Pharmaceutical care can be defined as “the care that a given patient requires and receives which assures safe and rational drug usage” (Mikael et al., 1975:567). The supply of medication is an important link in the health care chain, and the supply of chronic medication specifically was reviewed in this study. The World Health Organization (WHO, 2008d) states that chronic disease and related deaths are increasing in low- and middle-income countries, causing 39% and 72% of all deaths in low- and middle-income countries respectively. The main objective of this study was to investigate the difference between chronic medication prescribing patterns and subsequent claiming patterns for community (retail) and mail order (courier) pharmacies in the South African private health care sector. Computerized claims data for the period 1 January 2009 to 31 December 2010 were extracted from the database of a South African pharmaceutical benefit management company. The chronic database consisted of 6 191 147 prescriptions (N = 17 706 524), 14 045 546 items (N = 42 176 768) at a total cost of R2 126 516 154.00 (N = R4 969 436 580.88). A quantitative, retrospective, cross-sectional drug utilisation review was conducted, and data were analysed using the Statistical Analysis System® programme. Various providers of chronic medication were analysed, namely dispensing doctors, dispensing specialists, courier pharmacies and retail pharmacies. Chronic medication represented 34.97% of all medication prescribed. Retail pharmacies dispensed 79% of this chronic medication (n = 2 441 613 items) and courier pharmacies 19% (n = 610 964 items). Courier pharmacies dispensed 1 147 687 prescriptions containing chronic medication and retail pharmacies dispensed 4 900 282. The average cost per prescription for chronic medication at retail pharmacies was R325.43 ± R425.74 (2009) and R335.10 ± R449.84 (2010), and that of courier pharmacies was R398.56 ± R937.61 in 2009 and R436.57 ± R1199.46 in 2010. The top-five chronic medication groups dispensed by both these pharmacy types were selected according to the number of unique patients utilising these medications for at least four consecutive months. The most utilised chronic medication groups were ACE inhibitors (n = 1 611 432), statins (n = 1 449 732), diuretics (n = 962 670), thyroid medication (n = 885 891) and oral antidiabetics (n = 696 631). The average medication possession ratio for retail pharmacies indicated that, on average, statins, diuretics, thyroid medication and oral antidiabetics were undersupplied by retail pharmacies. Courier pharmacies tended to oversupply more often than retail pharmacies, with the cost of oversupplied medication ranging from 9% to 11% of total courier pharmacy medication costs. The average chronic prescription, item and levy cost did not vary significantly between courier and retail pharmacies. This indicates that the relative cost of acquiring chronic medication is similar at retail and courier pharmacy. The medication possession ratios of the top-five chronic medication groups, however, did differ significantly. In order to choose the most appropriate provider, the medical scheme provider needs to consider the over- and undersupply of medication. Oversupply may lead to unnecessary costs whilst undersupply may lead to future noncompliance and associated health problems. The costs associated with undersupply of medication in the South African health care sector need further investigation. / PhD (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

This study examines human capital constraints in the South African economy, and the austerity these constraints have on firms in the country. The first part of the study identifies the main human capital constraints facing South Africa, and explains how these constraints influence an economy. An inadequately educated workforce along with restrictive labour regulations makes out the central components of these constraints. The second part explores all the relevant constraints individually, and determines the cause of their existence. The final part of this study consists of a firm level analysis that describes human capital constraints experienced by firms in South Africa. Regression analysis examines the determinants of increased output per worker in manufacturing firms. These determinants also indicate the cause of growth in output per worker. Human capital aspects such as education, labour regulation, compensation and competition are all shown to have a considerable influence on output per worker. Principal Component Analysis (PCA) on the explanatory variables achieved similar results. For this analysis, latent variables that incorporated education, training, region and Sector Education Training Authority (SETA) support and effectiveness explained the highest percentage of the total variance. However, this study found no evidence to suggest that human capital development initiatives like training programmes and SETA support have a positive relationship with increased levels of productivity. / Thesis (M.Com. (Economics))--North-West University, Potchefstroom Campus, 2011.

