The research used a change management approach to analyze the restructuring of the Nelson Mandela Academic Hospital from a tertiary to a central hospital. The study was underpinned by two objectives. Firstly, to analyze the restructuring of the Nelson Mandela Academic Hospital from a tertiary to a "central" hospital using the Core Elements Framework of change management developed by Antwi and Kale (2014). Secondly, to use the knowledge gained through literature review combined with the experiences of the managers at Nelson Mandela Academic Hospital to inform future healthcare reforms in general and particularly in the restructuring of hospitals. The Core Elements Framework by Antwi and Kale (2014) identifies six fundamental change elements from both emergent and planned change management approaches. The six elements are regarded by theorists from the two different schools of thought i.e. emergent change and planned change as key for successful change. The Core Elements Framework by Antwi and Kale, (2014) demonstrates the strength of not viewing the two approaches to change management as mutually exclusive but as complementing each other when the other is falling short. The study identified the following: ■ The change was prompted by clearly identifiable external factors more than internal factors. ■ There was notable lack of organizational harmony which may have negatively impacted the change process. ■ The Private Public Partnership (PPP) funding model which was aimed at delivering the central hospital collapsed, after a study discovered that it benefited the private sector more than the public sector. ■ There was no proper consultation of major stakeholders for preparation of the change. ■ Resources in all material forms were not made available for the change to take off, this means that there was no organizational capacity to execute the change. The study draws the conclusion that lack of organizational capacity, organizational harmony and a proper consultation process for stakeholders are the main reasons why the restructuring of the Nelson Mandela Academic Hospital is not yielding the desired results. The study recommends that organizations should implement a multidimensional approach for any change initiative to be successful and that organizations must ensure the availability of the necessary resources when embarking on change.

In the 1960s, risk management primarily took the form of purchased insurance against force majeure events. Today, many corporate executives are worried about not only these types of events but also many others (Mair and Cendrowski, 2009:3). “People risks” versus environmental risks, financial risks and technical risks are examples of risks that are often overlooked. People risks include, succession planning (this refers to identifying and developing key talent) and competency and skills building (dealing with employees that do not have requisite skills for success), (William & Paul, 2007:4). Massingham (2010:464) mentions that corporate disasters, such as the collapse of Enron, have increased the need for effective corporate governance, while catastrophic natural disasters, man-made tragedies such as the September 11 terrorist attacks and tsunami of 2004, have increased risk awareness as well as its consequences.

