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Public sector primary care clinics in Free State Province, South Africa.To investigate the effects of on-site in-service clinical skills training for nurse practitioners on tuberculosis (TB) treatment outcomes in the same clinics.Analysis of TB programme data from clinics taking part in two consecutive randomised trials of educational outreach aimed at improving respiratory and human immunodeficiency virus/acquired immune-deficiency syndrome care based on the Practical Approach to Lung Health. We compared treatment outcomes between control and intervention clinics among all patients diagnosed with TB during either trial.During the two trials, participating clinics treated 4187 and 2333 TB patients, respectively. Neither intervention was associated with better outcomes overall. However, among retreatment patients, cure or completion rates in intervention clinics were significantly higher during the second trial (OR 1.78, 95%CI 1.13-2.76). Patients in clinics that had received both interventions had higher cure or completion rates (OR 1.99, 95%CI 1.53-2.58) and lower default rates (OR 0.25, 95%CI 0.097-0.63) than patients in clinics that had received neither intervention.Although not primarily focused on TB treatment, the interventions appeared to improve successful treatment completion rates among TB retreatment cases. Integrated care programmes support attainment of important TB programme goals.

BACKGROUND AND AIM: A recently carried out randomized controlled trial showed the benefit of a novel 20-G fine-needle biopsy (FNB) over a 25-G fine-needle aspiration (FNA) needle. The current study evaluated the reproducibility of these findings among expert academic and non-academic pathologists. METHODS: This study was a side-study of the ASPRO (ASpiration versus PROcore) study. Five centers retrieved 74 (59%) consecutive FNB and 51 (41%) FNA samples from the ASPRO study according to randomization; 64 (51%) pancreatic and 61 (49%) lymph node specimens. Samples were re-reviewed by five expert academic and five non-academic pathologists and rated in terms of sample quality and diagnosis. Ratings were compared between needles, expert academic and non-academic pathologists, target lesions, and cytology versus histological specimens. RESULTS: Besides a higher diagnostic accuracy, FNB also provided for a better agreement on diagnosing malignancy (ĸ = 0.59 vs ĸ = 0.76, P

BackgroundAlthough evidence suggests frequent gastrointestinal (GI) involvement during coronavirus disease 2019 (COVID-19), endoscopic findings are scarcely reported.AimsWe aimed at registering endoscopic abnormalities and potentially associated risk factors among patients with COVID-19.MethodsAll consecutive patients with COVID-19 undergoing endoscopy in 16 institutions from high-prevalence regions were enrolled. Mann-Whitney U, χ2 or Fisher’s exact test were used to compare patients with major abnormalities to those with negative procedures, and multivariate logistic regression to identify independent predictors.ResultsBetween February and May 2020, during the first pandemic outbreak with severely restricted endoscopy activity, 114 endoscopies on 106 patients with COVID-19 were performed in 16 institutions (men=70.8%, median age=68 (58–74); 33% admitted in intensive care unit; 44.4% reporting GI symptoms). 66.7% endoscopies were urgent, mainly for overt GI bleeding. 52 (45.6%) patients had major abnormalities, whereas 13 bled from previous conditions. The most prevalent upper GI abnormalities were ulcers (25.3%), erosive/ulcerative gastro-duodenopathy (16.1%) and petechial/haemorrhagic gastropathy (9.2%). Among lower GI endoscopies, 33.3% showed an ischaemic-like colitis.Receiver operating curve analysis identified D-dimers >1850 ng/mL as predicting major abnormalities. Only D-dimers >1850 ng/mL (OR=12.12 (1.69–86.87)) and presence of GI symptoms (OR=6.17 (1.13–33.67)) were independently associated with major abnormalities at multivariate analysis.ConclusionIn this highly selected cohort of hospitalised patients with COVID-19 requiring endoscopy, almost half showed acute mucosal injuries and more than one-third of lower GI endoscopies had features of ischaemic colitis. Among the hospitalisation-related and patient-related variables evaluated in this study, D-dimers above 1850 ng/mL was the most useful at predicting major mucosal abnormalities at endoscopy.Trial registration numberClinicalTrial.gov (ID: NCT04318366).