One of the aims included in the United Nations Millennium Development Goals is to decrease the number of the world’s population without access to sanitation and water that is safe, by half by the year 2015. The use of water that is not safe for consumption leads to water–related diseases. For the purpose of this study gastro–intestinal disease was redefined as diseases of the gastro–intestinal tract caused by pathogens that spread via contaminated drinking water, poor sanitation and inadequate hygiene. Information obtained regarding the use of gastro–intestinal disease medication, may provide information about the prevalence of gastro–intestinal disease in South Africa. The general objective of this study was to determine the prescribing patterns of gastro–intestinal medication in different geographical areas in the private health care sector of South Africa. A retrospective drug utilisation review was conducted on data obtained from a medicine claims database of a pharmacy benefit management company for 2007 and 2008. A pharmacoepidemiological approach was followed in order to determine the prevalence of gastro–intestinal disease as well as the use of gastro–intestinal medication in South Africa as well as the different provinces of South Africa. The impact of water quality and sanitation on the prevalence of gastro–intestinal disease was also investigated. Gastro–intestinal medication (used in the treatment of gastro–intestinal disease) included the following pharmacological groups according to the MIMS®–classification: antivertigo and anti–emetic agents (group 1.8), antispasmodics (group 12.3), antidiarrhoeals (group 12.7), minerals and electrolytes (group 20.4, selected according to specified NAPPI–codes) and antimicrobials (group 18). Antimicrobials had to be prescribed in combination with one of the specified gastro–intestinal medication groups in order to be classified as a gastro–intestinal medication. In 2007 and 2008 respectively, 428864 and 340921 gastro–intestinal medication items were prescribed. The most frequently prescribed gastro–intestinal medication pharmacological groups in 2007 and 2008 were beta–lactam antimicrobials (with proportion percentages of 22.77% and 20.85% in 2007 and 2008 respectively), antivertigo and anti–emetic agents, antispasmodics, antidiarrhoeals and quinolone antimicrobials. Minerals and electrolytes represented only a small proportion (2.99% and 2.56% in 2007 and 2008 respectively) of the prescribed gastro–intestinal medication in South Africa. In the Free State and Western Cape antivertigo and anti–emetic agents were the most frequently prescribed gastro–intestinal medication items, while in other provinces beta–lactam antimicrobials ranked the highest. In all provinces except the Western Cape and the Northern Cape, amoxicillin/clavulanic acid was the most frequently prescribed gastro–intestinal medication active ingredient. In the Western Cape loperamide was the most frequently prescribed active ingredient, while ciprofloxacin ranked highest as active ingredient in the Northern Cape in 2008. Based on the prescribing patterns of gastro–intestinal disease medications the treatment of gastro–intestinal disease in this section of the private health care sector of South Africa, does not fully comply with the Standard Treatment Guidelines with regard to the use of antimicrobials and electrolyte replacement therapy. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

Work–life balance is one of the most central issues and concerns for 21st century societies, and according to the American Psychological Association balancing work and family is one of the major challenges for the current generation of employees. Helping employees balance their work and family life is viewed as a social and business imperative since work–life imbalance experienced by employees negatively impacts on employers and society as a whole. Evidence from a study of international employers indicates significant increases in the implementation and use of workplace flexibility, more commonly known as flexitime, as a work–life balance policy. Research into the use and implementation of flexitime within South Africa is limited, especially with regard to the aspects that influence the use of flexitime as well as the associated benefits, challenges and consequences for both South African employees and organisations. Consequently, organisations are left to design, implement and manage their own flexitime policies, with very little information or guidance available to ensure employee and organisational benefit. In this study, a qualitative research design with an exploratory approach was used to explore and describe employees? perceptions regarding the implementation of flexitime. A non–probability purposive, voluntary sample of 15 participants was taken from the offices of an international auditing and consulting organisation located in Johannesburg. Data was collected by means of semi–structured individual interviews and the verbatim transcripts were analysed by means of content analysis. Seven themes were extracted from the interviews, namely: variations in the use of flexitime; factors influencing the use of flexitime; challenges relating to the use of flexitime; perceptions regarding the use of flexitime; required aspects for the effective use of flexitime; consequences relating to the use of flexitime; and the benefits resulting from the use of flexitime. Organisations should be made more aware of the individual as well as organisational benefits, challenges and consequences of flexitime as highlighted in this research. When implementing such policies, specific required aspects for the effective use of flexitime should be taken in consideration. Organisations interested in successfully implementing flexitime for the benefit of both the employee and organisation are advised to consider the findings of this study and take heed of the critical findings presented. Efforts should be made to accommodate employee preferences regarding their use of flexitime. Organisations should be alert to the potential challenges, consequences and negative perceptions surrounding flexitime and, consequently, the importance of ensuring that prerequisites or those aspects required for the implementation of flexitime are in place and perceptions relating to the policy are managed. / Thesis (M.Com. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2011.

