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Knowledge and practices of primary eye care among non-ophthalmic nurses working in Kweneng East District Clinics, Botswana.
Full text linkBackground: Primary eye care (PEC) is important in preventing and managing eye conditions, particularly in rural areas where access to specialized care is limited. Aim and Setting: The study aim was to assess the primary eye care knowledge and practices of non-ophthalmic nurses in Kweneng East District clinics, Botswana. Methodology: A descriptive cross-sectional study design, with quantitative methods of analysis was used. The study sample was selected using both systematic and convenience sampling methods. A self-administered questionnaire was developed and provided to 195 consenting non-ophthalmic nurses from 36 clinics. The completed questionnaires were collected, data captured and analyzed using both descriptive and inferential statistical methods. Results: 39.1% of all participants scored correct responses on knowledge of identification of common eye conditions. The overall proportion of correct management responses for all participants was 37.9%, while for correct PEC practices the proportion was 56.3%. The study found a significant relationship between professions (P=0.04), years of experience (P=0.03), and primary care training (P=0.05) and knowledge of primary eye care conditions. Conclusion The study found that knowledge, management, and practices of primary eye care was inadequate among non-ophthalmic nurses in the Kweneng East District. There is a need for continuous professional development, refresher training, and curriculum adjustments in nurses' education to enhance PEC services in the region. Contribution: The study will inform how to improve PEC services in the country
Is manufacturing the silver bullet engine of growth for South Africa?
Full text linkThis research paper is inspired by the developing country trap of South Africa, evidenced by over a decade of high inequality, high unemployment and stagnating economic growth. At the peak of industrialisation developed countries sustained economic growth, while developing countries experienced pathological premature de-industrialisation marked by economies that fail to realise their full potential resource utilisation, employment and growth. The Kaldorian framework established the manufacturing sector as serving a critical role in inducing sustainable growth of the economy. This framework articulated the manufacturing sector's dynamism and tradability, positioning it ahead of other sectors to drive their growth and facilitate intersectoral relationships. In addition, the success of the South Asian economy propelled by modern Information and Communication Technology (ICT) services-led growth has inspired a debate on the services sector as an alternative to manufacturing engine of growth. Within this context, this research examines re-industrialisation of the economy as a means to attain rapid growth. The research also examined value added and labour productivity (LP) growth per sector from 1991 to 2021, which are proxies of economic performance. Using the vector autoregression (VAR) multivariate ordinary least squares (OLS) model, the Granger causality was examined to test for intersectoral relationships amongst the sectors. Contrary to Kaldor's theory of the growth pulling effect of the manufacturing sector (Kaldor,1966,1968), the data analysis suggested that the manufacturing sector does not Granger cause growth of other sectors. Instead, a unidirectional relationship was observed wherein the growth in value of services and agriculture Granger cause manufacturing. Additionally, productivity in services, agriculture and the non-manufacturing Granger cause the LP of the manufacturing sector. The bidirectional relationship between the manufacturing sector and the services sector, confirmed by research on the export of intermediate goods, forms a strong evidence basis for the implementation of a targeted multi sub-sector investment policy. Moreover, long-term equilibrium was established for value added and LP growth per sector. The findings showed that manufacturing share of employment drives an increase in gross private savings (GPS) and TFP in the long term. Insignificant impact in the short term for total factor productivity (TFP) was observed. In the long term, periodic convergence to equilibrium for the GPS was observed, while a stable long-run relationship was established for TFP
Artificial neural networks and the cross-section of equity returns: identifying nonlinear opportunities on the Johannesburg Stock Exchange
Full text linkThis study investigates the potential of Artificial Neural Networks (ANNs) to forecast stock returns on the Johannesburg Stock Exchange (JSE) using fundamental and technical factors. The optimal neural network architecture is explored, considering varying model depths and node counts. The activation function, training algorithm, learning rate, number of epochs, batch size, and loss function are kept constant across architectures. The findings suggest that portfolios constructed from ANN forecasts have the potential to outperform an equal-weighted benchmark. Model performance depends on network architecture, with a three hidden layer model with 64 nodes in the first hidden layer yielding the best results. Addition of further hidden layers or nodes is found to reduce model generalization, mainly due to overfitting, while less complex models are found to underfit. Models with a reduced variables set