MMed, Chemical Pathology, Faculty of health Sciences, University of the Witwatersrand, 2009 / Background The 4-variable Modification of Diet in Renal Disease (4-v MDRD) and Cockcroft-Gault (CG) equations are commonly used for estimating glomerular filtration rate (GFR); however, neither of these equations has been validated in an indigenous African population. The aim of this study was to evaluate the performance of the 4-v MDRD and CG equations for estimating GFR in black South Africans against measured GFR and to assess the appropriateness for the local population of the ethnicity factor established for African Americans in the 4-v MDRD equation. Methods We enrolled 100 patients in the study. The plasma clearance of chromium-51–EDTA (51Cr- EDTA) was used to measure GFR, and serum creatinine was measured using an isotope dilution mass spectrometry (IDMS) traceable assay. We estimated GFR using both the reexpressed 4-v MDRD and CG equations and compared it to measured GFR using 4 modalities: correlation coefficient, weighted Deming regression analysis, percentage bias, and proportion of estimated GFR within 30% of measured GFR (P30). Results The Spearman correlation coefficient between measured and estimated GFR for both equations was similar (4-v MDRD R2 = 0.80 and CG R2 = 0.79). Using the 4-v MDRD equation with the ethnicity factor of 1.212 as established for African Americans resulted in a median positive bias of 13.1 (95% CI 5.5 to 18.3) mL/min/1.73m2. Without the ethnicity factor median bias was 1.9 (95% CI -0.8 to 4.5) mL/min/1.73m2. Conclusion The 4-v MDRD equation, without the ethnicity factor of 1.212, can be used for estimating GFR in black South Africans.

D. Lit. et Phil. / The process of change can be complex and the introduction of affirmative action in South Africa against an apartheid backdrop is undoubtedly one such change. In 1998 the Employment Equity Act was passed. The purpose of the Act was to achieve equity in the workplace by promoting equal opportunity and fair treatment in employment through the elimination of unfair discrimination and; implementing affirmative action measures to redress the disadvantages in employment experienced by designated groups, in order to ensure their equitable representation iIi all occupational categories and levels in the workforce (Government Gazette, 1998). Whilst the concept is not new and has been extensively researched in several countries, it was introduced under unique circumstances in South Africa (Luhabe, 1993). There is therefore, a need for the generation of additional theories that are relevant and applicable to South Africa's unique circumstances -theories that are grounded in, and account for this area in South Africa. As Stamp (1999) put it, a grounded theory that is generated form the ground up". The present study aimed to generate theory from the lived experiences of black affi'rmative action participants in South African organisations. The study intended to look at how affirmative action is experienced by beneficiaries without prior judgement from previous literature on the subject. It aimed not to verify past theories but to understand the situation as it is experienced. Hence, the grounded theory method of analysis was chosen by the researcher. Grounded theory is a qualitative method that generates theory by the systematic collection and analysis of data (Glaser,1992). The grounded theory method of research aims to generate new theory that is grounded in the data of a substantive area. It therefore aims to create theory from the central themes and categories that emerge form the data.

Financial literacy has been identified in previous studies as an area that has not been researched extensively in South Africa. This is particularly true for Black South Africans who have been previously disadvantaged and excluded from the mainstream economy and financial services in the apartheid regime. Lower savings and over-indebtedness amongst this group can be attributable to the lower financial literacy levels emanating from the inequalities of the past. This study aims to assess the financial literacy of Black South Africans with a commercial tertiary qualification working in Pretoria and Johannesburg based on descriptive research and structured questionnaires. The study first establishes that although people with a commercial tertiary qualification are more financially literate than those with non-commercial tertiary qualification, Black South Africans are nevertheless less financially literate than their Coloured, Indian and White contemporaries. Secondly, those who have savings have higher financial literacy than those who do not have savings. / Mini Dissertation (MCom)--University of Pretoria, 2016. / Financial Management / MCom / Unrestricted

