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The field of quantum resource theory (QRT) has emerged as an invaluable framework for the examination of small and strongly correlated quantum systems, surpassing the boundaries imposed by traditional statistical treatments. The fundamental objective of general QRTs is to characterize these systems by precisely quantifying the level of control attainable to an experimenter. In this review article, we refrain from providing an exhaustive summary of the extensive literature on QRT. Rather, our focus centers on a specific subliterature founded upon the theory of majorization. The primary aim is to augment our comprehension of genuine quantum phenomena manifested across diverse technological applications and incite investigations into novel resource theories encompassing multiple types of resources. Consequently, we emphasize the underlying similarities shared by various resources, including bipartite quantum entanglement, quantum coherence, and superposition, alongside informational, thermal, and generalized nonequilibrium resources. [ABSTRACT FROM AUTHOR]

ABSTRACTA number of recent articles have invoked the republican ideal of non-domination to justify either open borders, and/or the reduction of states’ discretionary powers to unilaterally determine immigration policy. In this paper, I show that such arguments are one-sided, as they fail to fully account for the deep ambiguity of the very ideal which they invoke. In fact, non-domination lends just as powerful support to maintaining state border controls as it does to dismantling them. There are only two exceptions to the rule. It is well established that promoting non-domination demands, one the one hand, that refugees be admitted, and second, that all migrants have a right to contest decisions concerning their own admission. But aside from these things, the policy implications of the ideal are unclear. In itself, therefore, it is insufficient to justify either open borders, or the reduction of states said discretionary powers. Such arguments will have to rely on other, additional moral criteria.

A number of recent articles have invoked the republican ideal of non-domination to justify either open borders, and/or the reduction of states' discretionary powers to unilaterally determine immigration policy. In this paper, I show that such arguments are one-sided, as they fail to fully account for the deep ambiguity of the very ideal which they invoke. In fact, non-domination lends just as powerful support to maintaining state border controls as it does to dismantling them. There are only two exceptions to the rule. It is well established that promoting non-domination demands, one the one hand, that refugees be admitted, and second, that all migrants have a right to contest decisions concerning their own admission. But aside from these things, the policy implications of the ideal are unclear. In itself, therefore, it is insufficient to justify either open borders, or the reduction of states said discretionary powers. Such arguments will have to rely on other, additional moral criteria. [ABSTRACT FROM AUTHOR]

Abstract Background Public health sector service delivery challenges leading to poor population health outcomes have been observed in the Free State province of South Africa for the past decade. A multi-method situation appraisal of the different functional domains revealed serious health system deficiencies and operational defects, notably fragmentation of healthcare programmes and frontline services, as well as challenges related to governance, accountability and human resources for health. It was therefore necessary to develop a system-wide intervention to comprehensively address defects in the operation of the public health system and its major components. Methods This study describes the development of the ‘Health Systems Governance & Accountability’ (HSGA) intervention model by the Free State Department of Health (FSDoH) in collaboration with the community and other stakeholders following a participatory action approach. Documented information collected during routine management processes were reviewed for this paper. Starting in March 2013, the development of the HSGA intervention model and the concomitant application of Kaplan and Norton’s (1992) Balanced Scorecard performance measurement tool was informed by the World Health Organization’s (2007) conceptual framework for health system strengthening and reform comprised of six health system ‘building blocks.’ The multiple and overlapping processes and actions to develop the intervention are described according to the four steps in Kaplan et al.’s (2013) systems approach to health systems strengthening: (i) problem identification, (ii) description, (iii) alteration and (iv) implementation. Results The finalisation of the HSGA intervention model before end-2013 was a prelude to the development of the FSDoH’s Strategic Transformation Plan 2015–2030. The HSGA intervention model was used as a tool to implement and integrate the Plan’s programmes moving forward with a consistent focus on the six building blocks for health systems strengthening and the all-important linkages between them. Conclusion The model was developed to address fragmentation and improve public health service delivery by the provincial health department. In January 2016, the intervention model became an official departmental policy, meaning that it was approved for implementation, compliance, monitoring and reporting, and became the guiding framework for health systems strengthening and transform in the Free State.

Since the COVID-19 outbreak emerged, SARS-CoV-2 has continuously evolved into variants with underlying mutations associated with increased transmissibility, potential escape from neutralizing antibodies, and disease severity. The SARS-CoV-2 pandemic in South Africa has been characterized by periods of infections with four major epidemic waves. To determine whether the variants driving the epidemic waves at the national level were also driving the epidemic waves at the local level, we performed analysis of a total of 1287 samples from qPCR confirmed SARS-CoV-2 positive individuals. The samples were subjected to viral RNA extraction, genomic amplification, and sequencing. Variant assignment of the viral sequences and mutation identification were conducted using PANGOLIN and SARS-CoV-2 genome annotator, respectively. Our analysis revealed that during the initial part of the first wave, B.1, B.1.1, B.1.1.53, B.1.1.448 and B.1.237 circulated in the Free State province, followed by Beta variant, B.1.351 later in the wave. Although most of the initially detected variants disappeared during the second wave, the Beta variant, B.1.351, persisted. Early in the third wave, the Beta variant, B.1.351, predominated but was replaced by the Delta sub-lineage, AY.45. The fourth wave was characterized by unique emergence of the Omicron sub-variant, BA.1. The data further indicates that SARS-CoV-2 variants driving the epidemic waves in the Free State at the local level correlated with the ones driving the epidemic waves at the national level. Findings from this study highlight the importance of continued genomic surveillance and monitoring of the circulating SARS-CoV-2 variants to inform public health efforts and ensure adequate control of the ongoing pandemic. [ABSTRACT FROM AUTHOR]

