3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Development of a shoulder pain prevention programme for wheelchair basketball players in South Africa(2024) Msadala, Tawina Faith FlorenceBackground Wheelchair basketball (WB) is plagued with shoulder pain (SP), associated with overuse and muscle imbalances among others, with prevalence rates ranging from 44% to 72% in South Africa. However, its prevention remains uncertain due to the scarcity of research. Aim The aim of this study was to map the range of strategies to prevent shoulder injuries and develop an exercise programme suitable for the prevention of SP for WB players in South Africa. Method A mixed methods study was conducted beginning with a scoping review followed by a modified Delphi survey. In the review, Scopus, Pubmed, EbscoHost, SportDiscus, Medline complete and CINAHL were searched. Then relevant studies were identified, and an exercisebased injury prevention programme was formulated from the data extracted. Then, in the second part of the study, individual exercises in the programme were rated on a 5-point Likert scale from strongly disagree to strongly agree in three rounds, by an expert panel of four physiotherapists and a sports scientist. The first two rounds were conducted via RedCap and a consensus meeting was conducted via zoom in the third round. Finally, a final shoulder pain prevention programme (SPP) was compiled from the exercises that reached a consensus agreement of ≥80%. Results Only five studies were identified from the scoping review. These studies supported strengthening exercises and stretching of the shoulder girdle muscles to prevent shoulder pain in WB and wheelchair sports. One study included a warm-up of active movements of the shoulder. Then, in the Delphi, 39.1% of the exercises reached consensus in the first round, none in the second round and then 75% of modified exercises had 100% agreement in the third round. These exercises formed the final SPP which consisted of muscle endurance, functional and scapular activation exercises in addition to strengthening exercises and stretching. Conclusion Few studies have been done on strategies for preventing shoulder pain in WB. A holistic programme incorporating shoulder muscle strength and endurance, scapular stabilisers activation and flexibility exercises may help in preventing shoulder pain among WB players and may inform further experimental research implementing the program.Item Moral justification of continued exceptionalism of HIV care in South Africa(2024) Maserumule, Letjie CharmainSouth Africa has the largest population of people living with HIV (PLWHIV) in the world, and specialized HIV clinics to treat them are unsustainable. Decentralisation of care to primary health care (PHC) facilities reduces the burden on HIV clinics, but the PHC facilities are already overburdened with limited human and infrastructure resources. My aim is to defend that it is morally and legally justified to temporarily continue exceptionalism of HIV care in South Africa while strengthening health systems. My arguments are based on patients’ right to healthcare, the bioethical principles of beneficence and non-maleficence, and deontological moral theory. I contend that the complete abandonment of HIV clinics would burden PHC facilities even more, thus affect rendered care negatively, and violate patients’ intrinsic dignity. The complete decentralization of HIV care will be morally and legally justified when PHC facilities are improved for the progressive realisation of access to quality healthcare for all.Item Investigating knowledge, attitudes and perceptions of COVID-19 vaccines among young people in Soweto, South africa(2024) Muthoni, JeliothVaccination against SARS-CoV-2 is the most prominent strategy in the global fight against COVID-19. Studies continue to show that vaccines are one of the most dependable and cost-effective public health interventions available as they save life every year. However, World Health Organization (WHO) has identified vaccine hesitation as one of the primary threats to global health. Little is known, however, about the causes and nature of vaccine hesitancy in Africa. Moreover, in South Africa a significant drop of COVID-19 vaccine when it was rolled out the youth. The age group is of critical importance as they are becoming productive people who would be essential in the development of any country hence the need to protect them. Furthermore, understanding why youth are hesitant to get vaccinated is critical if we are to increase and sustain public demand for vaccination and preserve the tremendous achievements of vaccination programs on the continent. Unfortunately, there are limited studies that have investigated vaccine hesitancy among the youth populations and precisely looking at their knowledge, attitudes, and perceptions of the COVID-19 vaccine. Hence, the study aims to investigate knowledge, attitudes and perceptions of COVID-19 vaccine among young people in Soweto. The study employed a quantitative method, whereby closed ended questionnaires were administered using Redcap a very power tool for collecting data. Quantitative method was the best fit for the study for it accommodates a large sample size. SowetoThembelihle Health Demographic Surveillance System database was in the identification of the samples. STATA version 13.0 was used for statistical analysis. Out of a sample size of 380, the study recorded a 79.2% (301/380) hesitancy levels. The study population recorded to be knowledgeable on COVID-19 disease and vaccine. However, negative attitudes and perceptions based on the study participants responses in some important elements. The elements included ‘COVID-19 is a hoax’ (p=0.011), ‘I prefer to gain immunity by being sick rather than by having a vaccine ‘(p=0.000) and ‘COVID-19 vaccine has serious side effects’ (p=0.000) The study found out that infordemic has played a significant on the knowledge levels precisely among the youth. The study participants were well- informed, but they had poor attitudes and perception towards COVID-19 vaccine. These insights could help to reinforce