Thesis (MScMedSc (Biomedical Sciences))--University of Stellenbosch, 2010. / Bibliography / ENGLISH ABSTRACT: Mycothiol (MSH) is unique to mycobacteria as the major low molecular weight cellular thiol responsible for protection of bacteria against oxidative stress. The design of drugs and inhibitors against enzymes of the mycothiol pathway was based on the premise that mycothiol is unique to mycobacteria, and is thus important for its survival. A total of 80 inhibitors designed against enzymes of the mycothiol pathway were screened for inhibition of growth on in vitro growing M. tuberculosis using the BACTEC 460TM assay. The most active compounds were further tested for inhibitory potential of M. tuberculosis within macrophages. Initial screening in the macrophage system was done using the human-like THP1 cell line and then mouse bone marrow-derived macrophages. In this investigation we established that phenothiazine can be exploited as an inhibitor of enzymes of the mycothiol pathway. Although tunicamycin significantly inhibited the growth of M. tuberculosis both in vitro and ex vivo; it was found to be cytotoxic to host macrophages. To this end we provide proof-of-concept that compounds which can inhibit the expression of mycothiol enzymes have potential as anti-tubercular drugs. The response of M. tuberculosis to stress conditions was assessed via LC-MS in which maximal levels of mycothiol were produced during the early time points of exposure to isoniazid. We used mycothiol-deficient (mshA) M. tuberculosis to investigate the role of mycothiol for survival as well as the resultant phenotype when such mutants are exposed to stress conditions. The mshA deletion mutants in M. tuberculosis were resistant to INH at concentrations which inhibited growth in the wild-type strains. We postulated that katG and inhA, the genes involved in INH metabolism, required mycothiol for their activation. Morphological alterations of M. tuberculosis within macrophages were assessed using electron microscopy approaches. In this way we attempted to follow the fate of M. tuberculosis within the phagosomes, and how mycobacteria is processed in phagosomes in terms of replication, survival and degradation. The establishment of a successful infection by M. tuberculosis depends on the initial encounter with host macrophages, which represent the first line of cellular defense against microbial invasion. At the interface between mycobacteria and macrophages, the complex outermost layer of the mycobacterial cell wall probably plays a role in facilitating host cell entry. Under normal conditions (i.e. ingestion of non pathogenic microorganisms), newly formed phagosomes intermingle contents and membrane with the successive compartments of the endocytic pathway (early endosomes, late endosomes, lysosomes) through a complex series of fusion and fission. As they are processed into phagolysosomes, they undergo gradual modifications by specific addition and removal of membrane constituents. In addition, they become acidified due to the vacuolar proton pump ATPase located in the membrane and acquire toxic constituents, including hydrolases that will ultimately destroy bacteria. / AFRIKAANSE OPSOMMING: Mycothiol (MSH) is uniek aan mycobacteria as die belangrikste lae molekulêre gewig sellulêre thiol verantwoordelik vir die beskerming van bakterieë teen oksidatiewe stres. Die ontwerp van dwelms en inhibeerders teen ensieme van die mycothiol pad is gebaseer op die veronderstelling dat mycothiol uniek is aan mycobacteria, en is dus belangrik vir sy oorlewing. 'n Totaal van 80 inhibeerders ontwerp teen ensieme van die mycothiol pad is gekeur vir die inhibisie van groei op in vitro groeiende M. tuberculosis met behulp van die BACTEC 460TM toets. Die mees aktiewe verbindings is verder getoets vir inhiberende potensiaal van M. tuberculosis binne makrofage. Aanvanklike sifting in die makrofage stelsel is gedoen met behulp van die mens-soos THP1 sel lyn dan makrofage afkomstig van muis beenmurg. In hierdie ondersoek het ons vasgestel dat fenotiasien kan gebruik word as 'n inhibitor van ensieme van die mycothiol pad. Alhoewel tunicamycin aansienlik die groei van M. tuberculosis beide in vitro en ex vivo inhibeer, was dit gevind word sitotoksies is vir makrofage. Om hierdie rede het ons bewys-van-konsep wat verbindings dat die uitdrukking van mycothiol ensieme inhibeer, die potensiaal het as anti-tuberkulose dwelms. Die reaksie van M. tuberkulose op stress is geëvalueer deur LC-MS waarin maksimum vlakke van mycothiol gedurende die vroeë tyd punte van blootstelling aan isoniasied geproduseer is. Ons gebruik mycothiol-deficient (mshA) M. tuberculosis om die rol van mycothiol vir oorlewing sowel as die gevolglike fenotipe te ondersoek wanneer sodanige mutanten blootgestel word aan stres kondisies. Die mshA-weglating mutanten van M. tuberculosis was bestand teen INH konsentrasies wat groei geïnhibeer in die wilde-tipe-stamme. Ons veronderstel dat katG en inhA, die gene wat betrokke is in INH metabolisme, mycothiol vereis vir hulle aktivering. Morfologiese veranderinge van M. tuberculosis binne makrofage is beoordeel met behulp van elektronmikroskopie. In hierdie manier waarop ons probeer om die lot van M. tuberkulose te volg binne die phagosomes, en hoe mycobacteria verwerk word in phagosomes in terme van replikasie, oorlewing en agteruitgang. Die vestiging van „n suksesvolle infeksie deur M. tuberculosis hang af van die aanvanklike ontmoeting met host makrofage, wat die eerste lyn 'n sellulêre verdediging teen mikrobiese inval verteenwoordig. Op die grens tussen mycobacteria en makrofage, speel die komplekse buitenste laag van die mikobakteriese selwand waarskynlik 'n rol in die intog van die gasheersel. Onder normale omstandighede (dws inname van non patogene mikroörganismes), nuutgevormde phagosomes meng inhoud en membraan met die opeenvolgende kompartemente van die endositiese roete (vroeë endosomes, laat endosomes, lisosome) deur 'n komplekse reeks van samesmelting en fisie. Soos hulle verwerk word tot phagolysosomes, ondergaan hulle geleidelike veranderinge deur spesifieke optel en verwydering van membraan komponente. Benewens, raak hulle versuur as gevolg van die vacuolair proton pomp ATPase geleë in die membraan en verkry giftige bestanddele, insluitend hydrolase wat uiteindelik bakterieë vernietig.