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Several studies have compared EUS-guided FNA with fine-needle biopsy (FNB), but none have proven superiority. We performed a multicenter randomized controlled trial to compare the performance of a commonly used 25-gauge FNA needle with a newly designed 20-gauge FNB needle.Consecutive patients with a solid lesion were randomized in this international multicenter study between a 25-gauge FNA (EchoTip Ultra) or a 20-gauge FNB needle (ProCore). The primary endpoint was diagnostic accuracy for malignancy and the Bethesda classification (non-diagnostic, benign, atypical, malignant). Technical success, safety, and sample quality were also assessed. Multivariable and supplementary analyses were performed to adjust for confounders.A total of 608 patients were allocated to FNA (n = 306) or FNB (n = 302); 312 pancreatic lesions (51%), 147 lymph nodes (24%), and 149 other lesions (25%). Technical success rate was 100% for the 25-gauge FNA and 99% for the 20-gauge FNB needle (P = .043), with no differences in adverse events. The 20-gauge FNB needle outperformed 25-gauge FNA in terms of histologic yield (77% vs 44%, P .001), accuracy for malignancy (87% vs 78%, P = .002) and Bethesda classification (82% vs 72%, P = .002). This was robust when corrected for indication, lesion size, number of passes, and presence of an on-site pathologist (odds ratio, 3.53; 95% confidence interval, 1.55-8.56; P = .004), and did not differ among centers (P = .836).The 20-gauge FNB needle outperformed the 25-gauge FNA needle in terms of histologic yield and diagnostic accuracy. This benefit was irrespective of the indication and was consistent among participating centers, supporting the general applicability of our findings. (Clinical trial registration number: NCT02167074.).

PhD (Missiology), North-West University, Potchefstroom Campus This study has emerged from the observation that there is not a single ordained female minister in the Reformed Church in Mozambique, which is in contrast with the fact that the female gender has attained significant success with regard to their position worldwide. In comparison to the times when women had no rights at all in the family circle or in the church and society at large, the above-mentioned success of women has been a struggle, fought not only by women, but by men as well (Chiziane, 2014:22). Though the female gender has made significant strides, the researcher strongly believes that at the present stage much has still to be investigated regarding the field of gender equality, either in church or society at large. The assumption is that the Reformed Church in Mozambique can partake in the missio Dei by transforming the church and society towards gender equality. The study firstly considers the revelational biblical and missiological narrative in order to gain knowledge on gender relationships therein. Secondly, the study is confined to the context of Mozambican society to determine gender relationships, given that some of the challenges that women (girls) face start or occur within the immediate family circle, which is the nucleus of the society. Then the history of the Reformed Church in Mozambique, which is now officially 107 years old (Gouws, 2005:19), is taken into consideration to establish a background to gender issues in this church. In ecclesiastical circles, where gender discrimination would not be expected to occur, women are still being sidelined to this day. As observed by Magagula (2014), there are no women serving in the pastoral offices of the church and since 1994, when the Reformed Church in Mozambique founded HEFSIBA, the church’s pastors training college, not a single woman has been trained so far. The ultimate purpose of this study is to assess how the Reformed Church in Mozambique can participate in the missio Dei by promoting gender equality in the church and society as well to develop a preliminary paradigm in order to help the church in this task. Doctoral

