The management of minor health ailments by doctors, clinical nurse practitioners and clients at the primary level of care in Cape Town

INTRODUCTION: Community Health Centres (CHCs) are overcrowded. The overcrowding poses a problem to health professionals as they are in charge of screening clients and the management of minor health ailments (MHA) in the primary health care setting. METHODOLOGY: The aim of this study was to describe and compare the perceptions and attitudes of clients presenting with MHA to those of doctors and clinical nurse practitioners (CNPs) (health professionals) at the CHCs regarding the management of MHA. The study was conducted at the four selected CHC in Khayelitsha and Phillipi, Cape Town. Information was collected from 100 clients and 15 health professionals. Data was analysed both qualitatively and quantitatively and the descriptive method was used. RESULTS: All three groups had similar perceptions of what MHAs are and how MHA should be managed. There were different perceptions regarding where these ailments should be managed. The doctors and CNPs were frustrated and felt overburdened by clients presenting with MHA. Doctors were of the opinion that educating clients about the management of these ailments would alleviate their load. CONCLUSION: Health education was identified as a tool that could assist in the situation of managing MHA and as the key underpinning principle for the delivery of comprehensive primary health care (PHC)

The profile of disability grant applicants in Bishop Lavis, Cape Town

Background: Disability grants in South Africa increased from 600 000 in 2000 to almost 1.3 million in 2004. This rise can be attributed to the HIV/AIDS epidemic, South Africa’s high rate of unemployment and possibly an increased awareness of constitutional rights. The Western Cape, which hasa disability prevalence of 3.8%, has also experienced an influx of applications. The study was conducted at Bishop Lavis Community Health Centre (BLCHC) in the Cape Town Metropole, Western Cape.The primary aim of this study was to establish the profile of adults applying for disability grants at Bishop Lavis. The secondary aim was thedetermination of the degree of activity limitation and participation restriction by means of the International Classification of Functioning, Disability and Health (ICF) shortlist of activity and participation domains.Methods: A descriptive study was conducted with emphasis on identifying and quantifying the relevant factors. The population studied included allprospective adult (18–59-year-old females and 18–64-year-old males) disability grant applicants in Bishop Lavis over a two-month period (April–May 2007). A structured, self-compiled questionnaire was administered during face-to-face interviews with applicants. The questionnaire included the demographic details of the applicants, disability/chronic illness/condition, educational level and social/living conditions. The second part of the questionnaire was based on the ICF shortlist of activity and participation.Results: There were 69 respondents over the period of data collection. Of the 69 applicants who participated in the study, 45 (65%) receiveda temporary disability grant, 6 (8%) received a permanent grant and 18 (26%) applications were rejected. The results demonstrated that mostapplicants were females over the age of 50, were poorly educated with chronic medical conditions and were living in formal accommodation withgood basic services but with minimal or no disposable income. The ICF questionnaire responses showed that the majority of respondents had nodifficulty in most domains, except for the general tasks and demands (multiple tasks), mobility (lifting and carrying, fine hand use and walking) and domestic tasks domains, which showed high percentages of severe to complete difficulty. However, further statistical analysis showed no association between degree of difficulty in the above domains and eventual outcome of type of grant received.Conclusions: This study confirmed that unemployment and a lack of income are the factors influencing patients to seek assistance in the formof disability grants. Most applicants had a chronic medical condition and reported functional restrictions but only received a temporary grant. Thismay be an indication that most patients require further evaluation before a final decision can be made. There is a need for a standardised, objectiveassessment tool for disability grant applications. A campaign to educate patients about disability grants could save patients and hospital medicalservices time and money

Factors associated with high school learners' poor performance: a spotlight on mathematics and physical science

This study, using a non-experimental, exploratory and descriptive method, established learners' and educators' views about factors that contribute to poor performance in mathematics and physical science. Participants were purposefully selected from seven schools with poor pass rates in District 3 of Tshwane North. Focused group interviews with ten Grade 11 learners from each school were used as a means to collect data. In addition, one-on-one semistructured interviews were conducted with ten educators from the participating schools. Results indicated that two factors were identifiable. The first identified to have a direct influence related to teaching strategies, content knowledge, motivation, laboratory use, and non-completion of the syllabus in a year. The second factor, associated with indirect influences, was attributed to the role played by parents in their children's education, and general language usage together with its understanding in the two subjects. Recommendations as well as suggestions for further research aimed at addressing the identified factors are advanced. South African Journal of Education Vol. 26(2) 2006: 253–26

Conflict implications of coal mining and environmental pollution in South Africa: Lessons from Niger Delta, Nigeria

Globally, mining and combustion of fossil fuels, especially coal, have resulted in various environmental problems. The adverse effects of these industries on human health, agriculture and the general ecosystem, and how they could result in conf lict, have been widely reported. Firstly, this study examines the current state of environmental pollution at a few places in South Africa, and how it could possibly result in environmental conf lict between the affected communities and the polluting industries. Secondly, using Nigeria as a case study, it suggests pre-emptive measures that can be taken to forestall such conflict. The issues raised in this study are supported by findings from previous studies conducted at Emalahleni, in the Mpumalanga Province of South Africa. This study used a mixed-methods  approach involving interviews with relevant stakeholders and scientific analysis to prove the levels of pollution in the Emalahleni area. The levels of certain air pollutants which are commonly linked with coal combustion and mining activities were assessed at five different schools around mines. Based on these scientific and qualitative results and other issues raised in this study, a number of recommendations are made. It was found that air pollution is a problem which cannot be ignored and immediate action should be taken to avoid future problems.Keywords: Coal mining, industries, pollution, environment, health implications, South Afric