Thesis (DCur)--Stellenbosch, 2000. / ENGLISH ABSTRACT: Guided by the researcher's clinical experience and through recent outreach research projects (Stellenberg, 1996 and 1997) the factors influencing the health status of two communities were identified through health screening. It was further identified that these problems affecting the health status of these communities were magnified through the poor accessibility, availability, and affordability of health services. According to the researcher, despite the efforts of the Government and attempts to remedy the disparities of the past, the introduction of any such policy should be based on scientific evidence. The researcher decided to investigate the factors influencing the health status of the Coloured people of the Western Cape. This population group is the largest in the Western Cape, being 60,8%. Its domination in this province determines the health status of the province. By acquiring knowledge about the factors influencing the health status of the Coloured population, it will be possible for the policy makers in health care to direct their emphasis on health care policies more appropriately. Currently differences in socio-economic and knowledge levels, along with existing inequalities in health service pose major challenges for the policy makers in health care. Therefore, knowledge about the health status, health practices and health beliefs of minority groups will improve the average health status of the general population. It is against this background, that this research study was undertaken. Specific objectives were set for the study. • To determine the health status of economically active Coloured people in an urban area as defined with specific reference to the indicators as identified by the researcher • To determine the prevalence of factors influencing the health status of economically active Coloured people in an urban area as defined. • To determine the relationship between the health status and the factors influencing the health status of economically active Coloured people in an urban area as defined. • To determine an association between factors influencing the health status of economically active Coloured people in an urban area as defined. • To make recommendations to the health policy-makers concerning factors influencing the health status of the economically active Coloured people in an urban area as defined and possibly related ethnic groups. These objectives were met through an in-depth research study of this population group in six identified suburbs. Factors influencing the health status of an individual as described in the literature were explored and described. The recommendations based on the findings confirmed that the health status of the Coloured population is influenced by the following factors: • Socio-economic Level (education, financial income and occupation) • Lifestyle of individuals (High Risk Behavioural Practice such as smoking, use of alcohol and illegal drugs, dietary intake, minimal exercise, stress management and leisure time) • Ethno-cultural Beliefs: health and illness • Religion, health and illness • Environmental factors • Health Services: accessibility and affordability of services Recommendations based on the findings • Emphasis on re-development and health education of all age groups. • The introduction of social grants for those who are unable to support themselves and their families have become essential in order to improve their health status. • The creation of jobs to improve the socio-economic circumstances of the populations. • Current health services at primary health care level and environmental factors influencing the health status of the population require urgent attention. / AFRIKAANSE OPSOMMING: Gelei deur die navorser se persoonlike kliniese onde'rvinding asook onlangse navorsingsprojekte oor uitreikingsaksies ten opsigte van gemeenskapsgesondheid (Stellenberg, 1996 en 1997), is faktore wat In rol in die gesondheidstatus van gemeenskappe speel, geïdentifiseer. Daar is ook bevind dat faktore wat probleme rondom die gesondheidstatus van hierdie gemeenskappe vererger, elemente is soos toeganklikheid, beskikbaarheid en bekostigbaarheid van gesondheidsdienste. Ten spyte van pogings van die regering om die ongelykhede van die verlede uit die weg te ruim behoort die regstelling daarvan volgens die navorser op wetenskaplike bewyse gegrond te word. Die navorser het daarom besluit om die faktore wat gesondheidsorg van die Kleurlinggemeenskap in die Wes-Kaap beïnvloed, te ondersoek. Hierdie bevolkingsgroep is die grootste in die Wes-Kaap, naamlik 60,8%. Die oorheersing van die Kleurling in die provinsie bepaal grootliks die gesondheidstatus van die provinsie. Deur kennis in te win van faktore wat die gesondheidstatus van die Kleurlinggemeenskap beïnvloed, is dit moontlik vir besluitnemers in gesondheidsorg om dit beter te bestuur. Daarom sal kennis oor gesondheidsorg, gesondheidspraktyke en -gelowe van minderheidsgroepe die gesondheidstatus van die totale bevolking verbeter. Dit is teen hierdie agtergrond wat die navorsing onderneem is. Spesifieke doelwitte vir die studie was om die volgende te bepaal: • Die gesondheidstatus van die ekonomies aktiewe Kleurling-gemeenskap in In stedelike gebied soos gedefinieer met spesifieke verwysing na die indikatore soos geïdentifiseer deur die navorser • Die prevalensie van faktore wat 'n invloed op die gesondheidstatus van die ekonomies aktiewe Kleurling-gemeenskap in In stedelike gebied soos gedefinieer • Die verwantskap tussen die gesondheidstatus en die faktore wat In invloed uitoefen op die gesondheidstatus van die ekonomies aktiewe Kleurling-gemeenskap in In stedelike gebied soos gedefinieer • Die moontlike assosiasie te bepaal tussen faktore wat die gesondheidstatus beïnvloed van die ekonomies aktiewe Kleurlinggemeenskap in In stedelike gebied soos gedefinieer. • Aanbevelings aan die gesondheidsowerheidsbeleidmakers oor bevindings wat In invloed uitoefen op die gesondheidstatus van die ekonomies aktiewe Kleurling-gemeenskap in In stedelike gebied soos gedefinieer, en moontlike verwant etniese groepe. Die doel is bereik deur in-diepte navorsingsonderhoud met die Kleurling bevolkingsgroep in ses geïdentifiseerde gebiede. Faktore wat die gesondheidstatus van individue soos in die literatuur beskryf beïnvloed, is ondersoek en beskryf. Die aanbevelings is gebasseer op bevindings gedoen in die ondersoek van die gesondheidstatus van die Kleurling bevolking, en is deur die volgende faktore in die ondersoekgroep beïnvloed: • Die sosio-ekonomiese vlak (opleiding, inkomste en beroep) • Lewenstyl van respondente (hoë risiko faktore soos rook, die gebruik van alkohol, verdowingsmiddeis, daaglikse dieët, oefening, hantering van spanning en vryetydsaktiwiteite). • Etnies-kulturele gelowe: gesondheid en siekte • Geloofsgesondheid en siekte • Omgewingsfaktore • Gesondheidsdienste: toeganklikheid en bekostigbaarheid van dienste Aanbevelings wat op die navorsingsbevindings gebaseer is, is die volgende: • Beklemtoning van die herontwikkeling van gesondheidsvoorligting vir alle ouderdomsgroepe. • Die instel van In toelae vir individue wat nie in staat is om hulself en hulle gesinne te help nie, is noodsaaklik vir die verbetering van hulle gesond heidstatus . • Die skep van meer werk om sosio-ekonomiese omstandighede in die bevolking te verbeter • Huidige gesondheidsdienste op pnmere gesondheidsorgvlak en omgewingsfaktore wat die gesondheidstatus van die gemeenskap beïnvloed, vereis dringend aandag.