PhD (Business Administration), North-West University, Potchefstroom Campus, 2017 One of the main challenges facing South African citizens in terms of sustainable community development, remains the fight against poverty. One of the strategies implemented by the South African government to eradicate poverty, is the implementation of income-generating community projects. The advantages of the development of such interventions include the development of skills in conjunction with financial benefits stimulated by economic activities in communities. The expectation exists that income-generating community projects should develop into sustainable businesses after the initial skill development and donor funding. Unfortunately, this expectation is unrealistic, because income-generating community projects fail to develop into sustainable businesses and have a limited life span. However, they do facilitate sustainable community development in terms of skills development, development of entrepreneurs and economic development. The main objective of this study was to construct a conceptual framework to guide the planning and implementation of income-generating community projects to facilitate sustainable community development through the use of income-generating community projects. The case study of the Holding Hands income-generating community project provided an opportunity to study the development, implementation and functioning of an income-generating community project to develop a framework for the development and implementation of future income-generating community projects. The methodology consisted of a qualitative approach to explore a case study in order to develop constructivist grounded theory. A document analysis of the available documents on the planning, development and implementation of the Holding Hands income-generating community project was used as the first phase of data analysis with the assistance of ATLAS.ti. This resulted in the development of 10 themes and 33 codes. The gaps identified in the data were filled with in-depth interviews conducted with the participants of the Holding Hands income-generating community project. The in-depth interviews confirmed that a SWOT analysis can be a useful tool to assist community mapping and that a social network analysis of the participants can provide required networks to enhance the impact of interventions on sustainable community development. The literature review provided additional information to support the identified codes and themes. The findings of the data analysis and the literature review were integrated to develop a conceptual framework based on four core principles consisting of five phases, ten steps and thirty-three actions to guide the planning, implementation and measurement and evaluation of income-generating community projects to facilitate sustainable community development. The limitation of the study was mainly rooted in the fact that it consisted of a single case study within a specific context. This provides an opportunity to test the conceptual framework in future research Doctoral

MBA, North-West University, Potchefstroom Campus, 2017 This study takes a look at entrepreneurial drivers and motivators for entrepreneurship and if the changing climate of business and the economy allows for new drivers and motivators to come forward. The study will determine if the current driving forces and motivators for entrepreneurship through the change economy and environment will change and if so try, and establish the degree of change. The literature review looks at the theoretical information regarding entrepreneurship, who the entrepreneur is, defining entrepreneurship together with the skills required for entrepreneurship, the characteristics of an entrepreneur, entrepreneurial drivers and motivators and the entrepreneurial risk associated with entrepreneurship. This qualitative study then interviewed a total number of 8 entrepreneurs which is situated in Gauteng South Africa whose business is three years and older to see if their drivers and motivators had changed, remained the same and what role technology had played in their respective businesses. The empirical evidence showed that the drivers and motivators for entrepreneurship had stayed the same. The core of the business has stayed the same, but the role of technology as an influencer in how business was conducted was vast and undeniable. Technology is used to speed things up in businesses and assists in making the business decision making and environment easier. Technology is seen as an internal influencer on the business. This study finds that entrepreneurs require a lot of skills which can be learned and taught when required by the entrepreneurs to move their businesses forward. Entrepreneurial characteristics are what the entrepreneur has, something that can be enhanced but not taught, the entrepreneur has character and certain characteristics. Entrepreneurs also define success in their ability to help other people live a better live rather than chasing wealth. According to the entrepreneurs, their view of risk is different than for someone working at a typical job. According to the entrepreneurs the typical definition of a stable job is actually more risky due to the economic climate of uncertainty and retrenchments Masters

