See the attached abstract below

MPH / Department of Public Health / Human Immune Deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) place a significant burden on the caregivers for people living with HIV/AIDS (PLWHA). Caring for PLWHA is usually carried out by community members who are recruited from the same community as the PLWHA. These community members are trained to provide services as volunteer caregivers. The caregivers face various challenges in the process of giving care to PLWHA, often inadequately assisted by relatives, friends, neighbours, private individuals, grassroots traditional and political leaders. This results in caregivers being overwhelmed by their responsibilities, making their coping process even more difficult. The aim of this study was to explore the challenges experienced by community home-based caregivers (CHBCGs) caring for people living with HIV/AIDS at Tsianda Village, in Makhado Municipality, South Africa. This study adopted a qualitative explorative design. The population for this study were all CHBCGs caring for PLWHA. Non probability purposive sampling was used to select the community home-based caregivers working at Tsianda Community Home-based care organisation. In-depth interviews, using a semi-structured interview guide, was conducted by the researcher and a voice recorder were used to record data from participants. Data saturation was reached at the 11th participant. This is when the participants were no longer giving new information. The data collected from the study were analysed thematically. The following themes emerged from data analysis: Challenges for community home-based caregivers, perceived support for community home-based caregivers, coping strategies for community home-based caregivers. Measures to ensure trustworthiness and the code of ethics to protect the rights of the participants was applied and observed. The findings of the study revealed that community home-based caregivers experience various challenges which have a negative impact on their personal life, as well as their physical and psychological wellbeing. Community home-based care also uses different strategies to cope with these challenges. It was concluded that the community home-based caregivers are experiencing serious shortages of personal protective equipment, which makes them work with the fear of being infected with the diseases. It is recommended that the DOH should take it into consideration to provide the CHBCG’s organization with enough personal protective equipment for their safety and working without fear of being infected with deadly viruses. / NRF

MSc (Microbiology) / Department of Microbiology / Background: Antiretroviral treatment (ART) has grown to be one of the most effective tool in the fight to control HIV/AIDS morbidity and mortality worldwide. However, due to the emergence of drug resistant HIV, ART efficacy can be jeopardized. Drug resistant HIV strain has a potential of becoming a major public threat, as its limit treatment options on people living with HIV. With several findings worldwide reporting drug resistant HIV to be currently being transmitted to ART-naïve persons, measures have been taken to genotype drug resistant HIV prior to treatment initiation. However, in resource limited countries such measures are not executed especially in public sectors due to the costs associated with the required assays for genotyping. Objective: The objectives of the study was to establish a deep sequencing protocol (Next Generation Sequencing-NGS) using an Illumina MiniSeq Platform and subsequently apply it to genotype HIV in chronically infected drug naïve persons for resistance mutations and viral genotypes Methods: HIV positive Individuals without any exposure to ART (Treatment-naive) were recruited. Partial pol fragment (complete protease and ~1104bp reverse transcriptase) were amplified and purified. Libraries were prepared using Nextera XT library preparation kit, fragmented, tagmented, pooled and denatured then sequenced with Illumina MiniSeq instrument. Consensus sequences were derived, aligned and phylogenetically analysed. The Stanford HIV Drug Resistance Algorithm was used to infer the presence of drug resistant mutants, at the viral minority and majority population levels. Results and discussion: An NGS protocol to generate nucleotide sequences for drug resistance inference was established. No major drug resistance mutations were detected against protease, reverse transcriptase inhibitors in the study subjects investigated. Nevertheless, V179D change was observed in one patient (8.3%). V179D has been shown to impact a low-level resistance to NNRTI. On the other hand, several secondary and unusual mutations at known drug sites were detected even at minority threshold level of <20%. Conclusion: No major drug resistance mutations was detected in the drug naïve study population. This finding suggests that there is no risk of treatment failure to the investigated subjects, however it is important to assess the potential phenotypic v | P a g e significance of the identified secondary resistance mutations in the context of HIV-1 subtype C. The established NGS protocol should be applied in subsequent HIV drug resistance studies. / NRF

