A Comparison of Inflation Expectations and Inflation Credibility in South Africa: Results from Survey Data

This paper reports a comparison of South African household inflation expectations and inflation credibility surveys undertaken in 2006 and 2008. The objective is to test for possible feed-through between inflating credibility and inflation expectations. It supplements similar earlier research that focused only on the 2006 survey results. The single most important difference between the survey results of 2006 and 2008 is that female and male respondents reported inflation expectations at the same level in 2006, while female respondents expected higher inflation than male respondents in the 2008 inflation expectations survey. More periodic survey data will be required for developing final conclusions on the possibility of feed-through effects. A very large percentage of respondents in the inflation credibility surveys indicate that they 'don't know' whether the historic rate of inflation is an accurate indication of price increases. It will be necessary to reconsider the structure of credibility surveys to increase the number of respondents providing views on the accuracy of historic inflation data.Inflation; inflation credibility; inflation expecttaions; inflation surveys; multinomial analysis

The ethical and legal concerns of the use of genetically modified (GM) foods in South Africa

A Research Report submitted to the Faculty of Health Science, University of Witwatersrand, in partial fulfilment of the requirements for the Degree of Masters of Science in Medicine in Bioethics and Health Law Johannesburg, 2016Worldwide genetically modified (GM) foods provide one of the major challenges facing the food industry in the twenty-first century. The safety of GM foods are being questioned by consumers, researchers and medical professionals as it is believed that these foods may pose a serious public health risk, especially for the young, aged, pregnant and immuno-compromised persons (Azadi and Ho, 2010). At present the safety of GM foods remains questionable mainly because of insufficient long term scientific data, and the vulnerability of the developing and developed countries to satisfy the food demands of their growing populations. There are already some 800 million people who do not have access to sufficient food to meet their needs. Malnutrition plays a significant role in half the nearly 12 million deaths each year in developing countries, of children under the age of five (Asante, 2008). Therefore, the need for increasing agricultural yields is of urgent concern in the entire developing world. A multitude of reasons are put forward to validate GM food production. The use of GM microbes does not necessarily raise alarms but there are considerable ethical concerns; concerns about “messing with nature”; concerns about safety for human health, and concerns about environmental impact (Racovita, 2013). However, the technology offers opportunities to accelerate the efficiency and extent of further agricultural improvements by the transfer of genes conferring resistance to pests, disease, herbicides and environmental stress, as well as quality traits such as improved post-harvest storage, flavour, enhanced nutritional content and colour (Coles and Ladikas, 2013). The aim of the research project is to raise the ethical, legal and social issues about the use of GM foods in South Africa. The research will also highlight the ongoing debate in the areas of environmental protection, public perceptions and acceptance and ethical concerns.MT201

The myths and realities of Generational Cohort Theory on ICT Integration in Education: A South African Perspective

There is an assumption that the younger cohort of teachers who are considered to be digital natives will be able to integrate technology into their teaching spaces with ease. This study aims to determine if there is a difference between generational cohorts with respect to ICT (Information Communication Technology) integration in classrooms among South African teachers. There is a paucity of research on ICT integration in education with respect to generational cohorts. This study involved a secondary analysis of two primary data sets, which contained qualitative and quantitative data. The quantitative data revealed that there are few statistical differences between the generations with respect to their ICT usage in the classroom. However, the qualitative data revealed that younger cohorts of teachers appear to be highly concerned about classroom management, while a recurring theme amongst all cohorts was the lack of access and time

outcomes of neonates with perinatal asphyxia at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) from 2007-2011

