Stresbelewing by leerders met leerinperkinge in die intermediêrefase

Text in AfrikaansPractical research has shown that children experiencing learning restraints may suffer from high stress levels. These children encounter difficulty adapting to normal scholastic challenges and their performance often appear marginalised. The objective of this study is to explore the phenomenon of stress experienced by three eleven year old learners with learning restraints in the intermediate phase. The literature study on this topic has shown that learning restraints not only affect a child scholastically, but in his entire being. Based on this understanding, learning restraints may cause stress due to habitual underachievement in the learning environment. These learners might not necessarily have extremely poor cognitive abilities, but perceive themselves as incompetent or "dumb". In the empirical study, projection techniques were mainly utilised to determine stress levels experienced by learning restrained learners, from their internal frame of reference. From these findings, certain recommendations are proposed for psychotherapy.Educational StudiesM. Ed. (Guidance and Counseling

Guidelines for empowering secondary school educators, In loco parentis, in addressing truancy among early adolescent learners

This study examined the prevalence and the nature of truancy among early adolescent learners attending secondary schools in the Education Management and Development Centre (EMDC) in the eastern metropole of the Western Cape. The main purpose of the study was to answer the following question: How can secondary school educators, in loco parentis, be equipped with the required skills and resources in order to deal with the issue of truant behaviour among early adolescent learners? A comprehensive literature review was conducted to explore the character and extent of truancy. Thereafter, various theories of child development were highlighted, followed by a synopsis comprising different dimensions of the development of the early adolescent learner. The empirical investigation was carried out through quantitative as well as qualitative research methodology. A focus group interview was conducted with six learners, offering them an opportunity to express their perceptions and experiences as truants. Interviews were conducted with principals to obtain their impressions regarding truant behaviour. Thereafter, a questionnaire, which investigated truancy related aspects such as interaction with peers, parents and caregivers' involvement in learners' school activities, educators' influence on learners' school work and learners' self-esteem regarding their schooling, was administered to three hundred learners. The quantitative investigation revealed significant aspects about truant behaviour, indicating that predominantly more male than female learners (173 male and 26 as in the case of the present study) display this type of behaviour, truants generally originate from single parent families, and that they experience their educators and learning environments as extremely negative. Finally, two in-depth case studies were conducted on two learners, one identified as a truant and the other as a non-truant respectively. The purpose of the in-depth studies was to explore possible differences in their experiential worlds. Although the qualitative data is not generalisable, the findings of the case studies have revealed significant differences in the life worlds of the two learners. Comparatively speaking, it appears that non-truant learners are significantly better adjusted on all their functioning levels than truant learners. The results of the empirical investigation were compared with relevant findings which emerged from the literature study. Based on the present investigation, the study was concluded by offering a range of recommendations to secondary school educators, in loco parentis, empowering them in addressing the phenomenon of truancy among early adolescent learners in the Western Cape with its distinctive problems.Educational StudiesD. Ed.(Psychology of Education