MSc (Microbiology) / Department of Microbiology / Background: Patients on antiretroviral (ART) are expected to be at least 95% adherent to their treatment, as this will increase their chances of achieving treatment success (maximum and durable suppression of HIV-1 viral load); non-adherence may lead to the development of HIV drug resistance, which may lead to virologic failure and treatment failure. Therapeutic drug monitoring (TDM) has been reported to be the most efficient method to assess treatment adherence in HIV individuals, since it quantifies the concentration of ARTs in biological matrices. This is very effective when using a robust technique such as liquid chromatography tandem mass spectrometry (LCMS/MS), which has played a significant role in the evaluation and interpretation of bioavailability, bioequivalence and pharmacokinetic data. Even with patient adherence, various intra-individual factors have an influence on the expression and function of the genes responsible for the transport (MDR1) and metabolism (CYP2B6) of Efavirenz (EFV). This may lead to single nucleotide polymorphisms (SNPs) in these genes, and this may affect the way antiretrovirals (ARVs) are metabolized. The aim of this study was to evaluate the EFV concentration in plasma to assess patient adherence to treatment and correlate this with genomic occurrences in human and viral genes. Hypothesis: The concentration of ARVs in patient plasma can be used to estimate adherence to treatment; while ARVs’ transport and metabolism can affect bioavailability in a patient’s system. Research Question: Can EFV concentration in plasma be used to estimate patient adherence to treatment? Can transport and metabolism of EFV affect their bioavailability in the patient’s system? Objectives: To determine EFV concentration in plasma to assess patient adherence to treatment and correlate this with genomic occurrences in human genes and viral genes. Methodology: Twenty blood samples were collected from HIV positive individuals before treatment initiation (baseline) and between six to twelve months following treatment initiation (follow-up). The concentration of EFV in patient plasma was measured by LC-MS/MS technique. To infer other factors influencing patient pharmacokinetics output, drug resistance and human genetic characteristics were analyzed. A 1.65kb fragment of the HIV-1 Pol gene was amplified and sequenced to determine drug resistant mutations; while 363bp and 289bp of the MDR-1 and CYP2B6 human genes respectively, were also amplified and sequenced to determine polymorphisms in the transport and metabolism genes. Obtained sequences were manually edited and analyzed using Geneious Version 11.1.5 software. The Stanford HIV Drug Resistance database was used for drug resistant mutation (DRMs) analysis and MDR1 and CYP2B6 test sequences were compared with variant reference sequences to detect the presence of any SNPs. Results: The plasma EFV concentration at baseline and follow-up range was as follows: 0 – 1183ng/ml and below limits of quantification (BLQ) to 15,670ng/ml, respectively. At baseline, 0ng/ml is the expected plasma EFV concentration for patients about to commence treatment; however, two out of twenty patients had 769.9 and 1,183ng/ml drug levels in their system. Post treatment, plasma EFV levels in patients are expected to range from 1,000 – 4,000ng/ml, however, of the twenty patients, two had <1,000ng/ml, and three patients had >4,000ng/ml in their plasma. For Pol amplification, 35% (7/20) were positively amplified at baseline and 25% (5/20) were positively amplified from the follow-ups; 100% (20/20) samples were amplified for both CYP2B6 and MDR1 genes. Detection of drug resistance in the baseline Pol sequences revealed the absence of major mutations in both NRTI and NNRTI drug classes. The G516T polymorphism was present in 15% of the study participants while the homozygous GG and heterozygous GT genotype was present in 25% and 40% of the study participants, respectively. Allele determination was impossible in 20% of the samples, due to the poor nature of the sequence. The homozygous TT variant polymorphism at position 3435 was absent in the entire population, however, the CC and CT genotype was present in 15% and 85% of the study participants respectively. Analysis