This study examines human capital constraints in the South African economy, and the austerity these constraints have on firms in the country. The first part of the study identifies the main human capital constraints facing South Africa, and explains how these constraints influence an economy. An inadequately educated workforce along with restrictive labour regulations makes out the central components of these constraints. The second part explores all the relevant constraints individually, and determines the cause of their existence. The final part of this study consists of a firm level analysis that describes human capital constraints experienced by firms in South Africa. Regression analysis examines the determinants of increased output per worker in manufacturing firms. These determinants also indicate the cause of growth in output per worker. Human capital aspects such as education, labour regulation, compensation and competition are all shown to have a considerable influence on output per worker. Principal Component Analysis (PCA) on the explanatory variables achieved similar results. For this analysis, latent variables that incorporated education, training, region and Sector Education Training Authority (SETA) support and effectiveness explained the highest percentage of the total variance. However, this study found no evidence to suggest that human capital development initiatives like training programmes and SETA support have a positive relationship with increased levels of productivity. / Thesis (M.Com. (Economics))--North-West University, Potchefstroom Campus, 2011.

One of the aims included in the United Nations Millennium Development Goals is to decrease the number of the world’s population without access to sanitation and water that is safe, by half by the year 2015. The use of water that is not safe for consumption leads to water–related diseases. For the purpose of this study gastro–intestinal disease was redefined as diseases of the gastro–intestinal tract caused by pathogens that spread via contaminated drinking water, poor sanitation and inadequate hygiene. Information obtained regarding the use of gastro–intestinal disease medication, may provide information about the prevalence of gastro–intestinal disease in South Africa. The general objective of this study was to determine the prescribing patterns of gastro–intestinal medication in different geographical areas in the private health care sector of South Africa. A retrospective drug utilisation review was conducted on data obtained from a medicine claims database of a pharmacy benefit management company for 2007 and 2008. A pharmacoepidemiological approach was followed in order to determine the prevalence of gastro–intestinal disease as well as the use of gastro–intestinal medication in South Africa as well as the different provinces of South Africa. The impact of water quality and sanitation on the prevalence of gastro–intestinal disease was also investigated. Gastro–intestinal medication (used in the treatment of gastro–intestinal disease) included the following pharmacological groups according to the MIMS®–classification: antivertigo and anti–emetic agents (group 1.8), antispasmodics (group 12.3), antidiarrhoeals (group 12.7), minerals and electrolytes (group 20.4, selected according to specified NAPPI–codes) and antimicrobials (group 18). Antimicrobials had to be prescribed in combination with one of the specified gastro–intestinal medication groups in order to be classified as a gastro–intestinal medication. In 2007 and 2008 respectively, 428864 and 340921 gastro–intestinal medication items were prescribed. The most frequently prescribed gastro–intestinal medication pharmacological groups in 2007 and 2008 were beta–lactam antimicrobials (with proportion percentages of 22.77% and 20.85% in 2007 and 2008 respectively), antivertigo and anti–emetic agents, antispasmodics, antidiarrhoeals and quinolone antimicrobials. Minerals and electrolytes represented only a small proportion (2.99% and 2.56% in 2007 and 2008 respectively) of the prescribed gastro–intestinal medication in South Africa. In the Free