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Effective integrated development plans in a transforming local government in South Africa
(University of the Free State, 2013) Mdhluli, Begizizwe Ephraim; Hofisi, Costa
The main aim or objective of the study was to provide clarity on why Integrated Development Plans (IOPs) are not effective in a transforming and developing local government in South Africa. This was done through analysing the development and implementation of the IDP itself. The Constitution of the Republic of South Africa (Act 108 of 1996), allows local government to provide services to the people in general. The conceptualisation of the IDPs within municipalities brought about this strategic apparatus, a tool that will help bring a better life and change to the living conditions of the poorest of the poor. The Municipal Systems Act, (Act 32 of 2000) states clearly that each municipal council must adopt a single, inclusive strategic plan for the development of their municipality. It further outlines that this plan must integrate, co-ordinate and take into account proposals from the community and all relevant stakeholders for the development of the municipality. Lastly, it must align the resources and capacity of the municipality with the implementation plan. It is against this background that the study has revealed that planning in municipalities in the Free State (in particular) has drastically advanced, but there is more work to be done. Particular reference is made to Mohokare Local Municipality, where the implementation of the IDP seems to be disadvantaged by a lack of resources, both funding and staff. The study involved qualitative research based on a case study. A research tool that was used during this study was face-to-face interviews with the participants/respondents; these included the Speaker/Mayor of the Council, the Municipal Manager and Managers directly accountable to the Municipal Manager, and few middle managers of the Mohokare Local Municipality. Findings reveal that the role of the IOP as a transformation tool is compromised by a number of challenges. The municipality lacks the capacity required for the development and implementation of the IDP. Although there are individuals within the municipality who have tertiary qualifications, they are incorrectly positioned. The community of Mohokare Local Municipality has indicated through its stakeholders that the municipality also has very serious financial problems and cannot deliver services as required by law. For the municipality to succeed there is a need for the development of the capacity of the municipality and for its community to effectively develop and implement the IDP.
Analysis of the perceptions of flood and effect of adoption of adaptation strategies on income of informal settlements of Mamelodi in South Africa
(Elsevier, 2024) Nyam, Y.S.; Modiba, N.T.S.; Ojo, T.O.; Ogundeji, A.A.; Okolie, C.C.; Selelo, O.T.
Extreme weather events are being experienced all over the world because of climate change, posing challenges for individuals and households who rely on agricultural operations as their major source of livelihood. Household-level adaptation is an efficient way of dealing with global climate change. As such, this study aims to examine the perception of informal settlers to flood risk and their adoption of adaptation strategies to flood. This study applied the seemingly unrelated regression (SUR) to identify factors influencing the perception of flooding on community members and probit regression to identify the factors influencing the adoption of adaptation strategies to floods and examined the impact of the adoption of adaptation strategies on income in Eerste Fabriek informal settlement in Mamelodi using two-step quasi-maximum likelihood estimates of fractional response model. Our results show that community members are perceptive of floods and their impact on the environment and their livelihoods, and on average, they believe flood impact is significant. Age, marital status, education, employment status, income, and household size are demographic factors that tend to influence their perception of the impact of flood events. Access to institutional facilities such as health and recreational facilities was also a significant factor in how community members adapt to the impact of floods. Timely healthcare access services are a significant precursor for people to form their perception, which is intended to help them adapt appropriately to situations as health is wealth. Community members' perceptions and adaptive capacity can be improved through policies that foster the adoption of effective adaptation strategies. Community-based adaptation strategies are necessary for involving all stakeholders and necessary for mitigating the effects of flooding.
Climate-influenced vector-borne diseases in Africa: a call to empower the next generation of African researchers for sustainable solutions
(BMC, 2024) Obame-Nkoghe, Judicaël; Agossou, Adjoavi Esse; Mboowa, Gerald; Kamgang, Basile; Caminade, Cyril; Duke, Dawn C.; Githeko, Andrew Karanja; Ogega, Obed M.; Engone Elloué, Nestor; Sarr, Fatou Bintou; Nkoghe, Dieudonné; Kengne, Pierre; Ndam, Nicaise T.; Paupy, Christophe; Bockarie, Moses; Voua Otomo, Patricks
We look at the link between climate change and vector-borne diseases in low- and middle-income countries in Africa. The large endemicity and escalating threat of diseases such as malaria and arboviral diseases, intensified by climate change, disproportionately affects vulnerable communities globally. We highlight the urgency of prioritizing research and development, advocating for robust scientific inquiry to promote adaptation strategies, and the vital role that the next generation of African research leaders will play in addressing these challenges. Despite significant challenges such as funding shortages within countries, various pan-African-oriented funding bodies such as the African Academy of Sciences, the Africa Research Excellence Fund, the Wellcome Trust, the U.S. National Institutes of Health, and the Bill and Melinda Gates Foundation as well as initiatives such as the African Research Initiative for Scientific Excellence and the Pan-African Mosquito Control Association, have empowered (or are empowering) these researchers by supporting capacity building activities, including continental and global networking, skill development, mentoring, and African-led research. This article underscores the urgency of increased national investment in research, proposing the establishment of research government agencies to drive evidence-based interventions. Collaboration between governments and scientific communities, sustained by pan-African funding bodies, is crucial. Through these efforts, African nations are likely to enhance the resilience and adaptive capacity of their systems and communities by navigating these challenges effectively, fostering scientific excellence and implementing transformative solutions against climate-sensitive vector-borne diseases.