of EFV concentration in close proximity with the human genetic characteristics reveals that the presence of a Single Nucleotide Polymorphism affects the pharmacokinetic output observed. Discussion and Conclusion: Post treatment, 90% of the study participants indicate adherence to treatment, with only 10% of them having lower than expected EFV concentrations, implying they were non-adherent to their treatment. However, because plasma drug concentrations only reflect a patient’s adherence pattern for a few hours to at most two days, the adherence patterns of these individuals cannot be concluded with certainty. Using plasma EFV as a biomarker to evaluate adherence to treatment in HIV seropositive individuals is a feasible technique, however, its application in non-research settings is still a drawback due to the cost of the method. Characterizing patient inter-individual differences should be taken into consideration, especially since any polymorphism in their transporter and metabolizing genes may influence their overall treatment success. / NRF

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2014. / Aim: A paucity of information on chiropractic patients presenting in public community clinics in South Africa (SA) exists. The purpose of this study was to carry out a demographic and disease survey of the patients that presented to the Marburg Haven Clinic, so to identify the patients that presented in a rural community outreach programme. Methods: A retrospective analysis on the patient files at Marburg Haven Clinic was completed in September 2012. Data recorded included demographic data, presenting complaints, patient history and management protocols. Results: Data of 117 patients were documented. Most patients were female (76.1%), with a mean age of 53.3 years. Indian patients (50.4%) presented most often, with a quarter of the patients unemployed (26.5%) or pensioners (21.4%). Of the employed patients, 26.5% had not specified the type of occupation and 9.4% were non-manual workers. Musculoskeletal complaints (21.2%) were the most common complaints at the Marburg Haven Clinic, with the primary diagnosis of sacroiliac syndrome (16.2%), followed by general myofascitis (22.4%). Common co-morbidities reported were hypertension, diabetes and asthma. Less than half the patient population had undergone previous surgeries and/or sought previous treatment from other medical practitioners. Sixteen patients were contra-indicated for manipulation. Common treatment protocols used were spinal manipulation, spinal mobilisation and stretching. Conclusion: This is a demographic and descriptive study of a public community outreach centre in South Africa. In relation to international studies, similarities were that the majority of the patients were female, anatomical sites of complaint (lumbar and cervical pain), common usage of radiographs, co-morbidities including cardiovascular and endocrine pathologies and manipulation were used as the treatment of choice. A prospective longitudinal study with more specific criteria for patient tracking and more defined data capture requirements is recommended to more accurately gather all data within similar settings.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / BACKGROUND: Low back pain (LBP) is a major health problem and a leading cause of disability worldwide, accounting for numerous medical and chiropractic consultations. Risk factors for developing as well as perpetuating LBP have been recognised, including psychosocial factors and to a lesser extent organic diseases. There is good evidence for the role of biological, psychological, and social factors in the aetiology and prognosis of back pain. The biopsychosocial model developed by Waddell (1987) has become a dominant consideration in determining the aetiology and prognosis of back pain, and has led to the development and testing of many back pain care interventions. This includes a focus on identifying and treating ‘yellow flags’ which are psychosocial factors that may result in LBP becoming chronic, and incorporating the treatment of these ‘yellow flags’ as a component of LBP care. AIM: The aim of this study was to determine a psychometric profile of patients attending the Durban University of Technology (DUT) Chiropractic Day Clinic (CDC) with non-specific LBP using the Keele STarT Back Screening Tool (SBST) and Bournemouth Questionnaire (BQ). METHODOLOGY: Once ethical clearance was obtained to conduct the research study at the DUT CDC, all patients over the age of eighteen presenting to the DUT CDC with non-specific LBP as new patients, or as former or current patients presenting with non-specific LBP as a new complaint, were directly approached by the researcher. The prospective participants were asked a