Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2014. / Background: Practitioners are required to practice evidence-based medicine. The availability of large volumes of information make this practice style difficult for the practitioner. However, a systematic review allows literature to be organised, rated and allows current, abbreviated research resources for practitioner in clinical practice. Objectives: The effectiveness of the Gonstead Chiropractic Technique (GCT) was evaluated to present current evidence available for various conditions for which the GCT is utilised in clinical practice. Thus, the aim of the study was to systematically review, collate and evaluate the research evidence in the literature to determine the effectiveness of the GCT. Method: A literature search was conducted, based on key terms including: Gonstead and manual, Gonstead and technique, and Gonstead and manipulative/manipulation. Databases searched were: CINAHL Plus, Google Scholar, MEDLINE, Metalib, Pubmed, Science Direct, Springerlink and Summons. The articles were screened according to inclusion and exclusion criteria, after which secondary hand and reference searches were done. Thereafter the articles were reviewed by six independent reviewers. Appropriate scales were used to rate the methodological rigour of each article (e.g. PEDro). The results were analysed and ranked, before these outcomes were classified and contextualised in the clinical conditions on which the included studies were based. Results: A total of 477 citations were identified; after screening 26 English articles remained. Two articles were added through the secondary hand-search. Limited to no evidence existed for the effectiveness of GCT for neck pain / headache / face pain and limited evidence existed for gynaecological issues, scoliosis, neurological disorders, fractures, blood pressure and physiological presentations. Consensus was evident for gynaecological issues, neurological disorders, fractures (with the exception of the undiagnosed fracture) and physiological presentations, whereas the neck pain / headache / face pain and scoliosis were conflicting. Conclusion: Limited evidence shows a need for future studies with stringent methodological rigour, so as to investigate the appropriateness / inappropriateness of the use of the GCT. The lack of evidence for GCT may compromise appropriate informed consent and treatment. Therefore practitioners are encouraged to use appropriate and validated tools to measure the patient’s clinical progress

Despite a general consensus concerning the relevance of supply partnerships to agility, the literature reveals disagreements and contradictions regarding their characteristics and, in particular, their duration. This is, whether partnerships in an agile strategy should be long-term (strategic partnerships) or short-term (agile partnerships). The research joins this debate by investigating the types and characteristics of supply partnerships to achieve agility. The underlying premise of the work is that the type of supply partnership is contingent on the degree of turbulence an agile strategy is designed to face. The research was carried out in the fashion industry, given the relevance of agility in this industry. Specifically, the research focused the supply partnerships developed by the footwear companies in the Macerata-Fermo district, the largest footwear district in Italy. The focus on district companies allow the comparison of several companies sharing a very similar business context, allowing a better control of external variables and increasing the internal validity of the study. The field research consisted of a preliminary survey on agility drivers and agile capabilities in the Macerata-Fermo footwear district, followed by an in-depth investigation on supply partnerships using multiple embedded cases studies. Overall six medium-large footwear companies have been analysed in their supply relationships with respect to five key supply categories. For each supply category, the buyer view of the focal firms has been complemented with a view from the supplier side. In total the fieldwork is built upon 30 interviews with 22 informants from 18 companies for a total of more than 23 hours of interviews. In all cases, except two, the key informant was owner, CEO or general manager of the company, eventually supported by another company manager. In two cases, the interviews data have been strengthened by a longitudinal analysis of purchase orders over eight years. The fieldwork highlights that agility drivers and agile capabilities impact on the footwear companies’ decision of developing agile supply partnerships. Specifically footwear companies that are under the pressure of high-turbulence agility drivers (here represented by a high collection renewal rate) and that have developed strong agile capabilities (here represented by a local supply network and a purchase orders postponement) choose agile supply partnerships with respect to supply categories that are sensitive to the fashion trends and therefore difficult to be sourced in a stable way – season after season – from the same suppliers. The main contribution to theory is related to the characteristics of supply partnerships in an agile strategy and specifically to the apparent paradox of “high-involvement & short- term” relationships (i.e. agile supply partnerships). In spite of the presence of time compression diseconomies in building up partnership and of the loss of relational (non- redeployable) benefits in closing down partnerships, scenarios of high-turbulence can give companies an incentive to look for short-term partnerships. Such finding can support a wider claim that different levels of turbulence call for different agility strategies requiring different capabilities and practices. The main contribution to practice is related to the way agile partnerships are selected, started and ended. Given that many industries are facing an increase in market turbulence, it appears that many companies – even outside the fashion industry – might have to learn how to balance high-involvement supply relationships with respect to a shorter time horizon.

