Don't blame the Constitution

South Africa has one of the most inclusive and progressive constitutions in the world, drafted with an acute awareness to the injustices of the past. It prescribes all of the safeguards of a civilised society and has become a model for emerging democracies. Our Bill of Rights, born of a long and difficult struggle against apartheid, entrenches our most cherished values of dignity, equality and freedom

Authoring lives : a case study of how grade 6 children in a South African township school construct themselves as readers and writers.

This thesis examines how six children at the end of the Intermediate Phase, i.e. Grade 6, in a school located in a South African township construct themselves as readers and writers. It investigates the literacy and discursive practices the children draw upon, from both their in- and out-of-school worlds, in their identity work. It also focuses on gendered differences within these practices. A Soweto primary school was selected as the research site. Adopting a single case study design, the six children were purposefully selected to constitute a ‘case’. The children represented ‘good readers and writers’ and an equal gender spread, i.e. three girls and three boys. Over a period of three months numerous group and individual interviews were conducted. The children’s school books and portfolio work, as well as a selection of literacy artefacts produced in the out-of-school domain, were collected. Informal field notes and interviews with the school principal and two Grade 6 teachers added valuable contextual information. Gee’s (1990, 1996, 1998, 2001) work forms a grounding theoretical orientation for the research which is centred on his understanding of identity as a cultural construct varying across settings and constituted within and by particular Discourses. Postructuralist theorising of subjectivity provides an additional theoretical orientation for the research (Bakhtin 1981; Mishler 1999; Norton 1997; Pavlenko & Blackledge 2004; Weedon 1997). In analysing the data, the thesis demonstrates a marked tension between the literacy and discursive practices of the children’s in- and out-of-school worlds. The children’s everyday out-of-school worlds are revealed to be rich sites of situated and social literacy. Within a variety of literacy practices the children are shown to draw on their out-of-school Discourses to construct themselves as active, competent and intentional meaning-makers. Alongside such findings, the children’s in-school worlds are found to be dominated by an autonomous model of literacy (Street 1984, 1993). The 2 emphasis on skills like decoding and encoding texts rather than meaning-making is shown to offer the children markedly different, and limited, constructions of their literate selves. The tension between the children’s in- and out-of-school worlds is further heightened by the varied opportunities available for using literacy to assert their gendered identities across the two domains. The principal argument of the thesis suggests that the children recognise the point of tension between their in- and out-of-school worlds and resolve it by establishing and maintaining a third space (Levy 2008; Moje et al. 2004). Within this space the children are shown to draw on the Discourses and positions offered within both domains to construct their identities as readers and writers. The space is therefore demonstrated to be a place where competing knowledges and Discourses are brought ‘into conversation’, as well as a ‘navigational space’, providing the children with the means to cross and succeed in different domains (Moje et al. 2004, p.44). Finally, the thesis concludes by exploring the implications of the research findings to the wider social context of the South African education system, and the opportunities for teacher professional development within the system

New-instutionalism and the origins of the African Union

The inauguration of the African Union (AU) in July 2002 represents an ambitious project to establish frameworks and institutions that promote regional integration and co-operation to address the continent’s perils. This is particularly true in the security and defence sectors. Because conflicts in Africa have been characterised by humanitarian catastrophes, regional co-operation now reflects the priorities of human security and development. In particular, the Constitutive Act of the AU enforces the principles of the responsibility to protect (R2P) the right to intervene in a member state in respect of grave circumstances and intolerance of unconstitutional changes of government. At first glance these principles seem contrary to international law, the notion of sovereignty and the primacy of the UN Security Council in matters of international peace and security. Using new- institutionalism approaches the research will examine the process whereby the AU originated and how the organisation affects member state behaviour. In particular, the research will examine whether one can identify a critical juncture to account for the origins of the AU and whether the norms enshrined in its Constitutive Act are being internalised by member states. It is the contention of the research that calculations of material interest and power balancing often compete with norm localisation thus affecting institutional predictability and the ability of the African Union to fulfil its mandat

Big deals et open access : quelle stratégie numérique pour les bibliothèques universitaires ?

Mémoire de fin d\u27étude du diplôme de conservateur, promotion 28, portant sur l\u27édition numérique en bibliothèques universitaires

Endoscopic capacity in West Africa

Background: Levels of endoscopic demand and capacity in West Africa are unclear.Objectives: This paper aims to: 1. describe the current labor and endoscopic capacity, 2. quantify the impact of a mixed-methods endoscopy course on healthcare professionals in West Africa, and 3. quantify the types of diagnoses encountered.Methods: In a three-day course, healthcare professionals were surveyed on endoscopic resources and capacity and were taught through active observation of live cases, case discussion, simulator experience and didactics. Before and after didactics, multiplechoice exams as well as questionnaires were administered to assess for course efficacy. Also, a case series of 23 patients needing upper GI endoscopy was done.Results: In surveying physicians, less than half had resources to perform an EGD and none could perform an ERCP, while waiting time for emergency endoscopy in urban populations was at least one day. In assessing improvement in medical knowledge among participants after didactics, objective data paired with subjective responses was more useful than either alone. Of 23 patients who received endoscopy, 7 required endoscopic intervention with 6 having gastric or esophageal varices. Currently the endoscopic capacity in West Africa is not sufficient. A formal GI course with simulation and didactics improves gastrointestinal knowledge amongst participants.Keywords: Endoscopic capacity, endoscopic demand, West Africa, training cours