national efforts to contain the pandemic across South Africa in particular Soweto and lessen other important consequences of the pandemic well-being.Item Ethical management of Gold mine workers with early and mild silicosis in South Africa(2024) Mojakwana, AngelineThe South African Gold Mining industry is an inherently risky working environment, with frequent accidents and crystalline silica dust exposure that causes silicosis and other cardiorespiratory and autoimmune complications. These diseases can considerably impact the gold mining industry and potentially lead to public health disasters by exacerbating existing tuberculosis (TB) burden in communities and the public health sector. It is of utmost importance to control silica dust exposure and to protect mineworkers from the impact of silicosis. In this study, I interrogate the morality of issuing certificates of fitness to already affected mineworkers to continue risk work underground where they are further exposed to silica dust, which leads to accelerated progression of their illness and its complications. Specifically, the study defends the thesis statement that mineworkers with early and mild silicosis ought not to be certified to continue risk work underground in the gold mining environment where they are further exposed to silica dust. A normative principle derived from the combination of key principles in welfarism and Afro -communitarian solidarity was used to defend the claim. This mostly evaluative study – that draws on desktop-based research – outlines many recommendations, including a revision of Occupational Diseases of Mines and Works Act ODMWA (given that the Act is insufficient and not adequately inclusive), continuous evaluation, monitoring and improvement of control processes to mitigate the impact of silica dust exposure and silicosis and alternative reasonable accommodation of mineworkers with silicosis to protect them from further exposure to silica dust.Item Logistic regression methods versus machine learning techniques in status and severity prediction of South African Covid-19 laboratory test data(2024) Strickett, MarkThe Covid-19 pandemic severely impacted on the lives of individuals around the world. Even now as the number of vaccinations has increased and there are fewer cases of Covid-19, knowledge of ones’ Covid-19 status remains important. It remains important as it impacts on the lives of family, friends, co-workers and the general public. Therefore, having tools such as the logistic regression and machine learning modelling techniques, in conjunction with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR), antigen and rapid Covid-19 tests only enables people to be more informed about their Covid-19 infection status. The aim of this study is to predict the Covid-19 status and severity of an individual using machine learning techniques and logistic regression methods on South African laboratory test data and determine the performance of each method. The data used in this study was supplied by the National Health Laboratory Service (NHLS) and under went cleaning and preparation phases after which the data was split into four different datasets. The datasets underwent confounding variable analysis, Principal Component Analysis (PCA) and Factor Analysis (FA) before two methods of variable selection were used to arrive at the final four datasets. Each dataset was then used to create five models (Random Forest (RF), Self-normalising Neural Network (SNN), Multinomial Logistic Regression (MLR), Ordinal Logistic Regression (OLR), and Baseline-category Logistic Regression (BLR)), these models were then used to predict the response variable given a test set of data. The performance of each model was then reviewed and discussed. The results show that the machine learning techniques outperformed the logistic regression methods. The best set of results produced for Dataset 1 was an Area Under the Curve (AUC) of 75.43% by the BLR model, an accuracy of 79.93% by the RF model, a Kappa score of 0.3385 by the SNN and a mean balanced accuracy of 60.85% achieved by the SNN. Dataset 2 saw the SNN produce the best AUC, Kappa score and mean balanced accuracy with values of 62.48%, 0.1960 and 54.66% respectively. The best accuracy score was achieved by the RF model (78.1%). Dataset 3 and Dataset 4 saw the same outcomes arise. The RF model produced the best AUC and accuracy, 71.58% and 74.5% for Dataset 3 and 63.04% and 75.51% for Dataset 4. However the SNN produced the best kappa scores and mean balanced accuracy values for both datasets, 0.3719 and 62.31% for Dataset 3 and 0.2576 and 57.56% for Dataset 4 The results of the study show that the machine learning techniques outperform the logistic regression methods in status and severity prediction of South African Covid-19 laboratory test data and that the best performing machine learning technique was the self-normalising neural network. Overall the models and networks performed the best when using Dataset 3. The results provide evidence that the machine learning techniques can be used as an indicative tool for Covid-19 status and severity prediction rather than a confirmation tooItem The nature of climate change communication in South Africa: its past, political and socio-economic undertones(2024) Sithole, EnochThe United Nation’s Intergovernmental Panel on Climate Change (IPCC) has noted that the observed and projected impacts and risks generated by climate hazards, exposure and vulnerability have increased with impacts attributable to climate change. The increase in climate extremes has led to some irreversible impacts as natural and human systems are pushed beyond their ability to adapt. Climate change has altered terrestrial, freshwater and ocean ecosystems at a global scale, with multiple impacts observable at regional and local scales, where changes in the ecosystem structure, species, geographic ranges, and timing of seasonal life cycles is apparent. Climate change is having diverse and adverse impacts on human systems throughout the world, affecting water security, food production, health, livelihoods, settlements, and