Thesis (MTech (Environmental Health))--Peninsula Technikon, Cape Town, 2003 / Recent studies have reported an increased prevalence (19%) of respiratory symptoms among furm workers exposed to pesticides. International studies suggest excessive pesticide use and biological factors such as outdoor mites as important factors responsible for asthma symptoms. Studies in Korea suggest that spider mites may be responsible for allergic asthma symptoms among workers on fruit (citrus, apple, and . pear) furms. The fuming of wine and table grapes in South Africa involves about 3000 farms employing over 50,000 workers. Workers on table grape farms, in contrast to other fruit farms have not been previously investigated for occupational respiratory allergy to spider mites. Objectives • To determine the spectrum and prevalence of work-related allergy and asthma among table grape farm workers • To determine the environmental and host factors associated with work-related symptoms and allergic outcomes. Methods: A cross-sectional study was conducted on 207 workers employed on nine table grape farms in the Hex River valley of South Africa. A modified European Community Respiratory Health Survey questionnaire was used to interview workers. Skin prick tests used 8 commercial extracts of common airborne allergens (ALK) and potential occupational allergens, which included grape mould (Botrytis cinerea) and an in-house extract of spider mite, Tetranychus urticae. Specific IgE to Tetranychus urticae was determined using enzyme-linked immunosorbent assay (ELISA) and to house dust mite (Dermatophagoides Pteronyssinus) and storage mite (Lepidoglyphus Destructor) using Pharrnacia CAPRAST. Results: The mean age of the workers was 36 years with a standard deviation of 11 years.

Most students are adolescents and young adults, a group characterized by a new-found sense of independence, experimentation with sex and sometimes drugs and a feeling of invincibility (Gayle, Richard, Keeling, Garcia-Tunon, Kilbourne, Narkunas, Ingram, rogers and Curran, 1990:1538). These behavioural, developmental and environmental issues may contribute to premature morbidity, mortality and reduced quality of life for university students (Patrick et al., 1992:260). The ages of staff on the other hand range from young adults to retirement age. The types of health problems that exist among staff who use the campus health service include First Aid treatment on site for injuries on duty and more chronic health problems such as, for example, hypertension and diabetes mellitus. To date there is very little evidence as to whether or not the healthcare needs of students and staff are being met comprehensively or whether the practitioners rendering the service are knowledgeable and complying with the PHC norms and standards developed by the department of Health’s Quality Assurance Directorate. The lack of such empirical data can contribute to misconceptions and hamper the management of public health problems experienced in SA, for example sexually transmitted infections and the transmission of HIV. Thus the purpose of this research was to develop a model that would assist registered nurses employed at a higher education campus health service in the Western Region of the Eastern Cape Province to render a healthcare service relevant to the healthcare needs of the students and staff on campus.

M.Tech. (Homoeopathy) / Acute tonsillitis is inflammation of the tonsils, caused by a bacterial or viral infection. In most cases it is caused by a viral infection (Clarence & Sasaki, 2008), which is a common cause of upper respiratory tract infections in children (Baker et al., 2012). Tonsillitis is one of the most common causes of absenteeism in school children, which affects school performance (De Martino & Ballotti, 2007). Conventional treatment for viral tonsillitis include anti-inflammatory drugs, which does not actively treat the condition and may cause side effects (Clarence & Sasaki, 2008; Cocazza et al., 2001; Roxane & Nahata, 2006) such as bruising, skin rash, tinnitus, oedema, dyspepsia, depression, nervousness, insomnia, pruritis, visual disturbance, renal failure and gastrointestinal irritation which can result in bleeding (Rainsford, 2003; Scherer, 2012; Snyman, 2007). Tonzolyt® is a commercially available homoeopathic complex remedy indicated for both acute and chronic tonsillitis and sore throat. However, there is a lack of research to support its effectiveness (Herbaforce, 2010). The aim of this study was to determine the efficacy of the homoeopathic complex Tonzolyt® on the symptoms of acute tonsillitis in black children attending a primary school in Gauteng. A Wong-Baker Face Pain Rating Scale measured pain intensity and a modified Semi-quantitative Basis Scale assessed changes in signs and symptoms of tonsillitis. This was a double-blind, placebo-controlled study conducted over six days with daily follow-up assessments. Thirty participants, aged 6-12 years, suffering from acute viral tonsillitis, were recruited from a primary school in Gauteng. Parents / guardians were informed about the study by means of a letter (Appendix H). Attached to the letter there was an information form (Appendix A), as well as a Participant Profile form (Appendix D) to fill in, and a consent form (Appendix B) to sign. Parents / guardians and teachers were requested to refer children who showed signs of tonsillitis to the researcher. The researcher was available on the school premises on...

