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Kritiese evaluering van die dominante beleidsrigtings van die vernaamste politieke partye in Suidwes-Afrika/Namibië vir 'n onafhanklike staatVan Zijl, Barend Francois 11 1900 (has links)
The study can be typified as "a probing case study
in comparing the policies of the most prominent
political groupings (AKTUR, DTA, NNF and
SWAPO-N) regarding a new society for South West
Africa/Namibia".
The paper consists of four chapters, namely a
Theoretical Perspective, in order to orientate the
readers regarding the specific problematics dealt
with in the paper; a Relevant Historical Perspective,
since the present political dispensation in
South West Africa/Namibia is characterised by
"dissension” that must be seen against the background
of eight variables which worked in cumulatively
on the territory over a period of a century; the Comparative Analysis of Specific Aspects
of Policy, in which the degree of similarity and
difference among specific policy trends of the
four most prominent political groupings is
examined; and an Evaluation, which is a synthetical
summary of the preceding analysis especially
in Chapter 111. / Political Sciences / M.A. (Internasionale Politiek)
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[en] THE DEMONIC ALLIANCES OF THE ANIMALISM TO COME / [pt] AS ALIANÇAS DEMONÍACAS DO ANIMALISMO POR VIRLUIZ GUILHERME V DIAS DA FONSECA 26 October 2018 (has links)
[pt] Esta dissertação propõe um estudo acerca da acentuação do controle dos corpos efetuado pelo regime farmacopornográfico (Paul B. Preciado) e sua produção de subjetividade, levando em conta a tensão entre as técnicas que compõem o que se habituou a chamar de humano e as invenções técnicas que se afastam do mesmo, das quais o bio-hackeamento e a intoxicação voluntária serão os exemplos analisados. Para isso, faz-se aqui um duplo movimento de investigação e experimentação dos conceitos de aliança intensiva (Deleuze e Guattari), ou alianças demoníacas (Viveiros de Castro), a partir de laços estratégicos possíveis entre os desumanizados pelo humanismo. Há também a proposição de uma alternativa ao humanismo levando adiante a provocação conceitual de Preciado de um animalismo por vir, em uma escrita especulativa que atravessa as obras de Eduardo Viveiros de Castro (Metafísicas Canibais) e Paul B. Preciado (Testo Yonqui). / [en] This dissertation proposes a study on the accentuation of the control of the bodies effected by the pharmacopornographic regime (Paul B. Preciado) and its production of subjectivity taking into account the tension between the techniques that compound what we are accustomed to call human and the technical inventions that deviate from it, of which the biohacking and the voluntary intoxication will be the examples analyzed. For this, a double movement of investigation and experimentation of the concepts of intensive alliance (Deleuze and Guattari), or demonic alliance (Viveiros de Castro), possible strategic ties between the dehumanized by humanism, is necessary. There is also the proposition of an alternative to humanism taking forward the conceptual provocation of Preciado of an animalism to come, in a speculative writing that runs through the works of Eduardo Viveiros de Castro (Cannibal Metaphysics) and Paul B. Preciado (Testo Junkie).