PhD (Business Administration), North-West University, Potchefstroom Campus, 2017 Entrepreneurship has been hailed as the new engine of economic growth in both developed and developing countries. It is paradigmatically referred to as the process of innovatively exploring and exploiting opportunities in the midst of risks and uncertainty, by synthesising resources to create novel outputs, often within the context of new organisational formation. Exalted as the driving force of innovation, entrepreneurship offers the benefits of increased economic efficiencies, alleviation of poverty, bringing, innovation to the market, job creation, and sustained employment. Traditionally, entrepreneurship was associated with the private sector and for-profit businesses, with entrepreneurial innovations considered to be those directed toward the marketplace. Therefore, the phenomenon initially received marginal attention in public school management. Schools are state-appointed suppliers of a service, funded by the government, and are considered as domesticated organisations, therefore their survival is seldom at doubt. On the other hand, schools are operating in an environment of increasing uncertainty. This uncertainty stems from their openness and consequent exposure to rapid environmental changes. It was found that public schools face various challenges, including a lack of entrepreneurial spirit and a fragmented approach regarding their visions, missions and strategic thrust. This study, through literature research and a quantitative empirical research, focused on the identification of the dimensions of entrepreneurial orientation (independent variables) and the factors related to perceived school success (dependent variables). Furthermore, the study exploits the relationship between the dependent variables and the independent variables to determine the impact of entrepreneurial orientation on perceived school success in three predetermined groups of secondary schools in Gauteng. Factors measuring entrepreneurial orientation were extracted from the literature review, and identified as autonomy, innovativeness, risk-taking, competitive aggressiveness and pro-activeness. Factors measuring perceived school success were identified in order to develop a measure of school success. The 13 identified dependent variables were classified into four different groups. After grouping, the four main categories were school leadership (leadership, evaluating school performance and staff development), teaching and learning (emphasis on academics, class size and high quality of teaching and learning), learner behaviour (safe and orderly schools, discipline and parental involvement) and learners (learner self-esteem, monitoring pupil performance, feedback and high expectations). The study was based on a sample of 800 educators, heads of departments, deputy principals and principals at selected public secondary schools in the province of Gauteng in South Africa, who completed a structured questionnaire. The majority of the respondents were between the ages of 50 and 59 and 74% of the respondents were female. The primary unit of measurement was public secondary schools, and as expected, respondents were mostly educated, with 97.6% in possession of post-matric qualifications. Only 74.1% had a degree or higher qualification though. A total of 79.3% of the respondents were educators on post level 1 and regarding the population group, 83.5% were White. The effect of each of the independent variables on each of the measures of perceived school success, as the dependent variable, was measured through 13 multiple regression coefficients, after the independent variable was proven reliable and valid through drawing a pattern matrix of Oblimin rotated-principal component factor analysis, Kaiser-Meyer-Olkin measures of sampling adequacy, and Bartlett‘s test of sphericity. The measurement instrument utilised in this study was proven to be reliable and valid. None of the factors loaded significantly onto the independent variable, risk-taking. A Hierarchical Linear Modeling was performed to determine whether there were significant differences between the school groups in terms of selected variables. A Spearman rho was also performed to determine the correlation between the independent variables and the four main groups of dependent variables. During the empirical research, it was found that significant relationships exist between leadership, autonomy, innovativeness, and competitive aggressiveness; evaluating school performance, autonomy, and innovativeness; staff development, autonomy, innovativeness, and competitive aggressiveness; emphasis on academics, autonomy, innovativeness, and competitive aggressiveness; class size, pro-activeness and competitive aggressiveness; quality of teaching and learning, autonomy and innovativeness; safe schools, autonomy, innovativeness and competitive aggressiveness; discipline, autonomy, innovativeness and pro-activeness; parental involvement, pro-activeness and competitive aggressiveness; learner self-esteem, innovativeness and pro-activeness; monitoring pupil performance, autonomy and innovativeness; feedback, autonomy, innovativeness; and high expectations, autonomy and innovativeness. In relation to the Hierarchical Linear Modeling of the independent variables, differences between the three groups of schools were found in terms of innovativeness (practical visible and practical significant differences), pro-activeness (practical visible difference), and competitive aggressiveness (practical visible difference). The results of the dependent variables indicate practical significant differences in terms of emphasis on academics and parental involvement. The results of the Spearman rho indicated that the four groups of dependent variables were reliable after determining the Cronbach alpha coefficients. Practical significant correlations were found between innovativeness, school leadership, teaching and learning and learner behaviour; competitive aggressiveness, school leadership, teachingand learning and learner behaviour. Practical visible correlations were found between autonomy, school leadership, teaching and learning, learner behaviour and learners; Innovativeness and learners; pro-activeness, school leadership, teaching and learning and learner behaviour; and competitive aggressiveness and learners. Both primary and secondary objectives were met and all research questions were answered. All criteria were met to ensure that the research was conducted according to research principles. Through this research, school principals and school management teams in South Africa can gain insight into the creation of entrepreneurial success as well as the measurements of perceived school success, in order to create sustainability and a competitive advantage. It is recommended that future research should include non-functional or poor performing schools Doctoral