The ‘ins and outs’ of colonoscopy at Wits Donald Gordon Medical Centre, South Africa: A practice audit of the outpatient endoscopy unit

Background. In South Africa, there are no national guidelines for the conduct or quality assessment of colonoscopy, the gold standard for investigation and diagnosis of bowel pathology.Objectives. To describe the clinical profile of patients and evaluate the practice of colonoscopy using procedural quality indicators at the Wits Donald Gordon Medical Centre (WDGMC) outpatient endoscopy unit (OEU).Methods. We conducted a prospective, clinical practice audit of colonoscopies performed on adults (≥18 years of age). A total of 1 643 patients were included in the study and variables that were collected enabled the assessment of adequacy of bowel preparation, length of withdrawal time and calculation of caecal intubation rate (CIR), polyp detection rate (PDR) and adenoma detection rate (ADR). We stratified PDR and ADR by sex, age, population group, withdrawal time and bowel preparation. CIR, PDR and ADR estimates were compared between patient groups by the χ2 test; Fisher’s exact test was used for 2 × 2 tables. A p-value <0.05 was used. Benchmark recommendations by the American Society for Gastrointestinal Endoscopy (ASGE)/American College of Gastroenterology (ACG) Task Force on Colorectal Cancer (CRC) were used in this audit to assess individual endoscopist performance and that of the endoscopy unit as a whole.Results. The mean age of patients was 55.7 (standard deviation (SD) 14.4; range 18 - 91) years, ~60% were female, and the majority (75.5%) were white. Of the outpatients, 77.6% had adequate bowel preparation (ASGE/ACG benchmark ≥85%). The CIR was 97.0% overall, and screening colonoscopy was 96.3% (ASGE/ACG benchmark ≥90% overall and ≥95% for screening colonoscopies). The median withdrawal time for negative-result screening colonoscopies was 5.7 minutes (interquartile range (IQR) 4.2 - 9.3; range 1.1 - 20.6) (ASGE/ACG benchmark ≥ 6minutes), and PDR and ADR were 27.6% and 15.6%, respectively (ASGE/ACG benchmark ADR ≥25%). We demonstrated a 23.7% increase in PDR and 14.1% increase in ADR between scopes that had mean withdrawal times of ≥6 minutes and <6 minutes, respectively. Although the number of black Africans in the study was relatively small, our results showed that they have similar ADRs and PDRs to the white population group, contradicting popular belief.Conclusions. The WDGMC OEU performed reasonably well against the international guidelines, despite some inadequacy in bowel preparation and lower than recommended median withdrawal times on negative-result colonoscopy. Annual auditing of clinical practice and availability of these data in the public domain will become standard of care, making this audit a baseline for longitudinal observation, assessing the impact of interventions, and contributing to the development of local guidelines

Guideline summary : appropriate use of tigecycline

Tigecycline, the first of a new class of broad-spectrum antibiotics (the glycylcyclines), has been licensed in South Africa for the parenteral treatment of adult patients with complicated intra-abdominal infections (cIAIs) and complicated skin and soft-tissue infections (cSSTIs).http://www.hmpg.co.za/journaldetail.php?journalno=

Guideline: Appropriate use of tigecycline

Introduction. Tigecycline, the first of a new class of antibiotics, the glycylcyclines, was licensed in South Africa for the parenteral treatment of adult patients with complicated intra-abdominal infections (cIAIs) and complicated skin and soft-tissue infections (cSSTIs). Methods. A multidisciplinary meeting representative of the Association of Surgeons of South Africa, the Critical Care Society of Southern Africa, the Federation of Infectious Diseases Societies of Southern Africa, the South African Thoracic Society and the Trauma Society of South Africa was held to draw up a national guideline for the appropriate use of tigecycline. Background information reviewed included randomised controlled trials, other relevant publications and local antibiotic susceptibility patterns. The initial document was drafted at the meeting. Subsequent drafts were circulated to members of the working group for modification. Output. The guideline addresses several important aspects of the new agent, summarising key clinical data and highlighting important considerations with the use of the drug. The recommendations in this guideline are based on currently available scientific evidence together with the consensus opinion of the authors. Conclusion. This statement was written out of concern regarding the widespread misuse of antibiotics. Its primary intention is to facilitate heterogeneous use of antibiotics as a component of antibiotic stewardship and to highlight the appropriate use of tigecycline in particular

Endoscopic capacity in West Africa.

Background: Levels of endoscopic demand and capacity in West Africa are unclear. Objectives: This paper aims to: 1. describe the current labor and endoscopic capacity, 2. quantify the impact of a mixed-methods endoscopy course on healthcare professionals in West Africa, and 3. quantify the types of diagnoses encountered. Methods: In a three-day course, healthcare professionals were surveyed on endoscopic resources and capacity and were taught through active observation of live cases, case discussion, simulator experience and didactics. Before and after didactics, multiplechoice exams as well as questionnaires were administered to assess for course efficacy. Also, a case series of 23 patients needing upper GI endoscopy was done. Results: In surveying physicians, less than half had resources to perform an EGD and none could perform an ERCP, while waiting time for emergency endoscopy in urban populations was at least one day. In assessing improvement in medical knowledge among participants after didactics, objective data paired with subjective responses was more useful than either alone. Of 23 patients who received endoscopy, 7 required endoscopic intervention with 6 having gastric or esophageal varices. Currently the endoscopic capacity in West Africa is not sufficient. A formal GI course with simulation and didactics improves gastrointestinal knowledge amongst participants