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The influence of animal-assisted play therapy on the self-esteem of adolescents with special needsSentoo, Gail Soobrayan 01 March 2004 (has links)
This research project focused on the influence of animal-assisted play therapy on the self-esteem of adolescents with special needs. The goal of this study was to ascertain whether principles of animal-assisted play therapy from the gestalt approach would enhance the self-esteem of adolescents with special needs. In order to achieve this goal, the following objectives were set out: to create a theoretical knowledge base through a literature study and consultation with experts, to conduct an empirical study in order to obtain qualitative and quantitative data and to formulate conclusions and recommendations with regard to the use of animal-assisted play therapy with adolescents with special needs. A combination of the quantitative and qualitative approaches was utilized, and applied research was done, as the focus was on practical solutions that is suitable for practice. A research hypothesis was posed, namely: If animal-assisted therapy from the gestalt approach is used with adolescents with special needs, their self-esteem will be enhanced. Two adolescents were selected as respondents through purposive sampling as sub-type of non-probability sampling. An empirical study was conducted through the use of questionnaires and interviewing as data-collection methods. The quantitative data was gathered through the use of self-constructed questionnaires and the Psychosocial Functioning Inventory for High School Children (PFI – HIGH – C) from Perspective College. The researcher utilized the A-B-A research design to conduct a pre-test and a post-test. Qualitative data was gathered through interviewing using the combined animal-assisted and gestalt play therapy techniques Empirical data was gathered and indicated improvement in the self-esteem of both the respondents who were exposed to the play therapy techniques. The research has thus shown that the use of animal-assisted play therapy does enhance the self-esteem of adolescents with special needs, and has benefits for future practice. The hypothesis of the study is thus proven to be true. / Dissertation (MSD (Play Therapy))--University of Pretoria, 2005. / Social Work and Criminology / Unrestricted
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Suid-Afrikaanse privaatskool-hoofde se siening van inklusiewe onderwys-implementering en skoolontwikkeling (Afrikaans)Bezuidenhout, Herman Stephanus 01 March 2010 (has links)
Education White Paper No.6 (2001) – Special Education: Special Needs Education. Building an Inclusive Education and Training System creates the expectation that more South African schools will need to follow an inclusive approach to address, effectively, the varying educational needs of all learners. A number of South African private schools implemented inclusive programs before the publication of this white paper. This research focuses on the perceptions of four South African private school principals with regards to the implementation of these programs and the consequential development of their schools. This qualitative research generated data about the selected private schools through a semi-structured interview, a document analysis, and a literature review. The processed data displayed the principals’ perceptions about the South African private schools’ nature; location; the expertise of the various stakeholders; the schools’ criteria and considerations for administering an inclusive program; the effects of the inclusive programs on the schools’ development; the influence of an inclusive approach on the development of staff, infrastructure and administration within these schools; and the nature of the systemic changes within these private schools. The literature review confirms that inclusive education is a diffuse term and that the American IDEA legislation, as the most progressive policy in this regard, ensures comprehensive inclusive mainstream schools for all learners, irrespective of their educational needs, in the least restrictive environment in their respective communities. The interview data was transcribed, labelled according to specific markers and thematically interpreted in five groups. The data analysis showed that the location of the private school, the expertise of the stakeholders at the school and the motivation for the program’s existence all play a definitive role in the extent; nature; marketing; assessment; policy formulation; accreditation; infrastructural developments; cost; policies; procedures; decision making; leadership style; in service training and staff allocation linked to the inclusive program. There are still misconceptions and questions about inclusive education within and outside the private school milieu. The growing cost and increased workload linked to this approach impede its widespread development and make other schools hesitant to implement it in the same manner as the private schools used in this research sample. AFRIKAANS : Onderwys Witskrif Nr.6 (2001) –Spesiale Onderwys: Die vestiging van ’n inklusiewe Onderwys en Opleidingstelsel se verwagting is dat meer Suid-Afrikaanse skole ’n inklusiewe benadering sal volg om al die onderwysbehoeftes van alle Suid-Afrikaanse leerders effektief aan te spreek. ’n Aantal Suid- Afrikaanse