Submitted in fulfillment of the requirements for the Degree of Master of Technology Hospitality and Tourism, Durban University of Technology, Durban, South Africa, 2014. / It has been accepted that health care within provincial hospitals has deteriorated. For most it has become routine to visit provincial hospitals and wait for majority of the day for basic treatment. Service delivery in provincial health care are confronted with challenges such as staff shortages, inadequate medical supplies and reduced budgets. The media contributes with letters and articles about poor patient treatment, the increase in deaths and diseases due to poor service delivery and weak hospital management. However, with the growing rate of poverty and unemployment, resources have become scarcer hence, adding to an already crippling economy. The rationale behind this research is to evaluate the role of hospitality within a Provincial Hospital in the southern area of Durban KZN that’s offering treatment to patients with more than just basic health care. And to establish a more effective and efficient delivery of services offered with scarce resources which enhances patient encounters within a provincial hospital. The aim of this research is to evaluate the current legislation around provincial hospitals for the efficient and effective practise of hospitality. In the form of a literature review a theoretical perspective was formulated around the study and an operational chapter detailing the Provincial Hospital in the southern area of Durban, KZN. The rationale was tested by research in the form of questionnaires and interviews with the Provincial Hospital. A target sample was selected with managers, senior management and patients. The major findings may be gravitated towards serious service delivery issues. The Provincial Hospital should therefore, consider the introduction of a hospitality approach in its attempts to improve the delivery of patient care. The study also found that hospitality management influences may improve employee output which impacts on the delivery of patient care. / M