A construction constraint is a condition that impedes progress toward meeting construction project goals. This paper seeks to assess the constraint factors affecting project performance in the South African construction industry. The study adopted a quantitative research design, and a questionnaire was designed to retrieve data from the target populations. The target population were construction professionals within the South African construction industry. One hundred and eighty questionnaires were administered to construction professionals within the study area through the purposive quota sampling technique. Retrieved data were analysed using descriptive and exploratory factor analysis. In order to determine the data reliability and the interrelatedness of the variables, Cronbach's alpha test was carried out on each component. The results of the exploratory factor analysis show that stakeholders' inappropriate project scheduling and coordination factors, organisation and government policies factors, and organisation and government policies factors were the leading constraints affecting construction project performance in the South African construction industry. Due to time and distance constraints, this study was limited to construction professionals in South Africa's Free State province. The paper concluded that to reduce the construction constraints affecting construction project performance, construction professionals must improve their project scheduling, coordination, organisational policies, and managerial capacity. The paper's findings will assist stakeholders in identifying and overcoming construction constraints in construction projects' execution and delivery. [ABSTRACT FROM AUTHOR]

Background: The factors contributing to probable postnatal depression (PND), a type of clinical depression that can affect woman after childbirth, are socially derived. Therefore, variations among groups of women necessitate studies in different communities. Aim: This study compared the prevalence of PND and associated factors among women attending postnatal services facilities. Setting: The study setting included Tshwane Municipal district in Gauteng province (GP) and Fezile Dabi District (FS) in Free State province (FSP), South Africa. Methods: A total of 477 mothers within 12 weeks of giving birth were recruited by convenient sampling in health facilities. A self-developed questionnaire was used to obtain information on socio-demographics, obstetric history, and children’s characteristics. The Edinburgh Postnatal Depression Scale (EPDS) was used to collect data on depression symptoms, with a score of ≥ 13 used as a cut-off for probable PND. Data were analysed using STATA 14. Multivariate logistic regression was used to determine association between probable PND and various covariates. Results: The overall mean age of women was 28 ± 6 years. The overall prevalence rate of PND was 22%, slightly higher in FS (23%) than in GP (21%). Most participants living in GP were married, had tertiary education, were employed and from the households with income of more than R8000.00. A chi-square test showed that planned pregnancy was significantly higher in GP compared with FS (p ≤ 0.001). Multivariate logistic regression showed that support from a partner or husband decreased the odds of a probable PND in GP (adjusted odd ratio [AOR] 0.37; 95% confidence interval [CI] [95%CI: 0.14–0.96; p = 0.041] and in the FS [AOR = 0.14, 95%CI: 0.05–0.40; p ≤ 0.001]). Significant associations of probable PND with several factors – planned pregnancy, baby age, support in difficult times, partner or husband drinking alcohol and stressful events – were more common in the FSP than in the GP. Conclusion: The prevalence of probable PND and its associated risk factors in the GP and the FS indicates the need for routine screening and targeted interventions in both urban and rural settings. Contribution: The results confirm that the prevalence of PND is similar in both rural and urban areas, and that pregnancy planning remains a challenge in the FS, which calls for increased efforts to revive family planning programmes in primary health care facilities.

Since the COVID-19 outbreak emerged, SARS-CoV-2 has continuously evolved into variants with underlying mutations associated with increased transmissibility, potential escape from neutralizing antibodies, and disease severity. The SARS-CoV-2 pandemic in South Africa has been characterized by periods of infections with four major epidemic waves. To determine whether the variants driving the epidemic waves at the national level were also driving the epidemic waves at the local level, we performed analysis of a total of 1287 samples from qPCR confirmed SARS-CoV-2 positive individuals. The samples were subjected to viral RNA extraction, genomic amplification, and sequencing. Variant assignment of the viral sequences and mutation identification were conducted using PANGOLIN and SARS-CoV-2 genome annotator, respectively. Our analysis revealed that during the initial part of the first wave, B.1, B.1.1, B.1.1.53, B.1.1.448 and B.1.237 circulated in the Free State province, followed by Beta variant, B.1.351 later in the wave. Although most of the initially detected variants disappeared during the second wave, the Beta variant, B.1.351, persisted. Early in the third wave, the Beta variant, B.1.351, predominated but was replaced by the Delta sub-lineage, AY.45. The fourth wave was characterized by unique emergence of the Omicron sub-variant, BA.1. The data further indicates that SARS-CoV-2 variants driving the epidemic waves in the Free State at the local level correlated with the ones driving the epidemic waves at the national level. Findings from this study highlight the importance of continued genomic surveillance and monitoring of the circulating SARS-CoV-2 variants to inform public health efforts and ensure adequate control of the ongoing pandemic.