privaatskole het voor hierdie publikasiedatum verskillende inklusiewe programme geïmplementeer. Dié navorsing werp lig op die sienings van vier Suid-Afrikaanse privaatskool-hoofde aangaande die implementering van dié programme én die skoolontwikkeling wat daaruit voortvloei. Die kwalitatiewe het data oor die geselekteerde privaatskole deur ’n semi-gestruktureerde onderhoud, ’n dokument-analise en literatuurstudie ingesamel en verwerk. Die data het die skoolhoofde se persepsies aangaande die Suid-Afrikaanse inklusiewe privaatskole se aard; ligging; die kundigheid van hulle belanghebbendes; die skole se kriteria en oorwegings om die inklusiewe program te bedryf; die effekte van die inklusiewe program op skool- ontwikkelings; die invloed van die inklusiewe benadering op die personeel-, infrastruktuur- en administratiewe ontwikkelings in dié skole; én die aard van die sistemiese veranderings in die privaatskole opgelewer. Die literatuurstudie het bevestig dat inklusiewe onderwys ‘n diffuse term is en dat die Amerikaanse IDEA-wetgewing, as die progressiefste beleid in hierdie verband, verseker dat ‘n volwaardige inklusiewe hoofstroomskool alle leerders, ongeag hulle onderwysbehoefte, in die minsbeperkte leeromgewing in hulle gemeenskap akkommodeer. Die onderhouddata is getranskribeer, volgens merkers geëtiketteer en tematies geïnterpreteer in vyf groeperings. Die data-analise toon dat die ligging van die privaatskool, die kundigheid van belanghebbendes by die skool en die motivering vir die program ‘n besliste rol speel in die omvang; aard; bemarking; assessering; beleidformulering; akkreditering; infrastruktuurontwikkelings; koste; beleide; prosedures; besluite; leierskapstyl; indiensopleiding en personeeltoewysing van die inklusiewe praktyke. Daar is steeds wanopvattings oor inklusiewe onderwys binne en buite die privaatskoolbedryf, en die verhoogde werkslas en groeiende koste hieraan verbonde rem die wydverspreide ontwikkeling en maak nuwe skole huiwerig om dieselfde stap te neem as die gevestigde skole. Copyright / Dissertation (MEd)--University of Pretoria, 2010. / Education Management and Policy Studies / unrestricted
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‘n Gemeenskapsgerigte model vir geloofsvorming van tieners in die verbondsgesin deur middel van simbole en rituele (Afrikaans)De Wet, Dirk Cornelis 02 October 2003 (has links)
Compare diagram 1: ‘n Paradigmaverandering van teorie na praktyk en van gemeente na gesin en gemeenskap” and diagram 2: “Die siklus van geloofsbemiddeling”. The family is the most important building system in the church, the society and the whole world. The family is also the cradle and even the womb of the symbolic way in religious education. Almost all families stay in a community where interactions of faith take place. Teenagers leave the church because there are not enough exciting activities in the community to be part of a transformation process for a better life. For that reason the paradigm in this research emphasises an event-driven teenage and family ministry within the community. That means a ministry that accentuates processes, people and relations. Faith development cannot find a place outside the relationship of human beings. Relationship is the password to understanding and the most natural form of relationship is the family. The covenantal family is the most important building system in the church, the society and the whole world. To develop a model for teenage and family ministry for this purpose, the research will emphasise practicing more than theorising, although the dialogue between these two factors in practical theology is of utmost importance. Better relationships within the family, congregation and the community needs better communication. For that reason symbols and rituals are a necessary part of the whole process of teenage and family ministry which is community-directed. God acts within the lives of individuals and groups, but planned the family as the most important unit for interaction. No religion can be without a God and no religion can be without people. All people are born into one or another kind of family and have a God-given need to be part of a group even when ostracised by families or the society. The community of faith never lives in a vacuum - it is always in the midst of cultural reality which is a powerful influence. The faith of this community is embedded in the context of symbols, rituals and narratives. To be busy with practical theology, with this paradigm in mind, needs a threefold exegesis: an exegesis of the Bible, an exegesis of the culture, and an exegesis of the self and the community. Strengthening the inner life of churches and their relation to their immediate communities should be the first priority of the leaders of churches. Churches have a covenant responsibility to help people develop and sustain strong and healthy families. / Dissertation (PhD)--University of Pretoria, 2004. / Practical Theology / unrestricted
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Gestremheidsreg : 'n internasionaalregtelike en regsvergelykende analise (Afrikaans)Grobbelaar-Du Plessis, IIze 08 October 2010 (has links)
