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An analysis into the relationship between tourism development and economic growth in South Africa amid the COVID-19 pandemic
Get PDFThe introduction of the COVID-19 and the start of the global pandemic dealt a blow to the global economy and resulted in the death of millions across the globe. The rapid spread of the COVID-19 virus not only put a severe strain on the healthcare sector but also on the global economy. The introduction of the pandemic saw the global economy experience a combination of both demand and supply shocks. The spread of COVID-19 and the measures put in place to contain it directly impacted production and disrupted global value chains. The pandemic additionally caused a reduction in global demand. With many economies across the globe experiencing contractions and economic growth experiencing a slowdown during the time, many governments sought the means to alleviate the effects of the pandemic while also sparking economic growth. This paper argues that the tourism sector potentially holds the key to igniting economic growth and uses South Africa as a case study to do so. It has previously been argued that the tourism industry is one that holds the potential to be a great contributor to economic growth and this has been somewhat supported within the literature. Following the hypothesis that tourism can be a great contributor to economic growth, this paper assesses how policies aimed at improving South Africa's Tourism industry amid the pandemic affects economic growth. The results of this study reveal that the policies associated with the Tourism Sector Recovery Plan manage to generate positive economic benefits within the tourism sector which then generated positive spillover effects throughout the economy as a whole, with output from each sector increasing as well as employment increasing. The implementation of each of the three policies namely, Corporate Support, Business Enablement and Tourist Experience resulted in a positive direct impact, indirect impact, and induced effects on the tourism industry and the economy as a whole. Moreover, each of the three policies under the Tourism Sector Recovery Plan managed to stimulate demand for commodities throughout the economy while creating jobs and resulted in increased output levels in the tourism sector and the economy. However, the percentage in output was modest. Despite the modest changes in output, many small to medium enterprises within the tourism sector and the economy at large greatly benefitted from the introduction of each policy
ETD: Case mix and coding error detection in Western Cape healthcare facilities
No full textSouth Africa has a two-tier structure for the delivery of hospital and health care services: the public sector and the private sector. The private sector is known for having better service quality, cost, and data management. The Clinton Health Access Initiative (CHAI) has been supporting the first steps towards Diagnosis Related Group (DRG) to categorise hospitalisation costs in the public health facilities in South Africa. DRG's are widely used in the private sector for active cost management. Additionally, an issue was raised by the on-site audit clinical coding report of the public hospitals managed by the Western Cape Department of Health, which must be addressed. This dissertation applies case mix adjustment for hospitals in the Western Cape based on DRG weights from the private sector. DRG weights represent the average resources required to care for cases in that particular DRG, relative to the average resources used to treat cases in all DRGs. This is then compared to another metric that uses actual length of stay data from the public sector, which will act as a proxy for resource utilisation (Fetter, Shin, Freeman, Averill, and Thompson, 1980). The objective is to find out if case mix will help in identifying hospitals which take on highly resource intensive procedures on average. The potential of using case mix in the public sector will allow for optimized resourcing. The second part looks at generating classification models that will be used to flag diagnosis coding errors by healthcare staff in the Western Cape. Patient-level data was used which includes length of stay, procedures, and cost centre. Models trained to classify diagnosis include neural networks, multinomial logistic regression, random forests, SMOTE (Synthetic Minority Over-sampling Technique), and finally an ensemble of the top 3 models using majority voting. These models are able to handle multiple response categories. The aim of the error detection model will be to increase data quality in the public sector. The results showed that the DRG weights from the private sector might not be appropriate for the public health sector. Next, it was shown that the best predictive model for diagnosis was a random forest with an accuracy of 57% on the unseen test dataset. Lastly, through the explanatory analysis, this dissertation identified both qualitative and quantitative relationships in the data that could open up avenues for more research and development. These results can be used to help stakeholders make informed decisions and improve data quality in the public sector
Mechanisms of atopic dermatitis and allergy development in African (AmaXhosa) children between 12-36 months of age