A large number of people all over the world suffer from skin conditions. Dermatological problems comprise about 10 % of a general practitioner's caseload and probably more for pharmacists. The literature furthermore emphasises that skin diseases are becoming a significant problem in the developing world. There is a need to establish an effective method to achieve good health and quality of life for patients with dermatological problems. The general objective of this study was to investigate the usage patterns and cost of dermatological products in the private health care sector of South Africa by using a medicine claims database. The focus was specifically on dermatological products with a prevalence of more than 10 % in the database. A quantitative retrospective drug utilisation research design was used to evaluate the usage patterns and costs of dermatological products in three four-monthly intervals of 2001 and 2004. Data were analysed by using the Statistical Analysis System, 9.1 (SAS). The dermatological product groups for this study were antibacterial and antifungal drugs, corticosteroids and anti-acne products and were analysed according to the MIMS classification. Of all analysed prescriptions issued only 8.57 % (n = 126 447) during 2001 (N = 1 475 380) and 6.82 % (n = 177 122) during 2004 (N = 2 595 254) consisted of dermatological products. Of the total number of products prescribed, the dermatological products constituted 4.77 %I (n = 140 701) for 2001 (N = 2 95 1 326) and 3.77 % (n = 199 976) for 2004 (N = 5 305 882). The total cost of the dermatological products was 4.98 % (n = R18 913 889.92) of the total cost of all medicine products during 200 1 (N = R379 708 489). During 2004 (N = R66 1 223 146) the total cost of dermatological products was 4.09 % (n = R27 025 540.48) of the total cost of all medicine products in the database. The cost-prevalence index for 2001 and 2004 respectively showed that the dermatological products were relatively expensive with values of 1.03 and 1.09. The antibacterial and antifungal drugs, corticosteroids and anti-acne products represented 91.92 % (n = 129 336) and 87.97 % (n = 175 9 16) of all dermatological products during 2001 (N = 140 701) and 2004 (N = 199 976), respectively. These dermatological groups named above represented 91.57 % (n = R17 319 645.61) and 85.85 '% (n = R23 200 594.71), respectively, of the total cost of dermatological products during 200 1 (N = R18 9 13 889.92) and 2004 (N = R27 025 540.48). It was further found that the majority of dermatological products prescribed during the research periods was innovator products. The prevalence of innovator products for 2001 was 86.17 % (n = 12 1 249) with a total cost representing 94.16 % (n = R17 809 603.12). For 2004 the prevalence was 82.33 % (n = 164 640) with a total cost representing 91 .O1 '% (n = R24 594 923.72) of all the dermatological products prescribed. The number of innovator and generic products claimed during 2001 amounted to 86.17 % (n = 12 1 249) and 13.83 % (n = 19 452) respectively of the total number of products claimed (N = 140 701). During 2004 the number of innovator and generic products represented respectively 82.33 % (n = 164 640) and 17.67 O/o (n = 35 336) of the total number of products claimed (N = 199 976). The prevalence in the use of the dermatological products during 2004 increased with 55.25 % from January to April versus September to December. The cost-prevalence index indicated that the dermatological products were relatively expensive during January to August 2004. During September to December 2004 the cost-prevalence decreased and indicated that dermatological products became inexpensive. The average cost of dermatological products during the 2004 study period showed that the cost decreased. January to April (before implementation of the new single exit price structure) was compared to September to December (after implementation of the new single exit price structure). This comparison indicated that the average cost decreased by 22.88 %. It can be summarised that the average cost in the last study period decreased due to the changed price structure. The innovator products' prevalence was high and therefore more generics are needed in dermatology. If more generics are used the total cost of dermatological products might also decrease. The number of dermatological prescriptions increased towards 2004, but this may be because of more members or more medical aids claiming through this database. / Thesis (M.Pharm.)--North-West University, Potchefstroom Campus, 2006.