AFRIKAANS: Hierdie proefskrif ondersoek die ontplooiing van die reg rakende persone met gestremdhede in die rigting van ʼn toenemend inklusiewe en geintegreerde regsorde wat die beskerming en bevordering van die regte van persone met gestremdhede op gelyke grondslag met alle ander persone bewerkstellig. Gestremdheid word aan die hand van twee uiteenlopende modelle beoordeel en hanteer. Die twee modelle - die mediese en die sosiale model van gestremdheid - verteenwoordig uiteenlopende opvattinge oor gestremdheid wat in duidelik onderskeibare regsbenaderings neerslag vind. Oor die onlangse dekades het die sosiale model beduidend veld teen die mediese model gewen. Dit het veral neerslag gevind in die internasionale reg, soos dit die afgelope dekades onder die aanvoering van die Verenigde Nasies in omvattende standaardisering en universalisering van menseregte ontwikkel het. Hierdie ontwikkelings word breedvoerig ondersoek. Die groeiende aanklank van die sosiale model ten koste van die mediese model is eweneens merkbaar in twee ander jurisdiksiegebiede, naamlik Europa – binne die konteks van sowel die Europese Raad as die Europese Unie - en die Verenigde State van Amerika. By albei weerspieel die ontplooiing van die positiewe reg ʼn verandering in die beskouing oor die regshantering van persone met gestremdhede. Daarvolgens word gestremdheid toenemend volgens ʼn sosiale model as ʼn vorm van diversiteit eerder as uitsluitlik in terme van ʼn mediese model as afwykend of abnormaal verstaan. Gestremdheid vereis ʼn besondere regsbedeling ten einde daadwerklike gelyke beregtiging vir persone met gestremdhede te verseker eerder as (net) mediese ingryping in ʼn “afwykende toestand” of ʼn “siektetoestand.” Die veranderde regsbedeling oor gestremdheid word deurlopend deur die prisma van die twee modelle beskryf en beoordeel. Na die uitklaar van die betekenis van die modelle aan die begin van die studie volg ʼn historiese oorsig wat die konteks vorm waarbinne die regsontwikkeling rondom gestemdheidsreg sedert die Tweede Wereldoorlog op internasionale terrein (onder die aanvoering van die Verenigde Nasies), in Europa, die VSA en in Suid-Afrika bespreek word. Die studie sluit af met gevolgtrekkings waarin die klem op ʼn beoordeling van die verandering van die reg rakende gestremdheid in die lig van modelle wat in die eerste hoofstuk toegelig is, val. ENGLISH: The thesis investigates a change in perception and the resulting altered juridical management of persons with disabilities towards a more inclusive and integrated public legal order. Such a change positions the protection and promotion of the rights and interests of persons with disabilities on an equal footing with that of other persons. Disability is dealt with and evaluated in relation to two opposing models. The two models of disability – the medical and the social – represent two different perceptions about disability that are laid down in clearly-distinguishable approaches in law. Over the recent decades the social model has gained considerable ground over the medical model. It has found particular favour in international law, as developed over the past decades in the comprehensive standardisation and universalising of human rights under the leadership of the United Nations. These developments are scrutinised thoroughly. The increasing acceptance of the social model to the detriment of the medical model is apparent in two other areas of jurisdiction, namely, Europe – within the context of the European Council and the European Union – and the United States of America. In both these the development of positive law reflects a change in view regarding the way disability is dealt with by the law. Disability is increasingly understood according to a social model as a form of diversity rather than exclusively in accordance with a medical model. Disability requires a unique legal dispensation in order to ensure genuine equal adjudication for persons with disabilities rather than a (mere) medical intervention as a “deviant state” or an “illness”. The changing legal dispensation regarding disability is continuously described and evaluated through the prism of the two models. After an exposition of the models at the beginning of the study a brief historical overview follows, constituting the context within which legal development since the Second World War in the international arena (by way of the activities of the United Nations), in Europe, the USA and South Africa, is discussed. The study ends with conclusions which emphasise an evaluation of the changes in disability law in light of the models that were expounded in the first chapter. / Thesis (LLD)--University of Pretoria, 2010. / Public Law / unrestricted
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Virtuální výroba / Virtual manufacturingBenešl, Tomáš January 2017 (has links)
This thesis deals with the Industry 4.0 focusing on virtual manufacturing and its inte- gration into education. The aim of the thesis is to summarize and describe the Industry 4.0, and create necessary materials designed for teaching the virtual manufacturing. There is also a discussion on the real use of the virtual manufacturing and possible economic return for firms. Moreover, software programs for the virtual manufacturing available on the market, their options and their real use are also involved in the thesis. It also includes an application design for virtual manufacturing including laboratory tu- torials and the use of this application in education. There are also suggestions for other exercises that could move the teaching of the virtual manufacturing in the Czech Republic further.