Get PDFAtopic dermatitis is a highly complex multifactorial inflammatory skin disease that disproportionately affects children and has increased rapidly during recent years in South Africa. Current data suggest that the changing diversity of environmental exposures, diet, and lifestyle factors across African societies might provide unique disease promoting effects in populations where a low risk of developing AD and allergic disease was previously documented. To identify novel immunological endotypes and responsible environmental exposures in South African children with AD, we collected data on environmental exposures, lifestyle factors, and conducted clinical assessments in 217 children (Urban AD, n=56; Rural AD, n=60; Urban Healthy Controls, n=49; Rural Healthy Controls, n=52). Detailed immunological analysis (cell counts, cytokine levels, serology and RNA-Seq) were performed on 152 of these children. Participants were from the same ethno-linguistic AmaXhosa background. Strong evidence for persistent TH2 responses (elevated circulating eosinophils, allergen-specific IgE, TARC, MCP-4, and IL-16 levels) with reduced TH17 responses (IL-17A and IL-23 levels) were seen in South African children with AD regardless of whether they lived in urban or rural communities. However, independent of AD, a vast array of circulating immune mediators (including proinflammatory cytokines, chemokines, soluble adhesion molecules and growth factors) were associated with early life nutrition, medications, animal exposures, indoor environment, sunlight exposure and household size. RNA sequencing of peripheral blood mononuclear cells corroborated the TH2 cytokine profile identified. Furthermore, multiple immunological pathways (including immunoregulatory factors, aryl hydrocarbon receptor and G protein-coupled receptors) were discovered to be differentially expressed in rural and urban children, regardless of atopic status. The study results address knowledge gaps on the immune interactions between atopic dermatitis and environmental exposures in South African children and clarify population-specific AD endotypes. Overall, protective exposures (e.g., animal) and potentially detrimental (e.g., pollutant) exposures shape the early life innate and adaptive immune response. Lastly, when immune-mediated disorders do occur in children, living environment is worth considering and its effects on background immune profile that can potentially interact with immune-targeting therapies and consequently impact treatment efficacy
The scientific and sociocultural value of citizen science
Get PDFAt its best, conservation science serves as an interface between multiple disciplines, bringing together innovation and insight from the humanities, arts, business and economics, health, natural and social sciences to address the most pressing challenges facing the planet and its biodiversity. Conservation is also unique in its ability to transcend the academic. Subdisciplines such as biological citizen science involve non-academic individuals in data collection and as co-creators in research design and implementation. There is wide theoretical appeal to these initiatives, as they may simultaneously generate enough data for fine-scale biological monitoring and, through community engagement, promote the democratic generation and dissemination of knowledge. However, despite their potential within both the scientific and sociocultural realms, the regional scale impacts of citizen science initiatives in continental Africa remain poorly understood. Studying local citizen science initiatives affords opportunities to gain an understanding of their impact; within the African context, citizen science participants contribute to African Bird Atlas Projects in fifteen countries by compiling comprehensive avian species checklists at a fine geographic scale. Two projects are of particular interest for analysis: The Second Southern African Bird Atlas Project (SABAP2), and the Nigerian Bird Atlas Project (NiBAP). SABAP2 occupies a unique position as a long-term African citizen science project with ample data for statistical analyses. NiBAP employs an innovative grassroots approach to atlasing and hosts an enthusiastic and growing community of citizen science participants. In addition to impressive datasets, 'atlasers' in South Africa and Nigeria are a wealth of information regarding the personal- and community-level values surrounding participation and motivation. Furthermore, variations in project structure and cultural contexts between SABAP2 and NiBAP allow for some comparison of the values of participants between subprojects and contribute towards an understanding of the broader values of African Bird Atlas Project participants. In light of this potential, this thesis aims to examine the scientific and sociocultural contributions of SABAP2 and NiBAP to the work of conservation—namely achieving fine-scale species monitoring and advancing the democratic generation and sharing of scientific knowledge—within continental Africa. I examine the quality of data collected by a community of SABAP2 atlasers in Hessequa, South Africa, and assess their value in monitoring species population trends. I ask 1. Does systematic atlasing improve the temporal quality of atlas data for monitoring? and 2. Can these data detect trends in species populations and inform local response? Then, I explore values to nature expressed by atlasers and non-citizen science participants in both Hessequa, South Africa, and Jos, Nigeria. I ask the following two questions: 1. Does the type and frequency of values (instrumental, intrinsic, and relational) differ between participants and non-participants, and between cultural contexts?, and 2. what relational values (if any) are linked to participant motivation? Results demonstrate the ability of SABAP2 data to support biodiversity monitoring at a local scale, and show the potential for democratising research by including participants in data collection, analysis and application. The study of values and motivations emphasises the particular importance of relational values in connection with participant motivations and human-nature relationships broadly. Overall, the findings of this research demonstrate the ability of African Bird Atlas Projects and similar initiatives to meet the challenges of contemporary conservation, and lay a foundation for future research into the practical application of co-created monitoring schemes and incorporating values into the design of both citizen science projects and conservation intervention