An investigation into the inflammatory properties of tenofovir in HepG₂ human liver cells
(University of the Free State, 2023) Vazi, Songezo; Tiloke, C.; Van Zyl, Sanet
𝗜𝗻𝘁𝗿𝗼𝗱𝘂𝗰𝘁𝗶𝗼𝗻: Since the introduction of antiretroviral (ARV) drugs in 1996, the life expectancy of HIV-infected individuals has been nearly comparable to that of HIV-uninfected individuals. However, increasing evidence shows that antiretroviral therapy (ART) is associated with increased metabolic disorders, systemic inflammation, and hepatotoxicity. Tenofovir induces oxidative stress via mitochondrial DNA polymerase inhibition in HepG2 cells at chronic exposure. Although in vitro and in vivo studies have been performed to determine the effect of tenofovir on the inflammatory response, the inflammatory effect of this antiretroviral drug in liver cells still needs elucidation.
𝗔𝗶𝗺: This study aimed to investigate tenofovir's potential pro- and anti-inflammatory properties in HepG₂ human liver cells at different time frames.
𝗠𝗲𝘁𝗵𝗼𝗱𝗼𝗹𝗼𝗴𝘆: HepG₂ cells were treated with tenofovir (1.2 μM) over 24h and 120h; pro- and anti-inflammatory cytokines levels were assessed using a SimpleStep human ELISA kit specific to each analyte (IL-6, IL-1β, TNF-α, IL-10). Protein expression of p-NF-ĸBp65, NF-ĸBp65, p-IĸBα, and IĸBα was determined with Western blotting. A quantitative polymerase chain reaction assessed the mRNA expression of 𝘕𝘍-κ𝘉𝘱65 and 𝘐𝘬𝘉α.
𝗥𝗲𝘀𝘂𝗹𝘁𝘀: Tenofovir significantly increased IL-6 and 10 levels, 𝘕𝘍-κ𝘉𝘱65 mRNA expression and NF-κBp65, p-NF-κBp65 and p-IκBα protein expression. Additionally, a significant decrease in IL-1β levels and 𝘐κ𝘉α mRNA expression at 24h were observed. After 120h, tenofovir-treated cells showed increased p-NF-κBp65 and IκBα protein expression. Furthermore, a significant decrease in IL-6 and IL-10 levels, 𝘕𝘍-κ𝘉𝘱65 and IκBα mRNA expression and NF-κBp65 and p-IκBα protein expression were observed.
𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻: The study demonstrated that tenofovir elevated the anti-inflammatory cytokines at acute exposure. Tenofovir increased pro-inflammatory cytokines and downregulated anti-inflammatory cytokines at chronic exposure of tenofovir in HepG₂ human liver cells. The knowledge obtained from tenofovir-induced inflammatory changes can provide valuable information regarding tenofovir’s clinical use.
A conceptual framework to improve the reporting quality of strength training exercise descriptors in anterior cruciate ligament reconstruction rehabilitation programs
(University of the Free State, 2023) Vlok, Arnold; Coetzee, F. F.
𝗜𝗻𝘁𝗿𝗼𝗱𝘂𝗰𝘁𝗶𝗼𝗻
Muscle weakness after anterior cruciate ligament reconstruction (ACLR) is persistent and associated with abnormal biomechanics, poor knee function, new knee injury and development of osteoarthritis. The proposed drivers of persistent muscle weakness after ACLR are changes in muscle morphology, atrophy-inducing cytokines in the knee joint, and neurological alterations on a cortical and spinal level. The most accessible approach to target muscle weakness is various types of strength training exercises. However, another explanation for persistent weakness after ACLR rehabilitation could be that programs are not following the best practice for strength training. Failure to improve muscle strength after ACLR could be caused by faulty programming of exercise descriptors (e.g., exercise type, frequency, load).