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A critical analysis of the VAT implications of over-allowances in the South African motor retail industryCoventry, Michelle Anne 09 March 2012 (has links)
The VAT treatment of over-allowances in the motor retail industry has proved contentious for South African Revenue Services (“SARS”). VAT legislation dictates that notional VAT may be claimed on the lower of the open market value and the consideration paid. The industry, however, claims notional VAT on the actual consideration paid for a used vehicle on the basis that a higher output VAT will be declared on the consequent sale of the new vehicle. This is because the over-allowance is offset against the lower discount granted. SARS allows this practice on account of SARS’ own issuance of a binding general ruling, provided certain criteria are met. This ruling is contained in the VAT Guide to Motor Dealers. This study performs an analysis of the current practice by South African motor retailers pertaining to over-allowances. The aim of the study is to determine the impact on the industry of the issuance of the Guide, both practically and from the perspective of compliance, focussing on VAT legislation and Competition Commission legislation. The study discusses the requirements contained in the Guide in the light of the Competitions Act and the practical benefits, and concludes that the industry is satisfied with the issuance of the Guide, despite its silence on the interpretation of certain key criteria. The industry has chosen to assume that, as SARS has acted reasonably in the issuance of the Guide, it would not expect the industry to deviate from any other legislation, including the Competitions Act. If SARS is not satisfied with this interpretation, the Guide will have to be amended to include definitions of terms such as “permissible discount”. AFRIKAANS : Die hantering van die toelating van oormatige BTW in die motorvoertuig-kleinhandelsindustrie is, insover dit die Suid-Afrikaanse Inkomstediens (“SAID”) betref, omstrede. BTW-wetgewing bepaal dat geagte BTW gehef mag word op die laagste van ope markwaarde en die werklike bedrag betaal. In die motorvoertuigindustrie word BTW egter altyd gehef op die werklike bedrag betaal vir ‘n gebruikte voertuig met die veronderstelling dat hoër uitset BTW verklaar gaan word met die verkoop van ‘n nuwe voertuig wat die inruiltransaksie tot gevolg gaan hê. Daar word geredeneer dat die oortoelating van BTW uitgekanselleer gaan word deur ‘n laer afslag op die nuwe verkope. As gevolg van bindende bepalings in die BTW Handleiding vir Motorhandelaars, wat uitgereik is deur die SAID en die nakoming van sekere voorwaardes deur die motorhandelaars, laat die SAID hierdie praktyk toe. In hierdie mini-verhandeling word die vereistes wat in die Handleiding vervat is teen die agtergrond van die Wet op Mededinging en die praktiese voordele daarvan bespreek. Die gevolgtrekking is dat die motorvoertuigindustrie tevrede is met die uitreiking van die Handleiding vir motorhandelaars ongeag die feit dat sekere sleutel aspekte nie in die Handleiding voldoende toegelig word nie. Die motorindustrie het die aanname gemaak dat SAID redelikerwys opgetree het deur die Handleiding uit te reik en sal daarom nie verwag dat die industrie van enige ander wetgewing sal afwyk nie, insluitende die Wet op Mededinging. As die SAID nie tevrede is met hierdie interpretasie nie sal dit beteken dat die Handleiding aangepas sal moet word om ander relevante terminologieë soos “toelaatbare afslag” beter te omskryf en te verduidelik. 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: Coventry, MA 2011, A critical analysis of the VAT implications of over-allowances in the South African motor retail industry, MCom dissertation, University of Pretoria, Pretoria, viewed yymmdd < http://upetd.up.ac.za/thesis/available/etd-03092012-112915 / > F12/4/77/gm / Dissertation (MCom)--University of Pretoria, 2012. / Taxation / unrestricted
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The effectiveness of the South African double taxation relief provisions for South African companies investing in other African estatesDe Souza Drummond, Elizabeth Lucy 29 July 2013 (has links)