Since 1994, South Africa has witnessed the fundamental transformation and restructuring of its Higher Education Sector. The restructuring of Higher Education Institutions in the Eastern Cape Province is manifested by inter alia the incorporation of the Port Elizabeth branch of the Vista University into the University of Port Elizabeth as a first phase and, as the final phase, the merger between the University of Port Elizabeth and the Port Elizabeth Technikon. A new, comprehensive university, the Nelson Mandela Metropolitan University (NMMU), emerged from this merger on 1 January 2005. The previous institutions each had its own unique brand identity, brand image and brand name. With reference to the newly established NMMU, the question can be raised whether the brand identity of this newly established institution impacts on its perceived brand image among all stakeholders who have an interest in the institution. Given the merger background, the purpose of this research project is twofold: firstly, to analyse the impact of independent variables (‘reputation’, ‘relevance’, ‘personality’, ‘performance’ and ‘relationship’) on brand identity (moderating variable) and the impact of brand identity on brand image (dependent variable); and secondly, to gauge the perceptions of NMMU stakeholders of the brand image of the University in terms of both expectations and actual experiences. In order to give effect to the above, a conceptual model on brand identity and brand image based on secondary sources on branding, was empirically tested. Given the purpose and nature of the research in question, a positivistic research paradigm was adopted. By means of a Likert seven-point scale, primary data was sourced from 1 092 respondents, who shared their perceptions on the expectations and actual experiences of using the NMMU brand. The statistical analysis of the data comprised six phases. Initially, the data was subjected to an exploratory factor analysis to assess the discriminant validity of (xvi) the research instrument. This was followed by an assessment of the reliability of the research instrument through an internal consistency measure (Cronbach alpha reliability coefficients). The items that remained were included in the multiple regression model to assess the impact of brand identity variables on brand identity. The next phase comprised a regression analysis of the impact of brand identity on brand image. Fifthly, to assess any differences between stakeholders’ expectations and actual experiences when using the NMMU brand, pair-wise t-tests were performed. Finally, to gauge the level of satisfaction of NMMU stakeholders when using the brand, a “gap” analysis was conducted by converting the mean scores into relative percentage ratings. The empirical findings did not fully support the conceptual model. The testing of the conceptual model revealed that the independent variable ‘relevance’ did not demonstrate sufficient discriminant validity and, as a result, no evidence of construct validity. This variable therefore had to be removed from the conceptual model before it was subjected to further empirical assessment by means of the multiple linear regression analysis. Based on this finding on ‘relevance’, NMMU marketing communication strategists could perform an in-depth investigation on the positioning of the brand. Further, it was found that the dependent variable ‘brand image’ was not a uni-dimensional construct as suggested in the conceptual model. Ideally, images (in this case, brand images of the NMMU) should feed into strategic vision, serving as a mirror in which a university can reflect on its true standing. This implies that instead of using stakeholder images as exact assessments of brand performance compared with strategic vision, images held by stakeholders of who the university is and what it stands for (e.g. personality and relevance comparisons) should become part of the strategic envisioning process. The linkage between strategic intent and brand image should be evident. The results of the pair-wise t-tests revealed that significant statistical differences (xvii) existed between stakeholders’ perceptions of the expected and actual experiences when using the NMMU brand. To assess the magnitude of a possible ‘gap’ between stakeholders’ expectations and actual experiences of the NMMU brand, mean score differences were converted into relative percentage ratings. The most significant findings on actual experiences (on which the level of satisfaction is based) of the NMMU brand are as follows: All relative rating scores were below 92.05%. These relative satisfaction percentages imply that respondents were not satisfied with the NMMU brand, because their expectations were not fully met. The highest rating percentage (92.05%) was obtained in respect of the statement regarding “The NMMU slogan (‘for tomorrow’) reflects the NMMU brand identity”. The lowest rating percentage (78.33%) was given to the statement “The NMMU brand exceeds expectations in terms of promises”. The second lowest rating percentage (79.67%) was found for the statement “The NMMU brand delivers on promises”. The principal recommendations emanating from this study are summarised in three groups of recommendations, namely: Recommendations pertaining to the strategic implications of the findings for the NMMU marketing communication strategists. Recommendations pertaining to the interpretation of secondary sources on brand literature, and Recommendations for future research.

At present, the Eastern Cape is the only province in South Africa lacking a clinical hospital-based hyperbaric facility. East Cape Hyperbaric, to be situated at Greenacres Hospital in the Nelson Mandela Metropolitan, will offer the Eastern Cape community access to a world-class facility that will offer their patients Hyperbaric Oxygen Therapy and a Wound-Healing Facility. The objective of this study was to assess the viability of establishing a Hyperbaric Oxygen Therapy (HBOT) facility for the Nelson Mandela Metropolitan Municipality (NMMM), using sound business planning principles. A business plan precisely defines the business, identifies the goals, and serves as the firm's resume. A business plan will assist in allocating resources effectively, handle unforeseen complications, and assist in making sound business decisions. Because it provides specific and organized information about the company and how the company will repay borrowed money, a good business plan is a crucial part of business planning. In order to quantify the demand for a Hyperbaric Oxygen Therapy facility, a questionnaire was designed, in such a manner as to identify the current demand for a HBOT facility. The questionnaires were distributed to all medical practitioners within the NMMM by means of fax, e-mail and hand-delivery. Research conducted indicates that the results are promising enough to warrant the expedient creation of this business facility.