State and Western Cape antivertigo and anti–emetic agents were the most frequently prescribed gastro–intestinal medication items, while in other provinces beta–lactam antimicrobials ranked the highest. In all provinces except the Western Cape and the Northern Cape, amoxicillin/clavulanic acid was the most frequently prescribed gastro–intestinal medication active ingredient. In the Western Cape loperamide was the most frequently prescribed active ingredient, while ciprofloxacin ranked highest as active ingredient in the Northern Cape in 2008. Based on the prescribing patterns of gastro–intestinal disease medications the treatment of gastro–intestinal disease in this section of the private health care sector of South Africa, does not fully comply with the Standard Treatment Guidelines with regard to the use of antimicrobials and electrolyte replacement therapy. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

Work–life balance is one of the most central issues and concerns for 21st century societies, and according to the American Psychological Association balancing work and family is one of the major challenges for the current generation of employees. Helping employees balance their work and family life is viewed as a social and business imperative since work–life imbalance experienced by employees negatively impacts on employers and society as a whole. Evidence from a study of international employers indicates significant increases in the implementation and use of workplace flexibility, more commonly known as flexitime, as a work–life balance policy. Research into the use and implementation of flexitime within South Africa is limited, especially with regard to the aspects that influence the use of flexitime as well as the associated benefits, challenges and consequences for both South African employees and organisations. Consequently, organisations are left to design, implement and manage their own flexitime policies, with very little information or guidance available to ensure employee and organisational benefit. In this study, a qualitative research design with an exploratory approach was used to explore and describe employees? perceptions regarding the implementation of flexitime. A non–probability purposive, voluntary sample of 15 participants was taken from the offices of an international auditing and consulting organisation located in Johannesburg. Data was collected by means of semi–structured individual interviews and the verbatim transcripts were analysed by means of content analysis. Seven themes were extracted from the interviews, namely: variations in the use of flexitime; factors influencing the use of flexitime; challenges relating to the use of flexitime; perceptions regarding the use of flexitime; required aspects for the effective use of flexitime; consequences relating to the use of flexitime; and the benefits resulting from the use of flexitime. Organisations should be made more aware of the individual as well as organisational benefits, challenges and consequences of flexitime as highlighted in this research. When implementing such policies, specific required aspects for the effective use of flexitime should be taken in consideration. Organisations interested in successfully implementing flexitime for the benefit of both the employee and organisation are advised to consider the findings of this study and take heed of the critical findings presented. Efforts should be made to accommodate employee preferences regarding their use of flexitime. Organisations should be alert to the potential challenges, consequences and negative perceptions surrounding flexitime and, consequently, the importance of ensuring that prerequisites or those aspects required for the implementation of flexitime are in place and perceptions relating to the policy are managed. / Thesis (M.Com. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2011.