South Africa has expressed its desire to be the gateway for investment into Africa. With its residence-based tax system which taxes the worldwide income of its tax residents, South African companies will be open to double taxation where the investee country claims jurisdiction to tax income generated from within its borders. In addition, other provisions in the South African tax legislation increase the possibility of double taxation by including the income of foreign subsidiaries. Two such examples are the definition of a tax resident, which includes foreign subsidiaries that are effectively managed by their holding companies in South Africa, and the anti-avoidance measures, such as the controlled foreign company provisions, which impute the income of a foreign subsidiary to the South African investment company. Many South African companies have chosen to route their investments in African countries through foreign subsidiaries. Besides having a more investor-friendly tax regime, these countries offer more favourable relief from double taxation, both unilaterally and by means of their network of tax treaties. South Africa has identified some of its shortcomings. It has introduced concessionary tax provisions for locally based headquarter companies that invest abroad. It recognises the high cost of doing business in Africa due to the fact that many African countries impose withholding taxes on several types of income even though they may not be from a local source. Therefore, South Africa is granting tax rebates for foreign withholding taxes paid on service fees charged to foreign entities despite the income being derived from a South African source. Both these measures reduce double taxation but, are they sufficient to encourage direct investment from South Africa into other African countries? This study seeks to evaluate the effectiveness of the South African double taxation relief provisions by using a case study of a South African company that has investments in several African countries. It compares the application of the double taxation relief provisions of South Africa, another African country and a non-African country to the case study. It analyses the outcomes and assesses the effectiveness of South Africa’s current legislation for unilateral tax relief and its tax treaties in minimising double taxation. Finally, it makes some recommendations on possible improvements to the legislation in order to achieve the stated goal of being the financial hub for investment into Africa AFRIKAANS : Suid Afrika het aangedui dat dit die poort vir belegging na Afrika wil wees. Die heffing van belasting op die wêreldwye inkomste van belastingpligtige inwoners stel Suid-Afrikaanse maatskappye egter bloot aan dubbelbelasting indien die land waarin beleggings gemaak word ook aanspraak maak op die reg om inkomste wat in daardie land verdien is, te belas. Sekere bepalings in die Suid-Afrikaanse belastingwetgewing stel belastingbetalers verder bloot aan dubbelbelasting indien die inkomste van buitelandse filiale ook by die inkomste van inwoners ingesluit moet word. Twee sulke voorbeelde sluit die definisie van belastingpligtige inwoner ingevolge waarvan buitelandse filiale wat effektiewelik deur hulle houermaatskappy in Suid-Afrika bestuur word en sekere teenvermydingsmaatstawwe, soos byvoorbeeld die beheerde buitelandse maatskappy bepalings ingevolge waarvan die inkomste van ʼn buitelandse filiaal aan ʼn Suid-Afrikaanse beleggingsmaatskappy toegeskryf word, in. Daar is heelwat Suid-Afrikaanse maatskappye wat verkies om hulle beleggings in Afrika deur middel van filiale wat in ander lande geregistreer is, te hou. Hierdie gekose lande het nie net gunstige belasting instellings bewinde nie maar bied ook meer voordelige verligting van dubbelbelasting, beide eensydig en deur middel van hulle netwerk van belastingooreenkomste, aan. Suid-Afrika het sy tekortkominge geidentifiseer. Voordelige belastingbepalings is geskep vir plaaslike hoofkantoor maatskappye wat beleggings in die buiteland hou. Erkenning is gegee