Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities

Background : Observational studies suggest higher pregnancy rates after the hysteroscopic removal of endometrial polyps, submucous fibroids, uterine septum or intrauterine adhesions, which are detectable in 10% to 15% of women seeking treatment for subfertility. Objectives : To assess the effects of the hysteroscopic removal of endometrial polyps, submucous fibroids, uterine septum or intrauterine adhesions suspected on ultrasound, hysterosalpingography, diagnostic hysteroscopy or any combination of thesemethods inwomenwith otherwise unexplained subfertility or prior to intrauterine insemination (IUI), in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). Search methods : We searched theCochraneMenstrualDisorders and Subfertility SpecialisedRegister (8 September 2014), theCochrane Central Register of Controlled Trials (The Cochrane Library 2014, Issue 9), MEDLINE (1950 to 12 October 2014), EMBASE (inception to 12 October 2014), CINAHL (inception to 11 October 2014) and other electronic sources of trials including trial registers, sources of unpublished literature and reference lists. We handsearched the American Society for Reproductive Medicine (ASRM) conference abstracts and proceedings (from January 2013 to October 2014) and we contacted experts in the field. Selection criteria : Randomised comparisons between operative hysteroscopy versus control in women with otherwise unexplained subfertility or undergoing IUI, IVF or ICSI and suspected major uterine cavity abnormalities diagnosed by ultrasonography, saline infusion/ gel instillation sonography, hysterosalpingography, diagnostic hysteroscopy or any combination of these methods. Primary outcomes were live birth and hysteroscopy complications. Secondary outcomes were pregnancy and miscarriage. Data collection and analysis : Two review authors independently assessed studies for inclusion and risk of bias, and extracted data. We contacted study authors for additional information. Main results : We retrieved 12 randomised trials possibly addressing the research questions. Only two studies (309 women) met the inclusion criteria. Neither reported the primary outcomes of live birth or procedure related complications. In women with otherwise unexplained subfertility and submucous fibroids there was no conclusive evidence of a difference between the intervention group treated with hysteroscopic myomectomy and the control group having regular fertility-oriented intercourse during 12 months for the outcome of clinical pregnancy. A large clinical benefit with hysteroscopic myomectomy cannot be excluded: if 21% of women with fibroids achieve a clinical pregnancy having timed intercourse only, the evidence suggests that 39% of women (95% CI 21% to 58%) will achieve a successful outcome following the hysteroscopic removal of the fibroids (odds ratio (OR) 2.44, 95% confidence interval (CI) 0.97 to 6.17, P = 0.06, 94 women, very low quality evidence). There is no evidence of a difference between the comparison groups for the outcome of miscarriage (OR 0.58, 95% CI 0.12 to 2.85, P = 0.50, 30 clinical pregnancies in 94 women, very low quality evidence). The hysteroscopic removal of polyps prior to IUI can increase the chance of a clinical pregnancy compared to simple diagnostic hysteroscopy and polyp biopsy: if 28% of women achieve a clinical pregnancy with a simple diagnostic hysteroscopy, the evidence suggests that 63% of women (95% CI 50% to 76%) will achieve a clinical pregnancy after the hysteroscopic removal of the endometrial polyps (OR 4.41, 95% CI 2.45 to 7.96, P < 0.00001, 204 women, moderate quality evidence). Authors' conclusions : A large benefit with the hysteroscopic removal of submucous fibroids for improving the chance of clinical pregnancy in women with otherwise unexplained subfertility cannot be excluded. The hysteroscopic removal of endometrial polyps suspected on ultrasound in women prior to IUI may increase the clinical pregnancy rate. More randomised studies are needed to substantiate the effectiveness of the hysteroscopic removal of suspected endometrial polyps, submucous fibroids, uterine septum or intrauterine adhesions in women with unexplained subfertility or prior to IUI, IVF or ICSI

Geography Educators’ Perceptions of Learner Performance in Grade 12 Geography in Public Schools

This research study arose out of the perceived poor performance of learners in Grade 12 geography from schools in the uThungulu District. To investigate the cause of the poor performance, the researcher explored Grade 12 educators’ perceptions of some of the challenges that could affect the academic performance of Grade 12 geography learners. The mixed method study was used to explore the educators’ perceptions. Data were collected from 50 educators who were selected through random and purposeful sampling to participate in both the survey and semi-structured interview. Of the 50 teachers, 40 were selected by means of systematic random sampling to fill in the questionnaires, while 10 were selected through purposeful and convenient sampling to participate in the semi-structured interview schedule. Data collected from the survey were analysed using t-test and Pearson product moment correlation coefficient and descriptive statistical techniques. The findings reveal that gender characteristics of educators, and educators’ teaching and marking experience were found to be significantly related to learners’ performance in geography in public high schools in the uThungulu District. The results reveal that educators’ teaching and marking experience significantly contributes to educator competence in the assessment, and learners’ answering of national examination questions

An investigation into the state of environmental education and the use of technology in environmental education in Gauteng, South Africa

