIKAANSE OPSOMMING: Fisieke aktiwiteit is 'n integrale deel van kinders se lewens. Dit maak 'n essensiële bydrae tot hul fisieke, psigologiese en sosiale welstand. Dit is dikwels deur beweging en aktiewe spel wat kinders leer om hulself te ontdek. Hierdie beweging en spel dien ook soms as 'n medium vir kommunikasie. Ongelukkig toon verskeie navorsing dat kinders nie aktief genoeg is nie en al hoe meer sedentêre leefstyle handhaaf, wat lei tot allerhande hipokinetiese siektetoestande. Tegnologie, asook die uitfassering van gestruktureerde Liggaamlike Opvoeding in skole is aspekte wat verantwoordelik gehou word vir die afname in aktiwiteitsvlakke van kinders. Die primêre doel van hierdie studie was om te bepaal of hedendaagse kinders (Graad 1 tot 3) se bewegingsvermoëns oor die jare heen verbeter of verswak het. Bewegingstoetse uit Katzenellenbogen (1976) is gebruik om bewegingsvermoëns van die kinders te toets. Aangepaste vraelyste uit Van Deventer (1999) is gebruik om die leefstylpatrone van leerders vas te stel en om inligting aangaande bewegingsprogramme in die skole by onderwysers te bekom. Die proefpersone (N=372) is uit vier skole (twee voorheenbenadeelde [VB]- en twee voormalige Model-C [VMC]-skole) in die Stellenbosch omgewing geselekteer. Die toetse het die volgende veranderlikes gemeet: snelheid; snelheid en dryfkrag; dryfkrag; snelheid en akkuraatheid; akkuraatheid en presiesheid; getoets. Kinders van VB- en VMC-skole, ouderdomme en geslagte is met mekaar vergelyk. Daar is ook 'n vergelyking met die 1976-studie van Katzenellenbogen getref. Die 1976-studie van Katzenellenbogen het slegs dogters ingesluit en is slegs by Blanke skole onderneem. Die veranderlikes se datametings is in rekenaarformaat gekodeer en statisties verwerk. Gemiddeldes is vergelyk deur middel van analise van variansie (ANOVA). Uit die resultate van die studie kan tot die gevolgtrekking gekom word dat kinders by die VMC-skole beter in meeste van die toetse gevaar het en dit blyk ook dat seuns oor die algemeen meer aktief is as dogters. Wat die vergelyking met die 1976-studie betref, het hedendaagse dogters swakker gevaar in byna al die toetse. Die 9-jarige dogters het ook met soveel as 7.2 kg in gewig vermeerder. Hierdie studie kan dus as 'n beginpunt dien vir verdere studie in 'n poging om die tendens van onaktiwiteit onder vandag se jongmense te bekamp.

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.

This thesis argued that Physical Education is marginalised in the South African primary school education sector. Through this marginalisation, Physical Education has been reduced from having full subject status, to being only one of the components of one of the primary school learning areas, namely, Life Orientation. Simultaneously, Physical Education finds itself in a situation in which it is generally being taught by a class teacher and no longer by a specialist Physical Education teacher. Possible reasons for this marginalisation are expressed, however, the argument that Physical Education is an imperative in the holistic development of the child, is also espoused. This thesis critically examined the route that South African primary school education is taking and focused on the issues of holistic education and development, Outcomes-based Education and Life Orientation.

No abstract available. / Thesis (LL.M.)-University of Natal,Durban, 2002.

The purpose of this study was to explore various aspects of discipline in secondary schools inter alia the views of educators to changes regarding the behaviour of learners today as compared to the past, the banning of corporal punishment in schools, commitment to provide support, and to elicit alternative methods of maintaining discipline. The study was an exploratory one aiming to bring the views of the educator to the fore in clinical research. It was also undertaken to spur other research into this area. The study was undertaken with educators from the town of Verulam in the north coast of Kwazulu- Natal, South Africa. All secondary schools in the area were targeted. This was a possibility sample as it was peculiar to the context and is valid because it does have resemblance to reality. The sample reflected the remnants of the old apartheid educational structures. Various types of schools were included inclusive of ex -House of Delegates, ex-Department of Education, private and religion-based schools. The sample had semblance of the general educator population. Educators in nine of the secondary schools responded to a questionnaire. The structured questionnaire had a quantitative and qualitative bias. The response rate was 58.3 percent. A statistical package was used to analyse the statistical aspects of the questionnaire. The results of the study indicate that educators believed that the incidents and severity of learner misbehaviour had increased rapidly post 1996. A significantly large number also stated that their superiors (the Department of Education-DOE) have left a void with the banning of corporal punishment by provldinq little or no alternatives to discipline learners. Many respondents believed that their authority was undermined and it affected discipline and hence the culture of teaching and learning. Serious offenders were handed to management of schools. Management in schools were viewed as supportative although there was a call for consistency in the application of the schools' Code of Conduct. Numerous methods of disciplining were suggested with the most popular being getting the parent involved and personal counselling. Sadly, the third popular measure believed to be effective was the use of corporal punishment, albeit it was used by a small percentage of respondents. There was no significant difference in views between male and female respondents. Various extraneous factors influencing poor behaviour were postulated. The learners' background, role of the parent and peer pressure, were viewed as most important. School contextual factors such as large classes and poor resources were also noted. Recommendations for better discipline and disciplinary measures were highlighted. The study called for a review of the Code of Conduct as required by the South African Schools Act 84 of 1996, with the focus being immediacy and relevance of sanctions and the more frequent use of the parent-component, of the Schools' Governing Body, in discipline. A more pro-active stance on the part of the DOE in assisting educators, in disciplinary measures, at grass-root level was recommended. The study also recommended further research into discipline and disciplinary measures at secondary schools. / Thesis (LL.M.)-University of KwaZulu-Natal, Durban, 2006.