Farmers' perceptions of the lay health worker on farms in the Western Cape, South Africa

This study is focussed on farms situated in the Boland health district of the Cape Winelands, South Africa. The aim was to explore, understand, and describe the perceptions of farmers of having a trained lay health worker (LHW) on the farm. A qualitative study design was applied. Data were collected during six in-depth interviews and two focus group discussions with participating farmers. The results show that farmers remained positive about the concept of having a trained LHW on the farm, but became frustrated with the lack of recognition of their and the LHWs' contribution by the public health service. Farmers who are willing to participate and remain active are key to introducing a farm community-based LHW intervention. Sustainable LHW interventions are dependent on public health sector support and recognition of all role players.Farm Management,

The PRIME model: a management solution in academic medicine

Background: The Health Sector and the rendering of health services in South Africa have undergone substantial adjustment since the political change in 1994, filtering through to academic medicine. The managerial responsibilities of the Heads of Department at Medical Schools multiplied. In order to improve their management skills; decrease their frustration; and optimally utilize the highly skilled person-power available, this study endeavoured to establish a management model for use by experienced as well as new Heads of Department in a School of Medicine, measured against the background of good management practices. Methods: A descriptive, explanatory survey comprising a literature review, a questionnaire survey and a Delphi process was performed. The literature study covered a few aspects, including assessing the possible needs of Heads of Department, exploring factors impacting on their environment, as well as the difference between management and leadership, and the difference between various management models that may be applicable to management in an academic setting such as a Medical School. The second part of the empirical study was the Delphi process, which involved six experts from the areas of management, health management, and education. A quantitative approach with open-ended questions was followed, focusing on measurement of experts' feelings about these areas. Results: Heads of Department are appointed in the academic environment with the primary focus on their educational achievements. Throughout the process, it was demonstrated that this is still relevant and needs to be part of the appointment process of Heads of Department in a School of Medicine. It was also indicated throughout this study that there is an increasing expectation from Heads of Department to take on sole responsibility for the management of their departments. In view of these developments, it was important to consider assisting them through establishing a management model, thus empowering them to manage their departments in the future. The main findings from the questionnaire to Heads of Department, the Delphi technique, and information obtained via the literature study enabled the researcher to make a recommendation on a management model that is flexible, individualized, relevant, and adaptable for Heads of Department at the School of Medicine at the UFS. Conclusion: Resources and services are spread thin by challenges from political changes and other challenges such as the AIDS pandemic and tuberculosis. Emphasis has shifted from hospital-based care to primary health care adding another dimension to the management strategy of academic institutions. A management model, the PRIME model, was developed that is simple, flexible, allows for individuality, integration and efficiency and should be easy to implement. It adds quality to management tasks but also to lives. It embraces multi-tasking and still focuses on the key position of the leader, while allowing growth and development of new talent. It is adjustable and should be the model of choice to address the ever changing environment of health management. It is recommended that a future study be conducted evaluating the possibility of utilising the principles of the PRIME model in other Medical Schools in South Africa in order to assist them with the managerial problems they might be experiencing. South African Family Practice Vol. 50 (1) 2008: pp. 71-71

Magnetoplasmon excitations in an array of periodically modulated quantum wires

Motivated by the recent experiment of Hochgraefe et al., we have investigated the magnetoplasmon excitations in a periodic array of quantum wires with a periodic modulation along the wire direction. The equilibrium and dynamic properties of the system are treated self-consistently within the Thomas-Fermi-Dirac-von Weizsaecker approximation. A calculation of the dynamical response of the system to a far-infrared radiation field reveals a resonant anticrossing between the Kohn mode and a finite-wavevector longitudinal excitation which is induced by the density modulation along the wires. Our theoretical calculations are found to be in excellent agreement with experiment.Comment: 9 pages, 8 figure

Perceptions of service quality by clients and contact-personnel in the South African retail banking sector

A superior level of service quality is an important objective for South African retail banks. This paper investigates the levels of perceived service quality among 550 clients and 559 branch contactpersonnel in retail banks in central South Africa. The perceptions are compared, and the findings reveal that clients regard the levels of service they receive to be better than what the contact-personnel perceive them to be experiencing. The physical branch environment was also shown to be an important dimension of perceived service quality among retail clients. A cluster analysis identified three market segments to use when adopting marketing strategies, and the demographic factors of age, race and geographical location were found to be important considerations when developing these marketing strategies. An explicit micro-market marketing approach that is flexible and tailor-made to the characteristics of the location of the branch is a recommendation of the paper.Key words: service quality, central South Africa, retail bank

Bayesian testing for process capability indices

Process capability indices have been widely used in the manufacturing industry. They measure the ability of a manufacturing process to produce items that meet certain specifications. A capability index relates the voice of the customer (specification limits) to the voice of the process. There is a need to understand and interpret process capability indices. Most of the existing work in this area has been devoted to classical frequentist large sample theory. An alternative approach to the problem of making inference about capability indices is the Bayesian approach. In this paper a Bayesian version of Tukey’s method is used for constructing simultaneous credibility intervals for all pairwise differences. A Bayesian procedure for testing all possible contrasts is also given. The problem of selecting the best supplier(s) has received considerable attention in the literature, but mainly from a classical frequentist point of view. A Bayesian simulation procedure is also illustrated to find the best supplier or group of suppliers.This method seems much easier to perform than the Monte Carlo integration method given in Wu, Shiau, Pearn and Hung (2016). In section 10, a sensitivity analysis regarding the prior choice is considered and in the last section, t-distributed data are analysed