Abstract : Since the Industrial Revolution, humankind has consumed and used the earth’s resources for its own gain, but at the expense of the earth’s biosphere (Maluleke, 2005; Govender, 2011). Such impacts did not go unnoticed within the realms of education. With the roots of Environmental Education can be traced back to the 18th century when Jean-Jacques Rousseau identified the importance of Environmental Education in that it is a learning area that focuses on the environment (Eneji et al., 2017). EE gained a significant boost in the 1960s and 1970s and gained a global platform in 1972. In 1972, Stockholm, hosted the United Nations Conference on the Human Environment, from which emanated a declaration to the effect that EE should be imperative as a tool to ‘address global environmental problems’ (Eneji et al., 2017). Since the 1970s, there have been significant advances in technology: from advances in automation to the use of mobile cellular devices and computers that have become exponentially more efficient and mobile. In fact, the list of types of technologies which have been developed since the 1970s is endless (Blažek et al., 2017). They have had an impact on almost every economic sector of the globe, including the education sector (Courville, 2011). The marriage of technology and EE is a perfect tool to enhance the latter. However, the implementation of both within the schooling system is often notably slow, as in South Africa. In line with this, the state of environmental education and how technology is used for it is largely unknown within South Africa. In line with this, this study investigates the state of Environmental Education and the use of technology in Environmental Education in the Further Education and Training (FET) phase presented by Gauteng secondary schools of South Africa. For which data was collected from educators’ utilising a questionnaire survey and was analysed by means of a SWOT analysis. The study found that similar challenges are faced in the implementation of both EE and technologies such as GIS and ICTs into the school systems in South Africa as are faced in countries around the world including South Korea and Tanzania. With the largest barrier to their implementation being a lack of access to resources. However, respondents of the study have largely embraced EE and the potential it has in creating environmentally literate citizens.M.Sc. (Environmental Management

Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities

Background : Observational studies suggest higher pregnancy rates after the hysteroscopic removal of endometrial polyps, submucous fibroids, uterine septum or intrauterine adhesions, which are present in 10% to 15% of women seeking treatment for subfertility. Objectives : To assess the effects of the hysteroscopic removal of endometrial polyps, submucous fibroids, uterine septum or intrauterine adhesions suspected on ultrasound, hysterosalpingography, diagnostic hysteroscopy or any combination of these methods in women with otherwise unexplained subfertility or prior to intrauterine insemination (IUI), in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). Search methods : We searched the following databases from their inception to 16 April 2018; The Cochrane Gynaecology and Fertility Group Specialised Register, the Cochrane Central Register of Studies Online,; MEDLINE, Embase, CINAHL, and other electronic sources of trials including trial registers, sources of unpublished literature, and reference lists. We handsearched the American Society for Reproductive Medicine (ASRM) conference abstracts and proceedings (from 1 January 2014 to 12 May 2018) and we contacted experts in the field. Selection criteria : Randomised comparison between operative hysteroscopy versus control for unexplained subfertility associated with suspected major uterine cavity abnormalities. Randomised comparison between operative hysteroscopy versus control for suspected major uterine cavity abnormalities prior to medically assisted reproduction. Primary outcomes were live birth and hysteroscopy complications. Secondary outcomes were pregnancy and miscarriage. Data collection and analysis : Two review authors independently assessed studies for inclusion and risk of bias, and extracted data. We contacted study authors for additional information. Main results : Two studies met the inclusion criteria. 1. Randomised comparison between operative hysteroscopy versus control for unexplained subfertility associated with suspected major uterine cavity abnormalities. In women with otherwise unexplained subfertility and submucous fibroids, we were uncertain whether hysteroscopic myomectomy improved the clinical pregnancy rate compared to expectant management (odds ratio (OR) 2.44, 95% confidence interval (CI) 0.97 to 6.17; P = 0.06, 94 women; very low-quality evidence). We are uncertain whether hysteroscopic myomectomy improves the miscarriage rate compared to expectant management (OR 1.54, 95% CI 0.47 to 5.00; P = 0.47, 94 women; very low-quality evidence). We found no data on live birth or hysteroscopy complication rates. We found no studies in women with endometrial polyps, intrauterine adhesions or uterine septum for this randomised comparison. 2. Randomised comparison between operative hysteroscopy versus control for suspected major uterine cavity abnormalities prior to medically assisted reproduction. The hysteroscopic removal of polyps prior to IUI may have improved the clinical pregnancy rate compared to diagnostic hysteroscopy only: if 28% of women achieved a clinical pregnancy without polyp removal, the evidence suggested that 63% of women (95% CI 45% to 89%) achieved a clinical pregnancy after the hysteroscopic removal of the endometrial polyps (OR 4.41, 95% CI 2.45 to 7.96; P < 0.00001, 204 women; low-quality evidence). We found no data on live birth, hysteroscopy complication or miscarriage rates in women with endometrial polyps prior to IUI. We found no studies in women with submucous fibroids, intrauterine adhesions or uterine septum prior to IUI or in women with all types of suspected uterine cavity abnormalities prior to IVF/ICSI. Authors' conclusions : Uncertainty remains concerning an important benefit with the hysteroscopic removal of submucous fibroids for improving the clinical pregnancy rates in women with otherwise unexplained subfertility. The available low-quality evidence suggests that the hysteroscopic removal of endometrial polyps suspected on ultrasound in women prior to IUI may improve the clinical pregnancy rate compared to simple diagnostic hysteroscopy. More research is needed to measure the effectiveness of the hysteroscopic treatment of suspected major uterine cavity abnormalities in women with unexplained subfertility or prior to IUI, IVF or ICSI

Community Development Evaluation Storymap and Legend

Community based organizations, funders, and intermediary organizations working in the community development field have a shared interest in building stronger organizations and stronger communities. Through evaluation these organizations can learn how their programs and activities contribute to the achievement of these goals, and how to improve their effectiveness and the well-being of their communities. Yet, evaluation is rarely seen as part of a non-judgemental organizational learning process. Instead, the term "evaluation" has often generated anxiety and confusion. The Community Development Storymap project is a response to those concerns.Illustrations found in this document were produced by Grove Consultants

2003 : Part-Time Programmes

Book containing information and full list of part - time courses for 2003 entry. 2003/2004 academic calendar. Faculty structure and key contacts at DIT

2005 : Part-Time Programmes

Book containing map of DIT main locations, frequently asked questions, key contacts and full listing of part-time programmes on offer at DIT 2005

Chapter 8: Executive Summary

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63118/1/15305620252933437.pd