Submitted in partial fulfillment of the requirements for the Degree in Masters of Technology in Chiropractic, Department of Chiropractic and Somatology, Durban University of Technology, Durban, South Africa, 2016. / Introduction: Evidence suggests that Indians are at a greater risk of developing chronic diseases due to their unhealthy diet and sedentary lifestyle. The increased emphasis placed on exercise and diet in preventative regimens is altering related mortality and morbidity. Physical activity plays a role in the prevention of coronary heart disease and other chronic diseases which occur at a higher rate in inactive people. Despite the need for exercise to improve health, no study has examined the exercise profile of Indians in KwaZulu-Natal, South Africa, their exercise patterns and motivations regarding exercise. Aim: This study determined the patterns of exercise participation by Indians residing in KwaZulu- Natal (KZN). Methodology: A quantitative, descriptive, cross sectional survey was used in this study. The study was conducted at the Durban North Beach on selected weekends during August and September 2015. The target population was South African Indians. A convenience sample was used, that is, potential participants, who were at North Beach on the data collection days were approached with a request to participate in the study. Following the signing of an informed consent form, data was collected by means of a self-administered questionnaire. A total of 450 self-administered questionnaires were handed out and 411 completed questionnaires were received. Descriptive statistics in the form of frequencies, means and standard deviations were calculated. Relationships between two variables were determined using chi-squared tests, Fisher’s Exact test, Pearson’s correlation test, as appropriate. Odds ratios were calculated where relevant. A p value less than 0.05 was considered statistically significant. Results: The mean age of respondents was 37.7 ± 13.7 years. The majority (70.1%) participants reported that they currently exercise. However, only 42.9% of the respondents were found to meet the international requirement of 150 minutes of physical activity per week. When unstructured physical activity, such as household and yard chores were added, the latter frequency increased to 45.3%. Physical activity levels were similar across all age groups, likewise, similar proportions of males and females exercised. The most common exercises performed included walking (45.5%) and jogging (25.3%). Gymnasiums (33.5%), public grounds (25.3%) and the beachfront (21.4%) were the most commonly used locations for physical activity. One third of these respondents reported their health conditions as their main reason for exercising and most were aware about the value of exercise. Respondents who did not exercise regularly cited time management for their lack of exercise. Conclusion: The prevalence of exercise among South African Indians is low, with less than half of the population being physically active. Interventions are required to make people aware of the benefits of physical activity in order to increase the prevalence of exercise in this population. / M