The burden of non-communicable diseases (NCDs) is high in South Africa. Behavioural conducts and lifestyle factors, unhealthy diets and physical inactivity are the major contributors to the development of NCDs among South Africans. Physical activity (PA) is a modifiable risk factor that is also low in cost for preventing and managing NCDs. PA for health outcomes remains low among black South Africans. Regular engagement in PA is influenced by the knowledge and perception that a person has about the influence of PA as a healthy lifestyle. No studies that investigate perceptions and knowledge of NCDs and PA among black South Africans could be found in literature. The main purpose of this study was to explore and determine the knowledge and perceptions of NCDs and PA among black South Africans. A total of 93 black South Africans from the Northern Cape and North West provinces voluntarily participated in the study. The participants consisted of groups of employed and unemployed men and women residing in an urban community, men working in unskilled labour conditions residing in rural areas and unemployed women residing in a deep rural area. The recruitment procedures included flyers, local radio announcements, participants recruited from previous researchers, mass communication, and word of mouth. A mixed method approach was performed that consisted of quantitative and qualitative methods. Quantitative methods were employed to determine the point prevalence of NCD risk factors among 93 participants. Of these participants, 54 participated in a survey to determine knowledge of NCDs and PA. Participants from deep rural areas were excluded from the survey owing to a high incidence of illiteracy. A qualitative exploration of perceptions of NCDs and PA was performed. The quantitative procedures included a survey for heart disease knowledge and PA knowledge questionnaires. This was followed by NCD risk factor profile measurements; weight, height, waist and hip circumference, resting blood pressure, peripheral blood measurements for glucose and total cholesterol and objective PA measurements using combined accelerometry and heart rate (Actiheart®) for seven consecutive days. Qualitatively, focus group discussions (FGDs) were conducted to explore perceptions of the PA and NCDs using an open-ended semi-structured questionnaire. SPSS version 22 was used in all quantitative statistical analyses. Descriptive statistics reporting means and standard deviations and frequencies were performed to determine knowledge of NCD risk factors and PA, and to determine the point prevalence of NCD risk factors. Partial correlation analyses were performed to determine the relationship between knowledge of heart disease, knowledge of PA and current PA and risk factors of heart disease. Statistical significance was set at p <0.05. Qualitative data was analysed. FGDs were audio recorded and transcribed for analysis. The Noticing, Thinking and Coding approach was used to analyse data using Atlas. ti7. Black South Africans have high risk profiles for NCDs. The highest prevalence was for systolic blood pressure (71%), physical inactivity (68%) and markers of overweight and obesity with 67%. NCD knowledge was 59 ± 8 % and the total sample mean for PA was 84 ± 16%. The results of this study found a significant relationship between NCD knowledge and activity levels among males (r = 0.38; p =0.03). Among women PA knowledge positively associated with PA, though not statistically significant (r = 0.29; p = 0.42). The knowledge of NCDs and NCD risk factors results from the qualitative exploration of this study showed that black South Africans have limited knowledge about NCDs and negative perceptions about NCDs. They have an undistinguished knowledge of PA and are unable to apply the PA knowledge for disease prevention or management. It is therefore concluded that among black South Africans there is limited knowledge and misconception about PA. Black South Africans also lack knowledge on NCDs and have negative perceptions about NCD. An improved understanding of the perceptions of the population about physical activity and disease outcomes should be assessed in future studies in order to ensure the adoption of physical activity for the management of risk factors for NCDs. / MSc (Biokinetics), North-West University, Potchefstroom Campus, 2015

