Language Matters: What are the Primary School Teachers\u27 Perspectives and Lived Experiences of Burundi\u27s Language Policy?

Burundi is a small country in the Great Lakes region of Africa. Burundian language policy dictates that four languages, Kirundi, French, English, and Kiswahili, must be taught starting in the second trimester of grade one. The language policy decision is not an obvious one since the country is linguistically homogenous, meaning that almost the entire population speaks Kirundi as their first language. Primary school teachers in the public education system typically receive training in a vocational setting that may not fully prepare them for the complex multilingual classroom environment they are expected to cultivate. The aim of this small-scale mixed-methods study is to better understand the perspectives and lived experiences of Burundian primary school teachers in relation to the language policy. To do so, this study utilizes surveys, focus groups, and interview methods to sample across eight different primary schools in the province of Bururi. A total of three school principals and 50 teachers participated in the study. Findings indicate that, with the exception of Kirundi, sampled teachers lack confidence in teaching the languages that are a required portion of the curriculum. Data highlight issues within the pre-service and in-service training for teachers including issues with corruption and funding by the government. The study emphasizes that participants struggle to meet their basic needs as a result of poor salaries and the threat of violence due to the political instability that exists in Burundi. Findings showcase that there is a difference between policy and practice as teachers tend to use Kirundi throughout the curriculum despite policy recommendations to help mitigate the issue of students’ weak linguistic abilities. The present study represents a contribution to the areas of language issues and teacher motivation in education by providing a strong focus on the neglected perspective of the teacher. The study serves to highlight their opinions on how these issues could and perhaps should be addressed

FIELD EXPERIENCE AT SALINE COUNTY HEALTH DEPARTMENT

Master of Public HealthPublic Health Interdepartmental ProgramAbbey L. NutschThe Saline County Health Department is located in Salina, Kansas. The population of the county that the health department serves is 55,740 people and it is 78.5% Non-Hispanic White, 11.7% Hispanic, 3.5% Non-Hispanic Black, 3.1% Asian, 2.4% two or more races, and 0.6% American Indian. The health department offers vaccination, WIC (Women, Infants, and Children assitance program), maternal and child health, home health, and reproductive services. The median income of this area is $7,000 lower than that of the state of Kansas. Poverty level may be related to lower levels of food safety knowledge. A survey was utilized to investigate if there was a relationship between poverty level and food safety knowledge. The survey was designed from methods retrieved from other studies that evaluated food safety knowledge. The survey was distributed through social media to people in the community. The income level for the household and the number of people in the household was used to determine if respondents were above or below the federally defined poverty level. Of the 140 responses, 121 (86%) of the participants were above the poverty level and 19 (14%) were below the poverty level. For the education levels 116 (83%) of the people surveyed had some sort of education beyond high school, 23 (16%) had only a high school diploma, and 1 person had less than a high school diploma. The ethnicity of the participants was primarily Non-Hispanic white with 125 (89%) people; 5 (4%) were Non-Hispanic black, 7 (5%) were Hispanic and 3 (2%) were other ethnicities. The age brackets for the survey were 18-25, 25-50 and 50+. There were 9 (6%) people in the 18-25 range, 94 (67%) in the 25-50 range and 37 (26%) that were 50+. The participants were asked if they had prior food safety training; 96 (69%) indicated they did and 44 (31%) indicated they did not. The overall mean number of questions answered incorrectly for the 140 participants was 1.8. There were 11 food safety questions in the survey. Participants who were in the 18-25 range had a higher mean number of questions answered incorrectly than any of the other age groups at 2.4. This is consistent with the research that states that young adults have poor food safety knowledge. SAS (Statistical Analysis System) was used to interpret data by putting poverty level vs the number of questions the participant answered incorrectly in an ANOVA table. This showed that the people above the poverty level answered an average of 1.8 questions incorrectly whereas the people below answered an average of 2.2 questions incorrectly. There was not enough data to determine if there was a correlation between food safety knowledge and poverty level

