Magister Pharmaceuticae - MPharm / Background: Venous thromboembolism (VTE) is reported to be the leading cause of death in hospitalised patients worldwide. Thromboprophylaxis provides a well-established and evidence-based approach to preventing VTE. This approach employs individualised patient risk stratification followed by the provision of pharmacological and/or non-pharmacological prophylaxis. Although various VTE risk assessment models (RAMs) are available, the Caprini RAM offers an objective, evidence-based and validated approach to risk assessment in hospitalised medical patients. Literature findings are indicative of a trend towards both under- and inappropriate VTE prophylaxis prescribing in this patient population. Together with the reported lack of medical practitioner appreciation for VTE risk assessment, the necessity to explore these aspects of practice is evident. Methods: This study used a retrospective, cross-sectional study design. It was conducted at one regional- and two district-level public hospitals in the Cape Town Metropole in the Western Cape province of South Africa. Medical folders of all adult hospitalised medical patients who were admitted to a general medical ward between January and July 2020 were retrospectively reviewed using a uniquely designed data collection tool. The data collection tool included the 2013 version of the Caprini RAM, which was employed to document VTE risk factors and assess overall VTE risk. Thromboprophylaxis regimens prescribed as well as contraindications to pharmacological thromboprophylaxis were also reviewed

The Social Assistance Act 13 of 2004 makes provision for social assistance in the form of older person’s grant, disability grant, child support grant, foster care grant, war veteran grant, care dependency grant and social relief of distress. The provision of a disability grant is prescribed in Section 9 of the afore-mentioned Act which sets out the qualifying criteria for a disability grant which stipulates that the applicant for a disability grant should have attained the prescribed age at the time of application. The Act further prescribes that, owing to the applicant’s physical or mental disability, which is unable to secure employment or profession to enable him/her to provide for his/her maintenance, may also submit an application. The purpose of the study was to “Evaluate the policy regulating access to South African Social Security Agency’s disability grant in Umlazi Township”. The focus is on the Umlazi Township in the eThekwini Metropolitan Municipality in the KwaZulu-Natal Province. The data collection techniques used in the collection of data was qualitative in nature. A semi-structured questionnaire with a mixture of a five-point Likert scale and open-ended questions was administered. The major findings of the study included the lack of policy for the disability grant, the lack of relevant training for staff and medical practitioners, the lack of community engagement and awareness, medical practitioners who use their discretion to make recommendations to the South African Social Security Agency (SASSA) administrators, the risk of inclusion and exclusion errors caused by poor gate-keeping, the impact of poverty, unemployment and the chronic illnesses resulting to demand for disability grants. / MA (Public Administration), North-West University, Potchefstroom Campus, 2015

The Social Assistance Act 13 of 2004 makes provision for social assistance in the form of older person’s grant, disability grant, child support grant, foster care grant, war veteran grant, care dependency grant and social relief of distress. The provision of a disability grant is prescribed in Section 9 of the afore-mentioned Act which sets out the qualifying criteria for a disability grant which stipulates that the applicant for a disability grant should have attained the prescribed age at the time of application. The Act further prescribes that, owing to the applicant’s physical or mental disability, which is unable to secure employment or profession to enable him/her to provide for his/her maintenance, may also submit an application. The purpose of the study was to “Evaluate the policy regulating access to South African Social Security Agency’s disability grant in Umlazi Township”. The focus is on the Umlazi Township in the eThekwini Metropolitan Municipality in the KwaZulu-Natal Province. The data collection techniques used in the collection of data was qualitative in nature. A semi-structured questionnaire with a mixture of a five-point Likert scale and open-ended questions was administered. The major findings of the study included the lack of policy for the disability grant, the lack of relevant training for staff and medical practitioners, the lack of community engagement and awareness, medical practitioners who use their discretion to make recommendations to the South African Social Security Agency (SASSA) administrators, the risk of inclusion and exclusion errors caused by poor gate-keeping, the impact of poverty, unemployment and the chronic illnesses resulting to demand for disability grants. / MA (Public Administration), North-West University, Potchefstroom Campus, 2015