series of screening questions in order to ensure that they qualified for the study. A total of 132 participants completed an informed consent, a pre-validated questionnaire, the SBST and the BQ. The questionnaires took approximately ten to fifteen minutes to complete; participants were given the choice to complete them either before or after their appointment so as not to interrupt the treatment time. All informed consents and completed questionnaires were collected by the researcher and stored in separate sealed ballot boxes. All questionnaires were kept confidential and only seen by the researcher and supervisor. A code was allocated to each questionnaire before data was captured on a spreadsheet for data analysis. The IBM SPSS version 22 was used for data analysis by a biostatistician. RESULTS: A total of 132 questionnaires were utilised for statistical analysis. Based on the SBST, 47.7% (n = 63) of the total population (N = 132), had a low risk of developing chronic LBP, 28.8% (n = 38) had a medium risk of developing chronic LBP, and 23.5 % (n = 31) had a high risk of developing chronic LBP. The BQ indicated that 63.6% (n = 84) of the total population (N = 132) scored 35 or less and thus had a low risk of developing chronic LBP, while 36.4% (n = 48) scored above 35 and thus had a medium to high risk of developing chronic LBP. A very strong association was found between the SBST and BQ risk groups (p = <0.001). A total of 87.1% (n = 27) of the participants who had a high risk of chronicity according to the SBST (N = 31) also had a high risk of chronicity according to the BQ. The female gender, being a current smoker and partaking in little or no physical activity were found to be statistically significant risk factors for chronic LBP. CONCLUSION: The results in this study suggest that patients presenting to the DUT CDC supports the notion that chronic LBP is a multifactorial condition with significant psychosocial implications and should be approached as such. / M

Thesis (MScPhysio)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Background: Pulmonary tuberculosis (PTB) remains a major concern worldwide. Although PTB is curable, both the disease and its treatment may have considerable medical, social and psychological consequences which may result in a decreased quality of life and functioning. Characterization of the functional capabilities of PTB patients post-treatment and the impact of PTB on their quality of life may identify a need for more holistic management of PTB treatment that extends beyond microbiological cure. Methods: Firstly, an in-depth scoping review was conducted using the following key words: Pulmonary tuberculosis (MESH term) and Health related quality of life (HRQoL), Pulmonary tuberculosis (MESH term) and Spirometry and Pulmonary tuberculosis (MESH term) and Six minute walk test or 6MWT to review the current literature reporting on the HRQoL, lung function measurements and exercise capacity of a PTB population (Chapter 2). Secondly, a cross-sectional, quantitative, descriptive study was conducted. The study setting included five primary health care facilities (PHCF) in the Breede Valley sub-district of the Cape Winelands East District, Western Cape, South Africa. Adult patients diagnosed with PTB, 18 years and older and who were successfully managed through the Cape Winelands District Health Care system were considered for the study if they had least two negative sputum sample results and had completed at least five months of anti-tuberculosis treatment. Post treatment bronchodilator lung function tests, health related quality of life using the BOLD core questionnaire and six minute walk test distance (6MWD) was measured. Findings: The comprehensive broad search of the literature yielded a total of 2446 articles. A total of 2422 articles were excluded since the title; abstract or full text article did not conform to the review question or were eliminated as duplicates across databases. Twenty-seven articles divided amongst the three subsections i.e. PTB and HRQoL (n=13), PTB and Spirometry (n=9) and PTB and exercise capacity (n=6), were included in the review. In the cross-sectional study, 328 names were obtained from the TB registers of the five included PHCF of which 45 patients were included in the study (56% male; mean age, 39.88±10.20 years). The majority of patients (n= 206; 63%) were not contactable, and could not be recruited. Approximately half the total sample, (n=23; 52%) presented with normal lung function while n=11 (25%) presented with a restrictive pattern, n=9 (21%) presented with an obstructive pattern and only n=1 (2%) presented with a mixed pattern (defined as FEV1<80% predicted, FVC<80% predicted and FEV1/FVC<0.7). The mean six minute walk distance (6MWD) was 