Thesis (MPhil)--Stellenbosch University, 2013. / Bibliography / ENGLISH ABSTRACT: This study investigates if and how the Dutch Reformed Church (DRC) uses its websites to create a public sphere. Since the end of apartheid this church and its media had to adapt to the changing environment in South Africa, particularly in its increasing use of the new media to involve believers and non-believers. Because of the internet’s potential to connect people from all over the world and its interactivity, scholars assert that the internet can create a public sphere. Habermas’ idea of the public sphere, a conceptual space where critical public discourse takes place and anyone can participate, forms the theoretical underpinning for this study. This theory, however, is slightly adapted by arguing that conflict – within bounds – is also part of the communication process within the public sphere. This study focuses on seven active websites of the DRC in order to examine its relation to public theology from a critical cultural perspective. The ideals of public theology closely relates to that of the public sphere. These ideals are a public debate on issues relating to the common good, which are discussed from a religious stance. A central view is that regulation can hinder the forming of a public sphere. Thus the nature and level of regulation on the church’s websites are examined. The nature of interaction between users and content on websites is also studied. This study combines qualitative and quantitative methods, including semi structured interviews, questionnaires, content analysis and systematic observation. The study found that Kerkbode’s Facebookpage facilitates a lively forum for debate on issues that advances the public sphere. The Facebookpage of the DRC has the potential to create such debates. On both these websites and Kerkbode-online and NG Kerk-online, regulation on midlevel curbs this potential. Other obstacles for creating a public sphere that was identified on the DRC’s websites, were personal insults, too narrow focus on internal church affairs and low participation in topics that could advance the public sphere. / AFRIKAANSE OPSOMMING: Hierdie studie ondersoek die vraag of die NG Kerk se webwerwe dit regkry om ʼn publieke sfeer te skep. Sedert die einde van apartheid het die kerk en sy media hom op verskeie maniere in die veranderende Suid-Afrika aangepas, onder meer deur die toenemende gebruik van nuwe media om gelowiges en nie-gelowiges te betrek. As gevolg van die internet se vermoë om mense van regoor die wêreld te verbind en die interaktiewe aard van die medium, meen kenners dat die internet ʼn publieke sfeer kan skep. Habermas se idee van ʼn publieke sfeer, wat ʼn konseptuele ruimte is waar kritiese, openbare diskoers gevoer word wat vir enigeen toeganklik is, vorm die onderbou van hierdie studie. Dié teorie word hier aangepas deur aan te voer dat konflik en meningsverskil – binne perke – ook deel van kommunikasieprosesse binne die publieke sfeer is. Hierdie studie fokus op die sewe aktiewe webwerwe van die NG Kerk om hul verbintenis tot publieke teologie binne ʼn krities-kulturele paradigma te ondersoek. Die ideale van publieke teologie hang nou saam met dié van die publieke sfeer, naamlik ʼn openbare gesprek oor sake van openbare belang wat vanuit godsdienstige oortuigings gevoer word. ʼn Sentrale vertrekpunt van die studie is dat ʼn ideale publieke sfeer deur regulering aan bande gelê kan word. Dus word die aard en vlak van regulering op die kerk se webwerwe ook nagevors. Die tipe interaksie tussen gebruikers en die inhoud van die webwerwe is ook bestudeer. Die studie gebruik ʼn kombinasie van kwalitatiewe en kwantitatiewe metodes, insluitend semi-gestruktureerde onderhoude, vraelyste, inhoudsanalise en sistematiese observasie. Die studie het bevind dat Kerkbode se Facebookblad ʼn lewendige forum bied vir debat oor sake wat die publieke sfeer bevorder. Ook die NG Kerk se Facebookblad het die potensiaal om sulke debatte te skep. Op albei hierdie webwerwe, asook Kerkbode-aanlyn en NG Kerk-aanlyn, het regulering op mesovlak dié potensiaal egter ingeperk. Ander hindernisse vir die skep van ʼn ideale publieke sfeer wat op die NG Kerk se webwerwe geïdentifiseer is, is beledigings, ʼn te noue fokus op interne kerksake en lae deelname aan debatte oor sake wat die publieke sfeer kan bevorder.