𝐀𝐢𝐦
The main aim of this study was to develop a conceptual framework to improve the reporting quality of strength training exercise descriptors in ACLR rehabilitation programs.
𝗠𝗲𝘁𝗵𝗼𝗱𝗼𝗹𝗼𝗴𝘆
The study was conducted in three stages, including a Scoping Review, focussing on which strength training exercise descriptors are reported in ACLR research after ACLR surgery, and comparing the current standards of reporting ACLR strength training exercise descriptors to international best practice strength training guidelines. The modified e-Delphi survey was utilised to formulate a conceptual rehabilitation framework for ACLR. The last stage included validating the preliminary ACLR conceptual framework that included a core outcome set (COS) of strength training exercise descriptors for reporting after ACLR.
𝗥𝗲𝘀𝘂𝗹𝘁𝘀 𝗮𝗻𝗱 𝗱𝗶𝘀𝗰𝘂𝘀𝘀𝗶𝗼𝗻
We extracted data on 117 exercises from 41 studies. A median of seven of the 19 possible exercise descriptors were reported (range 3-16). Reporting of specific exercise descriptors varied across studies from 93% (name of the strength training exercise) to 5% (exercise aim). On average, 46%, 35%, and 43% of the exercise descriptors included in the ACSM, CERT, and Toigo and Boutellier guidelines were reported, respectively. The e-Delphi results from 27 ACLR experts regarding the 21-exercise descriptor definition was 100% consensus agreement (>80% agreement), also 100% consensus agreement on a COS of strength training exercise descriptors (). However, very low consensus agreement on exercise dosages prescribed in ACLR strengthening programs. The validation meeting consisted of four panellists that validated the preliminary ACLR conceptual framework and proposed to re-organise the 13 COS of exercise descriptors into levels of importance regarding the frequency of reporting.
𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻
The proposed ACLR conceptual framework for researchers and clinicians provided a platform for the reporting of strength training rehabilitation after ACLR. Improving the reporting quality of strength training exercise descriptors, definitions, and exercise dosages for ACLR rehabilitation programs can aid in the transfer of ACLR rehabilitation research towards private practice. Therefore, enabling clinicians to implement evidence-based strength training exercise configurations.
Strategies to enhance the approach to prostate cancer screening of African men in the Free State
(University of the Free State, 2023) Benedict, Matthew Olukayode Abiodun; Claassen, Frederik M.; Steinberg, Wilhelm J.; Mofolo, Nathaniel
𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱: Prostate cancer is a significant public health concern in South Africa, with rising incidence and mortality rates, particularly among African men. Prostate-specific antigen (PSA) screening is a practical method for early detection and improved outcomes. However, it carries the risks of overdiagnosis and overtreatment. Recent studies have shown a more significant net benefit of PSA screening for Black men than the general population. However, there are knowledge, attitude and practice gaps among primary healthcare providers and users, especially Black men, regarding prostate cancer screening. Practical strategies to address these gaps are lacking. This study focuses on vulnerable African men in the Free State Province, South Africa.
𝗠𝗲𝘁𝗵𝗼𝗱𝘀: This thesis presents the results of five complementary studies aiming to identify gaps in prostate cancer screening and determine strategies to enhance prostate cancer screening among African men in the Free State Province from the perspectives of primary healthcare providers and users. The first study employed a cross-sectional descriptive design, using case record information and self-administered questionnaires to profile Black South African men with prostate cancer attending a tertiary hospital’s oncology and urology clinics in the Free State Province. The second study used a cross-sectional analytical survey design, administering self-administered questionnaires to assess the knowledge, attitude and practice of primary healthcare providers in the study setting. The third study also employed a cross-sectional analytical survey design, utilising self-administered questionnaires to investigate African men’s knowledge, cultural beliefs and screening intentions regarding prostate cancer screening. Factors associated with their intention to screen for prostate cancer were examined. Quantitative data were analysed using descriptive statistics, and associations were tested using chi-squared or Fisher’s exact tests. The fourth and fifth studies comprised a scoping review and a modified Delphi survey to identify and propose strategies to enhance prostate cancer screening among African men in the study setting, addressing the identified gaps.
