Die toepassing van didaktiese beginsels in die onderwyspraktyk*

In hierdie voordrag gaan dit by uitstek om drie sake, met nadere kwalifiseringe. Hierdie sake is: 1. Die terrein van die didaktiek. 2. Die normatiewe karakter van die didaktiek. 3. Die praktiese aanwendbaarheid van didaktiese begin- sels in die onderwyspraktyk. By wyse van toeligting sal daar dan kortliks na gedifferensieerde onderwys verwys word

Health promotion: From malaria control to elimination

Here we reflect on the achievement of some of the diverse activities that have brought malaria under control, highlight key challenges and propose specific health promotion interventions required to move South Africa’s malaria programme from control to elimination

A systematic literature review of sustainable urban planning challenges associated with developing countries

CITATION: Jooste, A. F., De Kock, I. H. & Musango, J. K. 2019. A systematic literature review of sustainable urban planning challenges associated with developing countries. South African Journal of Industrial Engineering, 30(3):253-261, doi:10.7166/30-3-2247.The original publication is available at http://sajie.journals.ac.zaENGLISH ABSTRACT: The purpose of this study is to uncover the most prominent challenges that urban planners face when tackling sustainable practices in developing countries. The time frame was set to after the 2012 Rio +20 global summit. Therefore, only articles that were produced from 1 January 2013 till 31 March 2019 were included, as they would have adhered to the contributions and protocols set forth at the largest UN Earth Summit conference. In this study, a review of the sustainable urban planning challenges was conducted. The challenges are then grouped into topics that align with the theme of the type of challenge. Finally, the challenges are analysed to identify the most well-known and disruptive challenges that restrict urban planners in developing countries.http://sajie.journals.ac.za/pub/article/view/2247Publisher's versio

Risk factors for coronary heart disease in the black population of the Cape Peninsula The BRISK study

A cross-sectional study of risk factors for ischaemic heart disease (IHO) in a random sample of 986 black people aged 15 - 64 years living in the Cape Peninsula revealed a population at lower risk for IHO than other South Africans. Blood pressures of 140/95 mmHg or above were found in 14,4% of males and 13,7% of females. Fifty-two per cent of males and 8,4% of females smoked, while 16,5% of males and 25,8% of females had a total cholesterol (TC) level imparting risk for developing IHO. In this population the TC level is not a good surrogate measure for low-density lipoprotein cholesterol because of the high level of high-density lipoprotein cholesterol (HOLC) found in this population. A protective HOLC/TC ratio of 20% was found in 96% of males and 96,1% of females. When considering the three major reversible IHO risk factors at a high level of risk, 30,8% of males and 12,5% of females had at least one such a risk factor. The population was frequently exposed to the media, with 80% listening to the radio every day and 55% watching television at least once a week. This suggests that a healthy lifestyle could be promoted successfully by means of these media. In addition, schools should promote a healthy lifestyle and the prevention of chronic degenerative diseases should be incorporated into the evolving primary health care services in South Africa

A comparison of South African national HIV incidence estimates: A critical appraisal of different methods

BACKGROUND: The interpretation of HIV prevalence trends is increasingly difficult as antiretroviral treatment programs expand. Reliable HIV incidence estimates are critical to monitoring transmission trends and guiding an effective national response to the epidemic. Methods and FINDINGS: We used a range of methods to estimate HIV incidence in South Africa: (i) an incidence testing algorithm applying the Limiting-Antigen Avidity Assay (LAg-Avidity EIA) in combination with antiretroviral drug and HIV viral load testing; (ii) a modelling technique based on the synthetic cohort principle; and (iii) two dynamic mathematical models, the EPP/Spectrum model package and the Thembisa model. Overall, the different incidence estimation methods were in broad agreement on HIV incidence estimates among persons aged 15-49 years in 2012. The assay-based method produced slightly higher estimates of incidence, 1.72% (95% CI 1.38 - 2.06), compared with the mathematical models, 1.47% (95% CI 1.23 - 1.72) in Thembisa and 1.52% (95% CI 1.43 - 1.62) in EPP/Spectrum, and slightly lower estimates of incidence compared to the synthetic cohort, 1.9% (95% CI 0.8 - 3.1) over the period from 2008 to 2012. Among youth aged 15-24 years, a declining trend in HIV incidence was estimated by all three mathematical estimation methods. CONCLUSIONS: The multi-method comparison showed similar levels and trends in HIV incidence and validated the estimates provided by the assay-based incidence testing algorithm. Our results confirm that South Africa is the country with the largest number of new HIV infections in the world, with about 1 000 new infections occurring each day among adults aged 15-49 years in 2012

Early development of water quality methods and approaches in ecological Reserve assessments

This project was initiated in 2000 to allow the ecological Reserve team for water quality to undertake additional research while working on eco-logical Reserve determinations funded by the Department of Water Af-fairs and Forestry. The results of this work form the basis of the meth-ods reported in the Water Research Commission report Hughes DA (Ed)(in press)