A Research Report submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Medicine in Paediatrics. 8 May 2014Background: Perinatal asphyxia is a significant cause of death and disability. Aim: To determine the outcomes (survival to discharge and morbidity post discharge) of neonates with perinatal asphyxia at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Methods: This was a descriptive retrospective study. Patient information was obtained from the computerised neonatal database of neonates admitted to CMJAH within 24 hours of birth between 1 January 2006 and 31 December 2011 with a birth weight of >1800 grams and a 5 minute Apgar score <6. Results: 450 babies were included in the study; 185 females (41.1%). Mean birth weight was 3034.80 grams (SD 484.936) and mean gestational age was 39.11 weeks (SD 2.2). Most babies were inborn 391/450 (86.9%) and most were delivered by normal vaginal delivery 270/450 (60%). The overall survival was 390/450 (86.6%). There were 42 babies admitted to ICU. The ICU survival was 37/42 (88.1%). Significant predictors of survival were place of birth (p value 0.006), mode of delivery (p value 0.007) and bag mask ventilation at birth (p value 0.040). The duration of stay (p value 0.000) was significantly longer in survivors (6.49 days SD 6.6). The remaining factors were not significantly different between the two groups. The rate of perinatal asphyxia (Apgar score <6) was 4.68 per 1000 live births; while 3.61 per 1000 live births had evidence of hypoxic ischaemic encephalopathy (HIE). Of the 390 babies discharged from CMJAH, 113 had follow up records (28.97%) to a mean corrected age of 5.88 months (SD 5.03). The majority (90/113 – 79.64%) had normal development. Conclusion: i) The high overall survival and survival after ICU admission provides a benchmark for further care. ii) Obtaining adequate data for long term follow up was not possible with the existing resources and surrogate early markers of outcome and / or more resources to ensure accurate follow-up are needed and iii) the high incidence of HIE suggest that a therapeutic hypothermia service including long-term follow-up component would be beneficial

Developing a conceptual model to improve patient experience as a strategy to engage public health sector reform in South Africa.

Doctoral Degree. University of KwaZulu-Natal, Durban.Patient Experience is well recognized in health quality improvement initiatives within developed countries due to the reforms that result thereof. Developing a conceptual model to improve patient experience in South Africa is undertaken in this study. The study consists of a qualitative (nine nursing service managers participated in semi-structured interviews) and quantitative component (three hundred patients were included in a survey). A one hundred percent response rate was noted for the qualitative interviews and a 93.3 percent response rate was noted for the surveys that were conducted. Data for the quantitative study was analyzed using the Statistical Package for Social Sciences and a thematic analysis using NVIVO was applied to the qualitative data. The results from the qualitative component highlight the need for patient experience to be incorporated in the drive for quality improvement and stress the value of a patient experience model. Nursing managers support that the patient experience is positive in the primary health clinic but the survey findings reveal that the majority of respondents reported a negative patient experience. The overall patient experience satisfaction variable indicates that more than 50% of the respondents are dissatisfied with the overall patient experience. The Kruskal-Wallis analysis reveals a significant association with age and race on the overall patient experience satisfaction. Older patients are more accepting of health service delivery as compared to younger patients who are more critical. Patients show agreement with more than 50% of respondents indicating that the fifteen domains as per the Conceptual Framework are influencers of their patient experience. Nursing managers showed support for all fifteen domains. A latent factor analysis revealed that Information, Communication, Management Effectiveness towards Producing Positive Outcomes and Patient Centered Care were not statistically significant towards influencing the patient experience. The conceptual model was developed by incorporating the remaining eleven domains that influence the patient experience and the positive reforms that result thereof. Given the changing landscape in SA, it was necessary to develop a model to improve patient experience in order to improve the quality of service delivery thus engaging sustainable positive reform

A systematic review of the efficacy and safety of Saccharomyces boulardii in the treatment of acute gastroenteritis in the pediatric population