Investigating factors inhibiting the implementation of IQMS in a South African school

After the 1994 elections education reform has been characterized by the introduction of laws and policies, including IQMS, that seek to reconcile post‐apartheid traditions to practices that would address deficiencies borne by the era in the education field. The IQMS is a clear reaction to the autocratic mode of evaluation that operated during the apartheid era and is a major shift from the old paradigm of external evaluators. It was designed to review performance and identify strengths and weaknesses, encouraging personal and professional development, drawing on peer and collegial feedback rather than official Department of Education surveillance. However, recent studies have shown that the IQMS has failed and is failing to achieve what it was intended to achieve. This study examines the reasons for this failure in a secondary school in the Eastern Cape, South Africa. This research is an interpretive case study that uses observation, document analysis and interviews utilising theories of learning organizations, management and leadership. The study reveals that the policy is not applied in the way it was intended and is failing in this regard. The policy process has been bureaucratised and suffers from superficial compliance. The developmental thrust of the policy seems to have been lost. It was also discovered that the involvement of teacher unions has both positively and negatively affected the implementation process and that the support schools receive from the department is not enough to keep the policy alive in schools. This research is likely to benefit school principals, policy makers and implementers, and IQMS coordinators, as it provides clarity on the issues restraining IQMS implementation in schools. The study also demonstrates the need for school principals to consider adopting transformational leadership as a strategy to lead teachers against political influence and expose them to professional development opportunities

Researching the lives of disabled children and young people

Why a Special Issue of Children & Society dedicated to disabled children and young people? The simple answer to that question is ‘because disabled children are children first and foremost’. The vast majority of disabled children and young people in the western world live at home with their families, most attending mainstream schools, and disabled children and young people worldwide have rights to inclusion and equal treatment enshrined in national legislation and international conventions. Yet they often remain left out – from generic children’s research, from policy-making about children’s services and, in their everyday lives, from inclusion in friendship groups and social and sporting activities

Mass Drug Administration and beyond: how can we strengthen health systems to deliver complex interventions to eliminate neglected tropical diseases?

Achieving the 2020 goals for Neglected Tropical Diseases (NTDs) requires scale-up of Mass Drug Administration (MDA) which will require long-term commitment of national and global financing partners, strengthening national capacity and, at the community level, systems to monitor and evaluate activities and impact. For some settings and diseases, MDA is not appropriate and alternative interventions are required. Operational research is necessary to identify how existing MDA networks can deliver this more complex range of interventions equitably. The final stages of the different global programmes to eliminate NTDs require eliminating foci of transmission which are likely to persist in complex and remote rural settings. Operational research is required to identify how current tools and practices might be adapted to locate and eliminate these hard-to-reach foci. Chronic disabilities caused by NTDs will persist after transmission of pathogens ceases. Development and delivery of sustainable services to reduce the NTD-related disability is an urgent public health priority. LSTM and its partners are world leaders in developing and delivering interventions to control vector-borne NTDs and malaria, particularly in hard-to-reach settings in Africa. Our experience, partnerships and research capacity allows us to serve as a hub for developing, supporting, monitoring and evaluating global programmes to eliminate NTDs

Plant Growth and Root Morphology Are Affected by Earthworm-Driven (Eisenia sp.) Changes in Soil Chemico-Physical Properties: a Mesocosm Experiment with Broccoli and Faba Bean

Earthworms are "ecosystem engineers" that improve soil water and nutrient content, soil macroporosity, and aeration, and provide suitable habitats for microbial populations. This study aimed at defining if the presence of epigeic earthworms (Eisenia sp.) affected the growth and development of two plant species (Brassica oleracea and Vicia faba) via the modifications of soil chemico-physical properties. A mesocosm experiment, in which plants were grown outdoors for 4 months with or without earthworms, was performed. The two plant species were selected based on their different habitus and root architecture and morphology. Soil macroporosity (M-soil) and water holding capacity (WHCsoil) were determined. Earthworm-driven bioturbation (B-soil) was measured by filling mesh bags with artificial soil. Earthworm abundance and biomass, together with plant morphometric parameters (root and leaf morphology by imaging and microscope techniques), were measured at the end of the trial. The presence of earthworms increased M-soil (on average +16%) and WHCsoil (on average +9%) and this was accompanied by a remarkable degree of B-soil. In most of the cases, earthworms enhanced plant growth in the two plant species studied, with a significant positive influence on the majority of the shoot and root traits. A significant increase of stomatal density (on average +24%) occurred in the leaves of both the plant species in the presence of earthworms. Our results confirmed the hypothesis that bioturbation by Eisenia sp. had a significant positive effect on plant growth, independently from the plant species cultivated, and that these growth-promoting effects were mediated by changes in soil chemico-physical parameters. By taking into account the essential role of earthworms in maintaining healthy soils and the vegetation they support, soils can become more resilient against environmental perturbations and climate change