The burden of non-communicable diseases (NCDs) is high in South Africa. Behavioural conducts and lifestyle factors, unhealthy diets and physical inactivity are the major contributors to the development of NCDs among South Africans. Physical activity (PA) is a modifiable risk factor that is also low in cost for preventing and managing NCDs. PA for health outcomes remains low among black South Africans. Regular engagement in PA is influenced by the knowledge and perception that a person has about the influence of PA as a healthy lifestyle. No studies that investigate perceptions and knowledge of NCDs and PA among black South Africans could be found in literature. The main purpose of this study was to explore and determine the knowledge and perceptions of NCDs and PA among black South Africans. A total of 93 black South Africans from the Northern Cape and North West provinces voluntarily participated in the study. The participants consisted of groups of employed and unemployed men and women residing in an urban community, men working in unskilled labour conditions residing in rural areas and unemployed women residing in a deep rural area. The recruitment procedures included flyers, local radio announcements, participants recruited from previous researchers, mass communication, and word of mouth. A mixed method approach was performed that consisted of quantitative and qualitative methods. Quantitative methods were employed to determine the point prevalence of NCD risk factors among 93 participants. Of these participants, 54 participated in a survey to determine knowledge of NCDs and PA. Participants from deep rural areas were excluded from the survey owing to a high incidence of illiteracy. A qualitative exploration of perceptions of NCDs and PA was performed. The quantitative procedures included a survey for heart disease knowledge and PA knowledge questionnaires. This was followed by NCD risk factor profile measurements; weight, height, waist and hip circumference, resting blood pressure, peripheral blood measurements for glucose and total cholesterol and objective PA measurements using combined accelerometry and heart rate (Actiheart®) for seven consecutive days. Qualitatively, focus group discussions (FGDs) were conducted to explore perceptions of the PA and NCDs using an open-ended semi-structured questionnaire. SPSS version 22 was used in all quantitative statistical analyses. Descriptive statistics reporting means and standard deviations and frequencies were performed to determine knowledge of NCD risk factors and PA, and to determine the point prevalence of NCD risk factors. Partial correlation analyses were performed to determine the relationship between knowledge of heart disease, knowledge of PA and current PA and risk factors of heart disease. Statistical significance was set at p <0.05. Qualitative data was analysed. FGDs were audio recorded and transcribed for analysis. The Noticing, Thinking and Coding approach was used to analyse data using Atlas. ti7. Black South Africans have high risk profiles for NCDs. The highest prevalence was for systolic blood pressure (71%), physical inactivity (68%) and markers of overweight and obesity with 67%. NCD knowledge was 59 ± 8 % and the total sample mean for PA was 84 ± 16%. The results of this study found a significant relationship between NCD knowledge and activity levels among males (r = 0.38; p =0.03). Among women PA knowledge positively associated with PA, though not statistically significant (r = 0.29; p = 0.42). The knowledge of NCDs and NCD risk factors results from the qualitative exploration of this study showed that black South Africans have limited knowledge about NCDs and negative perceptions about NCDs. They have an undistinguished knowledge of PA and are unable to apply the PA knowledge for disease prevention or management. It is therefore concluded that among black South Africans there is limited knowledge and misconception about PA. Black South Africans also lack knowledge on NCDs and have negative perceptions about NCD. An improved understanding of the perceptions of the population about physical activity and disease outcomes should be assessed in future studies in order to ensure the adoption of physical activity for the management of risk factors for NCDs. / MSc (Biokinetics), North-West University, Potchefstroom Campus, 2015

Thesis ((Ph.D. (Physiology))--North-West University, Potchefstroom Campus, 2010.

Thesis ((Ph.D. (Physiology))--North-West University, Potchefstroom Campus, 2010.

Magister Public Health - MPH / Introduction: In recent years, cardiovascular disease (CVD) has emerged as a leading cause of death in developing countries. It is important to identify and target people who are at risk,given that a third of all deaths are expected to be due to CVD by 2020. Studies have shown socio-economic patterning in the prevalence of risk factors for CVD, including obesity,smoking and lipid profile. In developed countries, the association between socio-economic status (SES) and CVD risk factors is negative, with a higher prevalence of CVD risk factors among people of lower SES. However, findings from studies in developing countries on this including South Africa has been inconsistent. In addition, there is scant information on differences in socio-economic patterning of CVD risk factors between urban and rural areas in South Africa.Aim: To examine the association between SES indicators and CVD risk factors among an adult population cohort of Black South Africans living in a rural and urban community.Study design: Quantitative cross-sectional analytical study of baseline data of a populationbased cohort of 2000 Black South African men and women aged 30-70 years who are part of the Cape Town arm of the Prospective Urban and Rural Epidemiology (PURE) Study. The study cohort has been established in Mount Frere, Eastern Cape (rural) and Langa, Cape Town(urban) since 2009 and the current work is secondary analysis of the baseline study data.Data collection/synthesis: SES indicators including income, employment status, marital status and completed education were gleaned from the baseline data of the PURE Cape Town study for all study participants. Then CVD risk factors including obesity, hypertension, selfreported diabetes, consumption of tobacco and alcohol consumption were also determined for the same participants. Data analysis: Data was analysed using SPSS version 20 for Windows. Descriptive statistics including frequency counts, percentages, mean and standard deviations (where normal distribution) and median and interquartile range (where non-normal) were used to summarise data on SES and CVD risk factors. This was performed separately for rural and urban study participants. Analytical statistics was used to examine associations between SES indicators and CVD risk factors with risk factors as both dichotomous and multi-level categorical variables. Kendall’s τ rank correlation coefficient was obtained to assess the relationship between the three indicators of SES. Prevalence rates reported with 95% confidence intervals was determined for risk factors across categories of SES indicators. P-values for trends in CVD risk factors were obtained by treating the SES indicators as categorical variables in logistic regression analyses. Multiple logistic regression analysis to estimate independent effects of the different SES indicators on risk factors was performed. In all analyses, P-values < 0.05 were regarded as significant.Results: There was a significant difference in the socioeconomic and CVD risk factors profile of urban and rural participants. Except for hypertension and tobacco use with insignificant higher prevalence in the urban location, all CVD risk factors were significantly higher in urban than rural participants. Some CVD risk factors (hypertension and diabetes) were positively associated with high SES (income) and some others (tobacco use) were negatively associated with employment status. Highest income earners had the highest risk of hypertension (AOR= 2.4, 95% CI 1.5-3.9) and diabetes (AOR= 2.2, 95% CI 1.2-4.1) after adjusting for age, sex and other SES variables. Marital status however showed the most consistent association across all CVD risk factors; widowed participants had a high risk of hypertension (OR=2.1, 95% CI 1.2-3.7) and diabetes (OR=2.0, 95% CI 1.1-3.7), but had the lowest risk of tobacco (OR=0.3, 95% CI 0.14-0.66) and alcohol use (OR=0.3, 95% CI 0.15-0.72). The distribution of CVD risk factors by SES gradient showed inconsistent patterning and difference between the urban and rural participants.Conclusion: In this cohort of adult Black South Africans, high income earning and widowed marital status were associated with higher hypertension and diabetes prevalence, while unemployment was associated with higher tobacco use.Recommendations: CVD risk reduction interventions that recognise the differential susceptibility of individuals in different SES group need to be designed and implemented.Widows and widowers should be given focussed attention in health screening as they may have increased vulnerability to diseases especially CVDs. There is however need for more research to establish the pathway through which SES factors predispose or protect individuals from CVDs.