294.5m±122.7m. Respondents scored poorly on all sub-domains of the SF-12v2 except vitality. Role emotional and role physical scored lowest with mean scores of 28.1 and 35.27 respectively, while vitality scored the highest with 52.78. Stellenbosch University https://scholar.sun.ac.za 4 | P a g e Conclusion The findings of this thesis suggest that even after microbiological cure, PTB patients may suffer from a decreased quality of life, impaired lung function and a decreased exercise capacity. Specific challenges to data collection in a rural region were identified; which included patient recruitment, field testing of exercise capacity (6MWD), and the generalizabilty of standardized questionnaires in rural regions. The findings of this pilot study serves to inform the planning of a larger observational study, in the rural Cape Winelands of the Western Cape, South Africa. / AFRIKAANSE OPSOMMING: Agtergrond Pulmonêre tuberkulose (PTB) wek wêreldwyd steeds groot kommer. Hoewel dit geneeslik is, kan die siekte sowel as die behandeling daarvan beduidende mediese, maatskaplike en sielkundige gevolge hê, wat lewensgehalte en funksionering kan knou. Die tipering van PTB-pasiënte se funksionele vermoëns ná behandeling sowel as die impak van PTB op hul lewensgehalte kan dalk dui op ’n behoefte aan die meer holistiese bestuur van PTB-behandeling, wat méér as blote mikrobiologiese genesing insluit. Metodes Eerstens is ’n diepgaande bestekstudie aan die hand van die volgende trefwoorde onderneem: pulmonêre tuberkulose (MeSH-term) en gesondheidsverwante lewensgehalte (HRQoL), pulmonêre tuberkulose (MeSH-term) en spirometrie, en pulmonêre tuberkulose (MeSH-term) en die ses minute lange stapafstandtoets (6MWT). Na aanleiding daarvan is die huidige literatuur oor die HRQoL, longfunksiemetings en oefenvermoë van ’n PTB-populasie bestudeer (hoofstuk 2). Tweedens is ’n kwantitatiewe, beskrywende deursneestudie onderneem. Die studie-omgewing het bestaan uit vyf fasiliteite vir primêre gesondheidsorg in die Breedevallei-subdistrik van die streek Kaapse Wynland-Oos, Wes-Kaap, Suid-Afrika. Volwasse pasiënte van 18 jaar en ouer wat met PTB gediagnoseer is en suksesvol deur die distriksgesondheidsorgstelsel van die Kaapse Wynland-streek bestuur word, is vir die studie oorweeg indien minstens twee van die pasiënt se sputummonsters TB-negatiewe resultate opgelewer het en die persoon reeds minstens vyf maande vir tuberkulose behandel is. Studiemetings het ingesluit brongodilator-longfunksietoetse ná behandeling, gesondheidsverwante beoordelings van lewensgehalte met behulp van die BOLD-vraelys, en die aflegging van ’n ses minute lange stapafstandtoets (6MWT). Bevindinge Die omvattende breë soektog van die literatuur het 'n totaal van 2446 artikels opgelewer. 'n Totaal van 2422 artikels is uitgesluit, aangesien die titel; abstrakte of volledige teks artikel het nie voldoen aan die navorsings vraag, of is uitgeskakel as duplikate oor databasisse. Sewe en twintig artikels verdeel tussen die drie onderafdelings, naamlik PTB en HRQoL (n = 13), PTB en Spirometrie (n = 9) en PTB en oefening kapasiteit (n = 6), is ingesluit in die oorsig. In die deursneestudie is 328 name uit die TB-registers van die vyf ondersoekpersele bekom. Altesaam 45 pasiënte (56% mans; gemiddelde ouderdom 39.88±10.20 jaar) is by die studie ingesluit. Die oorgrote meerderheid pasiënte (n = 206; 63%) kon nie bereik word nie, en dus ook nie gewerf word nie. Ongeveer die helfte van die algehele steekproef (n = 23; 52%) se longfunksie was normaal; n = 11 (25%) het ’n restriktiewe patroon getoon; n = 9 (21%) ’n obstruktiewe patroon, en slegs n = 1 (2%) ’n gemengde patroon (wat omskryf word as ’n FEV1-voorspellingswaarde van <80%, ’n FVC-voorspellingswaarde van <80%, en FEV1/FVC van <0.7). Die gemiddelde afstand wat in die ses minute lange staptoets afgelê is (6MWD), was 294,5 m±122,7 m. Respondente behaal swak Stellenbosch University https://scholar.sun.ac.za 6 | P a g e op al die sub-domein van die SF-12v2 behalwe vitaliteit. Rol emosionele en rol fisiese behaal laagste met die gemiddelde tellings van 28.1 en 35,27 onderskeidelik, terwyl vitaliteit behaal die hoogste met 52,78. Gevolgtrekking Die bevindinge van hierdie tesis gee te kenne dat PTB-pasiënte selfs ná mikrobiologiese genesing dalk swakker lewensgehalte, verswakte longfunksie en ’n afname in oefenvermoë ondervind. Bepaalde uitdagings vir data-insameling in ’n landelike omgewing is uitgewys, onder meer pasiëntewerwing, veldtoetsing van oefenvermoë (6MWD) en die veralgemeenbaarheid van gestandaardiseerde vraelyste in landelike gebiede. Die bevindinge van hierdie proefstudie kan gebruik word om die beplanning van ’n groter waarnemingstudie in die landelike Kaapse Wynland-streek in die Wes-Kaap, Suid-Afrika, te rig.