outperformed, confirming the importance of feature selection. While ANNs are found to underperform a linear model, the top performing ANN outperforms on risk-adjusted metrics over the test period, suggesting benefits to non-linear return forecasting on the JSE. However, with no clear relationship between in-sample and test period performance across architectures, this superior performance could be data specific, highlighting challenges in selecting an optimal model ex-ante. On the other hand, limitations in feature selection and training likely constrained model performance, with potential to improve generalization. This study provides a foundation for further research into return forecasting with ANNs on the JSE, contributing to the growing field of artificial intelligence and machine learning in finance. Future research could further optimize model hyperparameters, improve feature selection, and account for the time-varying nature of features
Synoptic weather systems over Antarctic sea ice: understanding the link between extratropical cyclones and extreme variability in Antarctic sea-ice concentration
Full text linkExtratropical cyclones and atmospheric rivers are key drivers in transporting extreme heat and moisture to the poles. Previous studies have shown that extratropical cyclones can promote change in sea-ice concentration at a synoptic scale, however, the extreme variability in synoptic-scale sea-ice concentration and the extent to which it is engendered by cyclones has not yet been studied. This thesis seeks to quantify extreme variability of Antarctic sea-ice concentration, and assess the role that cyclones and other synoptic features play over the extended Austral winter period (May - September). This is achieved through the use of reanalyses data (based on the European Centre for Medium-Range Weather Forecasts; ERA-Interim and ERA5) and output from a climate model tuned for representing Southern Hemisphere processes, whose atmospheric component is the Conformal Cubic Atmospheric Model (CCAM). To accomplish this, this study is formulated about three main research aims. The first aim is to test whether circulation patterns associated with cyclones or atmospheric rivers may routinely lead to the presence of unusually warm, moist air masses over ice-covered regions. This thesis points to a strong association between atmospheric rivers and extreme moisture anomalies found over the Antarctic sea-ice environment, while extreme temperature anomalies over Antarctic sea ice are relatively linked with intense cyclones. More specifically, approximately 27% of intense Southern Ocean cyclones and 20% of ARs occur in the vicinity of extreme temperature anomalies, while 12% of intense cyclones and 46% of ARs occur in the vicinity of extreme moisture anomalies. These results, showing that extratropical cyclones play a role in weather circulations over the sea-ice environment, lead to this study's second research aim: to identify extreme variability in Antarctic sea-ice concentration and investigate the extent to which it may be caused by extratropical cyclones. Atmospheric reanalysis and a cyclone-tracking algorithm were used to characterize sea-ice variability and cyclone activity in different Southern Ocean sectors: the King Haakon VII, East Antarctic, Ross/Amundsen, Bellingshausen, and Weddell sectors. The proportion of extreme sea-ice variability engendered by cyclones of different intensities was quantified, and reveals a significant link between variability in winter sea-ice concentration and: (i) all cyclones in the Ross/Amundsen sector; (ii) all but the weakest cyclones in the King Haakon VII, East Antarctic, and Bellingshausen sectors; and (iii) all but the most intense cyclones in the Weddell sector. More generally, roughly 30 - 40% of the extreme sea-ice variability is caused by extratropical cyclones within all regions apart from the Weddell sector, where extreme sea-ice variability is more closely connected to weaker cyclones. Finally, the third research aim is to explore the relationship between cyclones and synoptic-scale variability in sea-ice concentration in a climate model, CCAM, where simulated sea-ice variability is dynamically driven by the model atmosphere (unlike the second research aim which used the ERA5 reanalysis product). Whilst the use of ERA5 revealed an emphasis on intense cyclones engendering extreme variability, the results derived from the analysis using CCAM showed that extreme variability in sea-ice concentration only depended on cyclone intensity in the East Antarctic sector. In the other sectors, on average, cyclones of all intensities (apart from the 10% weakest ones) had a significant link to extreme variability in sea-ice concentration at a synoptic scale. Moreover, using CCAM, the total extreme variability in sea-ice concentration linked to cyclones increased to roughly 40 - 60%. In conclusion, the Antarctic atmosphere-ice interplay over the extended Austral winter period is complex, but the results presented in this thesis shed new light on the relationship between synoptic features over the sea-ice environment, and the role cyclones play in engendering extreme variability in sea-ice concentration. As the atmosphere continues to change with global warming, the results presented in this thesis serve as a foundation for further investigations into how the Antarctic sea-ice environment may also change over tim
Prehospital pain management in mass casualty scenarios: a scoping review