Thesis (MNutr)--Stellenbosch University, 2016.ENGLISH SUMMARY : Background: The yeast Saccharomyces boulardii has been classed a probiotic because it is a live microorganism known to confer a health benefit to its host, with one such benefit being in the management of gastrointestinal disturbances like gastroenteritis. Gastroenteritis is known to be the second leading cause of death in the world’s most vulnerable populations, with Rotavirus being the most common causative agent, responsible for 215,000 global child deaths during 2013. Together with a few other probiotics, Saccharomyces boulardii has been considered a potentially viable treatment option having been associated with a decreased duration of diarrhea, decreased number of days to the first formed stool, and decreased duration of hospital stay in individual studies. This systematic review was therefore designed to specifically investigate the effects of Saccharomyces boulardii on acute gastroenteritis caused by Rotavirus in the pediatric hospitalized patient. Objectives: To assess the efficacy and safety of Saccharomyces boulardii in the treatment of acute gastroenteritis in the pediatric population. Secondary objectives of cost-effectiveness in terms of length of hospital stay; optimal dosing and administration routes were also investigated. Methods: Data sources included Medline, CINAHL, Scopus and The Cochrane Library up to and including August 2015. Only randomized controlled trials in a hospital setting and involving subjects less than 16 years were included. Two reviewers independently evaluated studies for eligibility, quality and extracted the data. Data were analyzed using Review Manager 5 (RevMan 2008) software. A random effects model of meta-analysis was used due to the presence of heterogeneity of treatment effects between studies. Results: Out of a pool of 190 articles, 10 studies were selected for final inclusion and analysis. A meta-analysis involving five of the ten included studies showed that Saccharomyces boulardii significantly shortened the duration of diarrhea (in days), compared to the control/placebo group (MD -0.57, 95%CI: -0.83 to -0.30, P < 0.0001). Also, participants were passing solid stools in the Saccharomyces boulardii group compared to the control group on Day 2 (RR 3.00; 95% CI: 0.32 to 27.87), Day 3 (RR 3.17; 95% CI: 1.89 to 5.31), Day 4 (RR 1.63; 95% CI: 1.30 to 2.06) and Day 5 (RR 1.25; 95% CI: 1.08 to 1.44), (P = 0.06). Other outcomes like number of participants having less than three stools per day during the intervention and duration of hospital stay did not produce any statistically significant results. No studies reported on any significant adverse effects associated with the use of Saccharomyces boulardii. Conclusion: The results of the current systematic review appear to indicate there’s a potential benefit with using Saccharomyces boulardii to treat acute gastroenteritis in the pediatric patient. Offering this unique yeast probiotic at a dose of 250mg once to twice per day for up to five days has shown some benefit and appears to be safe. However, larger and more rigorous controlled trials are needed to further investigate the efficacy and safety of individual probiotics, like Saccharomyces boulardii, in order to offer specific treatment guidelines.AFRIKAANSE OPSOMMING : Agtergrond: Die gis Saccharomyces boulardii word beskou as ‘n probiotika aangesien dit ‘n lewendige mikroorganisme is wat gesondheidsvoordele inhou vir die gasheer. Een van die voordele is in die behandeling van gastrointestinale afwykings soos gastroenteritis. Alhoewel gastroenteritis slegs ‘n simptoom is van ‘n toestand, is dit bekend om die tweede mees algemene oorsaak van sterfte te wees onder vatbare populasies in die wêreld. Rotavirus, die mees algemene oorsaak van gastroenteritis, was verantwoordelik vir 215,000 kindersterftes wêreldwyd tydens 2013. Tesame met ‘n paar ander probiotika word Saccharomyces boulardii beskou as ‘n potensiële lewensvatbare behandelingsopsie. Hierdie gis probiotika word in individuele studies geassosieer met ‘n verkorte duurte van diaree, verminderde aantal dae tot die eerste gevormde stoelgang en ‘n verkorte duurte van hospitaal verblyf. Hierdie sistematiese literatuuroorsaak was dus beplan om die effek van Saccharomyces boulardii op akute gastroenteritis veroorsaak deur Rotavirus in pediatriese gehospitaliseerde pasiënte te ondersoek. Doelwitte: Om die effektiwiteit en veiligheid van Saccharomyces boulardii in die behandeling van akute gastroenteritis in die pediatrie populasie te bepaal. Sekondêre doelwitte was om die koste-effektiwiteit in terme van duurte van hospital verblyf, optimale dosering en administrasie roetes te ondersoek. Metodes: Data bronne het Medline, CINAHL, Scopus en die Cochrane Biblioteek tot en met Augustus 2015 ingesluit. Slegs verewekansigde gekontrolleerde proewe in ‘n hospitaal omgewing gedoen op persone jonger as 16 jaar is ingesluit. Twee evalueerders het die studies onafhanklik evalueer vir geskiktheid, kwaliteit en was betrokke by data ekstraksie. Data was ge-analiseer deur gebruik te maak van Review Manager 5 (RevMan 2008) sagteware. Die stogastiese-effekte model van meta-analise was gebruik as gevolg van die teenwoodigheid van heterogeniteit van behandelings-effekte tussen studies. Resultate: Uit ‘n poel van 190 potensiële artikels is 10 studies geselekteer vir finale insluiting en analise. ‘n Meta-analise op vyf van die tien studies het getoon dat Saccharomyces boulardii verantwoordelik was vir ‘n beduidende verkorte duurte van diaree (in dae), vergeleke met die kontrole of plasebo groepe (MD -0.57, 95%CI: -0.83 to -0.30, P < 0.0001). Resultate het ook gedui dat meer deelnemers in die Saccharomyces boulardii groep soliede stoelgane gehad het vergeleke met die kontrole groep op Dag 2 (RR 3.00; 95% CI: 0.32 to 27.87), Dag 3 (RR 3.17; 95% CI: 1.89 to 5.31), Dag 4 (RR 1.63; 95% CI: 1.30 to 2.06) en Dag 5 (RR 1.25; 95% CI: 1.08 to 1.44), (P = 0.06). Ander uitkomste soos die aantal deelnemers met minder as drie stoelgange per dag gedurende intervensie en duurte van hospital verblyf het nie beduidende resultate gelewer nie. Geen studies het enige newe-effekte geassosieer met die gebruik van Saccharomyces boulardii gerapporteer nie. Gevolgtrekking: Die resultate van die huidige sistematiese literatuuroorsig dui op ‘n potensiële voordeel met die gebruik van Saccharomyces boulardii vir die behandeling van akute gastroenteritis in die pediatriese groep. Die inname van hierdie unieke gis probiotika teen ‘n dosis van 250mg een tot twee maal per dag vir tot vyf dae het op sommige voordele gewys en blyk om veilig te wees. Groter en strenger gekontrolleerde proewe word egter aanbeveel om die effektiwiteit en veiligheid van individuele probiotika soos Saccharomyces boulardii verder te ondersoek ten einde spesifieke behandelingsriglyne te kan voorstel.Master

