Towards improving learner performance in the national senior certificate examination - script analysis research report

This summary report includes a) a summary of findings across subjects, b) the main findings from each subject area analysis, and c) a background section which describes the purpose, rationale and research approach

The process of developing a management system for subsistence fisheries in South Africa: recognizing and formalizing a marginalized fishing sector in South Africa

Subsistence fishers were first recognized as a formal fishing sector in South Africa when new fishing legislation, aimed at redressing past inequalities, was enacted in 1998. Little information was available about these fishers, their activities, and the resources upon which they rely. Recognizing the imperative to gain an understanding of the fishers and to consult broadly, the national agency responsible for the management of marine living resources, Marine and Coastal Management (MCM) of the Department of Environmental Affairs and Tourism, appointed a Subsistence Fisheries Task Group (SFTG) in December 1998 to provide advice on the implementation of appropriate management systems for subsistence fisheries. This paper describes the process followed to formulate recommendations that were presented by the SFTG to MCM in February 2000. The activities of the SFTG fell into two categories: research aimed at identifying subsistence fishers and gaining an understanding of their activities and socio-economic profiles; and consultation aimed at ensuring that the needs and aspirations of fishers and the experience of local managers were incorporated. Research included both field-based studies and synthesis of information about comparative fisheries elsewhere. Consultation took the form of local interviews and focusgroup discussions, meetings with fishers and a national workshop. A pivotal activity was the development of a clear definition and qualifying criteria for subsistence fishers. A significant outcome was the identification of a separate small-scale commercial sector, previously erroneously lumped with subsistence fishers. Needs of fishers and problems identified during the process provided the basis for recommendations in the following areas: definitions, assessment and categorization of resources, management systems, communication mechanisms, application and allocation procedures, capacity building, compliance, research and monitoring, and funding and staff required for the management of this new sector. An evaluation is made of the opportunities presented by the SFTG process, constraints experienced and lessons learnt, giving important insights that are applicable to other similar processes, yet seldom documented in formal literature. Keywords: management of fisheries, subsistence fisheriesAfrican Journal of Marine Science 2002, 24: 405–42

Comparing youth-friendly health services to the standard of care through "girl Power-Malawi": A quasi-experimental cohort study

Background: Adolescent girls and young women (AGYW) face challenges to seeking HIV and sexual and reproductive health services in sub-Saharan Africa. Integrated approaches designed for AGYW may facilitate service uptake, but rigorous evaluation is needed. Methods: Four comparable public-sector health centers were selected in Malawi and randomly assigned to a service delivery model. One offered "standard of care" (SOC), consisting of vertical HIV testing, family planning, and sexually transmitted infection management in adult-oriented spaces, by providers without extra training. Three offered youth-friendly health services (YFHS), consisting of the same SOC services in integrated youth-dedicated spaces and staffed by youth-friendly peers and providers. In each health center, AGYW aged 15-24 years were enrolled and followed over 12 months to determine use of HIV testing, condoms, and hormonal contraception. The SOC and YFHS models were compared using adjusted risk differences and incidence rate ratios. Findings: In 2016, 1000 AGYW enrolled (N = 250/health center). Median age was 19 years (interquartile range = 17-21 years). Compared with AGYW in the SOC, those in the YFHS models were 23% [confidence interval (CI): 16% to 29%)] more likely to receive HIV testing, 57% (CI: 51% to 63%) more likely to receive condoms, and 39% (CI: 34% to 45%) more likely to receive hormonal contraception. Compared with AGYW in the SOC, AGYW in the YFHS models accessed HIV testing 2.4 (CI: 1.9 to 2.9) times more, condoms 7.9 (CI: 6.0 to 10.5) times more, and hormonal contraception 6.0 (CI: 4.2 to 8.7) times more. Conclusions: A YFHS model led to higher health service use. Implementation science is needed to guide scale-up

Comparing four service delivery models for adolescent girls and young women through the Girl Power' study: Protocol for a multisite quasi-experimental cohort study

In sub-Saharan Africa, adolescent girls and young women (AGYW) face a range of sexual and reproductive health (SRH) challenges. Clinical, behavioural and structural interventions have each reduced these risks and improved health outcomes. However, combinations of these interventions have not been compared with each other or with no intervention at all. The Girl Power' study is designed to systematically make these comparisons. Methods and analysis Four comparable health facilities in Malawi and South Africa (n=8) were selected and assigned to one of the following models of care: (1) Standard of care: AGYW can receive family planning, HIV testing and counselling (HTC), and sexually transmitted infection (STI) syndromic management in three separate locations with three separate queues with the general population. No youth-friendly spaces, clinical modifications or trainings are offered, (2) Youth-Friendly Health Services (YFHS): AGYW are meant to receive integrated family planning, HTC and STI services in dedicated youth spaces with youth-friendly modifications and providers trained in YFHS, (3) YFHS+behavioural intervention (BI): In addition to YFHS, AGYW can attend 12 monthly theory-driven, facilitator-led, interactive sessions on health, finance and relationships, (4) YFHS+BI+conditional cash transfer (CCT): in addition to YFHS and BI, AGYW receive up to 12 CCTs conditional on monthly BI session attendance. At each clinic, 250 AGYW 15-24 years old (n=2000 total) will be consented, enrolled and followed for 1 year. Each participant will complete a behavioural survey at enrolment, 6 months and 12 months. All clinical, behavioural and CCT services will be captured. Outcomes of interest include uptake of each package element and reduction in HIV risk behaviours. A qualitative substudy will be conducted. Ethics/dissemination This study has received ethical approval from the University of North Carolina Institutional Review Board, the University of Cape Town Human Research Ethics Committee and Malawi's National Health Sciences Research Committee. Study plans, processes and findings will be disseminated to stakeholders, in peer-reviewed journals and at conferences