Full text linkBackground: Effective pain management in mass casualty scenarios (MCS) is critical due to the high prevalence of severe pain and its association with increased morbidity. MCS, defined as incidents where patient care needs exceed available resources, pose unique challenges for prehospital care providers. This scoping review aims to synthesize existing evidence on prehospital pain management strategies, identify gaps, and inform future research and policy development. Methods: Following PRISMA-ScR guidelines, a comprehensive literature search was conducted across major medical databases (PubMed/MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science) and grey literature repositories, covering studies published from 2005 to 2024. Inclusion criteria encompassed English-language studies addressing prehospital pain management in MCS, reporting on pain assessment, pharmacological/non-pharmacological interventions, or resource limitations. Excluded were hospital-based studies and non-evidence-based publications. Data were charted and synthesized into thematic categories. Results: The review included 22 studies, highlighting significant gaps in standardised pain management protocols and documentation. Key findings revealed underutilisation of analgesics, with only 3.2% of MCS cases receiving pain medication. Ketamine and regional anaesthesia emerged as viable options, particularly in resource-limited settings, while novel delivery systems like autoinjectors showed promise. Major barriers included resource shortages, provider training gaps, and limited integration of pain management in triage systems. Conclusion: Prehospital pain management in MCS requires scalable, evidence-based protocols emphasising early analgesic administration, particularly ketamine and multimodal strategies. Systemic barriers, including inadequate training and documentation, hinder effective implementation. Addressing these gaps through improved training, simplified protocols, and better resource planning can enhance patient outcomes and disaster response capabilities. Future research should prioritise paediatric care and standardised outcome measures to further refine pain management in diverse MCS contexts
Mothering a neonate/young infant with feeding and swallowing difficulties: barriers, facilitators, and support
Full text linkBackground: The anticipation of a new infant is typically characterised by feelings of joy, excitement, and hopeful expectations for the future. However, these positive emotions can be altered when mothers are faced with the reality of caring for an ill, hospitalised infant, particularly one with feeding and swallowing difficulties (FSD). FSD in infants significantly impacts not only the infant's health and development but also the mother's emotional and psychological wellbeing. Caring for neonates and young infants with FSD in hospital settings presents unique challenges, especially in resource-constrained environments like South Africa. Limited research exists exploring mothering an infant with FSD, highlighting a gap in understanding the maternal experience. Research aim and objective: This research aimed to explore ‘mothering' a neonate/young infant with FSD in a South African healthcare context. To achieve the aim, mothers' experiences of barriers, facilitators and support needs within a neonatal healthcare context are described. Methods: A qualitative, exploratory case study design was used. Semi-structured interviews were conducted with mothers whose infants presented with FSD in neonatal/infant units. A total of seven mothers were interviewed (n=7) whose infants (aged from birth to three months) were admitted at either Mowbray Maternity Hospital or Red Cross War Memorial Children's Hospital, for a minimum of seven days. The data were thematically analysed, allowing the emergence of key themes that represent maternal experiences. Results: The overarching theme of ‘mothering' emerged, encapsulated by the quote: “Baby comes first in everything.” Six distinct themes then emerged from the overarching theme, represented by relevant quotes from the participants: “Information helps”; “They help a lot”, “It's not home”, “Everything on you”, “It affects me emotionally”, “Not on your own” and lastly, “It's my baby”. These themes emerged from the accounts of the mothers, which were then described in terms of barriers such as separation and burden of care, facilitators such as information and maternal strength, and support structures. The findings outline the dedication and resilience of mothers when navigating the challenges of caring for infants with FSD, while also highlighting the intricate and often dichotomous realities they face in the hospital setting. Conclusion: This study highlights the complex experiences of mothers caring for infants with FSD in South African healthcare settings. While deeply committed to their infants' wellbeing and feeding, mothers face barriers such as inadequate communication, separation, and limited support, which heighten stress and guilt. Facilitators, including clear communication, practical support from healthcare professionals, and peer and family networks empower mothers and alleviate their emotional burden. A collective effort by healthcare professionals, families, and hospital systems is essential to ensure care that supports both the recovery of infants and the wellbeing of their mothers. These insights can inform healthcare practices and future research in similar resource-limited settings
Exploring the property development risks in modern South Africa and their impact on property development projects.