While ethical codes have been established for practitioners, there is a possibility that dual loyalty affects occupational medical practitioners’ (OMPs) decisions in determining fitness status of employees. Literature indicates dual loyalty of OMPs leads to ethical dilemmas. The study’s main objective is to determine if dual loyalty participates in OMPs’ decisions and influences OMPs to breach medical ethics required in their profession, resulting in employees unfairly losing their jobs. The study interrogates literature review on dual loyalty and adopts a multi-layered approach focussing on the Constitution; relevant Acts and guidelines; case law and ethical principles. Case studies from the Medical Inspector’s archives are interrogated to determine the influence dual loyalty has on OMPs’ decision-making. Case law indicates that conflict of interest is the source of dual loyalty. Occupational medical practitioners have fiduciary duties and need to serve the best interests of the employees. From case studies discussed, the study shows that OMPs are affected by dual loyalty and tend to disregard medical ethics. They may be conflicted when making decisions concerning employees’ fitness to work, especially when individualised assessments are not conducted. A guideline addressing ethical obligations and human rights should be drafted for OMPs, guiding them on dealing with dual loyalty. Employers will need awareness training in various institutions so that OMPs are supported and encouraged to have sound medical ethics. This will promote best practice in doctor-patient relationships, avoiding dual loyalty dilemmas. / Mini Dissertation (MPhil)--University of Pretoria, 2019. / Public Law / MPhil / Unrestricted

Dans le colloque singulier, désormais désacralisé du soignant avec son patient, la charge responsabilisante pesant sur l’activité des praticiens médicaux n’a cessé de croître ces dernières décennies dans une société où les questions de santé sont prépondérantes. Exercée au sein d’un ordre social complexe et technique qui pose un principe d’intangibilité du corps humain, simultanément but et objet de la pratique médicale, cette dernière est susceptible d’engager la responsabilité pénale du praticien médical en raison de sa faute pénale non-intentionnelle. Or malgré le particularisme évident de l’activité médicale et alors que l’on peut redouter un phénomène de judiciarisation qui conduirait les praticiens médicaux de plus en en plus souvent devant les juridictions répressives, la responsabilité pénale du praticien médical ayant commis une faute non-intentionnelle est engagée selon les dispositions du droit pénal commun et selon le principe d’une culpabilité non-intentionnelle dérogatoire au primat de l’intention en droit pénal. En matière de responsabilité pénale, on ne cherche pas seulement le responsable d’une faute, mais le coupable d’un crime ou d’un délit. Ce constat invite à se demander si un praticien médical qui se verrait poursuivi en raison d’une faute médicale non-intentionnelle ayant entrainé le décès ou les blessures involontaires de son patient, a la faculté de prévoir les suites judiciaires et d’organiser efficacement sa défense. L’étude de cette question met en lumière un texte insuffisant, d’essence interprétative, reposant sur une culpabilité non-intentionnelle dans laquelle l’élément moral pourtant théoriquement nécessaire à la caractérisation infractionnelle mais si ténu, relève d’une fiction juridique. De fait, se pose la question de l’existence même d’une culpabilité en cas de faute non-intentionnelle. Ainsi, fragile en son principe et critiquable dans sa rédaction, le droit commun relatif à la faute non-intentionnelle conduit à une responsabilité du praticien médical exorbitante. Les travaux de recherche mettent en évidence un droit prétorien contingent des composantes de la faute pénale non-intentionnelle et notamment de ses composantes causales par l’effet d’une approche jurisprudentielle volontariste, créative et affranchie du texte. L’analyse révèle aussi une appréhension de la faute pénale médicale qui dépend de l’expertise médicale, légitime substantiellement mais illégitime au plan processuel car insuffisamment contradictoire. De sorte que ces deux caractéristiques de l’appréhension judiciaire de la faute pénale médicale permettent d’envisager l’opportunité d’une évolution légale. / In a society where the issues of health are prominent, the doctor-patient bond is now desecrated as the load of responsibility bearing on the activity of medical practitioners has not stopped growing these last decades.Exercising within a complex and technical social order that puts a principle of intangibility on the human body, simultaneously purpose and object of medical practice, the penal responsibility of medical practitioners may be engaged even if the penal fault was non intentional.Yet, in spite of the particularism of the medical activity, and whilst we could fear a phenomenon of judicialisation which could lead medical practitioners to be more often in the forefront of the repressive judicial system, the penal responsibility of the medical practitioner who has committed a non-deliberate fault is engaged according to common rules and the principle of a non-deliberate guilt that represents an exception in criminal law.In terms of penal responsibility, not only do we look for someone responsible of a fault, but also the culprit guilty of a crime or an offence.This observation raises the question: does a medical practitioner, pursued on the basis of a non-deliberate médical fault leading to the death or injury of his / her patient, have the faculty to foresee the judicial consequences and to effectively organise his / her defence.The study of this issue highlights an insufficient text, interpretative by nature, based on a non-deliberate guilt in which the moral element, theoretically necessary to fully characterise the offence, is a legal fiction.De facto, one can therefore query the very essence of guilt in case of a non-intentional offence.Thus, fragile in its principle and questionable in its wording, common criminal law relative to a non-deliberate fault has led to an exorbitant responsibility placed upon medical practitioners.Research has put forward evidence of a contingent of praetorian law with components of non-deliberate faults, and notably the causal components through a jurisprudential approach which is not only pro-active and creative but also liberated from the text.The analysis also reveals an apprehension of the penal medical fault which would depend on the medical expertise, substantially legitimate, but considered illegitimate from the criminal proceedings point of view as it is deemed insufficiently contradictory.These two characteristics of the judicial apprehension of the medical penal fault could allow us the possibility to envisage a legal evolution.