Neue Entwicklungen in der Dialysetechnik

Die Hämodialyse ist das am weitesten verbreitete Verfahren zur Nierenersatztherapie in Deutschland. In Verbindung mit der Nierentransplantation gelingt es damit heute, das Leben junger betroffener Patienten bei guter Lebensqualität um Jahrzehnte zu verlängern. Die überwiegende Mehrzahl der jährlich neu hinzukommenden Patienten ist jedoch über 65 Jahre alt, weist eine hohe Komorbidität auf und toleriert Standard-Hämodialysebehandlungen weit weniger gut. Daraus resultieren höhere Anforderungen an eine Individualisierung der Dialysetherapie. Neue technische Verfahren bieten dafür vielversprechende Ansätze, die hier näher vorgestellt werden sollen. Dies betrifft zum einen die exakte Messung der Flüssigkeitskompartimente des Körpers mittels Bioimpedanz-Spektroskopie. Andererseits kann durch die Implementierung geschlossener Regelkreise zwischen Patient und Maschine die individuelle Behandlungstoleranz signifikant erhöht werden.Haemodialysis is the most significant method in renal replacement therapy in Germany. In alliance with kidney transplantation, it offers survival over decades with a reasonable good quality of life – especially to young patients. Today, however, the vast majority of incident patients are older than 65 years and display a considerable degree of co-morbidity, which in turn reduces their tolerance of standard treatment. New tools for an individualisation of haemodialysis therapy are therefore clearly needed. The most promising technical developments in this context are summarised here, including precise measurement of the fluid compartments in patients by way of bioimpedance spectroscopy, as well as closed feedback loops for a tighter integration between patient and dialysis machine

Beiträge zur Entwicklung Wasser speichernder Materialien auf Basis von Stärke und Lignin

Vor dem Hintergrund des weltweit wachsenden Bedarfes an Bodenverbesserungsmitteln, durch die Humus-, Nährstoff- und Wassermangel auf Problemstandorten kompensiert werden sollen, war es das Ziel der vorliegenden Arbeit, Bodenwasser-speicher auf Basis der nachwachsenden Biopolymere Stärke und Lignin zu entwickeln. Durch Derivatisierung der Stärke wurde deren Hydrophilie deutlich gesteigert, was Voraussetzung für die Bildung von Hydrogelen war. Es konnte gezeigt werden, dass durch Vernetzung der wasserlöslichen Stärkederivate Carboxymethylstärke und Monostärkemonophosphat mit Di-/Tricarbonsäuren quellfähige Hydrogele erzeugt werden, deren Quellungsvermögen und rheologische Eigenschaften über die Wahl des Vernetzers und die Vernetzerstoffmenge gezielt eingestellt werden können. Die Modifizierung von Lignin wurde durch Oxidation mit Wasserstoffperoxid, z.T. in Kombination mit Fe(II)- bzw. Mn(II)-Chloriden realisiert. Dadurch wurde die Vernetzbarkeit von Lignin deutlich verbessert, was auf oxidativ bedingte Strukturänderungen des Lignins zurückzuführen war. Diese bestanden im Wesentlichen in der Spaltung und Oxidation der Lignin-Seitenkette sowie der Hydroxylierung der Seitenkette und aromatischer Strukturen. Die Vernetzung von Lignin mit Poly-(ethylenglycol)-diglycidylether ergab quellfähige Hydrogele, deren Wasseraufnahmevermögen und rheologische Materialfunktionen von der eingesetzten Vernetzerstoffmenge abhängig sind. Es konnte gezeigt werden, dass durch den Einsatz von Stärkephosphat- und Lignin-Hydrogelen das Wasserspeichervermögen erhöht und die Evaporationsraten eines entsprechend behandelten Sandbodens verringert werden. Im Wachstumsversuch wurden die Frischmasseerträge von Gelbsenf (Sinapis alba) durch Behandlung eines Sandbodens mit Hydrogelen gesteigert.Soil degradation leading to a lack of humus, nutrients and water especially on exploited sites causes the worldwide need in soil amendments. Aim of the work was the development of hydrogels from renewable biopolymers starch and lignin improving water retention especially in degraded soils. A significant increase of hydrophilic properties of starch was obtained by chemical modification with the objective of forming starch based hydrogels. Swellable hydrogels were formed by cross-linking of water soluble starch derivatives like carboxymethyl starch and monostarch monophosphates with di- and tricarboxylic acids. Swelling capacity and rheological properties of the starch gels were selective adjusted by variation of cross linking agent and whose amounts. Modification of lignin was realized by oxidation with hydrogen peroxide partly in combination with ferrous and manganese chlorides, respectively. In consequence of oxidative structural changes which were cleavage and oxidation of side chain as well as aliphatic and aromatic hydroxylation, gelation of lignin was improved significant. Lignin hydrogels with different swelling capacities and rheological functions were formed by cross-linking lignin with different amounts of poly (ethylene glycol) diglycidyl ether. Application of hydrogels based on starch and lignin causes increased water storing capacity/field capacity and decreased evaporation of a sandy soil as well as an increased biomass yield of yellow mustard (Sinapis alba)