Thesis (MSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: In developing countries the increasing number of the aged are often viewed as a problem. In particular, the indigent elderly residing in poor urban areas are at risk of becoming marginalised and underserved. The Western Cape has the third largest elderly population in proportion to the total population in the country. Social assistance in the form of a monthly pension is paid out to all elderly who pass a national means test carried out by South African Social Security Agency (SASSA). An assessment of the characteristics and health status of the elderly collecting old age pensions living in low-income urban poor communities in the City of Cape Town was carried out at pension pay points across four communities, i.e. Gugulethu, Khayelitsha, Mitchells Plain and Bonteheuwel. In community health surveys, choices regarding the methodology have to be made that can have profound effects on the study design and study outcomes. The milieu of the present study is one of urban poverty and specifically those urban elderly who qualify for non-contributory pensions (also called social cash transfers or government grants). The paucity of existing community-based studies on old-age pensioners in the City of Cape Town meant that a cross-sectional survey with wide-ranging coverage of demographic, social and health factors was the most logical design to employ in order to determine the extent of present needs and generate hypotheses for further controlled studies. A systematic random sample of 703 elderly was drawn at nine pension pay-out points in Cape Town Metropole. No pensioners refused to participate in the study. Structured interviews were carried out covering demographics, number of dependents, living conditions, socioeconomic circumstances, health status and needs and utilisation of health services. A reported 43% of participants lived in shacks and 88% reported regularly eating less than 3 meals a day. Eighty-seven percent of respondents reported waiting 3 hours or longer for medication at a clinic while 90% reported being dissatisfied with the service at their clinic. Fifty-eight percent of pensioners reported not being able to see well while 83% did not know where to get their eyes tested. Almost 70% of pensioners said that they have been ill-treated by a family member and 64% scored as severely depressed on the geriatric depression scale. In this study, 266 pensioners solely supported 471 children of which 65 (14%) were disabled children. In 95% of cases the pensioner does not receive any support from the child's parents. The study found that the elderly on a state grant had considerable unmet health needs and required assistance with activities of daily living. The indigent pensioners in this study bore a huge duty of care for minor children as custodial grandparents while not receiving a high level of health support themselves. / AFRIKAANSE OPSOMMING: Die toenemende aantal bejaardes word dikwels in ontwikkelende lande as 'n probleem gesien. In die besonder loop die bejaardes wat in lae-inkomste stedelike gebiede woon die risiko om gemarginaliseer te word en swak dienslewering te ondervind. Die Wes-Kaap het die derde grootste populasie van bejaardes in verhouding tot die totale bevolking in die provinsie. Sosiale bystand in die vorm van 'n maandelikse pensioen word betaal aan alle bejaardes wat die inkomstetoets slaag wat deur die Suid-Afrikaanse Agentskap vir Maatskaplike Sekerheid (SAAMS) uitgevoer word. 'n Ondersoek na die eienskappe en gesondheidstatus van bejaardes wat hulle ouderdomspensioene in lae-inkomste stedelike gemeenskappe in die Stad Kaapstad kom afhaal is uitgevoer. Die studie is gedoen by pensioen-uitbetaalpunte in vier gemeenskappe, naamlik Gugulethu, Khayelitsha, Mitchells Plein and Bonteheuwel. In gemeenskapsgesondheid-opnames moet keuses gemaak word ten opsigte van die metodologie wat diepgaande gevolge vir die studieontwerp en -uitkomste kan inhou. Die milieu van die huidige studie in dié van stedelike armoede en spesifiek die leefruimte van stedelike bejaardes wat kwalifiseer vir nie-bydraende pensioene (ook genoem sosiale kontantoordragte of staatstoelaes). Die gebrek aan bestaande studies van ouderdomspensioenarisse in Kaapstad het beteken dat 'n dwarsdeursnit-opname van die demografie, sosiale en gesondheidsfaktore die mees logiese ontwerp was om uit te voer. Dit is gedoen om die omvang van huidige behoeftes te bepaal en verdere hipoteses te genereer wat deur vergelykende studies ondersoek behoort te word. 'n Stelselmatige ewekansige steekproef van 703 bejaardes is getrek by nege betaalpunte in die Kaapse stadsgebied. Geen proefpersone het geweier om deel te neem nie. Gestruktureerde onderhoude is gevoer wat die volgende aspekte gedek het: demografiese eienskappe, aantal afhanklikes, gesondheidstatus en benutting van gesondheidsdienste. Van die deelnemers het 43% in informele behuising ("shacks") gewoon en 88% het gerapporteer dat hulle gereeld minder as 3 daaglikse maaltye eet. Daar het 87% gerapporteer dat hulle 3 uur of langer gewag het om medikasie by hulle plaaslike kliniek te ontvang terwyl 90% ontevrede was met die diens wat hulle by die kliniek ontvang het. Daar het 58% van die bejaardes gerapporteer dat hulle nie goed kan sien nie terwyl 83% van hulle nie geweet het waar hulle hulle oë kan laat toets nie. Omtrent 70% van bejaardes het gesê dat hulle deur 'n familielid mishandel word en 64% kon as ernstig depressief geklassifiseer word op die geriatriese depressieskaal. In hierdie studie was 266 pensioenarisse die enigste sorg en voog van 471 kinders van wie 65 (14%) gestremd was. In 95% van gevalle het die pensionaris geen geldelike of ander bydraes van die kind(ers) se ouers ontvang nie. Die studie het bevind dat bejaardes wat 'n staatstoelaag ontvang aansienlike onvervulde gesondheidsbehoeftes het en hulp benodig met aktiwiteite van daaglikse bestaan. Die behoeftige pensioenarisse in hierdie studie het 'n groot las gedra aan die versorging van minderjarige kinders as toesighoudende grootouers ("custodial grandparents") terwyl hulleself nie 'n hoë vlak van ondersteuning geniet nie.