𝗥𝗲𝘀𝘂𝗹𝘁𝘀: The findings revealed that aggressive prostate cancer is prevalent among African men in the study setting. Poor knowledge and awareness of the disease and low screening uptake were observed. Factors such as dietary habits, lifestyle and presentation time were associated with aggressive disease at diagnosis. Cultural beliefs influenced screening uptake among men. Factors associated with a higher intention to screen included reduced fear, perceived benefits, situational barriers, and perceived risk of developing prostate cancer. Regarding primary healthcare providers, the majority demonstrated poor knowledge (64.8%), neutral attitudes (58.6%) and poor practice (40.0%) related to prostate cancer screening. Female providers, lower cadre nurses and community health workers had lower knowledge scores. Lack of prostate cancer-related continuing education was significantly associated with poor knowledge, negative attitudes and poor practice among healthcare providers. The study proposed strategies to address the identified gaps among African men and primary healthcare providers. Community-oriented approaches involving the active participation of both providers and community members were emphasised. These strategies focused on relevant prostate cancer health education topics in public spaces, employing diverse, comprehensive, user-friendly and culturally sensitive methods.
𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻: This thesis highlights the gaps in prostate cancer screening among African men and primary healthcare providers in the Free State Province, South Africa. Targeted strategies are needed to enhance prostate cancer screening uptake and improve outcomes in this vulnerable population. Implementing the proposed strategies can improve awareness and knowledge of the disease and ultimately enhance screening practices among African men in the study setting.
Experiences of health sciences students residing on campus during university recess: a photovoice study
(University of the Free State, 2023) Kekana, Palesa Mildred; van Jaarsveldt, Deirdre Elizabeth; Mathebula, Mikateko
This study addressed the lack of empirical research on the experiences of South African health sciences students residing on campus during university recess. The health professional governing bodies in South Africa require students to gain clinical competence through work-integrated learning, which is often undertaken during university recess. Yet, literature on this specific topic could not be retrieved. Studies on clinical learning in the health sciences environment focus solely on the clinical workplace, without considering students residing in campus residences during recess. The unknown struggles and potential challenges faced by health sciences students during recess could raise significant issues that higher education institutions in South Africa should consider. To address this research gap, participatory research utilising the photovoice method was employed to answer the research question: what are the experiences of health sciences students residing on campus during recess at a specific university? Four health sciences students were recruited through purposive sampling to participate in a series of workshops. They were provided with cameras to document their experiences on campus during university recess. Discussions and an exhibition of the photographs were conducted, resulting in the identification of 13 themes that were clustered into four, namely, sharing personal space, support services and structures, security, and character building and personal development. These clustered themes flagged that the co-researchers experienced a loss of sense of belonging, linked to inadequate support during university recess. Moreover, the study demonstrates the feasibility of implementing participatory research under challenging conditions, such as COVID-19 restrictions. The participatory method empowered co-researchers to advocate for themselves and others, thereby shedding light on issues that matter for institutional transformation. It would be advantageous to expand the research with more participants, across disciplines, and over longer periods of recess to inform policies and guidelines relating to recess periods.
Lesbian, gay, bisexual, transgender, and intersex content in nursing education programmes: a mixed method systematic review
(University of the Free State, 2023) Coetzee, Tyrone Brett; Van Jaarsveldt, Deirdre Elizabeth; Fichardt, Anna Elizabeth
𝗜𝗻𝘁𝗿𝗼𝗱𝘂𝗰𝘁𝗶𝗼𝗻: A prevailing heteronormative approach observed within nursing programmes could perpetuate non-inclusive attitudes amongst nurses. A paucity of published evidence indicated the need to undertake a comprehensive synthesis of evidence regarding LGBTI content in nursing programmes.
𝗣𝘂𝗿𝗽𝗼𝘀𝗲: This MMSR set out to critically synthesise existing evidence in the literature on LGBTI content in nursing programmes in order investigate what evidence exists in the literature on LGBTI content in nursing programmes. The MMSR is provided an updated and comprehensive insight into the presence/inclusion of literature which covers LGBTI-related content in nursing education programmes.
𝗠𝗲𝘁𝗵𝗼𝗱𝘀: A mixed method systematic review, conducted according to Joanna Briggs Institute (JBI) Manual for Evidence Synthesis Preferred Reporting Items for Systematic Reviews and Meta-Analyses using the (PRISMA) guidelines, guided the review process. The MMSR followed systematic approach to the search and selection of literature. Data sources were identified within EbscoHost Web, Scopus and Google Scholar. A convergent integrated approach for data integration and synthesis was followed. Data were extracted with the use of two standardised data extraction tools. Through inductive reasoning and MMSR processes of thematic analysis, data transformation, data integration and data synthesis of information from qualitative, quantitative, and mixed method studies. The main search identified 316 publications (n=316) resulting in ten (n=10) articles for quality appraisal. Data of nine (n=9) articles included in this review were extracted. A thematic analysis (manually performed) aided in identification of recurrent themes.