Administrative Preparation of Undergraduate Athletic Training Program Directors

ADMINISTRATIVE PREPARATION OF UNDERGRADUATE ATHLETIC TRAINING PROGRAM DIRECTORSBridgett Mary Passauer, EdDUniversity of Pittsburgh, 2004Throughout higher education, faculty members have assumed the roles and responsibilities of academic administrators. The field of athletic training is no different. Certified athletic trainers assume the roles and responsibilities of academic administrators when they are named program directors. The purpose of this study was to determine if undergraduate athletic training program directors perceived themselves as prepared for the roles and responsibilities of academic administration. The undergraduate athletic training program directors were also asked for suggestions on how best to prepare future athletic training program directors. Eighty-nine undergraduate athletic training program directors responded to an electronically distributed survey which revealed that, overall, undergraduate athletic training program directors do not feel prepared for the roles and responsibilities associated with academic administration. One of the interesting results was found when analyzing the difference between types of candidates selected for the position of undergraduate athletic training program director. Internal candidates had higher mean scores for all roles and responsibilities however; only one of the mean scores was above a 3.00. The overall population of respondents rated the role of leader and mentor as the role they felt most prepared for with the role of faculty developer being the role they felt least prepared for. When asked to recommend the level of education that a program specifically geared toward educating future athletic training program directors, a minimum of a Master's degree was recommended by all respondents. This research further supports previous research, which sites the need for more comprehensive preparation of academic administrators, ideally prior to, but minimally, once appointed to the position of academic administrator

Reduced endothelin-1– and nitric oxide–mediated arteriolar tone in hypertensive renal transplant recipients

Reduced endothelin-1– and nitric oxide–mediated arteriolar tone in hypertensive renal transplant recipients.BackgroundThe prevalence of hypertension is high in renal transplant recipients. It has been suggested that calcineurin inhibitors (CI) contribute to the development of post-transplant hypertension by stimulating endothelin (ET-1)-mediated and/or reducing nitric oxide (NO)-mediated vascular tone.MethodsWe tested this hypothesis using 2 groups of renal transplant recipients [normotensive patients without a need for antihypertensive medication (Normo-Tx), and hypertensive patients requiring antihypertensives (Hyper-Tx)] in the presence of CI-based immunosuppression. In addition, we studied matched control subjects (C). BQ 123 (ET-A receptor antagonist), BQ123 + BQ788 (ET-A/B-receptor antagonist), ET-1, L-NMMA (NO-synthase inhibitor), acetylcholine (ACH; endothelium-dependent vasodilator), glyceroltrinitrate (GTN, NO donor), and norepinephrine (NE, endothelium-independent vasoconstrictor) were infused into the brachial artery. Forearm blood flow (FBF) was measured by venous occlusion plethysmography.ResultsEndothelium-independent vasomotion in response to GTN and NE was similar in all groups. Vascular responses to selective and combined blockade of ET receptors in both Normo-Tx and Hyper-Tx did not exceed those of C. In fact, we observed a significantly lower increase in FBF after BQ 123 (P = 0.03), as well as after BQ 123/788 (P = 0.03) in Hyper-Tx compared with Normo-Tx. This was associated with an increased vascular sensitivity to exogenous ET-1 in Hyper-Tx compared with Normo-Tx (P = 0.04). Vasoconstriction after L-NMMA was reduced in Hyper-Tx compared with Normo-Tx (P = 0.015), while the response to ACH was reduced in both groups of Tx patients to a similar degree (P = 0.005 vs. C).ConclusionOur results do not support a major role for the vascular endothelin system in the hypertension of renal transplant recipients, whereas deficient baseline NO production may be a contributing factor

