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Strengthening primary care for diabetes and hypertension in Eswatini : study protocol for a nationwide cluster-randomized controlled trial
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Diabetes and hypertension are increasingly important population health challenges in Eswatini. Prior to this project, healthcare for these conditions was primarily provided through physician-led teams at tertiary care facilities and accessed by only a small fraction of people living with diabetes or hypertension. This trial tests and evaluates two community-based healthcare service models implemented at the national level, which involve health care personnel at primary care facilities and utilize the country's public sector community health worker cadre (the rural health motivators [RHMs]) to help generate demand for care.MethodsThis study is a cluster-randomized controlled trial with two treatment arms and one control arm. The unit of randomization is a primary healthcare facility along with all RHMs (and their corresponding service areas) assigned to the facility. A total of 84 primary healthcare facilities were randomized in a 1:1:1 ratio to the three study arms. The first treatment arm implements differentiated service delivery (DSD) models at the clinic and community levels with the objective of improving treatment uptake and adherence among clients with diabetes or hypertension. In the second treatment arm, community distribution points (CDPs), which previously targeted clients living with human immunodeficiency virus, extend their services to clients with diabetes or hypertension by allowing them to pick up medications and obtain routine nurse-led follow-up visits in their community rather than at the healthcare facility. In both treatment arms, RHMs visit households regularly, screen clients at risk, provide personalized counseling, and refer clients to either primary care clinics or the nearest CDP. In the control arm, primary care clinics provide diabetes and hypertension care services but without the involvement of RHMs and the implementation of DSD models or CDPs. The primary endpoints are mean glycated hemoglobin (HbA1c) and systolic blood pressure among adults aged 40 years and older living with diabetes or hypertension, respectively. These endpoints will be assessed through a household survey in the RHM service areas. In addition to the health impact evaluation, we will conduct studies on cost-effectiveness, syndemics, and the intervention's implementation processes.DiscussionThis study has the ambition to assist the Eswatini government in selecting the most effective delivery model for diabetes and hypertension care. The evidence generated with this national-level cluster-randomized controlled trial may also prove useful to policy makers in the wider Sub-Saharan African region.Trial registrationNCT04183413. Trial registration date: December 3, 2019
Towards sustainability : tracking carbon footprint trends at Ezemvelo KZN Wildlife
No full textCarbon footprint assessment is important to combat global warming and promote sustainability. Globally, organizations committed to biodiversity conservation are essential for maintaining ecosystems and the people who inhabit them. Nonetheless, these organizations produce a carbon footprint due to their operating operations. Hence, this study aimed to assess the specific carbon footprint of the Ezemvelo KZN Wildlife (EKZNW) to improve its understanding of its environmental implications and encourage sustainable behaviors within its particular missions. Using the greenhouse gas protocol corporate accounting and reporting standard as a guide, the study methodology examines greenhouse gas emissions from direct (Scope 1) and indirect (Scopes 2 and 3) sources related to Ezemvelo wildlife activities over five years (2014/2015--2018/2019). The results show that 34,016.62 tons of carbon dioxide equivalent (tCO2e) are emitted on average each year. The majority of these emissions are caused by Scope 2 electricity consumption, which accounts for 23,475.82 tCO2e, and Scope 1 emissions, which account for 7,826.20 tCO2e. Furthermore, there was a noticeable difference in emissions between the reserves, with the Imfolozi Game Reserve having the highest emissions. The findings of this study direct EKZNW toward ecologically conscious behaviors by acting as a catalyst for educated decision-making. The insight gained paves the way for proactive steps to lower carbon emissions, coordinating conservation efforts with more general goals of sustainability and climate resilience
Business intelligence adoption among small apparel retailers in KwaZulu-Natal
No full textBusiness intelligence (BI) can assist businesses with the analysis of information to make better decisions to improve business performance; however, a lack of research with respect to the adoption of BI tools specifically in the SMME apparel sector has been observed. Developments in information technology (IT) have led to an increase in competitiveness among providers, resulting in a plethora of offerings for customers to choose from. As such, businesses are operating in evolving and complex environments where business intelligence systems (BIS) have become essential. The aim of this study was to establish the factors that influence the adoption of BI by micro-small apparel retailers in KwaZulu-Natal. The study was a cross-sectional survey that sampled 132 apparel business owners who were selected using purposive sampling. A survey questionnaire was used to collect the data. The data was analyzed using the Statistical Package for Social Sciences (SPSS) Version 13.0. This study found that the main inhibitors to the adoption of BI systems among small apparel retailers are cost-related. However, an interesting finding was that although cost had a negative relationship to adoption in the results, most of the respondents still indicated that they were able to make financial plans to adopt BI. The study recommends that small apparel business owners prioritize the adoption of BI as a tool for business operations. The adoption of such tools would have a net positive effect on the operations of such businesses