Thesis (MPH) --University of Limpopo, 2011 / Since 1994, the post apartheid government and the Department of Health have developed and implemented a number of policies and pieces of legislation that impacted directly and indirectly on the delivery of health services such as the general public health, health personnel, financial matters, transportation of medicines and foodstuffs. These policies were timeously received by the hospitals from National Office, Provincial Departments and Local Government, but were not implemented due to numerous challenges. This study explores the health policy implementation challenges facing implementers in the public health sector in the Capricorn district in Limpopo that constrain them from rendering their managerial functions effectively and thus, impact negatively on policy implementation and service delivery. The objective of the study is to explore the challenges with a view of describing the nature and causes of the challenges, explore and document them, develop suggestions for minimizing these challenges and subsequently suggesting possible solutions. The study focused on the Capricorn district in Limpopo Province. The district is the biggest among the five districts and has eight functional hospitals which are under the leadership of Chief Executive Officers (CEO). The researcher used both qualitative and quantitative (mixed) research methods. The methodology entailed the distribution of self-administered questionnaires containing closed and open ended questions to the management of Capricorn district hospitals. The results obtained in this study revealed that there are numerous challenges that constrain policy implementers from implementing health policies effectively and efficiently in their work environments. These challenges range between poor incentives, lack of equipment, lack of office space, lack of dedicated transport for outreach, budget constraints, shortage of resources – human and physical, lack of career mobility, poor working conditions, communication problems and poor supervision style. These challenges impact negatively on policy implementation.It is therefore recommended that the comprehensive strategy to maximize the health workers’ motivation in the health sector has to involve a mix of financial and non-financial incentives, the provincial department of health and Social Development should open some communication lines with the service providers at grass root level in order to address some of the issues before they become chronic challenges, there should also be regular meetings where feedback about provincial and national issues are addressed to the service providers. The current system of dissemination of information from the province and national government to the hospitals is apparently not clear.