This article addresses the relationship between Brian O’Nolan’s writing and his career as a civil servant in the Irish Department of Local Government and Public Health. O’Nolan’s references to local government and the ambiguity of the law in Cruiskeen Lawn and The Third Policeman are placed in their proper historical context. By examining the contradictions of the Irish local government and local justice systems (from the pre-independence era to the Free State and successive administrations) a portrait emerges of O’Nolan as a writer of Irish biopolitics, who is concerned with the paradoxical relationship between national government and local organs of power. Biopolitical themes of legal and bureaucratic aporia are situated in the context of recent scholarly writing about the law, sovereignty, and the body in O’Nolan. The article also gives examples of historical episodes that were likely formative influences on his narrative style of political critique. From local issues such as land appropriation, to O’Nolan’s role as secretary to the tribunal of inquiry into a fire at St Joseph’s Orphanage in Cavan, a new image can be constructed of the author as a critic of Irish justice and a theorist of biopolitical concerns.

• Gut microbial colonisation in infants is a crucial, yet intricate, process, characterised by minimal diversity at birth that increases with age. • The infant gut virome is dominated by eukaryotic viruses, consisting primarily of human enteric viruses and non-human dietary viruses. • The infants' gut haboured high abundance of gastroenteritis-associated viruses, despite the absence of clinical symptoms. • The presence of plant viruses in the gut of infants who are not exposed to solid food could suggest vertical transmission from mother to infant, or possibly, contact between infant and other family members. The gut of healthy neonates is devoid of viruses at birth, but rapidly becomes colonised by normal viral commensals that aid in important physiological functions like metabolism but can, in some instances, result in gastrointestinal illnesses. However, little is known about how this colonisation begins, its variability and factors shaping the gut virome composition. Thus, understanding the development, assembly, and progression of enteric viral communities over time is key. To explore early-life virome development, metagenomic sequencing was employed in faecal samples collected longitudinally from a cohort of 17 infants during their first six months of life. The gut virome analysis revealed a diverse and dynamic viral community, formed by a richness of different viruses infecting humans, non-human mammals, bacteria, and plants. Eukaryotic viruses were detected as early as one week of life, increasing in abundance and diversity over time. Most of the viruses detected are commonly associated with gastroenteritis and include members of the Caliciviridae, Picornaviridae, Astroviridae, Adenoviridae , and Sedoreoviridae families. The most common co-occurrences involved asymptomatic norovirus-parechovirus, norovirus-sapovirus, sapovirus-parechovirus, observed in at least 40 % of the samples. Majority of the plant-derived viruses detected in the infants' gut were from the Virgaviridae family. This study demonstrates the first longitudinal characterisation of the gastrointestinal virome in infants, from birth up to 6 months of age, in sub-Saharan Africa. Overall, the findings from this study delineate the composition and variability of the healthy infants' gut virome over time, which is a significant step towards understanding the dynamics and biogeography of viral communities in the infant gut. [ABSTRACT FROM AUTHOR]

Background: Public health sector service delivery challenges leading to poor population health outcomes have been observed in the Free State province of South Africa for the past decade. A multi-method situation appraisal of the different functional domains revealed serious health system deficiencies and operational defects, notably fragmentation of healthcare programmes and frontline services, as well as challenges related to governance, accountability and human resources for health. It was therefore necessary to develop a system-wide intervention to comprehensively address defects in the operation of the public health system and its major components.Methods: This study describes the development of the 'Health Systems Governance & Accountability' (HSGA) intervention model by the Free State Department of Health (FSDoH) in collaboration with the community and other stakeholders following a participatory action approach. Documented information collected during routine management processes were reviewed for this paper. Starting in March 2013, the development of the HSGA intervention model and the concomitant application of Kaplan and Norton's (1992) Balanced Scorecard performance measurement tool was informed by the World Health Organization's (2007) conceptual framework for health system strengthening and reform comprised of six health system 'building blocks.' The multiple and overlapping processes and actions to develop the intervention are described according to the four steps in Kaplan et al.'s (2013) systems approach to health systems strengthening: (i) problem identification, (ii) description, (iii) alteration and (iv) implementation.Results: The finalisation of the HSGA intervention model before end-2013 was a prelude to the development of the FSDoH's Strategic Transformation Plan 2015-2030. The HSGA intervention model was used as a tool to implement and integrate the Plan's programmes moving forward with a consistent focus on the six building blocks for health systems strengthening and the all-important linkages between them.Conclusion: The model was developed to address fragmentation and improve public health service delivery by the provincial health department. In January 2016, the intervention model became an official departmental policy, meaning that it was approved for implementation, compliance, monitoring and reporting, and became the guiding framework for health systems strengthening and transform in the Free State. [ABSTRACT FROM AUTHOR]