aan die hoë koste om besigheid in Afrika te doen as gevolg van die feit dat menige Afrika-lande belasting op verskeie tipe inkomste weerhou selfs as die oorsprong van die inkomste nie vanuit daardie lande kom nie. Suid-Afrika is gewillig om belastingkortings vir die buitelandse belasting so weerhou toe te staan ten spyte daarvan dat die oorsprong van die inkomste in Suid-Afrika is. Beide die maatstawwe is gemik op tot die vermindering van dubbelbelasting, maar is dit voldoende om direkte beleggings vanaf Suid-Afrika in ander Afrika-lande aan te moedig? Die doelwit van hierdie studie is om te bepaal hoe effektief die Suid-Afrikaanse bepalings wat gemik is om dubbelbelasting te verhoed deur middel van ‘n gevallestudie van ʼn Suid-Afrikaanse maatskappy wat meervoudige beleggings in verskeie Afrika-lande het. Die studie vergelyk die toepassing van die vermindering van dubbelbelastingbepalings van Suid-Afrika, ʼn ander Afrika-land en ʼn nie-Afrika-land. Die resultate word geanaliseer en die effektiwiteit van die huidige wetgewing vir eensydige verligting van dubbelbelasting en die huidige belastingooreenkomste om dubbelbelasting te verminder, word beraam. Ten slotte, die studie beoog ook om aanbevelings wat dalk die wetgewing kan verbeter ten einde die gewensde doelwit om Suid Afrika die finansiële poort vir beleggings in Afrika te bereik, te maak. / Dissertation (MCom)--University of Pretoria, 2012. / Taxation / unrestricted
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Exercise compliance and health outcome in a chronic disease management programmeDu Plessis, Riana 07 October 2010 (has links)
In the latter part of the 20th century chronic diseases, especially cardio vascular-related diseases (CVDs) and Type 2 diabetes mellitus (DM) seemed to have emerged as substantial problems. This can be seen in the prevalence and the cost of CVDs in South Africa and worldwide. It was predicted that by the year 2030 more people would be dying from CVDs than from Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/Aids). The reasons for the occurrence of CVDs are linked to biological (i.e. hypertension, hyperlipidemia, obesity, insulin resistance, etc), psychological (i.e. emotional stress), and behavioural or lifestyle risk factors. It is known that physical exercise can aid in the treatment of CVDs. Institutions such as the American College of Sports Medicine (ACSM) recommended an exercise frequency of three times per week for 20 minutes. According to literature, a third of patients in exercise studies do not comply with their exercise protocol, and after three to six months, 50 percent will drop out of organised training groups. Less than a third of South Africans complied with exercising 30 minutes a day on most days of the week. Thus, there has been much interest among health-care providers to manage exercise compliance. Exercise compliance is a complex construct, and thus in the present study the role that behavioural patterns play was also investigated via psychological behavioural models. The major objectives of the study were the following: <ul> <li> Firstly, to determine if exercise compliance or non-compliance had an influence on shifts measured in the clinical parameters (i.e. blood pressure, blood lipid levels, blood glucose levels, body mass index, body fat percentage and cardiac risk percentage) over time.</li> <li> Secondly, to determine whether there were any correlation between the psychological behavioural models and the exercise compliance of the members over the course of the Best Med/Access Health-Disease Management Programme (BM/AH-DM Programme).