No full textProperty development in South Africa is inherently capital intensive and risky but has the potential to reward brave developers through high returns. The risks that property developers face is multi-layered and unique to each project, requiring discernment on the part of the developer. However, projects likely to yield high returns are fairly easy to identify, and mitigation strategies can be implemented to ensure that property development projects are completed within cost and time limitations, and to a high standard. The intention of this study was to identify the property development risks in modern South Africa and the impact of these risks on property development viability, and to make recommendations on how identifiable risks may be mitigated in the property development sector. Property professionals were selected as participants in this study. These included senior executives in some of South Africa's largest development companies, people in the property finance industry, and those who deal daily with property development projects. All participants were interviewed one-on-one. This strategy yielded insight into the research questions, since participants were able to draw directly from their personal experiences. Responses in the interviews answered all the research questions and thus informed the recommendations made in this study. The study revealed that the main risks to property development projects in South Africa are political and socio-economic factors, municipal inefficiencies, social unrest, increases in municipal costs and materials, and lack of consistent power supply from Eskom. Increased capital costs in property development projects have reduced returns for property developers, forcing many to consider investing outside of South Africa. This was identified as the main impact of the risks on property development projects. The recommendations made in this study to mitigate property development risks are government subsidies for bulk infrastructure, fixing of material prices, greater engagement of all stakeholders in the property development process, ensuring that construction contractors have the required capacity and skills, greater use of technology in property development projects, and municipal rebates for property developers, in order to incentivise development. It is also recommended that in all property development projects, developers factor in potential cost increases
‘Exploring the potential of the law of delict in South Africa to address climate harms caused by private actors'
No full textThis dissertation explores whether South Africa's law of delict, which allows individuals to claim damages for harm caused by the wrongful and culpable conduct of another, can evolve to address climate harms caused by private actors in the country. It does so in response to carbon-emitting companies (polluters) being identified, through advancing climate science, as primary contributors to climate change due to their sizable historic and cumulative greenhouse gas (GHG) emissions, meanwhile, marginalized and vulnerable communities with negligible emissions, particularly in the Global South, are disproportionately affected, suffering widespread climate harm that infringes many mutually reinforcing human rights and compounds existing systemic socio-economic inequalities. In South Africa, this reality threatens the Constitution's transformative goals to achieve social justice. The Constitution mandates that common law evolve in line with its transformative objectives, values, and the rights enshrined in the Bill of Rights. In light of this constitutional directive and the grave social injustices worsened by climate harm, this research explores whether delict, and its elements (damage, conduct, fault, causation, wrongfulness), can evolve to enable those most affected by climate harm to pursue claims for damages against polluters responsible for substantial historical and ongoing emissions. The research incorporates novel insights from notable foreign strategic private climate litigation concerning polluters' accountability for climate harm, including cases such as Re Greenpeace Southeast Asia, Lliuya v. RWE, Smith v Fonterra and Milieudefensie v. Royal Dutch Shell, and is framed by Murcott's theory of transformative environmental constitutionalism (TEC). Murcott explains that the transformative project's aspiration of social justice cannot be realised without implementing environmentalism, because well-functioning socio-ecological systems (dependent on a stable climate) is a pre-condition for human flourishing. Thus, TEC urges courts to embrace a socio-ecological systems perspective and justice-oriented framing of disputes concerning converging socio-ecological crises, considering how these disputes reflect intersecting social, environmental, and climate injustices to ensure that the adjudication process is responsive to the realities faced by particularly vulnerable groups and environments in the Anthropocene. Therefore, the research, adopting this framing, investigates the potential of delict to evolve along transformative constitutional lines, incorporating environmentalism through TEC, to adequately address climate harm and its underlying systemic causes and impacts, including interlocking social, environmental, and climate injustices
A quantitative characterization of tuberculin skin test indurations using hyperspectral imaging to enable automated latent tuberculosis screening