Submitted in partial compliance with the requirements for the Masters’ Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2015. / Research has shown that more than 90% of the scholars, use backpacks, worldwide. The backpack has the ability to transport books, sports equipment and clothing between school and home, climaxing in a capacity that may affect posture. Therefore, it is noted that a backpack, which is not carried correctly, fitted improperly and/or over packed may pose a threat to the scholar’s posture Aim: To determine the effect between a novel and school-issued backpack in terms of postural symmetry measurements (photographic measurements), when compared to no backpack, on high school adolescent standing posture. Method: This research was a quantitative descriptive cross sectional experimental design. Each participating scholar underwent a BMI, height and weight screening, prior to inclusion into the data collection process. One hundred asymptomatic scholars, aged between 12 to 14 years, were recruited using convenience sampling. Thereafter, digital photographic images of each scholar was taken in 3 groups, i.e. no Backpack, with a school-issued backpack (Backpack A) and a novel backpack (Backpack B). These digital photographic images were then uploaded, by the researcher, onto the Posturepro 8 Computer Postural Software System. The objective measurement tool (Posturepro 8 Computer Postural Software System) calculated, in degrees, the postural measurements of the scholars’ neck, shoulder and pelvis, by manually constructing lines (horizontal and vertical) between the anatomical landmarks (bilaterally). IBM SPSS version 21 was used to analyse the data. A two-tailed p value of <0.05 was considered as statistically significant. Parametric summary statistics such as mean and standard deviations were used to describe the outcomes in each group. Postural measurements were compared between the pairs (i.e. no Backpack versus Backpack A, no Backpack versus Backpack B and Backpack A versus Backpack B) using paired sample t-tests. A one sample t-test was used to compare the symmetry measurements to a null hypothesis value of 0. Results: The mean age of the one hundred scholars was 13.5 (± 0.6 SD) years. The age of the scholars ranged between 12 and 14 years. This research was performed to determine which backpack (A or B) performed better in maintaining the scholar’s posture (with no backpack). A direct comparison was performed with no Backpack to that of Backpack A and Backpack B. The comparison for each of the differences closest to zero (‘0’) in the no Backpack, Backpack A and Backpack B groups was performed using a one sample t-test. The values closer to zero (‘0’) indicated a normal postural symmetry. None of the postural symmetry measurements were significantly different from zero in all 3 groups as the mean differences were very close to zero. Therefore, when comparing Backpack A to Backpack B, this research showed that there was no significant differences between the two backpacks when looking at postural symmetry (p=0.05). Conclusion: The trends observed in this study partly supported the claims by the company (‘Improved Postural Alignment for You’) of the novel backpack. The novel backpack (Backpack B) showed significant differences in some instances when assessing other outcome measurements, but showed no significant difference when comparing postural symmetry between the two backpacks. Further studies need to be done incorporating all aspects of postural analysis, and not just postural symmetry measurements.

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

This study was concerned with investigating the perceptions of the conditions of the physical work environment on the psychological and physical wellbeing of employees at Nedbank. This was an important study to carry out due to the fact that people are increasingly spending time indoors more especially in the offices in which they work. Thus it becomes important to investigate the effects that the physical work environment in which people work has on their psychological and physical wellbeing. The buildings investigated in this study were green buildings, as they were concerned with limiting the negative impact of the physical work environment on the wellbeing of employees and the environment. The sample utilised in this study consisted of three hundred and forty nine (n=349) participants of Nedbank from two recently refurbished buildings known as Phase II and Ridgeside, the sampling technique utilised in order to obtain this sample was purposive sampling. The statistical analysis which were utilised was the multiple regression analysis which was used in order to find out which building conditions influenced psychological and physical wellbeing, whilst a partial correlation analyses was performed to investigate the moderating effect of time spent in building. From these analyses it was found that perceptions of the conditions of the physical work environment had a greater influence on the physical wellbeing of employees. Perceptions of the conditions of the physical work environment were found to have a lesser influence on the psychological wellbeing of employees at Nedbank. Results also revealed that time spent in building was not a moderator of the relationships between the perceptions of the conditions of the physical work environment with psychological and physical wellbeing respectively.