Thesis (Ph.D. (Social Work)) --University of Limpopo, 2015 / Refer to document

Thesis (MTech. degree in Agriculture.)--Tshwane University of Technology, 2011. / Using the Participatory Extension Approach adopted by the Limpopo Department of Agriculture, this study documented the development, implementation and impact of a community-based rodent control strategy at Regae in Limpopo Province. The results of a homestead survey and the trapping of rodents in dwellings, home gardens and fields confirmed the severity of the rodent problem in the village, which was caused by Rattus rattus, Mus musculus, Mus minutoides, Mastomys coucha and Rhabdomys pumilio.

This research is an endeavour to highlight the state of healthcare in South Africa as seen through the eyes of professional health care workers who are at the cold face of healthcare. Having worked in an environment of inequities and unjust circumstances, healthcare workers expressed their attitudes and beliefs that healthcare are in need of radical change. There appears to be insight from these professionals that the private and public healthcare sectors should forge a relationship, ultimately benefiting South African society. More research needs to be done on a major scale to determine more deeply the attitudes and beliefs of healthcare professionals. Such an endeavour will provide a stimulus for policymakers to harness this energy and direct it in a meaningful way in the transformation of healthcare in South Africa. Chapter 1 focused on several relevant perspectives and definitions on healthcare in South Africa and other countries. In Chapter 2, attention was given to socio-economic rights as per the South African Constitution and the states obligations to fulfil these rights. These rights were examined in the context of landmark Constitutional Court cases, viz. Soobramoney versus the State; TAC versus the State; and Grootboom versus the State. These cases give one the essence of interpreting rights and the constitutional obligation of the state to deliver on them. Healthcare developments in South Africa and other countries together with the RDP and GEAR considerations are outlined in Chapter 3. Research Methodology is outlined in Chapter 4, emphasizing also the limitations of this study. Chapter 5 examines the responses to the questionnaires and analyses its findings. Chapter 6 provides the conclusions and recommendations as well as a critique of healthcare in South Africa. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2004.

Perceptions of health and illness which include the perceived cause and recourse play an important role in diagnosis and management of illness. Traditional and allopathic medicines are used simultaneously and sometimes without the knowledge of the health professional and this has an impact on clinical outcomes. Overlooking patients’ subjective experience, health providers’ biases and prejudice may pose a negative impact on clinical outcomes. This study explores patients’, traditional healers’ and psychological counselors’ perception of illness by conducting interviews and administering open-ended questionnaires. The data is analyzed both qualitatively and quantitatively through the use of content analysis and non-parametric statistical procedures. The results indicate that the concept of illness is complex and multidimensional with physical and socio-spiritual aspects. Effective management requires a joint approach between indigenous and western health systems. The results further show that traditional healers fully embrace the integrated health approach while there is some skepticism and uncertainty from psychological counselors which could be stemming from their training. There is still work to be done in terms of health planning and policy but also the training of health professionals. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2008.

Master of Public Health - MPH / This study aimed to identify barriers to the availability of essential drugs at health facilities, to identify implementable solutions to those barriers, to develop a monitoring system for tracking implementation of solutions and for tracking drug supply. / South Africa

Please read the abstract in the section 00front of this document / Dissertation (MSc (Community Dentistry))--University of Pretoria, 2006. / Community Dentistry / unrestricted