Identifying obstacles to evaluating business intelligence in micro-small apparel enterprises : a case study in Durban, South Africa
No full textThe escalating financial burdens faced by the Small Medium and Micro Enterprise (SMME) sector necessitate a perpetual pursuit of enhanced managerial efficacy. For enhanced financial management, client relationship management and inventory control, it is necessary for businesses to utilise various technologies and methodologies. One approach involves the utilisation of business analytical technologies, such as Business Intelligence (BI). Business Intelligence (BI) serves as a valuable tool for enterprises, aiding in the examination and interpretation of data to facilitate informed decision-making processes aimed at enhancing overall business efficacy. The eThekwini region encompasses a significant presence of micro-small enterprises within the apparel manufacturing and retail sector. The primary aim of this research was to identify and analyse the many issues that hinder the evaluation of business intelligence (BI) in micro-small apparel enterprises located in Durban, a city in Kwa-Zulu Natal, South Africa. A cross-sectional quantitative study was undertaken to examine a cohort of 161 small apparel business owners. The participants were chosen through the utilisation of a judgemental sampling technique. The data was gathered through the utilisation of anonymous questionnaires. The data was analysed by utilising multiple linear regression analysis to determine the characteristics that hinder the evaluation of business intelligence (BI) in the small apparel industry. The study employs the Technology-Organisation-Environment (TOE) framework as its conceptual framework. The researcher identified several obstacles that hinder the evaluation of business intelligence in micro-small textile enterprises in South Africa. These factors include perceived relative advantage, cost, organisational data environment, organizational decision-making culture, and external support. However, there are numerous governmental institutions that are intended to provide support for micro-small companies. Therefore, it is recommended that these institutions establish training initiatives aimed at educating apparel SMMEs on BI. The implementation of target-driven training has the potential to significantly contribute to the achievement of vision 2030 for fostering the growth of small, medium, and micro enterprises (SMMEs) to enhance the South African economy
Effect of working capital management on financial performance of a state-owned enterprise in South Africa
No full textSouth Africa’s state-owned enterprises (SOEs) have reportedly found it difficult to conserve their financial position in order to improve financial performance. Working capital management (WCM) is a significant component of financial management practices by which firms can be measured and improve financial performance. The study aims to examine the employees’ perceptions of the effect of WCM on financial performance of an SOE in South Africa. Cross-sectional, quantitative research and questionnaire approaches were used to collect data from 51 respondents. The study identified the gaps in cash management. The regression coefficient suggests that there is a strong causal relationship between WCM and financial performance of the firm (r=0.597; p<0.001). The F test indicates that the relationship is statistically significant (p<0.001). It was found that review of WCM accounts for 35.7% (R2 = 0.357) of the variance in finance performance F (1, 49) = 27.1560, p<.000 and it (review of WCM) is also a significant predictor of financial performance, where the relationship was positive (β = 0.597, p<.001). The study recommends that the SOE considers WCM as a tool for its economic growth
Galaxy rotation curves in superfluid vacuum theory
No full textLogarithmic superfluid theory of physical vacuum suggests that gravity has a multiple-scale structure, where one can recognize sub-Newtonian, Newtonian, logarithmic, linear and quadratic (de Sitter) terms in the induced space–time metric and effective potential. To test the theory’s predictions on a galactic scale, we apply best-fitting procedures to the rotation curve data obtained from 15 galaxies by the HI Nearby Galaxy Survey, assuming their stellar disk’s parameters to be fixed to the mean values measured using photometric methods. Although the fitting results seem to be sensitive to the stellar disk model chosen, they correspond closely with the observational data, even for those galaxies for which the rotation velocity profiles do not have flat regions
Kink solutions in logarithmic scalar field theory : excitation spectra, scattering, and decay of bions
No full textWe consider the (1+1)-dimensional Lorentz-symmetric field-theoretic model
with logarithmic potential having a Mexican-hat form with two local minima
similar to that of the quartic Higgs potential in conventional electroweak
theory with spontaneous symmetry breaking and mass generation. We demonstrate
that this model allows topological solutions -- kinks. We analyze the kink
excitation spectrum, and show that it does not contain any vibrational modes.