Environmental Impact Assessment (EIA) is a process that seeks to reduce the negative environmental consequences of listed development activities, which could have a detrimental effect on the environment, in the advance of their implementation, and a requirement of legislation in South Africa. An important element of the systematic EIA process is the submission of an environmental impact or scoping report or an environmental impact report (EIR) to the relevant governmental department, interested and affected parties and/or specialist for review to determine the report's adequacy before a project can be authorised or if further information is required. The information made available in reports to decision-makers with regard to developments with the potential of affecting explosive projects, plays a significant role in the authorisation of the project after the authority review process, which is dependent on the quality of the report. In order to contribute more effectively to sustainable development, more attention must be placed on assessing the quality of ElA's as part of determining how effectively EIA has been functioning in South Africa; hence this study is aimed at assessing the quality of EIA assessment reports of four projects with the potential of impacting on explosive industry projects. The objectives of the study included the review by independent reviewers of the quality of four-selected impact reports using a checklist, analysis of the review process results and provision of recommendations to improve the quality of environmental impact reports for-explosive projects. Based on the review results it is concluded that the quality of the four reports for-explosive projects. Based on the review results it is concluded that the quality of the four reports were of an acceptable standard, although certain areas were found poorly performed i.e. improvement with regard to identification of key impacts and considerations of alternatives and mitigation as well as the control and treatment of waste. Otherwise the review method is fairly robust and consistent and therefore can be seen as a reliable indication of EIR quality. The following was recommended to improve the quality of the reports for explosive projects: The use of a quality review checklist for explosive projects by EIA practitioners and authorities to be used as an additional tool to the EIA regulations (DEAT 2002) and the Integrated Environmental Management series (DEAT 2002) can further improve the quality of the El reports for explosive projects. • The use by EIA practitioners of an explosive review checklist will assist in ensuring that all key aspects are addressed before submission to relevant authorities, i.e. the report contains all pertinent information and is technically sound, the report is set-up clearly and coherently organized and presented so that it can be understood and that it has addressed all the key issues to make a decision about the proposed development. This will further assist in fast-tracking the approval process often delayed by the request of additional information from the applicant as a result of inadequate reports. • Regular use of the review checklist by EIA practitioners and authorities for ascertaining the quality of the environmental impact reports will contribute to a baseline of EIR quality for evaluating EIA practice for explosive projects under the new regulations promulgated in June 2006. / Thesis (M. Environmental Management)--North-West University, Potchefstroom Campus, 2009.

South Africa and other countries are using Environmental Impact Assessment (EIA) as one of the Environmental management tools. The EIA process is reliant on the information presented in the Environmental Impact Report (EIR). The quality of information supplied by the developers in the EIR, plays an integral role in the whole decision making process done by the authorities; to approve and disapprove the EIR. If approved, a record of decision (ROD) is issued to the developers stipulating the conditions that they must adhere to, during the implementation of the project Using the South African modified Lee Colley review package this dissertation presents the results of research done on the assessment of quality of the EIR's for housing development in the Nkangala district of Mpumalanga province. The results reveal that 73% of Environmental Impact Reports of housing developments in the Nkangala district are of satisfactory quality. However, there were some omissions and inadequacies on alternatives and mitigation which are discussed in detail in this dissertation. The dissertation ends with a conclusion and recommendations. / Thesis (M. Environmental Science)--North-West University, Potchefstroom Campus, 2010.

In view of the recent implementation of a publicly funded rotavirus vaccination program in Ontario, we undertook studies to help guide the design of a safety evaluation of the vaccine with respect to intussusception. We used administrative data to develop and validate an algorithm for intussusception, and quantified its incidence in Ontario. We also conducted a systematic review of study designs used to evaluate post-licensure vaccine safety, and discussed each design’s strengths and weaknesses. The validated algorithm for intussusception was sensitive (89.3%) and highly specific (>99.9%). We observed the highest mean incidence (34 / 100,000) in males <1 year of age. While other designs are more robust, the inability to ascertain individual vaccination status from Ontario’s administrative data dictated our selection of an ecological design for safety evaluation of rotavirus vaccine. Data assimilated from this thesis represent a critical step toward the timely evaluation of rotavirus vaccine safety in Ontario.

Introduction: Thromboprophylaxis recommendations for hospitalized cancer are based on trials done for the general medically patients, as there are no randomized clinical trials(RCTs) looking at thromboprophylaxis in medically ill patients with cancer. Methods: To determine if thromboprophylaxis is safe and effective to prevent VTE these patients, a Systematic Review(SR) was done. A survey was performed to assess: clinical equipoise, trial design and minimally clinically important difference(MCID) for a potential trial. Lastly, a pilot study for an RCT was designed. Results: The pooled RR of VTE was 0.91 (95%CI:0.21 to 4.0;I2:68%) among hospitalized cancer patients receiving thromboprophylaxis compared to placebo. 63.9% believe there is clinical equipoise and 58.3% would consider participating in a RCT comparing different agents/dosing. The MCID for absolute reduction in symptomatic VTE between two arms was 2% and for “acceptable” increase in major bleeding events was 1%. Conclusion: The risk-benefit ratio of current doses of thromboprophylaxis administered to hospitalized cancer patients is unclear and additional RCTs are necessary.