Introduction: understanding the epidemiological profile of a disease in a particular region allows for proper planning of public health resources for prevention, early diagnosis and treatment. In this present study, we describe the epidemiological profile of viral, fungal, tuberculous and bacterial meningitis among adults at National District Hospital (NDH), Free State province, over three years period (January 2017 to December 2019). Methods: a retrospective, observational study of all adult meningitis cases, managed at the National District Hospital (NDH) Bloemfontein, Free State Province, South Africa between January 2017 and December 2019. Results: of the 236 case files reviewed, majority (93.2%; n=220) of the patients managed for meningitis were black, as well as males (55.5%; n = 131). Higher incidence was found between the ages 20 to 49 (81.7%). Of those who died, the majority (n = 14; 63.6%) were males, in the age group 40-49 (n = 7; 31.8%), had TB meningitis (n = 12; 54.5%), were HIV positive (n = 20; 90.9%), and had cell count <100 cells/mm3 (n = 10; 45.5%). Conclusion: our study suggests that combining information on patient demography, co-morbidities, clinical presentation, and examination findings can substantially contribute to raising clinical suspicion, leading to swift identification, diagnosis, and treatment of patients. [ABSTRACT FROM AUTHOR]

Background: The factors contributing to probable postnatal depression (PND), a type of clinical depression that can affect woman after childbirth, are socially derived. Therefore, variations among groups of women necessitate studies in different communities. Aim: This study compared the prevalence of PND and associated factors among women attending postnatal services facilities. Setting: The study setting included Tshwane Municipal district in Gauteng province (GP) and Fezile Dabi District (FS) in Free State province (FSP), South Africa. Methods: A total of 477 mothers within 12 weeks of giving birth were recruited by convenient sampling in health facilities. A self-developed questionnaire was used to obtain information on socio-demographics, obstetric history, and children's characteristics. The Edinburgh Postnatal Depression Scale (EPDS) was used to collect data on depression symptoms, with a score of ≥13 used as a cut-off for probable PND. Data were analysed using STATA 14. Multivariate logistic regression was used to determine association between probable PND and various covariates. Results: The overall mean age of women was 28 ± 6 years. The overall prevalence rate of PND was 22%, slightly higher in FS (23%) than in GP (21%). Most participants living in GP were married, had tertiary education, were employed and from the households with income of more than R8000.00. A chi-square test showed that planned pregnancy was significantly higher in GP compared with FS (p &8805; 0.001). Multivariate logistic regression showed that support from a partner or husband decreased the odds of a probable PND in GP (adjusted odd ratio [AOR] 0.37; 95% confidence interval [CI] [95%CI: 0.14-0.96; p = 0.041] and in the FS [AOR = 0.14, 95%CI: 0.05-0.40; p ≥ 0.001]). Significant associations of probable PND with several factors - planned pregnancy, baby age, support in difficult times, partner or husband drinking alcohol and stressful events - were more common in the FSP than in the GP. Conclusion: The prevalence of probable PND and its associated risk factors in the GP and the FS indicates the need for routine screening and targeted interventions in both urban and rural settings. [ABSTRACT FROM AUTHOR]

Abstract Background Since the advent of democracy, the South African government has been putting charters, policies, strategies and plans in place in an effort to strengthen public health system performance and enhance service delivery. However, public health programme performance and outcomes remained poor while the burden of disease increased. This was also the case in the Free State Province, where major public health system challenges occurred around 2012. Assessment was necessary in order to inform health system strengthening. Methods The study entailed a multi-method situation appraisal utilising information collated in 44 reports generated in 2013 through presentations by unit managers, subdistrict assessments by district clinical specialist teams, and group discussions with district managers, clinic supervisors, primary health care managers and chief executive and clinical officers of hospitals. These data were validated through community and provincial health indabas including non-governmental organisations, councils and academics, as well as unannounced facility visits involving discussions with a wide range of functionaries and patients. The reports were reviewed using the World Health Organization health system building blocks as a priori themes with subsequent identification of emerging subthemes. Data from the different methods employed were triangulated in a causal loop diagram showing the complex interactions between the components of an (in) effective health system. Results The major subthemes or challenges that emerged under each a priori theme included: firstly, under the ‘service delivery’ a priori theme, ‘fragmentation of health services’ (42 reports); secondly, under the ‘health workforce’ a priori theme, ‘staff shortages’ (39 reports); thirdly, under the ‘health financing’ a priori theme, ‘financial/cash-flow problems’ (39 reports); fourthly, under the ‘leadership and governance’ a priori theme, ‘risk to patient care’ (38 reports); fifthly, under the ‘medical products/technologies’ a priori theme, ‘dysfunctional communication technology’ (27 reports); and, sixthly, under the ‘information’ a priori theme, ‘poor information management’ (26 reports). Conclusion The major overall public health system challenges reported by stakeholders involved fragmentation of services, staff shortages and financial/cash-flow problems. In order to effect health systems strengthening there was particularly a need to improve integration and address human and financial deficiencies in this setting.