Reduced endothelin-1– and nitric oxide–mediated arteriolar tone in hypertensive renal transplant recipients

Reduced endothelin-1– and nitric oxide–mediated arteriolar tone in hypertensive renal transplant recipients.BackgroundThe prevalence of hypertension is high in renal transplant recipients. It has been suggested that calcineurin inhibitors (CI) contribute to the development of post-transplant hypertension by stimulating endothelin (ET-1)-mediated and/or reducing nitric oxide (NO)-mediated vascular tone.MethodsWe tested this hypothesis using 2 groups of renal transplant recipients [normotensive patients without a need for antihypertensive medication (Normo-Tx), and hypertensive patients requiring antihypertensives (Hyper-Tx)] in the presence of CI-based immunosuppression. In addition, we studied matched control subjects (C). BQ 123 (ET-A receptor antagonist), BQ123 + BQ788 (ET-A/B-receptor antagonist), ET-1, L-NMMA (NO-synthase inhibitor), acetylcholine (ACH; endothelium-dependent vasodilator), glyceroltrinitrate (GTN, NO donor), and norepinephrine (NE, endothelium-independent vasoconstrictor) were infused into the brachial artery. Forearm blood flow (FBF) was measured by venous occlusion plethysmography.ResultsEndothelium-independent vasomotion in response to GTN and NE was similar in all groups. Vascular responses to selective and combined blockade of ET receptors in both Normo-Tx and Hyper-Tx did not exceed those of C. In fact, we observed a significantly lower increase in FBF after BQ 123 (P = 0.03), as well as after BQ 123/788 (P = 0.03) in Hyper-Tx compared with Normo-Tx. This was associated with an increased vascular sensitivity to exogenous ET-1 in Hyper-Tx compared with Normo-Tx (P = 0.04). Vasoconstriction after L-NMMA was reduced in Hyper-Tx compared with Normo-Tx (P = 0.015), while the response to ACH was reduced in both groups of Tx patients to a similar degree (P = 0.005 vs. C).ConclusionOur results do not support a major role for the vascular endothelin system in the hypertension of renal transplant recipients, whereas deficient baseline NO production may be a contributing factor

Teamarbeit und Stress bei Routineeingriffen: eine Beobachtungsstudie multiprofessioneller OP-Teams