Helicobacter pylori (Hp) is found in half the population of the world. Its prevalence is highly variable in relation to geography, ethnicity, age, and socioeconomic factors high in developing countries and lower in the developed world. In general, however, there has been a decreasing trend in the prevalence of Hp in many parts of the world in recent years. Direct epidemiologic comparisons of peptic ulcer disease (PUD) between developing and developed countries are complex, as peptic ulcers may be asymptomatic and the availability and accessibility of the tests required for diagnosis vary widely. In developing countries, Hp infection is a public-health issue. The high prevalence of the infection means that public-health interventions may be required. Therapeutic vaccination is probably the only strategy that would make a decisive difference in the prevalence and incidence of Hp throughout the world. The short-term approach, however provided that resources allow for this would be a test-andtreat strategy for those who are at risk for peptic ulcer disease or gastric cancer, as well as for those with troublesome dyspepsia. EDuCATION IN GASTROENTEROLOGy

Background. Microbial translocation contributes to immune activation and disease progression during chronic human immunodeficiency virus type 1 (HIV-1) infection. However, its role in the African AIDS epidemic remains controversial. Here, we investigated the relationship between markers of monocyte activation, plasma lipopolysaccharide (LPS), and HIV-1 RNA in South Africans prioritized to receive combination antiretroviral therapy (cART). Methods. Ten HIV-1–negative African controls and 80 HIV-1–infected patients with CD4 T cell counts !200 cells/mL were sampled prior to ( ) or during ( ) receipt of effective cART. Viral load was measured n p 60 n p 20 by Nuclisens; LPS by the Limulus amoebocyte lysate assay; monocyte and T cell subsets by flow cytometry; and soluble CD14, cytokines, and chemokines by enzyme-linked immunosorbent assay and customized Bio-Plex plates. Results. Three distinct sets of markers were identified. CCL2, CXCL10, and CD14 + CD16 + monocyte levels were positively correlated with HIV-1 viremia. This finding, together with cART-induced normalization of these markers, suggests that their upregulation was driven by HIV-1. Plasma interleukin-6 was associated with the presence of opportunistic coinfections. Soluble CD14 and tumor necrosis factor were linked to plasma LPS levels and, as observed for LPS, remained elevated in patients receiving effective cART. Conclusions. Microbial translocation is a major force driving chronic inflammation in HIV-infected Africans receiving cART. Prevention of monocyte activation may be especially effective at enhancing therapeutic outcomes.

Hepatitis C virus (HCV) genotypes 4, 5 and 6 represent20% of all HCV cases worldwide. HCV-4 is mainly seen in Egypt, where it represents 90% of all HCV cases. Antischistosomal therapy was the main cause of contamination there, followed by procedures performed by informal providers and traditional healers such as dental care, wound treatment, circumcision, deliveries, excision and scarification. It is also highly prevalent in sub-Saharan Africa and in the Middle East. In Europe, its prevalence has recently increased particularly among intravenous drug users and in immigrants. HCV-5 is mainly found in South Africa, where it represents 40% of all HCV genotypes, but four pockets of HCV-5 were found in France, Spain, Syria and Belgium and sporadic cases were found elsewhere. The mode of transmission is mainly iatrogenic and transfusion. HCV-6 is found in Hong Kong, Vietnam, Thailand and Myanmar and also in American and Australian from Asian origin. The response to treatment in HCV-4 is intermediate between HCV-1 and HCV-2 and HCV-3. A sustained viral response is achieved in 43-70% with pegylated interferon and ribavirin. It is higher in Egyptians than Europeans and Africans and is negatively related to insulin resistance and to the severity of fibrosis. It increases to80% with 24 weeks of therapy only if a rapid virological response is achieved. In HCV-5, a sustained virological response is achieved in60% with 48 weeks of therapy. HCV-6 is also considered an easy-to-treat genotype, leading to a response in 60-85% of cases.