Enzymatic extraction of laminarin from brown seaweed Ecklonia maxima

Thesis (MEng)--Stellenbosch University, 2020.ENGLISH ABSTRACT: Response surface methodology was used to investigate the enzymatic extraction of β-glucan laminarin from Ecklonia maxima, a South African kelp. A commercial cellulase (Celluclast® 1.5L, “Celluclast”) was used to hydrolyse the seaweed material in the range of 0 to 4.0% (v/dw) enzyme dosage, pH 3.0 to 6.0, and 40 to 60 °C. Samples were taken at five evenly-spaced points over six-hour hydrolysis experiments. A spectrophotometric endo-1,3-β-D-glucanase assay for laminarin was developed, and samples were quantified for this response and various others. Response surfaces were regressed for solubilised yield (including supernatant dissolved solids, supernatant mass fraction, and pellet-solids loading), and the concentrations of laminarin, reducing sugars, inorganic sulfates, total phenolics, and antioxidant capacity in the hydrolysate supernatant. Response surfaces were validated, with laminarin extraction shown to be significantly influenced by pH and temperature linear and quadratic terms, but not by enzyme dosage. Reducing sugar and inorganic sulfate concentrations, solubilised yield, supernatant mass fraction, and pellet-solids loading showed the significant effect of the linear enzyme-to-substrate term. Total phenolics and antioxidant capacity, in contrast, were significantly influenced by temperature and pH only. Comparisons to alternate carbohydrase extraction (Accellerase® 1500, “Accellerase”) showed Celluclast to perform similarly to Accellerase in all responses. Further comparison to dilute-acid thermal (“conventional”) hydrolysis (pH 1.0 and 70 °C) showed that enzymatic extraction methods were superior for the release of reducing sugars, inorganic sulfate, and solubilised yield (after 4.5 hours). Conventional extraction was shown to be superior to enzymatic extraction methods for laminarin (when measured with the developed spectrophotometric assay) and antioxidant capacity. Comparison between kelp batches (May 2018 and June 2019 harvests) showed laminarin to be present in higher amounts in May 2018. Solubilised yield, reducing sugars, and supernatant mass fraction also measured significantly higher in May 2018 while inorganic sulfates, total phenolics, and antioxidant capacity were higher in June 2019. Differences were found between the spectrophotometric results of the developed laminarin enzymatic assay and the HPLC quantification of glucose in the ethanol-precipitated polysaccharide-rich fractions of the conventional, Celluclast, and Accellerase hydrolysed samples. These differences were theorised to be caused by either the inhibition of the 1,3-β-D-endoglucanase enzyme by various bioactive components in the enzymatic extracts (polyphenols, phlorotannins, and alginate), or the contamination of the HPLC results with cellulose-derived glucose. The assays showed similar readings when samples were conventionally hydrolysed (27 to 39 mgLE·gDW-1 and 36 to 39 mgGlE·gDW-1 for spectrophotometric and HPLC respectively) but enzymatic and raw extracts measured with the developed spectrophotometric assay were lower in comparison. The laminarin content of the raw supernatant was determined as 54.7 ± 12.3 mg·gDW-1(n = 3), compared to the spectrophotometric measurement of 6.7 ± 0.1 mgLE·gDW-1(n = 3). Enzymatic extraction showed no significant changes from the readings for raw material with either analysis technique, and HPLC measurement showed conventional extraction to decrease laminarin content. None of the treatment types tested increased the yield of laminarin over that found in the raw material. Further work on additional batches of E. maxima is required to ascertain the effect of enzymatic extraction on laminarin, and an additional 1,6-β-D-glucanase should be included in the analytical enzyme for spectrophotometric laminarin measurement. Inhibition of the 1,3-β-D-glucanase enzyme should be studied, and HPLC columns capable of polysaccharide separation and quantification should be considered.AFRIKAANSE OPSOMMING: Respons oppervlak metodologie is gebruik om die ensimatiese