The standard anti-retroviral drugs (ARVs) used for the treatment of HIV/AIDS have significant side effects resulting in a lack of adherence and the emergence of multidrug resistant viral strains. These drugs are also expensive, making it essential to investigate all alternatives to classical HIV/AIDS treatment. A wide variety of nonconventional medicines are used by patients for the treatment HIV and for symptoms associated with HIV. So long as they are safe and effective, traditional, complementary and alternative medicines (TCAMs) may be considered more advantageous for developing countries as they are relatively cheap, more accessible and widely accepted by local populations. The aim of this study was to determine the prevalence of TCAM use in HIV-positive patients, prior to, and during ARV therapy. The study was exploratory, cross sectional and observational in nature. Participants were selected via convenience sampling from the Nelson Mandela Bay Municipality, and included 244 HIV-positive patients, 29 health care professionals (HCPs) and 30 traditional, complementary and alternative practitioners (TCAMPs). A wide variety of TCAMs were used by the sample population. These medicines were more commonly used by non-ARV patients (36 percent) compared with ARV patients (22 percent). A significant statistical difference in TCAM use between the ARV and non- ARV population was found in relation to education, employment, period of status awareness, patient opinion of personal health and the reasons for TCAM use. Amongst the HCPs, 24 percent recommended TCAM use prior to ARVs, and 55 percent were aware of patients self-prescribing before and during ARV treatment. Amongst the TCAMPs, 90 percent provided a wide range of TCAMs for HIV, with some giving consideration to conventional management. TCAMs are commonly used by HIV-positive patients on ARVs, as well as by those not on ARVs. These medicines are also the preferred form of treatment for those not seeking conventional treatment. TCAMs are widely available and recommended by TCAMPs as well as some HCPs. Due to public health concerns, clinical trials of the widely used TCAMs are crucial in order to establish the safety and efficacy of these medicines in HIV.

A household survey of Helenvale Township in Port Elizabeth was conducted in order to gain an understanding of the strategies and activities that people in this poor community employ to sustain their livelihoods. The household profile, which entailed a survey of the household size, education levels and employment status was conducted. Dwelling units in terms of ownership, type, size, quality and building materials were also assessed. The income and expenditure of the Helenvale residents and community assets, as well as access to basic services were also assessed. The study found that the household size varied between 5 and 7 members. A more or less even distribution of the gender of household heads was noted, with 48 percent and 50 percent female male respectively. Among the HHs surveyed, no member had a higher qualification than Matric and quite a number were illiterate. Unemployment which stands at 54 percent was identified as the most serious problem plaguing Helenvale. A high level of home ownership (84 percent) was noted; of which 79 percent are formal dwellings and typically two-room structures of poor quality. Helenvale residents are largely dependent on child support grants as the major source of income. Casual jobs and disability grants are the other important sources of income identified. Human assets in the form of labour power are the most important assets that the community possesses. Physical assets are negligible, while financial ones are non-existent among all the respondents. Television and electric kettles are the most commonly owned appliances in the households. Basic services are readily accessible to the community, particularly water, health, refuse removal and sewage. Among the threats that the respondents identified, unemployment came to the fore as the biggest and major threat to households. Crime, teenage pregnancy and overcrowding are also considered as major threats, as are gangsterism and gambling violence. The study recommends the development of a long term plan for poverty alleviation. The creation of employment opportunities in the form of financing of small community projects which empower women and the youth is also recommended. All this should be underpinned by the expeditious delivery of housing.

Information is a vitally important asset to organizations and the information should be protected to sustain the value it provides to the organization. Information is transferred via different mediums in these organizations. An example would be Terrestrial Trunked Radio or TETRA, which is utilized within organizations to provide a technically very secure form of digital radio communication. TETRA is a communications technology that is currently being successfully used throughout the world for secure, reliable and robust critical communication. TETRA is used by Public Safety and Security (PSS) and transportation sectors, amongst others. PSS includes police officers, fire marshals and emergency medical units who require protected and accurate information that could influence decisions that could make difference between life and death. The TETRA educational programme offered by the TETRA Academy at the Nelson Mandela Metropolitan University (NMMU), educates TETRA users in various aspects of the TETRA standard. TETRA is viewed as a technically very secure communication standard, as it utilizes security features such as mutual authentication, air interface encryption, end-to-end encryption, jamming detection and ambience listening, amongst other security techniques to ensure that the information traversing through the network is kept secure. The TETRA educational programme material includes many physical and technical controls to assist TETRA users in protecting information. However, to what extent does the TETRA educational programme address operational controls? Operational controls address what is often referred to as the weakest link in information security – human behavioural issues. Humans can be exploited through human manipulation attacks, which include social engineering and bribery. Therefore, this study argues towards adapting the TETRA educational programme offered at the NMMU to address these human behavioural issues.