The contention of this study is that missiological cell group praxis is an appropriate vehicle to mobilize the local church for world evangelization - centrifugally reaching from "Jerusalem" and "Judea and Samaria" to the "ends of the earth (Acts 1:8). Methodologically it follows the pastoral circle of Holland & Henriot and investigates the missiological praxis of various small faith communities. The principles of the cosmological framework of Calvisnism (Kuyper, Dooyeweerd) are brought to bear on the missionary endeavours of the local church, with reference to the Dutch Reformed Church in South Africa. It argues for a missiologically integrated Cell Church, based on a definition of mission and evangelism, which is aimed at overcoming the fragmented missiological situation in mainline churches. This study argues that these small groups function as the basic cells of the local and universal Church, and shows how these communities come into existence and function as missiological outreach groups. / Christian Spirituality Church History and Missiology / M. Th. (Missiology)

Value-Added Tax (VAT) was introduced in South Africa in 1991 by the Value Added Tax Act No. 89 of 1991 (the VAT Act). The South African VAT system is based on the destination or consumption of the goods or service supplied. The initial place where these goods and services are supplied is not taken into consideration. As a result, non-residents in some instances will be liable to register as VAT vendors and account for VAT even if they are not physically present in South Africa. The absence of place of supply rules therefore impacts on determining where a supply takes place and on the VAT registration of for example non-residents. This study aims to determine whether the South African VAT legislation, to some extent, makes provision for place of supply rules, to establish whether general place of supply rules for certain African and developed countries exist, to draw a comparison between these countries and to determine the possibility of implementing similar rules for South Africa. The study concludes that although not sufficient, the South African VAT legislation provides for certain inferred VAT place of supply rules. Worldwide, different countries apply place of supply by different means, and it is therefore not viable to combine all the various countries’ rules into one set of rules for implementation in South Africa. However, in order for South African VAT legislation to be in line with international trends, the study suggests that South Africa should investigate and determine whether place of supply rules should not formally be introduced in its legislation. VAT place of supply rules is important, as introducing same will equip South Africa to better align itself with its international trading partners. It will enable the supplier and consumer to determine whether a person should register for VAT in South Africa, clarify where a supply takes place and at what rate VAT should be charged. It will also minimise confusion as to the application of VAT treatment of certain transactions and eliminate or limit the possibility of double or non-taxation that can arise. AFRIKAANS : Belasting op toegevoegde waarde (BTW) het in Suid Afrika in werking getree in 1991 deur die implementering van die Belasting op Toegevoegde Waarde Wet No. 89 van 1991 (die BTW Wet). Die Suid Afrikaanse BTW sisteem is van so aard dat BTW betaalbaar is by die uiteindelike bestemming of finale gebruik van goedere en dienste wat gelewer word. Die oorsprongklike plek van lewering word nie in ag geneem nie. Die gevolg hiervan is dat nie-inwoners in sommige gevalle aanspreeklik sal wees om te registreer vir BTW ondernemers en om BTW te betaal, selfs al is hulle nooit fisies in Suid Afrika teenwoordig nie. Die afwesigheid van plek van lewering reëls het ‘n invloed op die bepaling van die plek van oorsprong van die lewering asook die BTW registrasie van byvoorbeeld, nie-inwoners. Die studie het ten doel om te bepaal of Suid Afrikaanse wetgewing tot ‘n seker mate plek van lewering reëls insluit, om te bepaal of algemene plek van lewering reëls vir sekere Afrika en ontwikkelde lande in werking is, om ‘n vergelyking tussen hierdie lande se reëls te trek en om die moontlike implementering van soorgelyke reëls in Suid Afrika te ondersoek. Die slotsom van die studie is dat alhoewel nie voldoende, die Suid Afrikaanse BTW wetgewing wel voorsiening maak vir toevallige plek van lewering reëls. Verskillende lande hanteer plek van lewering reëls op verskillende wyses en dit is dus nie moontlik om een stel gekombineerde reëls op te stel en toe te pas in Suid Afrika nie. Om die Suid Afrikaanse BTW wetgewing egter in lyn met internasionale tendense te bring, stel die studie voor dat Suid Afrika ondersoek instel en bepaal of plek van lewering reëls nie formeel ingesluit moet word in diewetgewing nie.BTW plek van lewering reëls is belangrik omdat die implementering daarvan Suid Afrika beter sal toerus om in lyn te wees met sy internasionale handelsvennote. Dit sal ook die verskaffer en verbruiker in staat stel om te bepaal of ‘n persoon in Suid Afrika moet registreer vir BTW, duidelikheid verskaf rakende die oorsprong of plek van lewering en teen watter koers BTW gehef moet word. Dit sal ook die verwarring rondom die korrekte hantering van BTW op spesifieke transaksies verminder en die potensiaal van dubbel of geen belasting beperk of elimineer. Copyright 2011, University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. Please cite as follows: Janse van Rensburg, Z 2011, An explorative study : place of supply rules for Value-Added Tax in South Africa, MCom dissertation, University of Pretoria, Pretoria, viewed yymmdd < http://upetd.up.ac.za/thesis/available/etd-03192012-163350 / > F12/4/171/gm / Dissertation (MCom)--University of Pretoria, 2012. / Taxation / unrestricted