No full textAn estimated two billion people globally are believed to harbour latent tuberculosis infection (LTBI), which is a precursor to active tuberculosis (TB). Immunocompromising conditions, such as human immunodeficiency virus (HIV) infection, diabetes, chronic renal failure, and chemotherapy, are associated with the risk of progression from LTBI to active TB. People with LTBI represent a major reservoir for new active TB cases. Thus, the detection and management of LTBI is key to the world health organisation (WHO) goal to reduce TB incidence globally by 90% by the year 2035. The tuberculin skin test (TST) is the most widely used test for LTBI in low- and middle-income countries (LMICs). It involves the injection of tuberculin into the forearm skin of a participant. An induration – a subdermal lump – forms at the injection site 48 – 72 hours after the test. Using the Mantoux reading method, diagnosis is obtained using a pen and a ruler to measure the induration diameter and comparing it with consensus thresholds. Mantoux readings are subject to inter- and intra-observer subjective variations in readings. The manual nature of this method precludes any repeat analysis or validation after the 72-hour expiry of an induration. Furthermore, the Mantoux method does not provide any significant insight on the pathophysiology of indurations which could improve current understanding of LTBI. Recent applications of hyperspectral imaging (HSI) in other dermatological applications provides evidence of its viability in addressing the shortcomings of the TST. Thus, the aim of this research was to develop and validate an HSI-based approach for quantitative characterisation of TST indurations that can aid the diagnosis of LTBI. This aim was achieved through three objectives. The first objective was to develop and validate an HSI protocol for reliable and reproducible acquisition of spectral signatures of TST injection sites. An enclosure was designed to implement and validate the developed protocol. The validation was done using a range of light source types and ten participants with a wide range of skin tones. The effect of light source type on skin spectral signature was investigated to reveal factors that impact spectral reproducibility. The validated imaging protocol was utilized in the second objective to reliably capture the hyperspectral images of 70 participants (38 from South Africa and 32 from Vietnam). The objective was to develop and validate an HSI-model that can generate precise diameter estimations of TST indurations that are comparable to traditional Mantoux readings. Principal component analysis was utilized to transform the hyperspectral images (or hypercubes) into principal components and generate induration segmentation masks. Precise induration diameter estimations, which were comparable to corresponding Mantoux readings, were generated from the masks. An intraclass correlation coefficient score of 0.80, a median difference in reading of 0.29 mm, and a Pearson's correlation of 0.664 (p<0.001), was achieved between the HSI-based diameter estimations and corresponding Mantoux readings. This metrics surpassed the performance of similar studies. This is evidence that HSI can mitigate the subjectivity of the Mantoux method by generating comparable but more precise diameter estimations of TST indurations. The induration hypercubes and segmentation masks were utilized in the third objective to develop and validate an HSI framework capable of identifying biomarkers that accurately and consistently characterise TST indurations. The framework enabled the generation of chromophore maps from induration hypercubes. Radiomics was applied on the chromophore maps to generate a set of features. The features were used, in conjunction with a support vector machine model, to rank the ability of the generated chromophore maps to predict LTBI. Ferritin, water, and oxyhaemoglobin maps were identified as the most predictive chromophore maps for LTBI. The predictive accuracies for TST diagnosis using these chromophores were 90.0% across all participants, and 96.0% and 96.7% for the South African and Vietnamese participants. This is evidence that HSI can noninvasively facilitate the generation of chromophore biomarkers to characters TST indurations – a first of its kind in literature. These findings present HSI as a potential modality for mitigating the subjectivity of the Mantoux method and identifying digital biomarkers that noninvasively offer insights into induration pathophysiology. The potential impact of this research is improved health outcome for at-risk TBgroups via enhanced LTBI screening accuracy and precision
IFRS 17 and its effects on financial performance and the statement of financial position: a comparative analysis of the South African insurance companies including banks
No full textIn the South African market, insurance plays an important role by enabling businesses to manage risks they could not manage individually, while also reinvesting some of the premiums in South Africa to drive economic growth and create jobs. For individuals, insurance provides important protection for valuable assets. The introduction of International Financial Reporting Standards (IFRS) 17 by the International Accounting Standards Board (IASB), effective from 1 January 2023, resulted in a change in the measurement requirements of insurance contracts compared to IFRS 4. This study investigated the impact of the transition from IFRS 4 to IFRS 17 on the financial performance and the statement of financial position of insurance service providers in South Africa. This study, grounded in the Rational Choice Theory, the Liquidity Preference Theory and the Pecking Order Theory, analysed twelve insurance service providers licensed by the FSCA and operating in South Africa. The results of the study revealed that IFRS 17 did not have a statistically significant impact on the financial performance of these insurance service providers. However, the statement of financial position experienced a statistically significant decrease in reported total assets and total liabilities, while the changes to the reported equity and insurance liabilities were not found to be statistically significant. The decrease in the reported total assets and liabilities was noted to be due to the change in the measurement requirements for insurance contracts accounting such as the treatment of acquisition costs. Under IFRS 4, insurers were allowed to capitalise and defer acquisition costs as deferred acquisition cost assets on the balance sheet. The DAC asset was then expensed to the income statement over the life of the insurance contract. However, under IFRS 17, this DAC is included as part of the insurance service liability resulting in a decrease in reported total assets and total liabilities. Furthermore, the reported total assets and liabilities are impacted by the requirement to discount these balances using the IFRS 17 risk-adjusted approaches as well as the changes to the underlying assumption used in the measurement calculations. This analysis and results may assist regulators, investors and other users of financial statements to better understand the impact IFRS 17 has had on the financial performance of insurance service providers in South Africa