A review of the use of inhaled nitric oxide in the PICU at Red Cross Children's Hospital, 2011-2015: A retrospective cohort study

Background: Inhaled Nitric Oxide (iNO) functions as a selective pulmonary vasodilator. It is an expensive treatment that is often employed as rescue therapy for refractory hypoxaemia in acute respiratory distress syndrome (ARDS) and pulmonary hypertension (PHT) following cardiac surgery. Objectives: To describe the response to treatment with iNO. Secondary observations were deaths, comorbidities of the patients treated, lengths of treatment and admission, and the cost of treatment. Methods: A retrospective descriptive study of all patients treated with iNO in the Paediatric Intensive Care Unit (PICU) at Red Cross War Memorial Children’s Hospital (RCWMCH) from 2011- 2015. Results: A total of 140 patients were treated with iNO during this time period, 82 were for PHT following cardiac surgery, 53 for ARDS and 5 for PPHN. A response to treatment was observed in 64% of the cohort as a whole, 80% of those with PPHN, 67% of those with PHT post-cardiac surgery, and 64% of those with ARDS. A longer duration of ICU and hospital admission, and higher in hospital mortality (53%) was seen in the group with ARDS, in particular those with adenoviral infection (63%), when compared to patients treated for PHT (18%) and for PPHN (20%). There is no protocol in place guiding the use of iNO in our unit, and it was found that response to treatment was not being objectively measured and documented and that practise varied between clinicians. Conclusions: Considering the cost of treatment and lack of evidence to support beneficial effects of iNO therapy, its continued use in our resource poor setting should be guided by protocol

Transferrin receptor-mediated gene delivery using functionalised gold nanoparticles.