𝗥𝗲𝘀𝘂𝗹𝘁𝘀: LGBTI content in nursing programmes were found to be present but lacking specificity and relevance. The context in which the included studies were conducted linked several social and health related LGBTI aspects, regardless of location. However, location and local belief system dictated extremes to which LGBTI inclusivity was practiced. The review findings further elaborate that curricular revision is necessary in the advancement of social justice, to overcome challenges and barriers to LGBTI inclusion.
𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻𝘀 𝗮𝗻𝗱 𝗥𝗲𝗰𝗼𝗺𝗺𝗲𝗻𝗱𝗮𝘁𝗶𝗼𝗻𝘀: In nursing education, a prevailing heteronormative approach creates large gaps in cultural and clinical competencies regarding LGBTI health issues. The concepts of inclusivity, representation, respect, and recognition, according to the review findings, LGBTI content should be included in teaching and learning offerings provide new foci and understandings within the LGBTI research area. Education on LGBTI health disparities could foster a keen appreciation of the impact of stigma and discrimination experienced by LGBTI persons. To advance a social justice agenda for marginalised and vulnerable populations, LGBTI health-related content in nursing education and healthcare service delivery programmes could enrich and supplement content currently presented.
Economic inclusion: green finance and the SDGs
(MDPI, 2024) van Niekerk, Arno J.
Persistent economic exclusion and the high levels of natural resource depletion are alarming. The Sustainable Development Goals (SDGs) are among a few global initiatives aimed at bringing a turnaround in both of these areas of concern. Giving action to productive economic inclusion and transitioning towards a circular, regenerative economy is challenging for countries, particularly because of a lack of economic incentives. Green finance has emerged in the last few decades as a valuable mechanism that has the potential to meet this challenge. In answering the question of how to facilitate the necessary transition to a green, inclusive economy, the paper attempts to bring green finance and economic inclusion together as a possible means (like a bridge) to address economic exclusion and resource degeneration. That is the primary aim of the study, and it is investigated through an analysis of theoretical literature. The key findings include: a strong synergy exists between green finance and economic inclusion; different forms of green finance are able to facilitate economic inclusion; and green finance can be instrumental in attracting investors to fast-track SDG attainment. A key conclusion is that green finance can play a vital role in activating and prolonging broad-based benefit sharing in an eco-conscious way.
Combination treatment with EGFR inhibitor and doxorubicin synergistically inhibits proliferation of MCF-7 cells and MDA-MB-231 triple-negative breast cancer cells In Vitro
(MDPI, 2024) Abrahams, Beynon; Gerber, Anthonie; Hiss, Donavon C.
The role of the epidermal growth factor receptor (EGFR) in tumor progression and survival is often underplayed. Its expression and/or dysregulation is associated with disease advancement and poor patient outcome as well as drug resistance in breast cancer. EGFR is often overexpressed in breast cancer and particularly triple-negative breast cancer (TNBC), which currently lacks molecular targets. We examined the synergistic potential of an EGFR inhibitor (EGFRi) in combination with doxorubicin (Dox) in estrogen-positive (ER+) MCF-7 and MDA-MB-231 TNBC cell lines. The exposure of MDA-MB-231 and MCF-7 to EGFRi produced an IC₅₀ₛ of 6.03 µM and 3.96 µM, respectively. Dox induced MDA-MB-231 (IC₅₀ 9.67 µM) and MCF-7 (IC₅₀ 1.4 µM) cytotoxicity. Combinations of EGFRi-Dox significantly reduced the IC₅₀ in MCF-7 (0.46 µM) and MBA-MB 231 (0.01 µM). Synergistic drug interactions in both cell lines were confirmed using the Bliss independence model. Pro-apoptotic Caspase-3/7 activation occurred in MCF-7 at 0.1–10 µM of EGFRi and Dox single treatments, whilst 1 μM Dox yielded a more potent effect on MDA-MB-231. EGFRi and Dox individually and in combination downregulated the EGFR gene expression in MCF-7 and MDA-MB-231 (p < 0.001). This study demonstrates EGFRi’s potential for eliciting synergistic interactions with Dox, causing enhanced growth inhibition, apoptosis induction, and downregulation of EGFR in both cell lines.