infrastructure. According to the IPCC, it is “unequivocal” that human influence is warming the atmosphere, land, and oceans. The world climate body adds that humans are exacerbating climate change through the burning of fossil fuels and other activities. Faced with the global warming challenge, humanity has no choice but to engage in measures to mitigate and adapt to the resulting climate change. Climate change communication has been identified as one of the measures that will need to be applied in addressing climate change. This is so because for action against climate change to succeed, society will need to be mobilised to change behaviour and implement other measures. Climate change communication is the awareness, education, and mobilisation tool thereof. This PhD thesis investigates climate change communication in South Africa over the past century (since 1902) through an analysis of climate change-related news articles in three newspapers – the Rand Daily Mail, Mail & Guardian, and Business Day. The idea is to establish how key stakeholders – the government, the business sector, the scientific community, non-governmental organisations (NGOs) and the media – have communicated on climate change, and whether their communication on the subject has been underpinned by political and socio-economic considerations. Results show that while the scientific community has been communicating on ‘climate change’ from about 1935, when the first article on the subject was published by the Rand Daily Mail, other stakeholders such as the government, the business sector, and NGOs, only started communicating on climate change in the 1990s. Government and business sector communication has been underpinned by financial and economic undertones. Climate change communication scholarship in South Africa has been limited v compared to that elsewhere globally, especially in western countries. This thesis argues that South Africa will need to massively improve its climate change communication, as such communication plays a fundamental role to ensure a seamless transition from coal and other fossil fuels to a low carbon economy.Item The emergence of eco fashion in South Africa: fleeting fad or environmental conservation breakthrough?(2024) Gatawa, Nyasha GraceFrom the iridescent sunny slopes of the Alps to the murkily golden streets of London to heritage rich Kazakhstan and wildly exotic Kenya as well as cosmopolitan upbeat New York, the global fashion industry has a creative vibrancy. The fashion industry reverberates with palpable regional inspiration, drawing global cultural energy and unique local design artistry. The rise of sustainable fashion has been concentrated in the more developed countries but has now seen local designers in South Africa launch eco collections as they focus on sustainability. Eco friendly fashion has the potential to change the landscape of the fashion industry in South Africa. The fast fashion/slow fashion dichotomy has been a central feature of the industry in recent years. The emergence of eco fashion in South Africa is also in line with the growing policy priority of the green economy and the circular economy principles influence on fashion design. There has been very little study on the fashion industry in South Africa and currently only a few researchers are working in this sector providing a gap for the study. This study focuses on small fashion design businesses operating in a formal manner across South Africa and their approach to environmental sustainability as well as their launch of eco collections. While only a few designers participated in the study, findings from the study can be extrapolated to the rest of the small-sector and also give clues to the way medium sized and large players in the sector are dealing with sustainability in their operations. The study investigates to a limited extent sustainability trends across South Africa documenting trends observable in large clothing chains. The study findings indicate a high awareness of sustainability from the garment or apparel maker standpoint yet a very evident lack of engagement by the targeted consumer in the markets surveyed. Eco fashion in South Africa has not been widely studied and this study seeks to fill in the gaps and contribute to current debates by focusing on small designers and how there is an emergent interest and focus on eco fashion. The study presents six cases that are analysed as comparative cases that can provide insight into trends in this sector in response to eco 10 fashion. The study was mainly a qualitative study relying on email surveys, telephonic interviews and other online and social media investigations. The need to interrogate eco fashion in South Africa is apparent and to see how developments in this sector could be an avenue to spread environmental awareness through the sector. Eco fashion has had a slow trajectory in the African market and this study addresses this. The COVID- 19 pandemic has cast a concerning shadow on the fashion industry globally, shifting consumer purchasing patterns, and may significantly impact the values and approach of the industry regarding sustainability. The COVID- 19 pandemic had a devastating impact on many industries globally and even as lockdown restrictions are now being lifted, the future remains uncertain in many localities. The fashion industry has been one of the most industries affected by the ongoing pandemic, with the closure of ‘brick and mortar’ shops at the height of the pandemic fury, and a move to online shopping more discernibly. The COVID-19 pandemic has highlighted the need for nature and mankind to find a symbiotic balanced relationship safeguarding biomes, ecosystems, and the fragile balance of nature. The pandemic has revealed real fragilities in the way mankind has interacted with and impacted nature. Social justice inequalities in the global fashion value and supply chains have also been revealed by the pandemic in a visible way especially in countries that use cheap labour. When the pandemic suddenly emerged across the world in early 2020 and as the virus shutdowns occurred, countries in the