BACKGROUND Effective interprofessional teamwork and stress are important factors for quality of care and patient safety in the operating room (OR); however, there are just a few systematic investigations into the relationship of OR teamwork and occupational stress. OBJECTIVE Determination of the relationship between interdisciplinary OR teamwork and stress in routine procedures, for the whole OR team as well as individual professions. METHODS Multimethod study with expert observations using a standardized observation tool (OTAS-D) and systematic self-reports of the entire OR team. A total of 64 elective interventions across different surgical departments were observed. Relationships were calculated using mixed-effects regression models with control of procedural and provider characteristics. RESULTS The quality of the intraoperative teamwork was at a medium level. Reported stress during interventions was at comparatively low levels, with significant differences between the professions of surgery, nursing and anesthesiology. Members of the surgical team reported the highest stress levels. An association between teamwork and perceived stress could not be determined for the entire OR team; however, within the surgical sub-team there were significant positive correlations for the quality of teamwork and stress (as well as for the teamwork dimensions of collaboration and leadership). For the nursing sub-team, we observed significant negative correlations with overall teamwork as well as with the dimension team monitoring. CONCLUSION The findings suggest a profession-specific relationship between OR teamwork and occupational stress. Further research is necessary to investigate to what extent successful OR teamwork during routine procedures contributes to intraoperative stress.ZUSAMMENFASSUNG HINTERGRUND: Effektive interprofessionelle Teamarbeit im Operationssaal (OP) und intraoperativer Stress sind von großer Bedeutung für Patientensicherheit und Versorgungsqualität. Dennoch gibt es nur wenige systematische Studien zum Zusammenhang von Teamarbeit im OP und Arbeitsstress. ZIELE DER ARBEIT Untersuchung des Zusammenhangs von Teamarbeit und empfundenem Stress bei Routineeingriffen – für das OP-Team als Gesamtheit sowie für die einzelnen Professionen Chirurgie, Anästhesie und Pflege. MATERIAL UND METHODEN Durchgeführt wurde eine Mehrmethodenstudie bestehend aus Expertenbeobachtungen mittels eines standardisierten Beobachtungsinstruments (OTAS-D) und systematischer Selbstberichte des gesamten OP-Teams. Erfasst wurden 64~elektive Routineeingriffe unterschiedlicher chirurgischer Fachbereiche. Die statistischen Zusammenhangsanalysen unter Kontrolle prozeduraler Einflussfaktoren wurden mit „Mixed-effects“-Regressionsmodellen berechnet. ERGEBNISSE Die Güte der intraoperativen Teamarbeit lag auf mittlerem Niveau. Der situative Stress während des Eingriffs wurde durch die Befragten eher auf niedrigerem Niveau berichtet, mit signifikanten Unterschieden zwischen den Professionen Chirurgie, Pflege und Anästhesie. Mitglieder des chirurgischen Teams berichteten im Durchschnitt die höchsten Stressniveaus. Ein genereller Zusammenhang zwischen Teamarbeit und Stresserleben konnte nicht beobachtet werden, allerdings für die einzelnen Professionen: Für das chirurgische Team ergaben sich signifikante, positive Zusammenhänge, sowie für die Teamarbeitsdimensionen Zusammenarbeit und Führung. Signifikante negative Zusammenhänge ergaben sich für das Pflegeteam hinsichtlich der Qualität der interdisziplinären Teamarbeit insgesamt sowie für die Teamarbeitsdimension Team-Monitoring. DISKUSSION Die Effekte interprofessioneller Zusammenarbeit im OP auf subjektives Stressempfinden bei Routineeingriffen hängen von Professionszugehörigkeit, Aufgabe und Tätigkeit ab. Weitere Forschungsarbeit ist notwendig, inwiefern gute Teamarbeit bei Routineeingriffen innerhalb und über die Professionen hinweg intraoperativen Stress beeinflusst

Mechanisms of Endothelial Dysfunction in Resistance Arteries from Patients with End-Stage Renal Disease

The study focuses on the mechanisms of endothelial dysfunction in the uremic milieu. Subcutaneous resistance arteries from 35 end-stage renal disease (ESRD) patients and 28 matched controls were studied ex-vivo. Basal and receptor-dependent effects of endothelium-derived factors, expression of endothelial NO synthase (eNOS), prerequisites for myoendothelial gap junctions (MEGJ), and associations between endothelium-dependent responses and plasma levels of endothelial dysfunction markers were assessed. The contribution of endothelium-derived hyperpolarizing factor (EDHF) to endothelium-dependent relaxation was impaired in uremic arteries after stimulation with bradykinin, but not acetylcholine, reflecting the agonist-specific differences. Diminished vasodilator influences of the endothelium on basal tone and enhanced plasma levels of asymmetrical dimethyl L-arginine (ADMA) suggest impairment in NO-mediated regulation of uremic arteries. eNOS expression and contribution of MEGJs to EDHF type responses were unaltered. Plasma levels of ADMA were negatively associated with endothelium-dependent responses in uremic arteries. Preserved responses of smooth muscle to pinacidil and NO-donor indicate alterations within the endothelium and tolerance of vasodilator mechanisms to the uremic retention products at the level of smooth muscle. We conclude that both EDHF and NO pathways that control resistance artery tone are impaired in the uremic milieu. For the first time, we validate the alterations in EDHF type responses linked to kinin receptors in ESRD patients. The association between plasma ADMA concentrations and endothelial function in uremic resistance vasculature may have diagnostic and future therapeutic implications

Guided optimization of fluid status in haemodialysis patients

Background. Achieving normohydration remains a non-trivial issue in haemodialysis therapy. Guiding the haemodialysis patient on the path between fluid overload and dehydration should be the clinical target, although it can be difficult to achieve this target in practice. Objective and clinically applicable methods for the determination of the normohydration status on an individual basis are needed to help in the identification of an appropriate target weight