Co-morbid cardiometabolic diseases among people living with HIV/AIDS in Cameroon
Get PDFBackground and Purpose: To investigate the effects and mediators of HIV infection and related treatment on the prevalence and incidence of cardiometabolic diseases (CMDs) including hypertension, type 2 diabetes mellitus (T2D), and obesity in people living with HIV (PLWH) in Cameroon. Additionally, three systematic reviews were conducted to assess the global prevalence of hypertension, T2D, and obesity among ART-naïve PLWH; and to evaluate the methodological approaches to mediation analysis and handling missing data in studies on CMDs in PLWH. Methods: The study utilized data from 14,279 PLWH enrolled in the Cameroon arm of the International Epidemiology Databases to Evaluate AIDS (IeDEA). Analyses comprised multinomial and binomial logistic regressions, causal mediation analysis, and Cox proportional hazards regression. Systematic reviews were conducted by searching multiple databases, pooling the prevalence rates of hypertension, T2D, and obesity using a random-effects meta-analysis. Results: In Cameroon, significant determinants of hypertension and T2D included age over 50 years, male sex, and overweight/obesity. ART use was linked to lower odds of T2D, and BMI partially mediated the relationship between ART use and hypertension. Prevalence of overweight/obesity was 37.7% overall, and higher in females. Older age, female sex, and higher CD4 count were associated with increased odds of overweight/obesity, while current smoking was linked to reduced odds. The incidence rate of hypertension was 121.1 per 1,000 person-years, with older age, male sex, and overweight/obesity as predictors. ART exposure reduced the risk of hypertension. The systematic review with meta-analysis revealed a global prevalence of 13.6% for hypertension, 4.0% for T2D, and 12.3% for obesity among ART-naïve PLWH. The review on mediation analysis showed increased adoption of casual mediation frameworks but inconsistencies in reporting. The missing data review revealed both under reporting of missing data and how it was handled. Conclusion: The burden of CMDs in PLWH is significant, driven mainly by established risk factors. emphasizing the need for integrated healthcare strategies that address both HIV/AIDS and CMDs. It also underscores the importance of methodological rigor, which significantly impacts the interpretation and reliability of results
An exploration of female offenders' yoga experience in Worcester's correctional centre
Get PDFIn South Africa, there has been a lack of research on female offenders' incarceration experience. Research shows that female offenders are a vulnerable group with specific needs that deserve specialised treatment options. Yoga has become very popular as a holistic rehabilitation programme within many correctional centres, including South Africa. Yoga has become a symbolic resource that offenders can use to make sense of their incarceration experience and re(construct) their self-perception, while still incorporating ‘peace-making-mechanisms' that fit into correctional centres' agenda. This study explores the impact of a yoga programme called ‘The Freedom Project' in Worcester Correctional Centre. The objective of this study was to determine whether or not yoga could transform female offenders' behavioural patterns and help them cope with the pains of imprisonment. A qualitative research design allowed for rich accounts of the participants' yoga experience. The interviews were conducted with a panel of nine female offenders who participated in the yoga programme. While the design of the study makes it difficult to generalize the findings to the wider offending population, the participants nonetheless offered evidence that yoga is a life-affirming experience with a range of transformational consequences. The results of the study showed that the yoga programme allows for an open framework, and freedom of self-exploration and meets the goals of being a more women-centred and holistic approach within prison reform
The development of a retrospective neonatal clinical audit tool for transfers: a modified delphi study
Get PDFBackground: Due to limited availability of neonatal and paediatric specialist centres in South Africa, interfacility transfer of high-risk neonates is frequently required in order to access appropriate care, often across vast distances. Due to limited Emergency Medical Services (EMS) capacity, the majority of inter-facility transfers are undertaken by general EMS, as opposed to dedicated neonatal transfer teams. Many high-risk neonates are therefore transported by EMS personnel with very limited neonatal care experience and knowledge, as well as limited equipment capabilities. Interfacility transport of at-risk neonates is directly associated with increased mortality and morbidity, and numerous studies have described higher rates of adverse events and mortality particularly when neonates are transported by non-specialist transfer teams. There is currently no standardised clinical audit tool to assess the risks and clinical quality of care provided during neonatal retrieval. An established clinical audit tool that could be used in further research to establish the safety of neonatal transfers in the South African context would provide clinical value. Aim: The aim of this study is to develop a retrospective neonatal clinical quality audit tool according