Magister Public Health - MPH / Introduction: In recent years, cardiovascular disease (CVD) has emerged as a leading cause of death in developing countries. It is important to identify and target people who are at risk,given that a third of all deaths are expected to be due to CVD by 2020. Studies have shown socio-economic patterning in the prevalence of risk factors for CVD, including obesity,smoking and lipid profile. In developed countries, the association between socio-economic status (SES) and CVD risk factors is negative, with a higher prevalence of CVD risk factors among people of lower SES. However, findings from studies in developing countries on this including South Africa has been inconsistent. In addition, there is scant information on differences in socio-economic patterning of CVD risk factors between urban and rural areas in South Africa.Aim: To examine the association between SES indicators and CVD risk factors among an adult population cohort of Black South Africans living in a rural and urban community.Study design: Quantitative cross-sectional analytical study of baseline data of a populationbased cohort of 2000 Black South African men and women aged 30-70 years who are part of the Cape Town arm of the Prospective Urban and Rural Epidemiology (PURE) Study. The study cohort has been established in Mount Frere, Eastern Cape (rural) and Langa, Cape Town(urban) since 2009 and the current work is secondary analysis of the baseline study data.Data collection/synthesis: SES indicators including income, employment status, marital status and completed education were gleaned from the baseline data of the PURE Cape Town study for all study participants. Then CVD risk factors including obesity, hypertension, selfreported diabetes, consumption of tobacco and alcohol consumption were also determined for the same participants. Data analysis: Data was analysed using SPSS version 20 for Windows. Descriptive statistics including frequency counts, percentages, mean and standard deviations (where normal distribution) and median and interquartile range (where non-normal) were used to summarise data on SES and CVD risk factors. This was performed separately for rural and urban study participants. Analytical statistics was used to examine associations between SES indicators and CVD risk factors with risk factors as both dichotomous and multi-level categorical variables.Kendall’s τ rank correlation coefficient was obtained to assess the relationship between the three indicators of SES. Prevalence rates reported with 95% confidence intervals was determined for risk factors across categories of SES indicators. P-values for trends in CVD risk factors were obtained by treating the SES indicators as categorical variables in logistic regression analyses. Multiple logistic regression analysis to estimate independent effects of the different SES indicators on risk factors was performed. In all analyses, P-values< 0.05 were regarded as significant.Results: There was a significant difference in the socioeconomic and CVD risk factors profile of urban and rural participants. Except for hypertension and tobacco use with insignificant higher prevalence in the urban location, all CVD risk factors were significantly higher in urban than rural participants. Some CVD risk factors (hypertension and diabetes) were positively associated with high SES (income) and some others (tobacco use) were negatively associated with employment status. Highest income earners had the highest risk of hypertension (AOR= 2.4, 95% CI 1.5-3.9) and diabetes (AOR= 2.2, 95% CI 1.2-4.1) after adjusting for age, sex and other SES variables. Marital status however showed the most consistent association across all CVD risk factors; widowed participants had a high risk of hypertension (OR=2.1, 95% CI 1.2-3.7) and diabetes (OR=2.0, 95% CI 1.1-3.7), but had the lowest risk of tobacco (OR=0.3, 95% CI 0.14-0.66) and alcohol use (OR=0.3, 95% CI 0.15-0.72). The distribution of CVD risk factors by SES gradient showed inconsistent patterning and difference between the urban and rural participants.Conclusion: In this cohort of adult Black South Africans, high income earning and widowed marital status were associated with higher hypertension and diabetes prevalence, while unemployment was associated with higher tobacco use.Recommendations: CVD risk reduction interventions that recognise the differential susceptibility of individuals in different SES group need to be designed and implemented.Widows and widowers should be given focussed attention in health screening as they may have increased vulnerability to diseases especially CVDs. There is however need for more research to establish the pathway through which SES factors predispose or protect individuals from CVDs.