A construction constraint is a condition that impedes progress toward meeting construction project goals. This paper seeks to assess the constraint factors affecting project performance in the South African construction industry. The study adopted a quantitative research design, and a questionnaire was designed to retrieve data from the target populations. The target population were construction professionals within the South African construction industry. One hundred and eighty questionnaires were administered to construction professionals within the study area through the purposive quota sampling technique. Retrieved data were analysed using descriptive and exploratory factor analysis. In order to determine the data reliability and the interrelatedness of the variables, Cronbach’s alpha test was carried out on each component. The results of the exploratory factor analysis show that stakeholders’ inappropriate project scheduling and coordination factors, organisation and government policies factors, and organisation and government policies factors were the leading constraints affecting construction project performance in the South African construction industry. Due to time and distance constraints, this study was limited to construction professionals in South Africa’s Free State province. The paper concluded that to reduce the construction constraints affecting construction project performance, construction professionals must improve their project scheduling, coordination, organisational policies, and managerial capacity. The paper’s findings will assist stakeholders in identifying and overcoming construction constraints in construction projects’ execution and delivery.

Background: Nuclear protein in testis (NUT) carcinoma (NC) is a rare tumour easily mistaken for a number of other tumours if a NUT immunohistochemical stain is not performed, and there is no high index of suspicion. This tumour is exceptionally aggressive, with only isolated survivors. Early identification and aggressive treatment are required. No research on NC has been conducted in South Africa and only one case has been reported from the rest of Africa. The incidence of this tumour in South Africa is, therefore, unknown. Aim: The aim of this study was to determine the incidence of NC over a 12-year period and describe the demographic features of any patients identified. Setting: Department of Anatomical Pathology, University of the Free State and National Health Laboratory Service (NHLS) in Bloemfontein, South Africa. Methods: In this retrospective study, all undifferentiated malignant tumours and tumours with evidence of squamous differentiation from the head, neck and thorax seen between 01 January 2005 and 31 December 2016 were included. Nuclear protein in testis immunohistochemical staining was performed on all specimens. The stain was regarded as positive if speckled nuclear staining was observed in more than 50% of the tumour cells. Results: In total, 498 cases were investigated, of which 424 (85.1%) belonged to male patients. The mean age of the patients was 58.6 years. Only one positive case, a 30-year-old woman with a lung mass and lymph node metastases, was identified. Conclusion: Our findings confirmed the rarity of NC. Additional research in other provinces and the private sector is recommended to provide a comprehensive patient profile of NC in South Africa.

One of the most critical tasks within the scope of Design for Manufacturing (DfM) is to define the set of Geometrical Product Specifications (GPS) in the 3D model or in the engineering drawing that ensures the functionality and the interchangeability of parts, as well as the intended functional performance of an assembly. Several methodologies have been proposed for the optimal designation of such specifications; however, the majority of them do not effectively take into account the deformations that are inevitably induced during assembly and operation for the vast majority of mechanical components. Motivated by the widely accepted tolerancing practice for sheet metal parts in the automotive industry, where the distinction between free state and constrained state is considered, the paper investigates the influence of the deformations induced during assembly and operation on GPS. The effect of part stiffness in the resultant functional GPS of the assembly/component is explored, through CAD surfacing and non-linear numerical finite element analysis tools including the contact problem. The current stage of development of a novel, performance-based methodology for the GD&T design procedure is presented. The methodology is applied on a real-world mechanical assembly that is derived from tolerance stack up-related literature. This study illustrated is that for an unpredictably wide range of mechanical components the default, free-state GPS scheme should only be assigned after rigorous analysis of their compliance behaviour. The proposed approach will lead to deduce the correlation between production cost and performance through a further development in future study. [ABSTRACT FROM AUTHOR]

Background: Since the advent of democracy, the South African government has been putting charters, policies, strategies and plans in place in an effort to strengthen public health system performance and enhance service delivery. However, public health programme performance and outcomes remained poor while the burden of disease increased. This was also the case in the Free State Province, where major public health system challenges occurred around 2012. Assessment was necessary in order to inform health system strengthening.Methods: The study entailed a multi-method situation appraisal utilising information collated in 44 reports generated in 2013 through presentations by unit managers, subdistrict assessments by district clinical specialist teams, and group discussions with district managers, clinic supervisors, primary health care managers and chief executive and clinical officers of hospitals. These data were validated through community and provincial health indabas including non-governmental organisations, councils and academics, as well as unannounced facility visits involving discussions with a wide range of functionaries and patients. The reports were reviewed using the World Health Organization health system building blocks as a priori themes with subsequent identification of emerging subthemes. Data from the different methods employed were triangulated in a causal loop diagram showing the complex interactions between the components of an (in) effective health system.Results: The major subthemes or challenges that emerged under each a priori theme included: firstly, under the 'service delivery' a priori theme, 'fragmentation of health services' (42 reports); secondly, under the 'health workforce' a priori theme, 'staff shortages' (39 reports); thirdly, under the 'health financing' a priori theme, 'financial/cash-flow problems' (39 reports); fourthly, under the 'leadership and governance' a priori theme, 'risk to patient care' (38 reports); fifthly, under the 'medical products/technologies' a priori theme, 'dysfunctional communication technology' (27 reports); and, sixthly, under the 'information' a priori theme, 'poor information management' (26 reports).Conclusion: The major overall public health system challenges reported by stakeholders involved fragmentation of services, staff shortages and financial/cash-flow problems. In order to effect health systems strengthening there was particularly a need to improve integration and address human and financial deficiencies in this setting. [ABSTRACT FROM AUTHOR]