ekstrahering van β-glukaan laminarien uit Ecklonia maxima, ’n Suid-Afrikaans kelp, te ondersoek. ’n Kommersiële sellulase (Celluclast® 1.5L, “Celluclast”) is gebruik om seewiermateriaal te hidroliseer in die bestek van 0 tot 4.0% (v/dw) ensiemdosering, pH 3.0 tot 6.0, en 40 to 60 °C. Steekproewe is by elke vyf gelyk-gespasieerde punte oor ses-uur hidrolise eksperimente geneem. ’n Spektrofotometriese endo-1,3-β-D-glukanase proef vir laminarien is ontwikkel en steekproewe is gekwantifiseer vir hierdie respons en verskillende ander. Respons oppervlaktes is met regressie gepas vir opgeloste opbrengs (insluitend bodrywende opgeloste vaste stowwe, bodrywende massafraksie, en pellet-vaste-stof-lading), en die konsentrasies van laminarien, vermindering van suikers, anorganiese sulfate, totale fenoliese komponente, en antioksidantkapasiteit in die hidrolisaat bodrywende stof. Respons oppervlaktes is gevalideer, waar aangetoon is dat laminarienekstrahering beduidend deur pH en temperatuur liniêre en kwadratiese terme beïnvloed word, maar nie deur ensiemdosering nie. Reduserende suikers en anorganiese sulfaatkonsentrasies, opgeloste opbrengs, bodrywende massafraksie, en pellet-vaste-stof-lading het die beduidende effek van die liniêre ensiem-tot-substraat term aangetoon. Totale fenoliese komponente en antioksidantkapasiteit, in kontras, is beduidend beïnvloed deur slegs temperatuur en pH. Vergelykings met alternatiewe koolhidrase ekstrahering (Accellerase® 1500, “Accellerase”) het aangetoon dat Celluclast soortgelyk aan Accellerase in alle response optree. Verdere vergelyking met verdunde-suur termiese (“konvensionele”) hidroliese (pH 1.0 en 70 °C) het aangetoon dat ensimatiese ekstraheringmetodes superieur is vir die vrystelling van gereduseerde suikers, anorganiese sulfaat, en opgeloste opbrengs (na 4.5 ure). Konvensionele ekstrahering is bewys om superieur tot ensimatiese ekstraheringmetodes vir laminarien (as gemeet word met die ontwikkelde spektrofotometriese toets) en antioksidantkapasiteit te wees. Vergelyking tussen kelplotte (Mei 2018- en Junie 2019-oeste) het aangetoon dat laminarien teenwoordig was in hoër hoeveelhede in Mei 2018. Opgeloste opbrengs, gereduseerde suikers, en bodrywende massafraksie is ook beduidend hoër gemeet in Mei 2018, terwyl anorganiese sulfate, totale fenoliese komponente, en antioksidantkapasiteit hoër was in Junie 2019. Verskille is gevind tussen die spektrofotometriese resultate van die ontwikkelde laminarien ensimatiese toets en die HPLC-kwantifisering van glukose in die etanol gepresipiteerde polisakkariedryke fraksies van die konvensionele, Celluclast en Accellerase gehidroliseerde steekproewe. Hierdie verskille is geteoritiseer om veroorsaak te word deur of die inhibisie van die 1,3-β-D-endoglukanase ensiem by verskeie bio-aktiewe komponente in die ensimatiese ekstrakte (polifenole, florotanniene en alginaat), of die kontaminasie van die HPLC-resultate met sellulose-afgeleide glukose. Die toetse het soortgelyke lesings aangetoon as steekproewe konvensioneel gehidroliseer is (27–39 mgLE·gDW-1 en 36–39 mgGlE·gDW-1 vir spektrofotometrie en HPLC onderskeidelik) maar ensimatiese en rou ekstrakte gemeet met die ontwikkelde spektrofotometriese toets was laer in vergelyking. Die laminarieninhoud van die rou bodrywende stof is bepaal as 54.7 ± 12.3 mg·gDW-1(n=3), in vergelyking met die spektrofotometriese mate van 6.7 ± 0.1 mgLE·gDW-1(n=3). Ensimatiese ekstrahering het geen beduidende veranderinge uit die lesings vir rou materiaal met beide analisetegnieke aangetoon nie, en HPLC-meting het gewys dat konvensionele ekstrahering laminarieninhoud verminder. Geen behandelingstipes getoets het die opbrengs van laminarien verhoog in vergelyking met die in die rou materiaal gevind nie. Verdere werk op addisionele lotte van E. maxima word benodig om die effek van ensimatiese ekstrahering op laminarien vas te stel, en ’n addisionele 1,6-β-D-glukanase ensiem moet by die analitiese ensiem vir spektrofotometriese laminarienafmeting ingesluit word. Inhibisie van die 1,3-β-D-glukanase ensiem moet bestudeer word en HPLC-kolomme geskik vir polisakkariedskeiding en kwantifisering moet oorweeg word.Master

