National expenditure on health research in South Africa : What is the benchmark ?

PKThe Mexico (2004), Bamako (2008) and Algiers (2008) declarations committed the South African (SA) Ministry of Health to allocate 2% of the national health budget to research, while the National Health Research Policy (2001) proposed that the country budget for health research should be 2% of total public sector health expenditure. The National Health Research Committee has performed an audit to determine whether these goals have been met, judged by: (i) health research expenditure as proportions of gross expenditure on research and development (GERD) and the gross domestic product (GDP); and (ii) the proportion of the national health and Department of Health budgets apportioned to research. We found that total expenditure on health research in SA, aggregated across the public and private sectors,was R3.5 billion in 2009/10, equating to 16.7% of GERD. However, the total government plus science council spend on health research that year was only R729 million, equating to 3.5% of GERD (0.03% of the GDP) or 0.80% of the R91.4 billion consolidated government expenditure on health. We further found that R418 million was spent through the 2009/2010 Health Vote on health research, equating to 0.46% of the consolidated government expenditure on health or 0.9% of the R45.2 billion Health Vote. Data from other recent years were similar. Current SA public sector health research allocations therefore remain well below the aspirational goal of 2% of the national health budget. We recommend that new, realistic, clearly defined targets be adopted and an efficient monitoring mechanism be developed to track future health research expenditure

Home Office Expenditure: A critical analysis of the applicable law governing the deductibility of home workspace expenses incurred by persons in employment - given the shift to working from home

The applicable law governing the income tax deductibility of home workspace expenses incurred by persons in employment has remained contentious and inconclusive. This has been heightened given the accelerated shift toward employees working from home in recent years. It is therefore necessary for there to be research conducted in resolving this heightened contention, with potential legislative amendments being recommended to National Treasury, who have acknowledged that the applicable law needs to be updated. An exposition of the applicable law over the last fifty years is provided, which includes historical analyses and the general mechanics of the law. More complex matters relating to the interpretation of the applicable law are then highlighted and analysed in light of the applicable principles of fiscal statutory interpretation (mainly using the landmark Endumeni approach). The South African Revenue Service (‘SARS') has attempted to update the existing Interpretation Note (‘IN') dealing with home workspace expenditure, for which they released two drafts, both in 2021; and finalised such IN in 2022. Although SARS' interpretations are determined to not be authoritative in terms of the law, their interpretations are analysed in terms of the applicable law to identify and analyse inconclusive matters. These matters relate to the types of home workspace expenses that are tax deductible, and the ‘tests' under section 23(b). Some of the key findings in this regard are that the legislation does not require a separate-room home workspace, and that all of the ‘tests' should be performed for the period which an employee is working from home, even if this period is less than a full year of assessment. Potential legislative amendments are identified, specifically in the short-term, by looking to comparable jurisdictions, namely the United Kingdom and Canada. These jurisdictions offer taxpayers a ‘simplified cost' deduction which is capped to a legislated amount. Legislating a ‘simplified cost' deduction accordingly will provide the fiscus more time to adequately review the applicable law substantially, given the accelerated shift toward employees working from home and heightened contention in this regard

The Durban World Congress Ethics Round Table conference report: I. Differences between withholding and withdrawing life-sustaining treatments

Introduction: Withholding life-sustaining treatments (WHLST) and withdrawing life-sustaining treatments (WDLST) occur in most intensive care units (ICUs) around the world to varying degrees. Methods: Speakers from invited faculty of the World Federation of Societies of Intensive and Critical Care Medicine Congress in 2013 with an interest in ethics were approached to participate in an ethics round table. Participants were asked if they agreed with the statement "There is no moral difference between withholding and withdrawing a mechanical ventilator." Differences between WHLST and WDLST were discussed. Official statements relating to WHLST and WDLST from intensive care societies, professional bodies, and government statements were sourced, documented, and compared. Results: Sixteen respondents stated that there was no moral difference between withholding or withdrawing a mechanical ventilator, 2 were neutral, and 4 stated that there was a difference. Most ethicists and medical organizations state that there is no moral difference between WHLST and WDLST. A review of guidelines noted that all but 1 of 29 considered WHLST and WDLST as ethically or legally equivalent. Conclusions: Most respondents, practicing intensivists, stated that there is no difference between WHLST and WDLST, supporting most ethicists and professional organizations. A minority of physicians still do not accept their equivalency

Prevalence of low serum testosterone levels among men with type 2 diabetes mellitus attending two outpatient diabetes clinics in Durban, South Africa.