MBA, North-West University, Potchefstroom Campus, 2016 South Africa’s agriculture sector is characterised by two very different constituents: a small number of very modern mechanised commercial farmers and a much larger number of small-scale farmers. This dualism was a product of the Apartheid legacy that began with the controversial Natives Land Act (No 27) of 1913 followed by almost 70 years of Government policies and subsidies to advance white commercial agriculture on 84% of the land area. In contrast, black farmers were forced off their land and prohibited to farm on a large scale. The land issue in South Africa is sensitive and emotional and to add to this emotion in the current day, the land reform process in South Africa is slow to correct the unequal land distribution of the past. To ensure black commercial farmers are successful the government and the private sector should provide adequate support to improve their success rate and ultimately protect food security in South Africa. To understand what will constitute adequate support for these farmers, the role players in the industry should first understand what factors impacts on their success. The primary objective of this study is firstly to investigate the factors that influence the success of black commercial farmers in the North West Province and secondly to provide recommendations to industry role players and policy makers to ensure that their support structures will be suitable to increase the success of these farmers. In order to achieve the objective a semi-structured interview questionnaire was performed with 14 successful black commercial farmers in the North West Province. Conclusions were drawn from this study on the outcomes of the factors influencing the perceived success of black commercial farmers in the North West Province. Finally, a critical evaluation was done and practical recommendations are suggested to improve the success rate of black commercial farmers in South Africa. Masters

MBA, North-West University, Potchefstroom Campus, 2015 Entrepreneurship has a significant role in the economy of South Africa, hence it is important to embrace entrepreneurship especially women entrepreneurs because there is a lot of stereotyping around women entrepreneurs. However, woman inherited historical imbalances because of the history of South Africa, and this create women entrepreneurs to be faced with unique challenges and barriers as compare to men entrepreneurs. The Information Technology and Communication (ICT) industry is a male dominated industry, meaning a lot of businesses are owned by man as compared to women. This industry requires a lot of technical background which is normally acquired by men. Therefore, a lot of women entrepreneurs face a lot of challenges and barriers in this industry. This research investigated the unique challenges and barriers faced by women entrepreneurs in the ICT industry. The literature study provided information on entrepreneurship and the process of entrepreneurship on how to identify opportunities. The literature also included background information on women entrepreneurs and what motivates them to be self-employed. The characteristics of a woman entrepreneur were explored, and the unique challenges or barriers a woman entrepreneur faces. The empirical study was researched by a questionnaire developed by North-West University, specifically the Potchefstroom Business School (PBS). A total of 70 printed copies of the questionnaires were distributed and two were sent via email to the women entrepreneurs. The data from the questionnaires was converted into useful outputs such as percentage graphs and frequency tables. The percentage graphs and frequency tables were used to make recommendations and conclusions regarding the assessment of women entrepreneurs in the ICT industry. Women entrepreneurs that participated in the research indicated the need for marketing support as well as the growth support. Government and all other relevant stakeholders should promote public awareness and ensure that resources for programs to foster entrepreneurship are decentralised; this will also have to include awareness on ICT industry. Masters

MA (Missiology), North-West University, Mafikeng Campus, 2014 It is a common myth that "natural man" seeks God or lives in harmony with the Creator. Contrasting the "praetercolonial"1 Baka Pygmies'2 conception of wellbeing with the true ideal of wellbeing, depicted in the New Testament (specifically in John 6 and Philippians 4), it becomes evident that they lack an important aspect, shared with the rest of humanity: total reliance on the Creator. The New Testament ideal of wellbeing is closely related to a reliance on the mercy of God, born from the realisation of inadequacy and the need for redemption. The Gospel speaks of a God that not only offers that redemption, but in effect became redemption. This contradicts a common African belief that God abandoned His creation and that humanity is now at the mercy of the spiritual powers confined to a naturalistic world. Applying Brueggemann's three-storied worldview shows that God is actively involved in humanity, thereby contradicting the false notion of a distant Creator. The Baka do not consider themselves sinful and share the rest of humanity's unwillingness to surrender their independence to the mercy of God (Luke 18:9-14). They are consequently vulnerable to manipulation by spirits and powers in their search to interact with "superhuman" forces, in an effort to achieve an idealised state of wellbeing. Missiologically speaking, by transforming this subjective, anthropocentric ideal of wellbeing, the praetor colonial Baka is led to a new ideal based upon the surrender of self- reliance that leads to comprehensive salvation in Jesus Christ, avoiding vestiges of syncretism, relativism and dualism in new converts. Masters