Background: Nuclear protein in testis (NUT) carcinoma (NC) is a rare tumour easily mistaken for a number of other tumours if a NUT immunohistochemical stain is not performed, and there is no high index of suspicion. This tumour is exceptionally aggressive, with only isolated survivors. Early identification and aggressive treatment are required. No research on NC has been conducted in South Africa and only one case has been reported from the rest of Africa. The incidence of this tumour in South Africa is, therefore, unknown. Aim: The aim of this study was to determine the incidence of NC over a 12-year period and describe the demographic features of any patients identified. Setting: Department of Anatomical Pathology, University of the Free State and National Health Laboratory Service (NHLS) in Bloemfontein, South Africa. Methods: In this retrospective study, all undifferentiated malignant tumours and tumours with evidence of squamous differentiation from the head, neck and thorax seen between 01 January 2005 and 31 December 2016 were included. Nuclear protein in testis immunohistochemical staining was performed on all specimens. The stain was regarded as positive if speckled nuclear staining was observed in more than 50% of the tumour cells. Results: In total, 498 cases were investigated, of which 424 (85.1%) belonged to male patients. The mean age of the patients was 58.6 years. Only one positive case, a 30-year-old woman with a lung mass and lymph node metastases, was identified. Conclusion: Our findings confirmed the rarity of NC. Additional research in other provinces and the private sector is recommended to provide a comprehensive patient profile of NC in South Africa. [ABSTRACT FROM AUTHOR]

Fertilizer not only plays a major role in the profitability of the farmer’s business, but also represents an expensive farm input. The emerging farmer market segment is expanding and holds a great deal of potential for fertilizer companies to supply the growing need for fertilizer in this market. Almost all fertilizer marketing strategies of South African companies have been designed to cater for the commercial farming sector; however, if fertilizer suppliers want to focus on the emerging farmer market segment, they need to understand buying behavior of emerging farmers, as well as their needs when developing strategies to utilize opportunities in this developing market. This study aims to identify factors playing an important role in the buying behavior of emerging farmers in the Free State when purchasing fertilizer. The results show that service, brand, product, and learning or psychological factors highly influence emerging farmers’ fertilizer purchase decision. The study also finally draws recommendations and conclusions for managerial perusal.

The aim of this paper is to summarize our knowledge of the birds of the Bloemfontein area, Free State, South Africa. It presents data on the status, distribution, population densities and habitat of the birds of this area, during the years 1977-2000 (with a special emphasis on the years 1993-1998). Both published and unpublished data are analysed. Population densities were estimated mainly using the line transect method and territory mapping method. For most fairly common, common and very common species, data on population densities are provided, while for 19 species (mainly rare or very rare), distribution maps of their occupied territories are presented. A total of 324 bird species were recorded. Breeding birds comprised 60.2% of the overall species (195), while non-breeding birds made up the remaining 39.8% (129). Among the breeding species, most (55.9%) were residents throughout the year, 3.1% were intra-African migrants and 1.2% were nomads. Non-breeding birds were represented by Palearctic migrants (35 species, 10.8%) classified as vagrants, irregular and regular visitors; and African non-breeding species (94; 29.0%), which were mainly vagrants. Among the breeding species, most were rare or very rare (100 species, 56.4%). Only 24 (12.3%) of them were very common, nine of which were non-passeres and 15 passeres. The main threat to birds in the Bloemfontein area is intensive agriculture. Some suggestions and recommendations are given for more effective and efficient bird conservation in this important area. [ABSTRACT FROM AUTHOR]

Ruminiclostridium cellulolyticum and Lachnoclostridium phytofermentans are cellulolytic clostridia either producing extracellular multienzymatic complexes termed cellulosomes or secreting free cellulases respectively. In the free state, the cellulase Cel9A secreted by L. phytofermentans is much more active on crystalline cellulose than any cellulosomal family‐9 enzyme produced by R. cellulolyticum. Nevertheless, the incorporation of Cel9A in vitro in hybrid cellulosomes was formerly shown to generate artificial complexes with altered activity, whereas its incorporation in vivo in native R. cellulolyticum cellulosomes resulted in a strain displaying a weakened cellulolytic phenotype. In this study, we investigated why Cel9A is so potent in the free state but functions poorly as a cellulosomal component, in contrast to the most similar enzyme synthesized by R. cellulolyticum, Cel9G, weakly active in the free state but whose activity on crystalline cellulose is drastically increased in cellulosomes. We show that the removal of the C‐terminal moiety of Cel9A encompassing the two X2 modules and the family‐3b carbohydrate binding module (CBM3b), reduces its activity on crystalline cellulose. Grafting a dockerin module further diminishes the activity, but this truncated cellulosomal form of Cel9A displays important synergies in hybrid cellulosomes with the pivotal family‐48 cellulosomal enzyme of R. cellulolyticum. The exact inverse approach was applied to the cellulosomal Cel9G. Grafting the two X2 modules and the CBM3b of Cel9A to Cel9G strongly increases its activity on crystalline cellulose, to reach Cel9A activity levels. Altogether these data emphasize the specific features required to generate an efficient free or cellulosomal family‐9 cellulase. [ABSTRACT FROM AUTHOR]