to which the safety of neonatal transfers in South Africa can be assessed. Methods: This study was conducted in two phases using multiple methods. First, a scoping review was conducted to identify normal clinical parameters, aspects of neonatal patient safety, adverse events, and quality of care during transport. Multiple databases were searched using an a priori developed search strategy. Titles and abstracts were screened for relevance, before selecting full text articles for review and data extraction. Data from articles were collated into an extraction matrix, summarise and reported narratively. The results of the scoping review informed the first round survey tool of a modified Delphi study – the second phase of this study. A modified Delphi study was undertaken to obtain a list of consensus-based items that could be collated into a clinical quality audit tool for neonatal transfers in South Africa. Experts in neonatal retrieval, neonatology, paediatrics and intensive care were approached and asked to indicate whether they agreed with each item. They were also requested to provide free-text feedback on items. Consensus was set at 75%. Two rounds of the modified Delphi study were undertaken. Results: For the scoping review, a total of 866 articles were identified initially. Following application of eligibility criteria, ten articles were finally included in the scoping review. Most articles originated from high-income countries and were observational in nature. However, six categories of adverse events were identified (clinical events, equipment events, medical errors, patient safety risks, quality of care, and other). Specific adverse events and clinical parameters were also extracted and combined to form the first-round survey tool of a modified Delphi study. In round one 28 respondents consented to form part of the expert panel, and completed the Delphi questionnaire, yielding a response rate of 70%. In round one the expert panel consisted of neonatologists (n=4), paediatric intensivists (n=2), paediatricians (n=2), other medical doctor working in the field of retrieval (n=1) registered nurses (n=3), and advanced life support (ALS) paramedics or emergency care practitioners (ECPs) (n=16). In round two, 19 experts consented and completed the Delphi questionnaire, yielding an attrition rate of 33%. In round two the expert panel consisted of neonatologists (n=1), paediatric intensivists (n=2), other medical doctor working in the field of retrieval (n=1), registered nurses (n=3), and advanced life support (ALS) paramedic or emergency care practitioners (ECPs) (n=12). Following two rounds of consensus, a 41-item 6 retrospective audit tool was developed and organised into five sections: Airway, respiratory and ventilation, haemodynamic events, medication events, or general and logistic events. Additionally, each item was allocated a severity rating or range requiring additional information gathering to ascertain the severity of the event. Conclusion: This study enabled the development of a consensus-based retrospective clinical audit tool that can be utilised to assess the quality of care of neonatal transfers performed in South Africa. The clinical audit tool was developed through literature-based evidence, and validated for content through the contributions of a national multidisciplinary panel of experts in the field of neonatal retrieval. The utilisation of the audit tool in the framework of a robust clinical governance system, would enable reporting of adverse events according to standardised parameters. This would contribute to the identification of risk factors and knowledge gaps in neonatal transfer teams, which could assist in the development of improvement projects. In addition, it can be used in before-and after interventional studies, to assess for the effectiveness of the intervention in the setting of improved patient safety. Through utilisation in future research projects it can assist in the development of standardised guidelines for clinical care standards during neonatal transfer
Determination and analysis of land deformation in major landslide areas in Kenya using geospatial techniques: A case study of Murang a and Nyeri counties
No full textThis thesis presents a meticulous investigation into determining and analysing land deformation in the prominent landslide-prone areas of Kenya, specifically within the central highlands encompassing Murang'a and Nyeri counties. The research employs a spectrum of areal deformation methods, including Small Baseline Sub-set (SBAS) Interferometric Synthetic Aperture RADAR (InSAR) from processed ALOS PALSAR and Sentinel-1 datasets, Gravity Recovery and Climate Experi-ment (GRACE/GRACE-FO) satellite data, and hydrological modelling data from the Global Land Data Assimilation System (GLDAS), to elucidate and dissect the time series deformation trends prevalent in the study area. A multi-faceted methodology was employed to investigate the deformation induced by landslides in the study area. Various datasets were harnessed to provide a compre-hensive understanding of the phenomena. Satellite gravimetry data from GRACE and GRACE-FO, in conjunction with hydrological modelled data from GLDAS, delivered valuable insights into vertical deformation rates at selected points of inter-est. These points were identified through InSAR processing using RADAR imagery from Sentinel-1 and ALOS PALSAR, which offered finer spatial resolution. While Sentinel-1 imagery was acquired and processed in both the ascending and descend-ing nodes, ALOS PALSAR imagery was solely processed in the ascending node due to dataset availability constraints. In the Sentinel-1 SBAS analysis, temporal and perpendicular baselines were constrained to 60 days and approximately 200 metres, respectively. For