Thesis (MTh)--Stellenbosch University, 2008. / ENGLISH ABSTRACT: Conventional HIV intervention strategies are based on the presupposition that scientific knowledge and appropriate information about HIV will curb the spread of the disease. The dominant approaches to the HIV debate and pandemic focus mostly on the medical, pedagogical and ethical dimensions of the pandemic. Governments are concerned with democratic and human rights and the juridical implications of HIV. This study proposes that a team approach should be followed, with the emphasis on a holistic model of prevention care. In this regard it is hypothesised that the spiritual dimension, emphasising our human quest for meaning, moral decision-making and virtues as related to the transcendent dimension of our being human, should play a substantial role. One of the most burning issues in the pandemic is the phenomenon of stigmatisation. This investigation is in search of an approach that can effectively penetrate the realm of prejudice, blaming, and discrimination. If spirituality can address stigmatisation, antistigma interventions must acknowledge the role of pastoral care with its emphasis on ‘soul care’, values and meaning. The study explores the possibility of extending the traditional understanding of theology as fides quarens intellectum, with its emphasis on knowledge (the rational), to fides quares imaginem, with its emphasis on imagination (the aesthetic dimension of life). Therefore the important presupposition that, due to the aesthetic dimension of faith, care to people living with HIV should include the aesthetic dimension. If one links fides quares imaginem to fides quarens visum new options can be created for Practical Theology. In this regard, the visual dimension of life as represented by media, and specifically film, should be investigated in a HIV prevention strategy. The study thus proposes that a specific form of art, namely film, has potential as an effective antistigma intervention. It is hypothesised that film inherently has a spiritual dimension. This spiritual dimension could be linked to issues that can determine the direction and meaning of life, as well as the understanding of human identity and dignity. In this regard the study wants to determine to what extent film can play a fundamental role in addressing the realm of attitudes, convictions and belief systems. Film is thus suggested as a medium for spiritual intervention in order to bring about change on the level of perceptions. Lesser-educated people are very vulnerable, especially in relation to HIV. The study wants to explore whether film can be an effective medium of addressing, educating and influencing such people at their level. In order to test this, an empirical study was done to assess the effect that film has on HIV stigmatisation within such a group of people. The aim of the empirical research was not to create statistical evidence, but to illustrate certain trends and tendencies. A group of people from Vlaeberg, a rural area outside of Stellenbosch, South Africa, was chosen for the study. In order to empirically explore the potential of film in addressing HIV stigmatisation it was decided to use the film Yesterday, the first South African film to be nominated for an Oscar. The film was chosen for the following reasons: a) it is set within South Africa, depicting vulnerable persons within a rural setting; b) it has a positive, though realistic approach to HIV; c) it depicts the cruelty of stigmatisation; d) it shows how you can assist those with HIV; and e) it is easily understandable. The film was positively received and able to influence the stigmatising perceptions, attitudes and convictions of the target group. The empirical study proved that film has a spiritual dimension and should be used as a medium for spirituality formation. Due to this, it has an important role to play in antistigma interventions. In this regard, the research showed that film can indeed play a decisive role in a HIV prevention strategy and an antistigma intervention. / AFRIKAANSE OPSOMMING: Konvensionele MIV-ingrypingstrategieë word gebaseer op die aanname dat wetenskaplike kennis en geskikte inligting aangaande MIV die verspreiding van die virus sal kan halt. Die dominante benaderings tot die MIV-debat en –pandemie fokus meesal op die mediese, pedagogiese en etiese dimensies van die pandemie. Regerings is bemoeid met die demokratiese regte, menseregte en wetlike implikasies van MIV. Hierdie studie stel voor dat ’n spanbenadering gevolg moet word, waarbinne die fokus sal wees op ’n holistiese model van voorkomende sorg. Die hipotese is dat die spiritualiteits-dimensie ’n substansiële rol moet speel, aangesien dit ons menslike strewe na betekenis, morele besluitneming en waardes, soos dit in verhouding staan tot die transendente dimensie van ons menswees, in ag neem. Een van die kwellende vraagstukke van die pandemie is stigmatisasie. Hierdie navorsing soek ’n benadering wat effektief die gebied van vooroordele, beskuldiging, en diskriminasie kan penetreer. Indien spiritualiteit stigmatisasie kan aanspreek, moet antistigma-ingrypings die rol van pastorale sorg, wat klem lê op ‘sielesorg’, waardes en betekenis, erken. Die studie ondersoek die moontlikheid dat die tradisionele