Philosophiae Doctor - PhD / Black South Africans have been exposed to an unequal and divided education system. It has been expected that the basis for an equitable education system would be laid in the post apartheid period. In this thesis I have provided an analysis of education policy development in South Africa between May 1994 and mid-1997. My main aim has been to understand the policy vision that the post apartheid state has enacted as the basis for educational reconstruction. The conceptual framework of this thesis is located in the academic fields of Education and Development and Policy Sociology. I have focused on the interaction between the broad delimitations set by the structural, economic and political dimensions in society on the one hand, and the political and policy dynamics that have given education policy its specific meaning on the other hand. The role of the government in enacting a specific policy vision has been at the centre of my analysis. The government has effected a conservative vision with the adoption of the Growth, Employment and Redistribution (GEAR) macroeconomic strategy. GEAR has targeted the development of an export-based global economy along post fordist lines. Predicated upon an emphasis on fiscal discipline, the dominant policy orientation has supported equity but without an emphasis on redress. This approach has not provided the necessary basis for education reconstruction. The National Qualifications Framework (NQF)and Outcomes-based education (OBE) embody a definite vision in terms of which education policy would be aligned with economic development. This vision is based on the false assumption that education should playa fundamental role in producing the sophisticated labour demands of a globally competitive economy. The logic of both GEAR and the NQF is internally inconsistent and the relationship between these two policy frameworks is unsustainable. By mid-1997 a definitive narrow and conservative education policy vision had been established which would impede the development of an equitable education system. Education policy 'narrowing' has not been achieved easily, nor has its outcome been inevitable. The specificity of the political context and policy processes has shaped the policy outcomes. A moderate constitutional dispensation has impeded the possibility of developing a radical policy vision. The semi-federal powers awarded to the provinces have led to inconqruence between national and provincial policy. Court challenges aimed at protecting historically acquired educational privileges, have been brought by conservative groups against national education legislation. The apartheid-era bureaucrats, whose jobs were protected by the negotiated constitution, have impeded the development of progressive policy. They brought the conservative policy reformism of the apartheid state into the new policy processes. The NQF has been developed on the basis of a policy consensus between labour and capital in support of skills training and upgrading of workers. Participation in policy processes has been determined 0[1 the basis of identified stakeholders This has given rise to a technicist policy approach that bas excluded many interest groups, academics and professional experts. Most teachers felt alienated by the curriculum policy process. Policy has been developed in a reconstituted civil society. The progressive education movement has been demobilised, and its place has been taken by a constellation of conservative forces who have used the moderate political climate to advance conservative policy interests. The government has had to make policy within a constrained political and policy environment. With regard to the main conceptual underpinning of this thesis, i.e. the relationship between equality and (economic) development, it is clear that the government has favoured the development dimension in pursuit of an education framework that would aid the generation of a globally competitive economy. Social equality has thus been sideline. I have advanced the view that where the government has reneged on the delivery of the social welfare and educational demands of an expectant polity, education policy has manifested as, means of compensatory legitimation at the symbolic level to 'signal', rather than give effect to real change. In my analysis of school access and school curriculum policy, I have suggested that policy has been limited to 'signalling' a commitment to a reconstructed and equitable education system. This has masked the conservative framework that has come to underpin education policy by mid-1997.