</li></ul> In the present study, a retrospective data analysis was done on data collected from Best Med Medical Aid members (n = 400) who participated in a chronic disease management programme for three and a half years. The inclusion criteria for participation on the programme were the presence of one or more of the following CVDs namely: hypercholesterolemia, hypertension and DM. The members’ clinical parameters (height, body weight, body fat percentage, blood pressure, finger-prick non-fasting (random) blood cholesterol level, finger-prick non-fasting (random) blood glucose, sub-maximal V02 fitness test) were measured every three months. After a baseline assessment was done, an exercise programme was given to each member and a norm of exercising twice a week was prescribed. If members adhered to the norm they were considered compliant and if they did not adhere to the norm, they were considered as being non-compliant. Their exercise compliance, and relevant clinical parameters were measured over 30 months, although data analysis was only a reflection of the first 12 months’ data. At the beginning of the BM/AH-DM Programme the members’ Level of Readiness (LOR) to make a lifestyle change was measured via a questionnaire and by the end of the programme they completed an Implicit Theory Scale (ITS) questionnaire. Descriptive statistics (means, standard deviation) were used to determine the entire groups’ compliance, and to divide the group into compliant and noncompliant groups. The T-test or the Mann-Whitney Test (an equivalent nonparametric technique) was applied to determine significant differences between groups. Thus did the clinical parameters measured over time (baseline to 3 months, baseline to 6 months and baseline to 12 months), change more in the compliant than in the non-compliant group? And were there correlations between psychological questionnaires answers and the two exercise groups? The results indicated that the group’s exercise compliance trend decreased drastically over time. Statistical significant decreases were demonstrated in systolic (p = 0.007) and diastolic (p = 0.012) blood pressure, BMI (p = 0.072 and p = 0.0003), cardiac risk percentage (p = 0.003), and body weight (p = 0.003 and p = 0.0000). All of these decreases were seen in the exercise compliant group. There were no statistical correlations between the psychological questionnaires and the exercise groups. Limitations were the quality of the clinical data, the exercise compliance data that deteriorated over time, and the LOR and ITS questionnaires was neither valid nor reliable tools in making predictions regarding exercise behaviour/compliance. For future research it is recommended that measurements of blood pressure and cholesterol be done more thoroughly, and dietary fat intake must be monitored. A valid and reliable cardiac risk tool, LOR and ITS questionnaires must be designed. AFRIKAANS : Die voorkoms en kosteïmplikasies van kroniese siektetoestande in Suid–Afrika en wêreldwyd, het in die laaste gedeelte van die 20ste eeu ‘n wesenlike probleem geword. Kardiovaskulêre (KVS) siektes en tipe 2 diabetes mellitus (DM) is veral voorbeelde van sulke siektetoestande. Daar is voorspel dat in die jaar 2030, meer mense wêreldwyd aan KVS sal doodgaan, as aan Menslike Immuniteitsgebrekvirus/Verworwe Immuniteitsgebreksindroom (MIV/Vigs). Die risikofaktore wat met die oorsake van KVS geassosieer word, is die volgende: <ul> <li> Biologiese (met inbegrip van hipertensie, insulienweerstandigheid, hoë bloedcholesteroltellings, ens)</li> <li> Sielkundige (bv emosionele spanning) • Risikofaktore wat verband hou met lewenstyl.</li></ul> Literatuur bevestig dat fisiese oefening help om KVS en diabetes mellitus te behandel. Die American College of Sports Medicine (ACSM) het ‘n oefenriglyn van drie maal per week vir 20 minute lank as ‘n minimumfrekwensie daargestel. Volgens literatuur oefen ‘n derde van pasiënte wat deelneem aan oefeningnavorsingsstudies nie volgens die riglyne wat gestel word nie en binne die eerste drie tot ses maande sal 50% van die pasiënte ophou oefen. Navorsing wat op die Suid-Afrikaanse bevolking gedoen is, toon dat minder as ‘n derde 30 minute lank op meeste dae van die week oefen. Dus is die belangstelling van gesondheidsterapeute rakende die bestuur van gereelde oefeningdeelname geprikkel. Gereelde oefeningdeelname sluit ook die rol van gedragspatrone in en dus is sielkundige gedragsmodelle gebruik om dit ook in die huidige studie te ondersoek. Copyright / Dissertation (MA)--University of Pretoria, 2009 / Biokinetics, Sport and Leisure Sciences / unrestricted
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