Masters Degree. University of KwaZulu-Natal, Durban.Background: Studies showing a high prevalence of low serum testosterone in men with type 2 diabetes mellitus (T2DM) are well documented but evidence from sub-Saharan Africa is scanty. Aim: To determine the prevalence and associated risk factors of low serum testosterone and the prevalence of androgen deficiency symptoms in South African men with T2DM. Methods: A cross-sectional observational study was performed among men with T2DM attending two outpatient adult diabetes clinics in KwaZulu-Natal. Androgen deficiency symptoms were assessed using the Ageing Male’s Symptom Scale (AMS) questionnaire and direct enquiry. Serum total testosterone (TT), sex-hormone binding globulin (SHBG), luteinising hormone (LH), HbA1c, fructosamine, serum lipids were measured and free-testosterone (FT) was calculated. TT, SHBG and FT levels were measured in control subjects with no history of diabetes. Results: The study included 148 men with T2DM (Study Group) and 50 control subjects (Control Group). The mean age of the control group was 43.9 ± 10.7 years and the mean BMI was 27.11 ± 4.2 kg/m2. In the study group, the majority were African (Black) (58.7%); Indians (39.2%) and Whites (2.1%) constituted the remainder. Mean age was 57.5 ± 11.2 years; mean duration of diabetes 11.4 ± 8.9 years; mean HbA1c was 8.6 ± 1.9%. Metabolic syndrome was found in 86.4% (n:127) of the Study group. Mean TT, SHBG, FT and median LH (IQR) in the Study group were within normal range (14.5 ± 5.8 nmol/l, 40.7 ± 20.3 nmol/l, 265.9 ± 90.4 pmol/l and 5.3 [3.8-7.3] IU/l, respectively). However, mean serum TT and FT was lower in the Study group than Control subjects (14.5 ± 5.8 vs. 18.8 ± 7.2 nmol/l, p <0.001 and 265.9 ± 90.4 vs. 351.7 ± 127.3 pmol/l, p<0.001). The prevalence of LSTT and LSFT was 35.8% and 16.2%, respectively. Prevalence of LSFT increased with age and higher body mass index (BMI) categories with the highest rate noted in >40 kg/m2 BMI category (50%). In multivariate analysis, LSFT was significantly associated with age [OR 1.05 (95% CI 1.02-1.218), p=0.043] and waist circumference (WC) [OR 1.033 (95% CI 0.999- 1.068), p=0.059]. LSTT was associated with BMI only [OR 1.138 (95%CI 1.063- 1.218), p<0.0001]. TT correlated inversely with BMI, WC and the number of metabolic syndrome criteria. FT correlated inversely with BMI, WC and WHR. For both FT and TT, no significant correlation was observed with HbA1c. The prevalence of androgen deficiency symptoms using AMS score was 74.5%. The prevalence of any androgen deficiency symptom on direct enquiry was 68.9%. The AMS score correlated poorly with LSTT or LSFT and was not superior to direct enquiry. Conclusion: In this group of predominantly African and Indian men with T2DM from KwaZulu-Natal, there was a high prevalence of LSTT and LSFT. Serum TT and FT was lower in men with T2DM compared to control subjects. Waist circumference was a significant risk factor associated with LSFT while LSTT was associated with higher BMI and older age. There was a high prevalence of androgen deficiency symptoms using both the AMS score and on direct enquiry. The AMS score was a poor predictor of low testosterone and was not superior to direct enquiry. More research is required locally and from other sub-Saharan African countries before routine screening can be recommended

Nocturnal Behavior of the Common Loon, Gavia immer

Very little is known about nocturnal activity of Common Loons (Gavia immer). Knowledge of both diurnal and nocturnal behavior is needed to gain a complete understanding of their ecology. I used night vision light intensifiers to observe nocturnal behaviors of Common Loons. Results were consistent with the hypothesis that, as visual predators, loons would not forage at night and also that they would spend the majority of their time resting (92%). Loons, however, were just as active locomoting (patrolling) during the night as they were during the day. This suggests daily energy budgets need to be reexamined to incorporate this overlooked aspect of loon behavior. Lastly, loons on large lakes with multiple loon territories spent more time locomoting than loons on lakes that had just a single pair

The influence of low physical activity levels versus extreme physical activity levels on brain structure and working memory