In an attempt to improve the quality of lives of its citizens, the South African government has introduced low-cost housing projects through the Reconstruction and Development Programme. This is supported by the relevant policy framework and the Constitution. Many historically disadvantaged communities in the urban areas have benefitted from the low-cost housing programmes initiated by government. The community of Joe Slovo, which has houses which were built between 2008 and 2010, in the Nelson Mandela Bay Municipality is one of them. However, concerns about the poor quality of some of the houses delivered through government’s low-cost housing programmes have been expressed. These concerns were attributed to the defects which tend to show up in some of the houses, shortly after they have been built. In view of such concerns and the importance of the optimal utilization of the country’s limited resources, the author decided to undertake this study. In this study he focused on the perceptions of the beneficiaries of the houses delivered through the Joe Slovo housing project in the Nelson Mandela Bay Municipality. The main focus was on the perceptions about the quality of the recently acquired houses. The study revealed that not all beneficiaries were satisfied with the quality of their houses. Hence recommendations for addressing this scenario are made.

This study explored and described the perception of clinical psychologists regarding thebarriers to the provision of psychological services in urban public health settings for people with first-episode schizophrenia. The qualitative research study utilised an explorative, descriptive interpretive research design. Purposive sampling was utilised to gain access to clinical psychologists, who had at least two years of public health experience working with people recently diagnosed with schizophrenia. Data was gathered from 11 participants from the Nelson Mandela Bay Health District of the Eastern Cape by means of in-depth interviews that were conducted in English by the researcher until data saturation had occurred. A computer-assisted qualitative thematic analysis of the collected data was conducted using NVIVO software. The findings have been categorised according to three broad domains: 1)contextual barriers 2)health care system-related barriers and 3)first-episode schizophrenia syndrome-related barriers. Several specific sub-themes were identified for each of these main domains allowing for recommendations and suggestions to be provided for attending to and overcoming these perceived barriers.

In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients’ Rights Charter. The quality of health care delivery has dropped drastically, and reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with thousands of patients being treated in condemned hospitals. Receiving and rendering health care in the face of such challenges, the question arose: “Are patients receiving patient-centred care in public hospitals?” The answer to this rhetorical inquiry appeared to be obvious, but this research study explored and described professional nurses’ perceptions of patient-centred care in public hospitals and their understanding of evidence-based practice and best practice guidelines. The proposed study followed a qualitative, exploratory, descriptive and contextual design. The research population included professional nurses who are employed in public hospitals in Nelson Mandela Bay, and consisted of nurse managers and nurses who work in the wards. The research study consisted of three phases. In Phase 1, semi-structured interviews and focus groups were conducted with nurse managers and professional nurses working in the wards in order to collect data about their perceptions of patient-centred care and their understanding of evidence-based practice and best practice guidelines. The interviews were transcribed and Tesch’s eight steps of data analysis were followed to create meaning from the data collected. Themes were identified and grouped together to form new categories. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness, which consists of the following four constructs: credibility, transferability, dependability and confirmability. An independent coder assisted with the coding process. In Phase 2, an integrative literature review was conducted in order to identify previous guidelines regarding best practice for patient-centred care. Relevant guidelines were selected, critically appraised, data was extracted and synthesised for the development of a best practice guideline for patient-centred care. An independent appraiser critically appraised the guidelines, thereby ensuring trustworthiness. In Phase 3, the data in Phase 1 and Phase 2 were integrated to formulate a draft best practice guideline for patient-centred care. The guideline was submitted to an expert panel for review and was modified according to the recommendations of the panel, whereby the best practice guideline for patient-centred care in public hospitals in Nelson Mandela Bay was finalized.