Supplement 1) Peer-reviewed paper

Abstract This study was conducted to investigate the effect of dietary fatty acids (FA) on the fertility and hatchability of laying hens at the end-of-lay period (69 -77 weeks of age). Five isoenergetic (12.4 MJ ME/kg DM) and isonitrogenous (170 g CP/kg DM) diets were formulated using different lipid sources (30 g/kg inclusion) to manipulate the dietary FA profile. The control diet was formulated using a 50 : 50 blend of linseed and fish oil, while fish oil was used in the polyunsaturated n-3 treatment. Sunflower oil was used in the polyunsaturated n-6 treatment, while in the mono-unsaturated n-9 diet high oleic acid (HO) sunflower oil was used. Lastly, tallow was used as a lipid source in the saturated FA diet. One hundred and twenty five hens (n = 25/treatment) and 50 cockerels (n = 10/treatment) of the Hy-Line Silver-Brown genotype were randomly allocated to the five dietary treatments at 20 weeks of age. From 69 weeks of age, hens were inseminated with 0.06 mL undiluted semen from cockerels within the same dietary treatment. Between 71 and 78 weeks of age (49 days) a total of 588 eggs-per-treatment were collected, individually marked (date and hen number) and incubated in a single-stage still-air incubator. Eggs were candled on D7 and D14 to determine embryonic mortalities and a 24 h window for hatching was allowed (D21 + 24 h). Although the fish oil treatment resulted in the lowest egg weights (59.3 g) and fertility (84.6%), it recorded the highest hatchability (76%). In contrast, the sunflower oil treatment recorded the lowest hatchability (58.2%) of all treatments, despite its high egg fertility (89.6%). Results of the study suggest that the dietary fatty acid content, in particular the n-3 and n-6 levels, need critical consideration in terms of concentration and ratio in the formulation of breeder diets to limit embryonic mortalities during incubation

Thombosis, major bleeding, and survival in COVID-19 supported by veno-venous extracorporeal membrane oxygenation in the first vs second wave: a multicenter observational study in the United Kingdom

Background Bleeding and thrombosis are major complications of veno-venous (VV) extracorporeal membrane oxygenation (ECMO). Objectives To assess thrombosis, major bleeding (MB), and 180-day survival in patients supported by VV-ECMO between the first (March 1 to May 31, 2020) and second (June 1, 2020, to June 30, 2021) waves of the COVID-19 pandemic. Methods An observational study of 309 consecutive patients (aged ≥18years) with severe COVID-19 supported by VV-ECMO was performed in 4 nationally commissioned ECMO centers in the United Kingdom. Results Median age was 48 (19-75) years, and 70.6% were male. Probabilities of survival, thrombosis, and MB at 180 days in the overall cohort were 62.5% (193/309), 39.8% (123/309), and 30% (93/309), respectively. In multivariate analysis, an age of >55 years (hazard ratio [HR], 2.29; 95% CI, 1.33-3.93; P = .003) and an elevated creatinine level (HR, 1.91; 95% CI, 1.19-3.08; P = .008) were associated with increased mortality. Correction for duration of VV-ECMO support, arterial thrombosis alone (HR, 3.0; 95% CI, 1.5-5.9; P = .002) or circuit thrombosis alone (HR, 3.9; 95% CI, 2.4-6.3; P < .001) but not venous thrombosis increased mortality. MB during ECMO had a 3-fold risk (95% CI, 2.6-5.8, P < .001) of mortality. The first wave cohort had more males (76.7% vs 64%; P = .014), higher 180-day survival (71.1% vs 53.3%; P = .003), more venous thrombosis alone (46.4% vs 29.2%; P = .02), and lower circuit thrombosis (9.2% vs 28.1%; P < .001). The second wave cohort received more steroids (121/150 [80.6%] vs 86/159 [54.1%]; P < .0001) and tocilizumab (20/150 [13.3%] vs 4/159 [2.5%]; P = .005). Conclusion MB and thrombosis are frequent complications in patients on VV-ECMO and significantly increase mortality. Arterial thrombosis alone or circuit thrombosis alone increased mortality, while venous thrombosis alone had no effect. MB during ECMO support increased mortality by 3.9-fold. Keywords: COVID-19; extracorporeal membrane oxygenation; hemorrhage; mortality; thrombosi

The efficacy and safety of prokinetic agents in critically ill patients receiving enteral nutrition: a systematic review and meta-analysis of randomized trials.

BACKGROUND: Intolerance to enteral nutrition is common in critically ill adults, and may result in significant morbidity including ileus, abdominal distension, vomiting and potential aspiration events. Prokinetic agents are prescribed to improve gastric emptying. However, the efficacy and safety of these agents in critically ill patients is not well-defined. Therefore, we conducted a systematic review and meta-analysis to determine the efficacy and safety of prokinetic agents in critically ill patients. METHODS: We searched MEDLINE, EMBASE, and Cochrane Library from inception up to January 2016. Eligible studies included randomized controlled trials (RCTs) of critically ill adults assigned to receive a prokinetic agent or placebo, and that reported relevant clinical outcomes. Two independent reviewers screened potentially eligible articles, selected eligible studies, and abstracted pertinent data. We calculated pooled relative risk (RR) for dichotomous outcomes and mean difference for continuous outcomes, with the corresponding 95 % confidence interval (CI). We assessed risk of bias using Cochrane risk of bias tool, and the quality of evidence using grading of recommendations assessment, development, and evaluation (GRADE) methodology. RESULTS: Thirteen RCTs (enrolling 1341 patients) met our inclusion criteria. Prokinetic agents significantly reduced feeding intolerance (RR 0.73, 95 % CI 0.55, 0.97; P = 0.03; moderate certainty), which translated to 17.3 % (95 % CI 5, 26.8 %) absolute reduction in feeding intolerance. Prokinetics also reduced the risk of developing high gastric residual volumes (RR 0.69; 95 % CI 0.52, 0.91; P = 0.009; moderate quality) and increased the success of post-pyloric feeding tube placement (RR 1.60, 95 % CI 1.17, 2.21; P = 0.004; moderate quality). There was no significant improvement in the risk of vomiting, diarrhea, intensive care unit (ICU) length of stay or mortality. Prokinetic agents also did not significantly increase the rate of diarrhea. CONCLUSION: There is moderate-quality evidence that prokinetic agents reduce feeding intolerance in critically ill patients compared to placebo or no intervention. However, the impact on other clinical outcomes such as pneumonia, mortality, and ICU length of stay is unclear