verstaan van teologie as fides quarens intellectum, met die klem op kennis (die rasionele), uitgebrei moet word na fides quares imaginem, met die klem op die verbeelding (die estetiese dimensie van die lewe). Daarom word die belangrike aanname gemaak dat, as gevolg van die estetiese dimensie van geloof, sorg vir dié met MIV die estetiese dimensie moet insluit. As ’n mens fides quares imaginem skakel met fides quarens visum word nuwe moontlikhede ontsluit vir Praktiese Teologie. In hierdie opsig moet die visuele dimensie van die lewe, soos dit uitgebeeld word deur die media en meer spesifiek film, ondersoek word in ’n MIV-voorkomingstrategie. Die studie stel voor dat ’n spesifieke vorm van kuns, naamlik film, potensiaal het as ’n effektiewe antistigma-ingryping. Daarom die hipotese dat film inherent ’n spirituele dimensie het. Hierdie spirituele dimensie kan geskakel word met kwessies wat die rigting en betekenis van lewe kan bepaal, sowel as ons verstaan van menslike identiteit en waardigheid. Gevolglik wil hierdie studie bepaal tot watter mate film ’n fundamentele rol kan speel in die aanspreking van houdings en oortuigings. Film word dus voorgestel as ’n medium vir spirituele ingryping om sodoende verandering te bring op die vlak van persepsies. Mense met minder opvoeding is baie kwesbaar en blootgestel, veral in terme van MIV. Hierdie studie ondersoek of film ’n effektiewe medium kan wees om sulke mense aan te spreek, op te voed en te beïnvloed. Om dit te bepaal is ’n empiriese studie gedoen wat moes vasstel watter effek film het op MIV-stigmatisering binne so ’n groep. Die doel van die empiriese studie was nie om statistiese bewyse te lewer nie, maar om sekere neigings en tendense aan te toon. ’n Groep mense van Vlaeberg, ’n plattelandse area buite Stellenbosch, Suid-Afrika, is gebruik vir die studie. Die film Yesterday is gebruik vir die empiriese ondersoek aangaande die potensiaal wat film het om MIV-stigmatisering aan te spreek. Yesterday is die eerste Suid-Afrikaanse film wat vir ’n Oscar benoem is. Die film is gekies om die volgende redes: a) dit speel af in Suid- Afrika en weerlose mense binne ’n plattelandse omgewing word uitgebeeld; b) dit het ’n positiewe, dog realistiese benadering tot MIV; c) dit beeld die wreedheid van stigmatisering uit; d) dit dui aan hoe ’n mens diegene met MIV kan bystaan; en e) dit is maklik verstaanbaar. Die film was positief ontvang en het die stigmatiserende persepsies, houdings en oortuigings van die groep beïnvloed. Die empiriese studie het bewys dat film ’n spirituele dimensie het en as medium vir spirituele vorming gebruik moet word. Dus het film ’n belangrike rol te speel in antistigma-ingrypings. In hierdie opsig het die navorsing gewys dat film wel ’n deurslaggewende rol in ’n MIV-voorkomingstrategie en ’n antistigma-ingryping kan speel.

M.Ed. / Orphans living in child-headed households within underprivileged communities are amongst the most vulnerable children, and protection of their rights deserves to be the main focus of all individuals, governments and agencies dealing with such children. There is a need to stimulate broad-based discussion, heightened awareness of, and sensitivity to their plight, special needs and ... rights.

Thesis (M.A. (Clinical Psychology)) --University of Limpopo, 2014 / The aim of the study was to investigate help-seeking pathways that are followed by patients with chronic disease in one rural community in Limpopo Province. Specifically, the objectives of the study were: a). to investigate help-seeking pathways that were followed by patients with chronic diseases before and after they were diagnosed with their condition; b). to explore the treatment modalities that were used by the patients before they started receiving hospital treatment for their chronic conditions; and, c). to determine whether or not the patients received other forms of treatment in addition to their treatment for the chronic diseases. Through snowball sampling, 10 participants (female = 6; male = 4) drawn from Ga-Dikgale community (Limpopo Province) were selected and requested to participate in the present study. The ages of the participants ranged from 42 to 96 years. Data were collected using semi-structured interviews and analyzed using interpretative phenomenological analysis (IPA) The results of the study are presented under the following themes: a). participants‟ understanding of chronic disease; b). participants‟ view or understanding of factors that could have led to their chronic disease ; c). the help-seeking pathways that were followed by patients with chronic diseases before and after they were diagnosed with their condition; d). the treatment modalities that were used by the patients before they started receiving hospital treatment for their chronic conditions; and, e) whether or not the patients received other forms of treatment in addition to their treatment for the chronic diseases. The study found that different treatment agencies are consulted by patients with chronic diseases. These agencies include: spiritual leaders, traditional healers, to mention few. Based on the findings of the present study, it is concluded that help-seeking pathways are mainly determined by the perceived causes of the disease, which are culturally rooted.