east like Bangladesh where fashion producing factories are located faced devastating financial losses and employee welfare imbalances were exposed almost immediately. Mass cancellations of scheduled fashion orders and scheduled deliveries to regions around the world hit factories in the east with real impact leading to factory closures and job losses particularly in the east (McIntosh, 2020). Eco fashion may have arrived in South Africa to herald a new era in garment making but against the backdrop of a time in history (COVID- 19) that has crippled businesses. The trajectory of sustainability in the South African fashion industry may well be derailed or significantly altered.Item Wealth and suburban stratification in Cape Town: Investigating the persisting effect of housing segregation(2022) Chikte, AliyaThis report aims to provide an estimate for the post-Apartheid distribution of growth in residential housing wealth, disaggregated according to historical race-based spatial classifications. Economic policies to address inequality in one of the world’s most unequal contexts have primarily centred on increasing income transfers and expanding the social wage. Despite the removal of legally codified race-based discrimination, inequality in South Africa is increasing both between and within racial groups. The objective of this report is to use the case study of Cape Town in South Africa to demonstrate whether housing wealth plays a role in consolidating, enhancing, or reducing divergence. The paper addresses a gap in the literature by accounting for the impact of race-based socio-spatial penalties on contemporary housing asset values, appreciation, and the accumulation of wealth in an urban and contemporary South African context. Data from the Cape Town General Valuations (GV) roll during 2012 and 2015 is used in combination with Census and historical Apartheid race-based spatial classifications to conduct descriptive and hedonic regression analyses. It is shown that houses in formerly White areas, on average, have a higher initial endowment and grow at 2 percentage points more per year compared to houses in previously Black and Coloured neighbourhoods. Although the difference in growth appears modest, it is shown that during the first 20 years of democracy in South Africa, there was an 8-fold difference, on average, in the additional gains from residential housing between previously White and Black areas.Item A re-evaluation of the estimated overcharge by the South African cement cartel(2022) Brunette, AlexanderThe topic of overcharge estimation regarding cartels is scarce in both the international and domestic regard. This paper aims to re-estimate the overcharge by the South African cement cartel after it was forced to disband following the end of the apartheid regime. In order to avoid the problem of spurious regression results, the time series data are thoroughly analysed for unit roots. To combat the presence of the confirmed nonstationarity, an error correction model is employed in order to yield more accurate estimates. When controlling for nonstationarity, it is found that the price overcharge is higher than that provided by static ordinary least squares regressions and is on par with more recent estimates.Item Essays on competition and technical efficiencies in South Africa’s medical scheme industry(2022) Ndlovu, ThabangAccording to existing economic literature there are idiosyncratic elements within healthcare markets that prevent normal market forces, such as competition, to shape the healthcare industry in the same manner as other industries. The reasons for this are regulatory barries to entry, fixed costs, the role of insurance, information frictions and asymmetries. More so, the healthcare sector is comprised of various interconnected sub-sectors that all have their own institutions and nuances. In the South African Context, the Health Market Inquiry, which was conducted by the Competition Commission of South Africa, submit that the South African healthcare sector comprises a complex set of interrelated stakeholders that interact in markets that are not transparent and not quite understood. Given this, the primary objective of conducting this doctoral study was to understand the competition and efficiency dynamics within South African healthcare insurer markets through a collection of related empirical papers on competition and efficiency. Annual firm level data on South African medical schemes was used to study various economic theories using panel data econometric techniques. The results suggest that open medical schemes tended to be more efficient than restricted medical schemes in terms of technical, scale and pure technical efficiency over the sample period. More so, the empirical results reveal that there is room for improvement in terms of efficiencies for both open and restricted medical schemes. This is specifically true for restricted medical schemes. In addition, the empirical results seem to support the view that firms with market power, operating in highly concentrated markets, will limit competition and will operate under a reduced efficiency level. Further, the empirical results revealed that both the structureconduct-performance and efficient structure hypotheses can be rejected in relation to South African medical schemes. The empirical evidence further suggests support for differing hypotheses for open and restricted medical schemes when traditional structural approaches to assessing competition are employed. Moreover, the empirical evidence suggests that the market for restricted medical schemes is highly concentrated and operating under a reduced efficiency level which produces less than desirable outcomes. These findings are supported when nonstructural approaches to competition are employed as the empirical results from the nonstructural approaches to assessing competition suggest that both open and restricted medical schemes are operating under conditions of monopolistic competition. Furthermore, once efficiency is incorporated in the model, the empirical findings still reveal conditions of monopolistic competition