Surveillance alone plays a key role in curbing the overuse of antimicrobials: The major role of antibiotic stewardship

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South Africa's response to terror : the case of PAGAD

Includes abstract.Includes bibliographical references (leaves 79-84).During the mid-1990s to 2001, South Africa was the victim of numerous terrorist acts carried out by the People Against Gangsterism and Drugs (PAGAD). This paper discusses the problems and the procedures and methods used to combat domestic terrorism in constitutional democracies as well as the problems encountered by democratic South Africa in responding to PAGAD bearing in mind the legal-constitutional and the political constraints that this democracy faces. Using PAGAD as a case-study and discussing and analyzing the South African counter-terrorism strategies that were used against PAGAD, many interesting features are observed which clearly show that, while South Africa exemplified the problems that older constitutional democracies face when responding to terrorism, the country also deviated from what is usually expected from a constitutional democracy responding to terrorism

A “rejoinder” to a response-able reviewing of A posthumanist re-reading of teacher agency in times of curriculum reform

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A posthumanist re-reading of teacher agency in times of curriculum reform

Teacher agency in times of curriculum reform has often been researched and studied from a humanist perspective that focuses on human experiences and narratives. While this way of conducting research has contributed to a better understanding of curriculum design and implementation, it is nevertheless important to move away from a human-centred approach and to consider intra-actions between teachers and their material conditions as they inhabit multiple macro-policy and micro-institutional spaces across temporal dimensions. In this article, emphasis is laid on teacher agency as a hybrid collective between teachers and others (policy documents, formal and informal infrastructures, technology, textbooks). Teacher agency is consequently re-thought as a fluid process of entangled and diffracted possibilities that is not predetermined, but as a result of intra-actions, it is one that is always in “becoming”

Microbiological surveillance and antimicrobial stewardship minimise the need for ultrabroad-spectrum combination therapy for treatment of nosocomial infections in a trauma intensive care unit: An audit of an evidence-based empiric antimicrobial policy

Background. Nosocomial infections are a major cause of morbidity in the critically injured, and the incidence of resistant strains of bacteria is increasing. Management requires a strategy that achieves accurate empiric cover without antibiotic overuse - a goal that may be achieved by surveillance and antibiotic stewardship.Objectives. With the aim of minimising the use of empirical ultrabroad-spectrum combination antimicrobial prescriptions and reducing bacterial resistance, the level I Trauma Intensive Care Unit (TICU) at Inkosi Albert Luthuli Central Hospital (IALCH) in Durban employs stewardship and an antimicrobial policy based on surveillance. This study was undertaken with three aims: (i) to describe the spectrum and sensitivities of nosocomial pathogens in a level I TICU; (ii) to ascertain, based on surveillance data, how frequently initial empiric choice of antimicrobials was correct; and (iii) to determine how frequently ultrabroad-spectrum antimicrobials were prescribed and were actually necessary.Methods. Over a 12-month period, all critically injured patients who  underwent mechanical ventilation in the TICU were identified from a prospectively gathered database. Information regarding every specimen submitted to the National Health Laboratory Services (NHLS) situated at IALCH was extracted from the laboratory computer database. For each patient, bacterial isolates and antimicrobial susceptibility were identified using standard laboratory techniques. Empiric prescriptions for presumed nosocomial sepsis were identified from the hospital’s computerised patient record system and compared with culture results. Acinetobacter species were regarded as colonisers and treatment not offered unless this was the sole isolate in the presence of signs of severe sepsis.Results. Of 227 patients, 106 (46.6%) had 136 culture-positive isolates with a total of 323 pathogens (201 Gram-negative, 119 Grampositive,3 Candida albicans). There were 19 species of Gram-negative pathogens, of which 56% comprised Enterobacteriaceae. Extended spectrum  beta-lactamase (ESBL) production was found in 6/31 (19%) Escherichia coli coli and 6/24 (25%) Klebsiella isolates. Staphyloccocal species accounted for 60% of the Gram-positive isolates, of which 18 were methicillin-resistant Staphylococcus aureus (MRSA). All Candida isolates were sensitive to fluconazole. One hundred and one empiric and 14 directed prescriptions were issued. Despite positive cultures, antimicrobials were not prescribed for 21 patients who had no evidence of sepsis. Excluding multidrug-resistant Acinetobacter isolates, there were 87 (93.5%) appropriate and 6 (6.5%) incorrect prescriptions. Ultrabroad-spectrum combination therapy (U-bSCT) was employed for 11 patients but was necessary in only 2.Conclusions. When combined with regular bacterial surveillance,  antimicrobial stewardship allows accurate empiric antimicrobial prescription with minimal need for ultrabroad-spectrum combination therapy. This policy can potentially reduce the emergence of multidrug-resistant  pathogens, precluding the need for broad-spectrum antimicrobials and the attendant problems of overuse

Staff motivation in a contact centre environment : an empirical study of contact centres in the Durban area.

Thesis (MBA)-University of Natal, 2003.Staff motivation in a contact centre environment was analysed from the perspective of Herzberg's Motivation- Hygiene theory in the present study using survey data from seven contact centres in the Kwa-Zulu Natal region. The study investigates the relationship between intrinsic and extrinsic motivation factors and the extent of the existence of equity factors in the and the relationship between intrinsic and extrinsic motivation factors with equity factors in the South African environment, specifically favouritism, discrimination and consistency. The findings confirm that contact centre agents need to be highly skilled and adequately supported by management in order to fulfil the significant role that they play in an organisation. The support required goes further than technical skill and training but moves into the emotional well being of the agent. The emphasis shifts from the agent providing a service to the customers and the organisation and moves from the organisation providing its agents with the recognition and incentives to motivate them to strive for their very best at their jobs

Understanding the experiences of caregivers of HIV infected children at a public hospital in Durban.

Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2013.Globally HIV and AIDS are considered to be a major health and developmental challenge facing humanity. The HIV infection of children is not only an area of great concern for families but for the future of humankind. Caring and nurturing of children generally is considered as a challenging responsibility. Caregivers of HIV infected children are faced with the added responsibility of ensuring that these children have access to life saving health care at all times. Caregivers who are responsible for the health and well being of HIV infected children face constant challenges in their care giving role and this has implications for the quality of care of the child. The needs of HIV infected children are complex and vital to their basic needs is the administration of antiretroviral therapy (ART). This study aimed to explore, describe and interpret the experiences of caregivers, caring for HIV infected children and accessing services from a public hospital in Durban. Using the ecosystems theory, this qualitative study explored the experiences of thirty caregivers caring for HIV infected children. The data was collected using semi structured interviews with the caregivers. Four main themes emerged from the data analysis; namely: The caregivers’ intrapersonal experiences, their perspectives on HIV and ART, their access to health and social services and their coping strategies. This study concludes that caregivers of HIV infected children within the public hospital setting, experience numerous psycho-social and economic challenges on a daily basis. Subsequently, these challenges impacted on the quality of care to the HIV infected child. It was evident that respondents dealt with challenges differently, as the older respondents were more equipped emotionally and psychologically than the younger respondents. Generally, all respondents were negatively affected by poor psychological and socio-economic circumstances that prevented them from ensuring the wellbeing of the child. The challenges that they faced on the micro level (economic and psycho-social experiences), the mezzo (stigma, community and family support) and exo levels (health and welfare services) together with the macro level (DOH strategic plans and childcare legislations) determined how they provided for the care of the HIV infected child. Despite these challenges respondents’ resilience and commitment to providing for the health and wellbeing of the HIV infected child was consistent and remained a priority. Multi-level intervention programmes are required to help caregivers cope with their challenges. As such social work practitioners need to take cognizance of the psycho-social, emotional and material support required by caregivers of HIV infected children

Consumer Perceptions and Behaviors on Digital Payment Adoption Among Older Generation Z and Younger Millennials in Phnom Penh, Cambodia

Purpose:  The study's goal is to better understand how older and younger generations in Phnom Penh, Cambodia, behave when it comes to using digital payments. Investigating the choice of mobile payment application in the Phnom Penh region is another objective of this study. Here, it is also investigated how usage, economic situation, and adoption of mobile payments are related.   Theoretical framework:  One of the most well-known research models on consumer behavior among younger and older generations and the adoption of new technical systems emphasizes the influence of geography, socioeconomic status, and specific traits on consumer acceptance. The concept considers factors including social effects, credibility requirements, effort expectations, and performance requirements when determining the best digital payment application.   Design/Methodology/Approach: The Unified Theory of Acceptance and Use of Technology (UTAUT) model and K-mean clustering for distance and economic status studies were used in this research paper to select 150 locals in Phnom Penh from the target population in order to study consumer behavioral intention to accept digital payment method and application.   Findings:  The result we aimed to show and analyses the Digital payment methods, payments sharing, receiving, storing evidences, that older generation started understanding the digital payment by Khmer language and accepting the digital transactions from known customers. The current generation using Sathapana application and English Language in wide ranges through the Phom Penh region. The study also trying to exhibit the purpose of the digital payment systems in and across the e-commerce activities, through the older and younger generation.   Research, Practical & Social implications:  The elder generation Z handled digital payments for regional transactions like banking, home tasks, loan repayment, peer lending, travel, and local marketplaces in Khmer. The subsequent generations of millennials also incorporated cross-border payments in English and Khmer.   Originality/Value:  Bringing up a Digital Platform shall make a positive change in economy and circulation of economy to the people and country. Unless the people trust the digital payments, they cant share their money for the business or basic operations to run the government. Thy the Digital Payment applications shall understand the behavior of the customers and share the services through the digital payment systems

Cosmological models and the deceleration parameter.

Thesis (M.Sc.)-University of Natal, 1992.In this thesis we utilise a form for the Hubble constant first proposed by Berman (1983) to study a variety of cosmological models. In particular we investigate the Robertson-Walker spacetimes, the Bianchi I spacetime, and the scalar-tensor theory of gravitation of Lau and Prokhovnik (1986). The Einstein field equations with variable cosmological constant and gravitational constant are discussed and the Friedmann models are reviewed. The relationship between observation and the Friedmann models is reviewed. We present a number of new solutions to the Einstein field equations with variable cosmological constant and gravitational constant in the Robertson-Walker spacetimes for the assumed form of the Hubble parameter. We explicitly find forms for the scale factor, cosmological constant, gravitational constant, energy density and pressure in each case. Some of the models have an equation of state for an ideal gas. The gravitational constant may be increasing in certain regions of spacetime. The Bianchi I spacetime, which is homogeneous and anisotropic, is shown to be consistent with the Berman (1983) law by defining a function which reduces to the scale factor of Robertson-Walker. We illustrate that the scalar-tensor theory of Lau and Prokhovnik (1986) also admits solutions consistent with the Hubble variation proposed by Berman. This demonstrates that this approach is useful in seeking solutions to the Einstein field equations in general relativity and alternate theories of gravity