Congenital rubella syndrome surveillance in South Africa using a sentinel site approach : a cross-sectional study

BACKGROUND. Congenital rubella syndrome (CRS) includes disorders associated with intrauterine rubella infection. Incidence of CRS is higher in countries with no rubella-containing vaccines (RCV) in their immunization schedules. In the World Health Organization African region, RCVs are being introduced as part of the 2012–2020 global measles and rubella strategic plan. This study aimed to describe the epidemiology of confirmed CRS in South Africa prior to introduction of RCVs in the immunization schedule. METHODS. This was a descriptive study with 28 sentinel sites reporting laboratory-confirmed CRS cases in all 9 provinces of South Africa. In the retrospective phase (2010 to 2014), CRS cases were retrieved from medical records, and in the prospective phase (2015 to 2017) clinicians at study sites reported CRS cases monthly. RESULTS. There were 42 confirmed CRS cases in the retrospective phase and 53 confirmed CRS cases in the prospective phase. Most frequently reported birth defects were congenital heart disease and cataracts. The median age of mothers of CRS cases was 21 years in the retrospective phase (range: 11 to 38 years) and 22 years in the prospective phase (range: 15 to 38 years). CONCLUSION. Baseline data on laboratory-confirmed CRS will enable planning and monitoring of RCV implementation in the South African Expanded Programme on Immunization program. Ninety-eight percent of mothers of infants with CRS were young women 14–30 years old, indicating a potential immunity gap in this age group for consideration during introduction of RCV.The NICD/NHLS, South Africahttp://cid.oxfordjournals.orgam2020Paediatrics and Child Healt

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Higher Order Thinking Skills: Graphic Organisers

A graphic organiser is a way of organising information visually. Some are visual but not very organised (eg Attribute Web) and some are organised but not very visual (eg Storyboard = scaffold for writing and understanding narrative). ... Teachers need to scaffold students' use of graphic organisers but gradually withdraw the scaffolding. The higher order thinking skills that are needed to construct a graphic organiser will not be developed fully until the scaffolding has been removed. Scaffolding can include teacher demonstration, handouts with part of the graphic organiser filled in and part blank for the students to fill in, and joint construction in pairs or cooperative groups

Research related to mixed-age classes

Type of classroom organisation by itself cannot predict 'success' but teachers of a multiage class are more likely to use frequent and flexible grouping, have an individual focus, have an articulated philosophy, and know their students well - all of which have an effect on both cognitive and affective factors

Being a 'Reflective Practitioner': How My Beliefs About Learning Have Influenced My Teaching (and Vice Versa)

Helping pre-service teachers develop into reflective practitioners is a difficult process. My attempts to encourage such development have taught me valuable lessons about learning and teaching; the most valuable lesson being that 'reflection' is of primary importance but it cannot occur without a base in 'practice'. Practice is difficult to provide within university classes, especially when a large number of students study externally. My current approach is to embed reflection in applied assessment tasks so that students must first use a strategy or theory in practice and then reflect on this practice. In this paper I describe my current beliefs about learning, how they have been influenced by my attempts to encourage my students to develop into reflective practitioners, and the role of assessment in this process

Multi-age classes: Philosophy &amp; practice

Multiage Class: • Formed by choice • Committed to philosophy • Emphasis on flexible grouping, including whole-class group • Often team taught • Focus on individual and continuous progress • Parental support important • Children move often • Programming starts with outcomes desired • Learning often student-directed (negotiated curriculum, emphasis on independent learners). Academic Achievement - General: • in sum: 'no academic disadvantage' • positive findings are related to provision of 'developmentally appropriate' curriculum (which MAY mean ability groups

Multiage Classes: what research tells us about their suitability for rural schools

Rural schools often have mixed-age (multigrade) classes because of small enrolments. There is a body of research which supports classes which are mixed-age by choice - multiage classes. To what extent can the successful practices of multiage teachers be adopted by multigrade teachers in rural schools? This article presents a summary of the research findings related to both multiage and multigrade classes, and explores the factors which are relevant in explaining the success of multiage classes

A Different Chariot?: Response to 'Cauliflowers, Chariots and Creative Cognition'

Fritjof Capra has, according to Brian Barratt 'demonstrated fascinating and valid parallels between atomic and subatomic physics and the philosophies of the ancient East'. I know very little about these ancient philosophies but I found as I read Barratt's article that I saw parallels between what he was reporting about ancient Indian images/beliefs and current educational images/beliefs. In the spirit of creativity, I attempted to draw parallels for myself. Whether they are as valid and fascinating as those of Fritjof Capra is debatable, but I offer them nonetheless to Brian Barratt. I do not know him but from his writing I suspect he would be pleased that someone felt motivated to drive her chariot temporarily down a different road. In my discussion I have italicised those terms in current educational use

Research evidence: Does the multiage structure support increased student learning?

Much has been published about the effects of various classroom structures on student learning, and multiage in some form is often mentioned as having positive effects (both cognitive and affective). Multiage is an umbrella term used to describe classes where the age range is at least two years and the students would normally be assigned to separate classes in consecutive grades.The major distinction between the various types of multiage classes are whether or not the students are seen as members of a particular grade. When they are, and are taught separately for significant periods oftime, the class is a composite class or multi-grade class, and is likely to have been formed for reasons of administrative convenience. Composite classes are also likely to be temporary. When the students are not seen as members of a particular grade but as individuals at varying stages of development and with different needs in different areas, and are taught as such,the class is likely to be a nongraded class, formed because of a belief about the necessity for 'developmentally appropriate' schooling. In such classes, the teacher regroups the students frequently depending on their particular stage of development rather than on their age.The children are likely to remain in the class with the same teacher for several years, progressing from being the younger members to being the older members in the class

Developing tertiary students' literacy skills

Not all students arrive at university with the basic literacy skills they require to be successful in their studies. In fact, many students display a considerable deficit in their spoken and written English which seems at times to be at odds with their sometimes considerable ability to use higher-order thinking skills to comprehend and interact with the subject matter of their chosen fields of study. This seeming lack of control over the primary areas of spelling, punctuation, grammar and sentence formation is often the reason for poor assignment and exam marks, and requires addressing in a practical and systematic way. If the literacy problems of individuals and groups of students are systematically analysed and identified, then programs can be developed to assist students to understand and overcome areas of weakness in communication skills and to apply their new understanding successfully in university assessment tasks. In this session participants will analyse some of the literacy issues which have arisen in a teacher education course and discuss with presenters the development and application of strategies to overcome what appears to be a high literacy deficit in students studying to be teachers of literacy themselves. In spite of being competent users of new technologies, many students require old-fashioned 'back to basics' teaching. In an evaluation of the Literacy Mentorship program at their university, the presenters argue that boundaries of teaching sometimes need pushing backwards as well as forwards