We also study the scattering dynamics of kinks for a wide range of initial
velocities. The critical value of the initial velocity occurs in kink-antikink
collisions, which thus differentiates two regimes. Below this value, we observe
the capture of kinks and their fast annihilation; while above this value, the
kinks bounce off and escape to spatial infinities. Numerical studies show no
resonance phenomena in the kink-antikink scattering
Superfluid vacuum theory and deformed dispersion relations
No full textUsing the logarithmic superfluid model of physical vacuum, one can formulate an essentially quantum post-relativistic theory, which successfully recovers Einstein’s theory of relativity in low-momenta limit, but otherwise has different foundations and predictions. We present an analytical example of the dispersion relation and show that it should have a Landau form which ensures the suppression of dissipative fluctuations. We show that in the low-momentum sector of the theory, a dispersion relation becomes relativistic with small deformations, such that a photon acquires effective mass, but a much more complex picture arises at large momenta
Low back pain as an occupational risk among supermarket cashiers in KwaZulu-Natal, South Africa
No full textBackground: Work-related low back pain (LBP) has received growing attention, especially
regarding the effect it has on work productivity and activities of daily living (ADL). Super
market cashiers are at high risk of LBP due to maintaining awkward postures for prolonged
periods.
Objectives: To investigate the prevalence and intensity of LBP among supermarket cashiers
in KwaZulu-Natal, South Africa, and to identify occupational and non-occupational risk
factors for LBP.
Methods: Supermarket cashiers from 12 conveniently selected stores of a major South
African supermarket franchise were included in this cross-sectional study. Questionnaires
were administered in October and November 2018. Mean LBP disability scores were used as
a measure of pain intensity experienced during various activities. Univariate analysis of vari
ance (ANOVA) was used to measure the effect size of different variables on the LBP intensity
score. The associations between LBP and both occupational and non-occupational factors
were assessed using Fischer’s exact test and forward stepwise logistic regression analysis.
Results: One hundred and forty-six cashiers participated in the study. Most of the partici
pants reported having minimal LBP (n = 132, 90.4%), indicating that they could cope with
most living activities. Based on the mean disability scores, only the effect size of age was
large. The odds of having LBP were associated with age 30 years and older (p = 0.001), race
other than black African (p = 0.037), and working for more than 10 hours a day (p = 0.039).
Conclusion: Reporting of LBP was common among the supermarket cashiers in this study.
Older workers are at a higher risk of having LBP, which may be exacerbated by long working
hours. Workplace interventions such as ergonomic programmes, structured and defined
working hours, and home-based interventions such as exercise therapy, should be imple
mented
Higher education and its contribution to economies of African countries : move towards competence-based and skills demand-driven standards in collaboration with industry
No full textThis study explores the ecosystemic impacts of higher education (HE) on the economies of African countries, emphasizing the need for competence-based, and skills-demand-driven standards in collaboration with industry. HE is vital for equipping individuals with essential knowledge and skills for socio-economic transformation. However, in Africa, this role has weakened, with industry assuming a leading position. Curricula in HE institutions are slow to adapt to the skills needed by industries, leading to a range of challenges such as outdated curriculum delivery, desertion of technical and vocational training, inadequate research resources, insufficient collaboration frameworks between HE and industries, minimal support for entrepreneurship, and poor infrastructure. Aligning HE curricula with industry skills requirements is crucial for enhancing African economic development and competitiveness. Unfortunately, there is a notable lack of partnerships and practical mechanisms for curriculum integration among African HE institutions, which results in graduates possessing skills that do not meet industry demands. This paper reviews the extensive literature on HE's role in African economies, advocating for in-depth collaboration between HE and industry in order to tackle skills mismatches. Accordingly, establishing a healthy partnership between HE institutions and industries could facilitate work-integrated learning, encourage industry-led curriculum development, and prepare graduates with applicable skills and relevant knowledge for the job market. Thus, developing a proactive framework that can facilitate and enforce collaboration between higher education and industries could be critical in addressing the challenges faced by African economic development