Masters Degree. University of KwaZulu-Natal, Durban.Gene therapy strategies have shown their potential in treating numerous central nervous system (CNS) disorders, including highly aggressive brain cancers. Gold nanoparticles (AuNPs) are popular vectors for gene delivery, due to their low toxicity, and ease of synthesis and functionalisation. However, the in vivo efficacy of these vectors is dependent on their ability to cross the blood-brain barrier (BBB), a specialised capillary network preventing the movement of compounds into the CNS. Passage across the BBB is often facilitated through targeting of the transferrin (Tf) receptor, leading to uptake by receptor-mediated transcytosis. This study aimed to develop untargeted and Tf-targeted functionalised AuNP (FAuNP) vectors and assess their potential as gene delivery vectors. AuNPs were prepared through citrate reduction and functionalised with chitosan (CS) and poly(ethylene) glycol 2000 (PEG2000) in two weight ratios [2% and 5% (ww⁄)] to produce untargeted FAuNPs. The holo-transferrin protein was conjugated to both PEGylated and unPEGylated FAuNPS to produce the Tf-targeted FAuNPs (TfAuNPs). The physicochemical characteristics of FAuNPs were evaluated using UV spectroscopy, Fourier-transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM) and nanoparticle tracking analysis (NTA). TEM revealed AuNP to be spherical and relatively monodisperse. FAuNPs displayed hydrodynamic diameters ranging from 94.7 – 196.4 nm with good colloidal stability, as evidenced by NTA. Binding studies viz. band shift and ethidium bromide intercalation assays showed that all FAuNPs were able to fully complex and efficiently condense pCMV-luc plasmid DNA, with PEGylated and targeted FAuNPs being capable of partially protecting DNA from nuclease degradation, as determined in nuclease protection assays. In vitro studies were conducted in the HEK293, Caco-2, and the Tf receptor-positive HeLa cell lines. Cytotoxicity was assessed using the MTT cytotoxicity assay, which revealed FAuNPs to be relatively non-toxic to HeLa and HEK293 cells. Notably, TfAuNPs displayed low cytotoxicities, and generally exhibited increased cell viabilities compared to the untargeted FAuNPs. The luciferase gene reporter assay was conducted to assess the transfection efficiency of the FAuNPs. Transfection levels were highest in Caco-2 cells, with PEGylated FAuNPs observed to produce reduced transfection compared to the unPEGylated FAuNPs. TfAuNPs displayed favourable transfection in HeLa cells; with the competition binding assays confirming receptor-mediated uptake for AuCSTf and AuCSTf-5% PEG FAuNPs only, suggesting that a grafting density of the 2% (ww⁄) PEG interfered with receptor binding. These Tf-targeted FAuNPs show the potential to be utilised as vectors for brain delivery; however further optimisation and investigations in an in vivo system are required.Date of publication is assumed as it is not indicated in the thesis

Aerodynamic parameter identification for an unmanned aerial vehicle

A dissertation submitted to the Faculty of Engineering and the Built Environment, School of Mechanical, Industrial and Aeronautical Engineering, University of the Witwatersrand, in fulfilment of the requirements for the degree of Master of Science in Engineering. Johannesburg, May 2016The present work describes the practical implementation of systems identification techniques to the development of a linear aerodynamic model for a small low-cost UAV equipped with a basic navigational and inertial measurement systems. The assessment of the applicability of the techniques were based on determining whether adequate aerodynamic models could be developed to aid in the reduction of wind tunnel testing when characterising new UAVs. The identification process consisted of postulating a model structure, flight test manoeuvre design, data reconstruction, aerodynamic parameter estimation, and model validation. The estimators that were used for the post-flight identification were the output error maximum likelihood method and an iterated extended Kalman filter with a global smoother. SIDPAC and FVSysID systems identification toolboxes were utilised and modified where appropriate. The instrumentation system on board the UAV consisted of three-axis accelerometers and gyroscopes, a three-axis vector magnetometer and GPS tracking while data was logged at 25 Hz. The angle of attack and angle of sideslip were not measured directly and were estimated using tailored data reconstruction methods. Adequate time domain lateral model correlation with flight data was achieved for the cruise flight condition. Adequacy was assessed against Theil’s inequality coefficients and Theil’s covariance. It was found that the simplified estimation algorithms based on the linearized equations of motion yielded the most promising model matches. Due to the high correlation between the pitch damping derivatives, the longitudinal analysis did not yield valid model parameter estimates. Even though the accuracy of the resulting models was below initial expectations, the detailed data compatibility analysis provided valuable insight into estimator limitations, instrumentation requirements and test procedures for systems identification on low-cost UAVs.MT201