At the end of the nineteenth century, the actions of belligerents were constrained by the Hague Convention of 1899 and the Geneva Convention of 1864. The Hague Convention differentiated between combatants and non-combatants, but both the British implementation of a scorched earth policy and the Boer execution of blacks violated this convention. The Geneva Convention centred on medical immunity, which presupposes medical neutrality. The British opposed the voluntarism fundamental to the Red Cross movement and all British medical personnel in the field were subservient to the military establishment. Imperial patriotism, the shortcomings of the army and the insistent claims of military necessity subverted best medical practice, producing dilemmas that doctors had to negotiate. On the Boer side too, there was the moral complexity of doctors who were not only medical professionals but also social agents with personal commitments. This article considers the dilemmas that confronted doctors involved in the South African War in the Free State and concludes that trends in dealing with ethical challenges in this war became normative in subsequent conflicts. [ABSTRACT FROM AUTHOR]

Background: According to the World Health Organization (WHO), malnutrition can be linked to 45% of deaths in children under the age of five years. The Integrated Nutrition Programme (INP) was introduced in 1994 to address malnutrition in South Africa. There had been no systematic evaluation of how well clinics perform regarding nutritional services. Malnutrition rates worsened in the Free State from 3.9% in 2009 to 10.7% in 2013. This study aimed to assess the effectiveness of the INP Supplementary Feeding Programme in primary healthcare facilities in the Mangaung University of the Free State Community Partnership Project, known as MUCPP, catchment area of Bloemfontein, Free State, in children aged six months to five years. Methods: This was a retrospective, descriptive cohort study. All children between six months and five years entering the feeding scheme between July 2014 and June 2015 at the MUCPP, which is the hub of the feeding scheme, and three primary healthcare clinics were included. Data were collected from September to November 2015 from the INP registers and captured on dataextraction forms. Results: In total, 730 children were included in the study, 38.8% at risk for malnutrition and 61.2% malnourished. Most of the children (80.7%) stopped attending before change was seen. Only 14.1% exited the INP successfully with a normal weight for age and 3.0% deteriorated despite nutrition interventions. Of all children with one or more follow-up visits, 50.4% (119/236) improved from severe malnutrition to underweight or exited at target weight. Conclusions: The follow-up of the children and the monitoring and implementation of the INP are inadequate. There is some evidence that children who attend the INP regularly benefit from the programme. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1340252

Background: The majority of health care users in South Africa utilise primary health care (PHC) services where these services are free at the point of entry. There is a dearth of knowledge on the factors influencing patient satisfaction with PHC clinic services. Aim: This study compared patient satisfaction with PHC services in the Free State (FS) and Gauteng (GP) provinces Setting: Secondary data analysis was conducted on a cross-sectional survey obtained from the Research on the State of Nursing Project run by the Centre for Health Policy in 2012. Methods: A pre-tested satisfaction survey questionnaire with questions on facility evaluation, experience with providers and receipt of medication was administered to 1110 systematically randomly sampled adult patients attending antiretroviral, hypertension, diabetes and tuberculosis services. Results: Of 1110 respondents, 1096 responded to the patient satisfaction survey signifying a 98.8% response rate. Over 60% of respondents were women in both provinces. Over 90% of patients were satisfied with PHC services in both provinces. Factors associated with satisfaction in GP and FS were time spent waiting for consultation, nurses listened, being given information on condition and being treated politely. Having privacy respected came out as a significant factor in FS. Conclusions: High levels of satisfaction with PHC services were experienced by study participants in both provinces. Satisfied patients adhere to treatment plans and have better health-seeking behaviour, which translates to improved clinical outcomes. Therefore, nurses should continue listening, respecting and treating their patients with politeness, and also implement efficient work schedules to reduce patient waiting times.

Background: According to the World Health Organization (WHO), malnutrition can be linked to 45% of deaths in children under the age of five years. The Integrated Nutrition Programme (INP) was introduced in 1994 to address malnutrition in South Africa. There had been no systematic evaluation of how well clinics perform regarding nutritional services. Malnutrition rates worsened in the Free State from 3.9% in 2009 to 10.7% in 2013. This study aimed to assess the effectiveness of the INP Supplementary Feeding Programme in primary healthcare facilities in the Mangaung University of the Free State Community Partnership Project, known as MUCPP, catchment area of Bloemfontein, Free State, in children aged six months to five years. Methods: This was a retrospective, descriptive cohort study. All children between six months and five years entering the feeding scheme between July 2014 and June 2015 at the MUCPP, which is the hub of the feeding scheme, and three primary healthcare clinics were included. Data were collected from September to November 2015 from the INP registers and captured on data-extraction forms. Results: In total, 730 children were included in the study, 38.8% at risk for malnutrition and 61.2% malnourished. Most of the children (80.7%) stopped attending before change was seen. Only 14.1% exited the INP successfully with a normal weight for age and 3.0% deteriorated despite nutrition interventions. Of all children with one or more follow-up visits, 50.4% (119/236) improved from severe malnutrition to underweight or exited at target weight. Conclusions: The follow-up of the children and the monitoring and implementation of the INP are inadequate. There is some evidence that children who attend the INP regularly benefit from the programme. [ABSTRACT FROM PUBLISHER]