ALOS PALSAR imagery, the temporal and perpendicular baselines were constrained to 875 days and 2500 metres, respectively. Furthermore, to discern the most probable causes of deformation, a range of factors were considered. These encompassed precipitation data, which was critical in as- sessing the role of rainfall in triggering landslides. Additionally, geomorphological factors, such as slope, aspect, and surface roughness, extracted from SRTM Arcsec- ond DEM were incorporated. Land Use Land Cover data spanning from 1973 to 2022 were analysed to understand the impact of human activities and land cover changes on the occurrence of landslides. The amalgamation of these datasets and analyses facilitated a comprehensive examination of the factors contributing to deformation and landslides in the study area. Results reveal distinctive deformation patterns over the study area from various datasets. Sentinel-1 Ascending imagery indicates varying uplift rates from 19.8 to 189.3 mm/yr and varying subsidence rates from -169.4 to -63.8 mm/yr over the area Iv of study. Sentinel-1 Descending data corroborates these trends, with varying uplift rates from 59.5 to 209.9 mm/yr, and varying subsidence rates from -200.8 to -90.7 mm/yr. Results from the ALOS PALSAR dataset contributes additional complexity but with lower values than Sentinel -1 data, probably due to data gaps. The rates of uplift observed from ALOS PALSAR dataset vary from 16.5 to 100.8 mm/yr, while the rate of subsidence vary from -715.9 to -60.8 mm/yr. GRACE/GRACE-FO and GLDAS datasets provide smaller values of uplift and subsidence at a larger scale, devoid of large deformations at smaller scales captured by InSAR. Among investigated possible causes of landslides, geomorphological factors emerge as prominent influencers of deformation patterns, while changes in land use and land cover, high and extreme rainfall events and lithology and soil properties also play pivotal roles. Crucially, this thesis underscores that landslides and deformation are rarely attributed to single causative agents; rather, they result from an intricate interplay of various factors, often occurring simultaneously
MARKET INTEGRATION BETWEEN CRYPTOCURRENCY AND TECHNOLOGY INDICES
Get PDFThis study investigates the relationship between cryptocurrency and semiconductor/technology indices for the period 2018(Q2) to 2023(Q2). The relationship was explored through use of correlation, Johansen cointegration, and Granger pairwise causality testing. The findings are key for determining the diversification benefits of cryptocurrencies and further examining the direction of causal relationships. The correlation results indicated weak to moderate correlation between cryptocurrencies and equity indices. The findings indicated that cryptocurrencies are cointegrated among each other and a bilateral causal relationship is present. Cointegration was found between cryptocurrencies and the Philadelphia Stock Exchange Semiconductor index, NASDAQ, S&P500, and Dow Jones. The NASDAQ, S&P500 and Dow Jones were found to cause crypto prices movements, but the reverse was true – for the latter two – when Binance was removed from the index. These findings suggest a lack of diversification benefits of cryptocurrencies compared to the semiconductor/technology sector. Investors should be careful when including cryptocurrencies into their portfolios as to not overexpose themselves to risk pervasive in both markets
Design and Development of a Portable Multi-user Medical Grade Oxygen Concentrator
Get PDFIntroduction: The COVID-19 pandemic has increased the demand for high-flow oxygen concentrators, particularly in resource-limited areas. There is a pressing need for an innovative, high-flow, multi-user oxygen concentrator using local materials to address this healthcare challenge. Methods: The study focused on creating a portable, medical-grade oxygen concentrator using the Skarstrom pressure swing adsorption cycle, incorporating a silica gel drying tank and 13X Zeolite adsorption beds. Critical parameters such as compressor output pressure, heat exchanger efficiency, systemic pressure losses, air separation duration, and peak flow rate of oxygen-enriched air were extensively analysed through experiments and simulations. Results: The concentrator achieved a 21 litres per minute flow rate with over 85% oxygen purity at 100kPa. Cost efficiency was ensured using local components. Enhancements included an orifice in the sieve beds to increase back pressure and equalisation valves to reduce cyclic duration, thus improving efficiency. An internal spacer in the sieve bed was designed to optimise airflow and oxygen production. Discussion: This device addresses the scarcity of oxygen in resource-constrained regions like sub-Saharan Africa. It aims to reduce the cost of oxygen therapy (currently R20.00-R40.00 per patient per day) and should be expanded and implemented in similar settings. Future efforts should focus on integrating advanced functionalities such as remote monitoring for operational efficacy and safety. Conclusion: This multi-user oxygen concentrator represents a significant advancement in medical technology, especially for resource-limited settings. It provides a high oxygen flow rate and concentration at an optimised cost, addressing the oxygen shortage exacerbated by the pandemic. Its innovative design utilises local materials and features that enhance efficiency, offering a cost-effective solution and a model for future healthcare technologies. Future developments should aim to extend this technology's reach, ensure adaptability, and continuously improve its features for enhanced efficacy and safety. This contributes to more equitable medical resource distribution in areas with significant resource constraints