Background: Habitual levels of moderate to vigorous levels of physical activity (MVPA) levels are associated with positive health outcomes and improvement in cognitive function. A challenge facing optimal health outcomes is determining optimal levels of physical activity levels; people can engage in extreme sedentary or high levels of physical activity. For example, levels of low physical activity and participation in ultra-endurance events are increasing. However, the impact of extreme physical activity levels on brain matter volume and working memory is not well understood. This thesis thus investigated the relationship between different levels of MVPA, brain structure, and working memory. The aim of the thesis was to understand the relationship between large volumes of physical activity with global and regional brain matter volumes using brain imaging, and the impact of physical activity on cognitive function using the N-back task. The first part of the thesis examined how habitually high or low levels of MVPA differently impacted brain matter volume in healthy individuals. Whilst, the second part of the thesis investigated the differences in working memory between the low active and high active groups. Methods: Participants aged 20-59 years, were split into a High Activity (HA) group (N = 12, 27.9 ± 26.6 years) that exercised for > 9 hours of per week (MVPA > 540 minutes) and a Low Activity (LA) group (N = 9, 28.33 ± 11.192 years) that exercised 9 hours of per week (MVPA > 540 minutes) and a Low Activity (LA) group (N = 6, 30.14 ± 15.31 years) that exercised < 2 hours (MVPA < 120 minutes). Working memory was compared between the two groups using a PC-based N-back task. Results: The HA group had greater total brain matter and total white matter volumes vs. the LA group, and brain matter volumes were positively associated with increasing physical activity levels. However, the HA group had reduced regional brain volumes in the postcentral gyrus, middle frontal lobe, and the sub-lobar thalamus. HA and LA groups did not differ in working memory performance on the N-back task. Conclusion: Larger than normal amounts of weekly PA was associated with increased total brain matter and total white matter volumes, however, the volume of three regional brain areas were reduced

Compassion or condemnation? South African Muslim students' attitudes to people with HIV&AIDS

Given the dearth of literature on the influence of religiosity on attitudes toward people with HIV/AIDS, the present study surveyed these variables in a sample of South African Muslim university students using the Religious Orientation Scale (ROS) and an attitude to people with HIV scale. Gender differences in attitudes towards people with HIV were also examined. The sample comprised 90 male and female undergraduate and postgraduate Muslim students. While both males and females displayed high religiosity scores, male students were found to be significantly more religious than female students. No gender differences were found on the attitude to people with HIV scale, with students indicating positive attitudes to people with HIV. Higher religiosity was significantly correlated with a more positive attitude to people with HIV. The implications of the findings are discussed. Keywords: HIV/AIDS, attitudes, religiosity, Muslim, students. RÉSUMÉ Etant donné le manque de littérature sur l'influence de la bigoterie sur les attitudes envers des gens séropositifs, cette étude a examiné ces variables auprès d'un échantillon d'étudiants universitaires musulmans sud-africains en utilisant le barème d'orientation religieuse (ROS) et le barème de l'attitude envers les gens séropositifs. Les différences de sexes aux attitudes envers des gens séropositifs étaient également étudiées. L'échantillon consistait de 90 étudiants musulmans hommes et femmes de deuxième et troisième cycles. Pendant que tous les étudiants, hommes et femmes, montraient des résultats de la bigoterie élevés, les hommes étaient plus religieux que les femmes. Il n'y a pas eu de différences de sexes sur le barème des attitudes envers les gens séropositifs chez les étudiants qui montraient des attitudes positives envers les séropositifs. Une bigoterie plus élevée était sensiblement en corrélation avec une attitude plus positive envers des séropositifs. Les implications des résultats sont exposés. Mots clés:VIH/SIDA, attitudes, bigoterie,Musulman, étudiants

The Transitional Executive Council (TEC) as transitional institution to manage and prevent conflict in South Africa (1994)

One of the most critical moments during any transition is when the executive power of the old regime is transferred to a new government in waiting. This is often characterised by instability and conflict. Hence the Transitional Executive Council (TEC) was established in South Africa to facilitate its gradual and peaceful transition in 1994. The TEC can be seen as a negotiated, temporary and transitional institution that managed and prevented conflict in South Africa prior to the April 1994 general election. Although it existed only for four months, from December 1993 to April 1994, it played a significant role in South Africa's democratic transition. The TEC contributed to levelling the political playing field and creating a climate favourable for free and fair elections. The TEC's seven sub-councils further contributed to the smooth transition and creation of the Government of National Unity. In this study special attention has been given to the Sub-council on Foreign Affairs and its role in integrating South Africa into the international community. The Foreign Affairs sub-council played a pivotal role in laying the foundation for South Africa's membership of the various organizations like the Organization of African Unity (OAU) and the Commonwealth. In order to gain a deeper understanding of the TEC, several theoretical frameworks are applied to analyse the different perspectives namely: transition theory, conflict resolution, power-sharing and constitutional negotiations.MA (INTERNAT POLITICS)POLITICAL SCIENC