Background South Africa has experienced the most severe consequences of the HIV/AIDS pandemic. Every community has been affected in some way, many experiencing huge increases in mortality,particularly before antiretroviral therapies (ART) were readily available. However, the micro-level understanding of the HIV epidemic in South Africa is weak, because of a lack of detailed data for most of the population. This thesis is based on detailed individual follow-up in the Agincourt Health and Demographic Surveillance Site (HDSS) located in the Agincourt subdistrict of Mpumalanga Province and investigates micro-level determinants of HIV epidemiology and the impact of treatment provided. Methods The Agincourt HDSS has followed a geographically defined population since 1992,approximately the time when the HIV/AIDS epidemic first became apparent. This population based surveillance has included capturing details of all deaths, with cause of death determined by verbal autopsy, as well as the geographical location of individual households within the overall Agincourt area. Background information on the roll-out of ART over time was also recorded. Results A comparison immediately before and after the major roll-out of ART showed a substantial decrease in HIV-related mortality, greater in some local communities within the area than others. Individual determinants associated with a decreased risk of HIV/AIDS mortality included proximity to ART services, as well as being female, younger, and in higher socioeconomic and educational strata. There was a decrease in the use of traditional healthcare sources and an increase in the use of biomedical healthcare amongst those dying of HIV/AIDS between periods before and after the roll-out of ART. Conclusions Understanding micro-level determinants of HIV/AIDS infection and mortality was very important in terms of characterising the overall epidemic in this community. This approach will enable public health interventions to be more effectively targeted towards those who need them most in the continuing evolution of the HIV/AIDS epidemic.

This dissertation deals with a theological-ethical evaluation of the Termination of Pregnancy Act of 1996 on the area of abortion on demand. It aims at empowering women and also solving the problem of backstreet abortion. Chapter one gives a brief introduction to the Termination of Pregnancy Act of 1996. Chapter two gives a historical background of abortion and the factors tbat eventually led to the Termination of Pregnancy Act of 1996. Chapter three focuses mainly on the teachings of the Roman Catholic Church on abortion. Issues relating to the value of human life are discussed in this chapter. Is~~es relating to the Termination of Pregnancy Act of 1996 and their theologicalethical in.Jplications are discussed in this chapter, i.e. chapter four. Empowering of women, sex education, instilling good moral values to the youth and also changing the pastoral attitude of churches towards sexuality can help to alleviate the problem of unwanted pregnancy. / Philosophy, Practical & Systematic Theology / M. Th. (Theological Ethics)

This dissertation deals with a theological-ethical evaluation of the Termination of Pregnancy Act of 1996 on the area of abortion on demand. It aims at empowering women and also solving the problem of backstreet abortion. Chapter one gives a brief introduction to the Termination of Pregnancy Act of 1996. Chapter two gives a historical background of abortion and the factors tbat eventually led to the Termination of Pregnancy Act of 1996. Chapter three focuses mainly on the teachings of the Roman Catholic Church on abortion. Issues relating to the value of human life are discussed in this chapter. Is~~es relating to the Termination of Pregnancy Act of 1996 and their theologicalethical in.Jplications are discussed in this chapter, i.e. chapter four. Empowering of women, sex education, instilling good moral values to the youth and also changing the pastoral attitude of churches towards sexuality can help to alleviate the problem of unwanted pregnancy. / Philosophy, Practical and Systematic Theology / M. Th. (Theological Ethics)