Calibration artefacts in radio interferometry. I. Ghost sources in WSRT data

This work investigates a particular class of artefacts, or ghost sources, in radio interferometric images. Earlier observations with (and simulations of) the Westerbork Synthesis Radio Telescope (WSRT) suggested that these were due to calibration with incomplete sky models. A theoretical framework is derived that validates this suggestion, and provides predictions of ghost formation in a two-source scenario. The predictions are found to accurately match the result of simulations, and qualitatively reproduce the ghosts previously seen in observational data. The theory also provides explanations for many previously puzzling features of these artefacts (regular geometry, PSF-like sidelobes, seeming independence on model flux), and shows that the observed phenomenon of flux suppression affecting unmodelled sources is due to the same mechanism. We demonstrate that this ghost formation mechanism is a fundamental feature of calibration, and exhibits a particularly strong and localized signature due to array redundancy. To some extent this mechanism will affect all observations (including those with non-redundant arrays), though in most cases the ghosts remain hidden below the noise or masked by other instrumental artefacts. The implications of such errors on future deep observations are discussed.Comment: 19 pages, 15 figures, submitted to MNRA

A COMMUNICATIVE APPROACH TO THE TEACIDNG OF LATIN

INTRODUCTION At the University of the Western Cape (UWC) there is a large number of students (about 300) who enrol for the introductory Latin course. Most of these students hope to become lawyers. It is with this in mind that one of the major aims of the UWC Latin course is to enable students to read with comprehension simple Latin texts e.g. 1he Institutes of Gaius, (cf. Kriel 1982). The prescribed handbook is Legal Latin - A Basic Course by Scholtemeijer and Hasse. There are, however, formidable obstacles in the way of enabling students to achieve the aim of reading Latin with confidence. Some of these are constraints faced by most universities, such as not more than 26 weeks of actual teaching time per year, large groups (80-120 students per group), some apathy because Latin is seen as a compulsory requirement, and often a very genuine fear of Latin as a very difficult subject to pass. At UWC yet another factor has become increasingly important over the past few years. A growing percentage of students are studying Latin through the medium of English while English is not their first language. (At the moment we have one: Afrikaans medium group, who are not similarly handicapped). This paper describes how we attempted during 1992 to make learning Latin a meaningful experience for our students; it also draws some conclusions based on the performance of the students and on feedback obtained from them by means of questionnaires about the course. The first section deals with problems generally experienced by students, the second with the methodology adopted to deal with these problems and finally there is an evaluation of the procedure and an indication of the road ahead. Contact time comprised two eighty minute lectures per week dealing with grammar and related experiences, and a weekly tutorial of 40 minutes for which students were divided into groups of approximately 20. There were approximately 15 tutorial groups, and each group maintained their tutor throughout the year. Students were required to write a weekly practical test for which they had to study the grammar and vocabulary introduced during the previous week. They could also practise their vocabulary and paradigms, and later in the year their setwork comprehension, on the CONSENSUS computer programme

Prevalence of a postoperative troponin leak in patients with cardiac risk factors undergoing knee and hip arthroplasty in a South African population

Background. Patients undergoing arthroplasty may have comorbidities that put them at risk of myocardial injury after non-cardiac surgery (MINS). MINS, a new clinical concept that has a different pathophysiology from conventional myocardial infarction, is related to a supply-demand mismatch ischaemia in the perioperative setting. MINS is often a silent event, and the diagnosis relies on cardiac biomarker testing such as troponin T. The incidence is estimated at 40%, with a fourfold increase in morbidity and mortality risk 1 year post surgery.Objectives. To determine the prevalence of postoperative troponin leak in a single-centre arthroplasty unit in patients with various cardiac risk factors undergoing hip or knee arthroplasty and investigate the differences in troponin T levels between comorbidities and different types of arthroplasty, i.e. total hip replacement (THR), total knee replacement (TKR) and neck of femur (NoF) fracture hip replacement.Methods. A prospective, cross-sectional study of patients with one or more cardiac risk factors undergoing replacement surgery was conducted from October 2017 to April 2018. Troponin levels of all included patients were recorded on days 1 and 3 post surgery using a high-sensitivity cardiac troponin T assay (Roche hs-cTnT). A level of >15 ng/L is considered abnormal and termed a positive troponin leak, while >100 ng/L is considered suspected acute coronary syndrome (ACS).Results. One hundred and sixty patients (n=66 THR, n=55 NoF hip replacement, n=39 TKR) were included. Sixty-eight patients (42%) had a positive troponin leak, and in 6 of these cases ACS was suspected. The highest prevalence of troponin leak was recorded in patients undergoing NoF hip replacement (62%), followed by TKR (46%) and then THR (24%). Sixty-two patients (38%) had positive troponin levels on day 1 and 53 patients (33%) had positive levels on day 3. Important patient cardiac risk factors were identified in the presence of a positive troponin leak, with ischaemic heart disease, hypertension, diabetes, renal disease, age >65 years and atrial fibrillation being statistically most likely.Conclusions. Postoperative troponin surveillance is an inexpensive and reliable way to identify patients at risk of MINS and subsequently enhance early detection, medical optimisation and referral strategies. Simple interventions may improve outcomes and contribute to lower ACS rates and the timeous prevention of other complications. The prevalence of MINS in orthopaedic-specific patients in South Africa (SA) and other resource-constrained developing countries is unknown. Our finding of 42% positive troponin leaks raises awareness of this issue, and we recommend routine postoperative troponin surveillance for all arthroplasty units in SA.