Bloemfontein and the greater Mangaung Metropolitan Municipality is today a modern metropolis using and consuming a considerable amount of water on a daily basis. Due to the severe droughts of 2014 and 2015, the water surface levels of the rivers and dams providing water to the Mangaung Metropolitan Municipality dropped critically low. Although boreholes still supply sufficient water in some areas, strict water restrictions were imposed in July 2015 to kerb the use and consumption of municipal supplied water. It is, however, nothing new for Bloemfontein to experience serious shortages of water during periods of drought. In order to grasp an understanding of the water problems of the capital of the Free State Province, one have to turn to the history of the city’s water supply. In this article problems regarding water supply in Bloemfontein during the late 19th century is investigated. Due to the fact that Bloemfontein is not located next to a large river, the capital started experiencing water shortages as early as the 1880s. The water sources in the immediate vicinity such as fountains, the Bloemspruit, wells and dams, initially supplied sufficient water to the residents of Bloemfontein, but as the town developed rapidly since the advent of the railway in 1890 and became more populated, the existing water supply was no longer sufficient to provide for the capital’s growing needs. To solve this problem the town required an additional, reliable water source beyond its boundaries. For this purpose the Bloemfontein Water Supply Company was founded in 1889 to explore the possibility of obtaining “water pure and wholesome”. As several private concessionaries to whom concessions were granted to provide the capital with additional water failed, the Bloemfontein city council decided to take matters in own hand; especially since by 1894 the water shortage reached critical levels. In 1896 the Modder River Water Scheme was approved and by 1899 the Free State capital was supplied with water from the nearby Modder River. In spite of additional waterworks that were built at Maselspoort during the early 20th century and several large dams and reservoirs added over time, it did not adequately address the city’s water shortages, especially in times of severe droughts. Due to the current reality that an aging water and sanitation infrastructure is only repaired and not replaced, added to the fact that the Free State Province is known for its frequent droughts, the current Mangaung Metropolitan Municipality, that includes the city of Bloemfontein, today still experiences problems with water supply. Accordingly the water problems that started in the 1880s are continuing in the 21st century and even intensify. A solution to this problem is urgently required.

Background: Medical internship refers to the 24-month period of supervised training in an accredited facility, where newly qualified doctors rotate through all relevant medical domains before starting their community service as medical practitioners. The Free State province has one academic complex and three regional hospitals accredited for internship training. Objectives: To evaluate the experience and future plans of final-year interns enrolled in a two-year medical internship programme in the Free State, and whether they felt sufficiently prepared to be medical doctors. Methods: This study was a cross-sectional study. A questionnaire was distributed to all consenting interns from the Free State completing their second year of internship during 2013 and 2014. Results: A total of 80 second-year internship doctors from four healthcare facilities completed the questionnaire. The majority (87.2%) indicated that they believe internship prepared them well for community service and 65.0% were positive about the supervision they received. However, only 52.5% felt that they were properly orientated. Conclusion: Medical interns felt positive about their experiences at their allocated Free State healthcare facilities and acknowledged they were better prepared for their careers. In some domains, insufficient supervision and lack of orientation impacted on the internship experience. Workload, lack of resources, insufficient staff and work environment at institutions are the main push factors.

Background: The Health Professions Council of South Africa (HPCSA) requires all registered Health Practitioners in South Africa to complete accredited learning opportunities, and provide proof thereof. CPD is the chosen model, which focuses on holistic development of the professional. The UFS Department of Family Medicine presents refresher courses for general practitioners, covering all relevant fields of interest. Aim: The aim of this study was to find reasons and possible solutions for the perceived lack of interest in refresher courses by determining general practitioners’ needs and preferences for CPD training. Methodology: A cross-sectional study design was chosen, whereby a systematic sample of 300 general practitioners registered with the HPCSA as doctors in the Free State were asked to complete a questionnaire. Needs and preferences regarding learning opportunities and factors influencing usage of these learning opportunities were assessed. Results: The responses from 60 participants revealed that general practitioners still prefer the lecture form of presentations in large or small groups. Topics that ranked highly were Infective Diseases, Cardiology and Respiratory Diseases. Respondents indicated that general practitioners prefer not to leave their practices unattended for an extended period of time. Conclusion: Free State general practitioners still prefer the traditional lecture-room style of learning. Their declared learning needs are in line with the regular ailments they encounter within their practices. Strategies to accommodate those who find it difficult to attend, due to time and distance concerns, should be considered.