Arterial hypertension

Hypertension is a complex, multifactorial and multisystem disorder and a leading cause of morbidity and premature death globally. Major guidelines define it as systolic blood pressure > 130 mmHg and/or diastolic blood pressure > 80 mmHg. Hypertension is a very common disease with prevalence rates of about 30% in adults worldwide. The incidence of hypertension is age-related. At younger ages, hypertension is more prevalent in males than females, but this trend is reversed by age 65. Gender-related differences in hypertension may relate to cardiovascular effects of sex hormones. The underlying cause of the disease is identified in only ∼ 5% of patients (secondary hypertension), while in 95% of patients, no etiology is found (primary or essential hypertension). Multiple factors including genetics, environmental factors and interacting physiological systems contribute to the pathophysiology of hypertension. High blood pressure is a major preventable risk factor for heart failure, ischemic heart disease, chronic kidney disease, stroke and vascular dementia. The risk of hypertension-related complications and target organ admage increases as blood pressure increases. Hypertension is typically associated with vascular dysfunction, cardiovascular remodeling, renal dysfunction, and stimulation of the sympathetic nervous system. Growing evidence indicates that the immune system is also important and that activated immune cells promote inflammation, fibrosis, and target-organ damage. Common to these processes is oxidative stress, defined as an imbalance between oxidants and antioxidants in favor of the oxidants, which cause disruption of oxidation-reduction (redox) signaling and promotion of molecular and cell damage. This chapter provides a comprehensive review on hypertension and highlights some new concepts on molecular mechanisms and pathophysiological processes underlying hypertension and approaches to diagnosing and managing hypertension in the clinic

Track D Social Science, Human Rights and Political Science

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138414/1/jia218442.pd

Mitochondrial respiratory states and rate

As the knowledge base and importance of mitochondrial physiology to human health expands, the necessity for harmonizing the terminologyconcerning mitochondrial respiratory states and rates has become increasingly apparent. Thechemiosmotic theoryestablishes the mechanism of energy transformationandcoupling in oxidative phosphorylation. Theunifying concept of the protonmotive force providestheframeworkfordeveloping a consistent theoretical foundation ofmitochondrial physiology and bioenergetics.We followguidelines of the International Union of Pure and Applied Chemistry(IUPAC)onterminology inphysical chemistry, extended by considerationsofopen systems and thermodynamicsof irreversible processes.Theconcept-driven constructive terminology incorporates the meaning of each quantity and alignsconcepts and symbols withthe nomenclature of classicalbioenergetics. We endeavour to provide a balanced view ofmitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes.Uniform standards for evaluation of respiratory states and rates will ultimatelycontribute to reproducibility between laboratories and thussupport the development of databases of mitochondrial respiratory function in species, tissues, and cells.Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Effect of Self-monitoring of Blood Pressure on Blood Pressure Control in Pregnant Individuals With Chronic or Gestational Hypertension: The BUMP 2 Randomized Clinical Trial

Importance: Inadequate management of elevated blood pressure is a significant contributing factor to maternal deaths. The role of blood pressure self-monitoring in pregnancy in improving clinical outcomes for the pregnant individual and infant is unclear. Objective: To evaluate the effect of blood pressure self-monitoring, compared with usual care alone, on blood pressure control and other related maternal and infant outcomes, in individuals with pregnancy hypertension. Design, Setting, and Participants: Unblinded, randomized clinical trial that recruited between November 2018 and September 2019 in 15 hospital maternity units in England. Individuals with chronic hypertension (enrolled up to 37 weeks' gestation) or with gestational hypertension (enrolled between 20 and 37 weeks' gestation). Final follow-up was in May 2020. Interventions: Participants were randomized to either blood pressure self-monitoring using a validated monitor and a secure telemonitoring system in addition to usual care (n = 430) or to usual care alone (n = 420). Usual care comprised blood pressure measured by health care professionals at regular antenatal clinics. Main Outcomes and Measures: The primary maternal outcome was the difference in mean systolic blood pressure recorded by health care professionals between randomization and birth. Results: Among 454 participants with chronic hypertension (mean age, 36 years; mean gestation at entry, 20 weeks) and 396 with gestational hypertension (mean age, 34 years; mean gestation at entry, 33 weeks) who were randomized, primary outcome data were available from 444 (97.8%) and 377 (95.2%), respectively. In the chronic hypertension cohort, there was no statistically significant difference in mean systolic blood pressure for the self-monitoring groups vs the usual care group (133.8 mm Hg vs 133.6 mm Hg, respectively; adjusted mean difference, 0.03 mm Hg [95% CI, -1.73 to 1.79]). In the gestational hypertension cohort, there was also no significant difference in mean systolic blood pressure (137.6 mm Hg compared with 137.2 mm Hg; adjusted mean difference, -0.03 mm Hg [95% CI, -2.29 to 2.24]). There were 8 serious adverse events in the self-monitoring group (4 in each cohort) and 3 in the usual care group (2 in the chronic hypertension cohort and 1 in the gestational hypertension cohort). Conclusions and Relevance: Among pregnant individuals with chronic or gestational hypertension, blood pressure self-monitoring with telemonitoring, compared with usual care, did not lead to significantly improved clinic-based blood pressure control. Trial Registration: ClinicalTrials.gov Identifier: NCT03334149