One of the earliest recorded references to polyuria is found in the Papyrus Ebers (1500 BC) and much later the occurrence of "honey urine" was noted by an ancient Hindu physician, Sushrutha, in old Indian Sanskrit (400 BC). However, the first good clinical description of the disease is ascribed to Celsus, although the name "diabetes" was introduced by Aretaeus of Cappadocia. The body of knowledge which has accumulated since these early recordings to the present state of the art reflects a most impressive sojourn, punctuated by many milestones, each adding impetus to future attempts in a relentless endeavour to unravel the aetiopathogenesis of this common malady. However, this "sweet evil" (diabetes) remains an enigma in many ways. There is little doubt today that there are 2 major types of diabetes: juvenile onset diabetes, presently known as insulin-dependent diabetes mellitus (IDDM) and maturity onset diabetes, referred to as non-insulin dependent diabetes mellitus (NIDDM). In NIDDM aggregation of HLA types, evidence of cell mediated immunity and the presence of circulating islet cell antibodies, which are characteristically associated with IDDM, are not found. There is also a vast difference in concordance of diabetes in the co-twins between the two types of diabetes suggesting that a different mixture of genetic and environmental factors is operative in the pathogenesis of these two types of diabetes. In I960, Fajans and Conn drew attention to the existence of a form of diabetes with an onset before the age of 35 years. Their patients showed a substantial improvement in glucose tolerance when treated with an oral hypoglycaemic agent, tolbutamide. Subsequent to this report numerous studies from various parts of the world confirmed this entity of non-insulin dependent diabetes in the young (NIDDY) in White Caucasians. There are, however, several different syndromes presenting as mild carbohydrate intolerance in the first two to three decades of life. The classical form of NIDDY is a mild non-insulin requiring form of diabetes in which the disorder is inherited as a dominant trait; there is little progression of glucose intolerance, if any, with time, and the diabetes is rarely accompanied by vascular complications. This subtype of diabetes is referred to as MODY (maturity onset diabetes in the young) and thus constitutes a subset under the broad umbrella of NIDDY. However, recently compelling evidence for heterogeneity within MODY has been presented. This evidence is based on the prevalence of certain HLA antigens, insulin responses to oral glucose, occurrence of vascular complications, progression of hyperglycaemia to the stage of insulin requirement and failure to demonstrate autosomal dominant inheritance in some families studied. In the South African Indian population which has a high prevalence of diabetes, Campbell was the first to draw attention to NIDDY in Indians more than two decades ago. Since this initial report, nobody has really studied NIDDY in any depth in South Africa and certainly not in the Indian population. NIDDY in the local Indian population is of particular interest for the obvious reason that diagnostic and management problems arise daily in a population with a high prevalence of non-insulin dependent diabetes. It is vital that the clinical features, endocrine and associated biochemical aberrations be known in detail if this condition is to be managed appropriately and adequately. A study of these aspects therefore became the primary task of this thesis. To pre-empt any challenge that patients were not really diabetic, the strict criteria of the W.H.O. for the diagnosis of diabetes were chosen. It should therefore be borne in mind throughout this study that a group of rather severe diabetics were selected by design. The patients studied represent the rather extreme end of the spectrum. But, in the event, this selection proved advantageous in that it covered an unstudied part of the spectrum and some light could be shed on the natural history of the disorder. In the long term the purpose was to prepare the ground for what must become the thrust of future studies, namely the biochemical pathogenesis of NIDDM. If it is true that some forms of NIDDY are inherited dominantly, existing techniques should make it possible to identify a gene(s) locus and if this is done the biochemical basis of this disorder must be identifiable. In the present study direct examination of these aspects were not undertaken, but an attempt was certainly made to pinpoint those biochemical abnormalities which are perhaps primary or central to the whole disorder. / Thesis (M.D.)- University of Natal, Durban. 1982.

This study investigated the needs assessment phase of the health education process for school children. The objectives of the study were to identify health education needs of school children using three approaches, namely, the epidemiological, consumer and social science approaches. In the social science approach, a PRECEDE model has been used. Time taken in using each approach and the skills of PHC nurses necessary to use each, were investigated in order to determine the most effective and efficient approach. A comparative case study design has been used, whereby each approach was considered as a case, hence, an embedded case study. One rural administrative area in the district of Umtata, which has a health centre in its catchment area, was selected. The population for the sudy were school children aged 12 to 16 years doing standard five. Four out of ten Junior Secondary schools in the area were randomly selected. In the epidemiological approach, records from the health centre and three of the four selected schools were analysed. In the consumer approach, focus group interviews (two groups of boys and two groups of girls) were conducted. In the social science approach, focus group interviews of school children(four groups) from the other two remaining schools, focus group interviews of mothers as carers( four groups), and in-depth interviews of standard five teachers from each of the four schools were conducted. Data analysis was done using Tesch's method of qualitative data analysis.A time activity sheet was used to estimate time used in each approach. A questionnaire was distributed among PHC nurses to determine their skills in relation to the approaches used. Results showed that the social science approach was the most comrehensive approach but used the longest time. The consumer was balanced and efficient though the least time was used. The epidemiological was found to have identified physical problems to the exclusion of the social and psychological problems. / Thesis (Ph.D.)-University of Natal, Durban, 1998.