Sustainability is vital to the success of our cities and settlements. While communities are becoming increasingly conversant with sustainability concepts, uncertainty remains over how to translate these into planning practice. This practicum explores the role of sustainability checklists as one tool for planning and designing more sustainable communities. The inquiry examines the design, implementation and effectiveness of these tools and seeks to understand the motivation and context in which they are developed, the varying approaches and components of checklist tools, and the impact that they are having on planning and development practices. A review of twenty-four sustainability checklists from a selection of BC municipalities, an online survey and key informant interviews were used to inform this study. Nine key findings are identified suggesting that while checklists are helping to communicate sustainability objectives and are encouraging better development, they are not resulting in the large scale shifts to development patterns and urban systems that are required to achieve sustainable outcomes; therefore, checklists need to be integrated with other policies, regulations and tools in order to assist in achieving sustainable settlements.

Environmental Impact Assessment (EIA) is a process that seeks to reduce the negative environmental consequences of listed development activities, which could have a detrimental effect on the environment, in the advance of their implementation, and a requirement of legislation in South Africa. An important element of the systematic EIA process is the submission of an environmental impact or scoping report or an environmental impact report (EIR) to the relevant governmental department, interested and affected parties and/or specialist for review to determine the report's adequacy before a project can be authorised or if further information is required. The information made available in reports to decision-makers with regard to developments with the potential of affecting explosive projects, plays a significant role in the authorisation of the project after the authority review process, which is dependent on the quality of the report. In order to contribute more effectively to sustainable development, more attention must be placed on assessing the quality of ElA's as part of determining how effectively EIA has been functioning in South Africa; hence this study is aimed at assessing the quality of EIA assessment reports of four projects with the potential of impacting on explosive industry projects. The objectives of the study included the review by independent reviewers of the quality of four-selected impact reports using a checklist, analysis of the review process results and provision of recommendations to improve the quality of environmental impact reports for-explosive projects. Based on the review results it is concluded that the quality of the four reports for-explosive projects. Based on the review results it is concluded that the quality of the four reports were of an acceptable standard, although certain areas were found poorly performed i.e. improvement with regard to identification of key impacts and considerations of alternatives and mitigation as well as the control and treatment of waste. Otherwise the review method is fairly robust and consistent and therefore can be seen as a reliable indication of EIR quality. The following was recommended to improve the quality of the reports for explosive projects: The use of a quality review checklist for explosive projects by EIA practitioners and authorities to be used as an additional tool to the EIA regulations (DEAT 2002) and the Integrated Environmental Management series (DEAT 2002) can further improve the quality of the El reports for explosive projects. • The use by EIA practitioners of an explosive review checklist will assist in ensuring that all key aspects are addressed before submission to relevant authorities, i.e. the report contains all pertinent information and is technically sound, the report is set-up clearly and coherently organized and presented so that it can be understood and that it has addressed all the key issues to make a decision about the proposed development. This will further assist in fast-tracking the approval process often delayed by the request of additional information from the applicant as a result of inadequate reports. • Regular use of the review checklist by EIA practitioners and authorities for ascertaining the quality of the environmental impact reports will contribute to a baseline of EIR quality for evaluating EIA practice for explosive projects under the new regulations promulgated in June 2006. / Thesis (M. Environmental Management)--North-West University, Potchefstroom Campus, 2009.

South Africa and other countries are using Environmental Impact Assessment (EIA) as one of the Environmental management tools. The EIA process is reliant on the information presented in the Environmental Impact Report (EIR). The quality of information supplied by the developers in the EIR, plays an integral role in the whole decision making process done by the authorities; to approve and disapprove the EIR. If approved, a record of decision (ROD) is issued to the developers stipulating the conditions that they must adhere to, during the implementation of the project Using the South African modified Lee Colley review package this dissertation presents the results of research done on the assessment of quality of the EIR's for housing development in the Nkangala district of Mpumalanga province. The results reveal that 73% of Environmental Impact Reports of housing developments in the Nkangala district are of satisfactory quality. However, there were some omissions and inadequacies on alternatives and mitigation which are discussed in detail in this dissertation. The dissertation ends with a conclusion and recommendations. / Thesis (M. Environmental Science)--North-West University, Potchefstroom Campus, 2010.