Selected committee reports

Committee reports were from the Education Committee, Research Task Force for the 1991 Conference, Accreditation and Class Coverage of Accounting History task force, reports on Garner monograph and December conference, American Research Committee, editor\u27s report for the Accounting Historians Journal, and the International Research Committee

Staff Time and Motion Assessment for Administration of Erythropoiesis-Stimulating Agents: A Two-Phase Pilot Study in Clinical Oncology Practices

BACKGROUND: Erythropoiesis-stimulating agents (ESAs) are used for the management of anaemia in patients with non-myeloid malignancies where anaemia is due to the effect of concomitant myelosuppressive chemotherapy. Assessing the impact of different ESA dosing regimens on office staff time and projected labour costs is an important component of understanding the potential for optimization of oncology practice efficiencies. OBJECTIVES: A two-phase study was conducted to evaluate staff time and labour costs directly associated with ESA administration in real-world oncology practice settings among cancer patients undergoing chemotherapy. The objective of Phase 1 was to determine the mean staff time required for the process of ESA administration in patients with anaemia due to concomitantly administered chemotherapy. The objective of Phase 2 was to quantify and compare the mean staff time and mean labour costs of ESA administered once weekly (qw) with ESA once every 3 weeks (q3w) over an entire course of chemotherapy. METHODS: Phase 1 was a prospective, cross-sectional time and motion study conducted in six private oncology practices in the US based on nine steps associated with ESA administration. Using findings from Phase 1, Phase 2 was conducted as a retrospective chart review to collect data on the number and types of visits in two private oncology practices for patients receiving a complete course of myelosuppressive chemotherapy. RESULTS: In Phase 1, the mean total time that clinic staff spent on ESA administration was 23.2 min for patient visits that included chemotherapy administration (n(chemo) = 37) and 21.5 min when only ESA was administered (n(ESAonly) = 36). In Phase 2, the mean duration of treatment was significantly longer for q3w than qw (53.84 days for qw vs. 113.38 for q3w, p < 0.0001); thus, analyses were adjusted using analysis of covariance (ANCOVA) for episode duration for between-group comparisons. Following adjustment by ANCOVA, qw darbepoetin alfa (DA) patients (n(qw) = 83) required more staff time for ESA + chemotherapy visits and ESA-only visits than q3w patients (n(q3w) = 118) over a course of chemotherapy. Overall, mean total staff time expended per chemotherapy course was greater for patients receiving qw versus q3w DA. Weekly DA dosing was associated with greater projected mean labour costs ($US38.16 vs.$US31.20 [average for 2007–2010]). CONCLUSIONS: The results from this real-world study demonstrate that oncology practices can attain staff time and labour costs savings through the use of q3w ESA. The degree of savings depends on the individual oncology practice’s staffing model and ESA administration processes, including those that allow for optimized synchronization of patient visits for ESA and chemotherapy administration. These findings indicate that additional research using standard ESA administration protocols for longer periods of time with a larger number of oncology practices and patients should be conducted to confirm these findings

Subject-controlled, on demand, dorsal genital nerve stimulation to treat urgency urinary incontinence:a pilot

Contains fulltext : 171558.pdf (publisher's version ) (Open Access)OBJECTIVES: To evaluate the effect of subject-controlled, on-demand, dorsal genital nerve (DGN) stimulation on non-neurogenic urgency urinary incontinence (UUI) in a domestic setting. MATERIALS AND METHODS: Non-neurogenic patients >18 years with overactive bladder symptoms and UUI were included. Exclusion criteria were mainly stress urinary incontinence. Patients underwent 1 week of subject-controlled, on-demand, DGN stimulation, delivered by a percutaneously placed electrode near the DGN connected to an external stimulator (pulse-rate 20 Hz, pulse-width 300 mus). Patients activated the stimulator when feeling the urge to void and stimulated for 30 s. The amplitude was set at the highest tolerable level. A bladder diary including a severity score of the UUI episodes/void (scores: 0 = none, 1 = drops, 2 = dashes, 3 = soaks) and a padtest was kept 3 days prior to, during, and 3 days after the test period. The subjective improvement was also scored. RESULTS: Seven patients (4 males/3 females) were enrolled, the mean age was 55 years (range 23-73). Six completed the test week. In the remaining patient the electrode migrated and was removed. 5/6 finalized the complete bladder diary, 1/6 recorded only the heavy incontinence episodes (score = 3). 4/6 completed the padtest. In all patients who finalized the bladder diary the number of UUI episodes decreased, in 3/5 with >/=60%. The heavy incontinence episodes (score = 3) were resolved in 2/6 patients, and improved >/=80% in the other 4. The severity score of the UUI episodes/void was improved with >/= 60% in 3/5 patients. The mean subjective improvement was 73%. CONCLUSION: This feasibility study indicates that subject-controlled, on-demand DGN stimulation using a percutaneously placed electrode is possible over a longer time period, in a home setting, with a positive effect on non-neurogenic overactive bladder symptoms with UUI. Although the placement is an easy procedure, it is difficult to fixate the electrode to keep it in the correct position. Improvements in hardware, like a better fixated electrode and an easy to control stimulator, are necessary to make SODGNS a treatment possibility in the future

Digital futures challenge-based learning in Higher Education in Europe: The DIFUCH Erasmus+ Project

Within DIFUCH, we are developing innovative challenge-based pedagogies, tools and platforms for the virtual delivery of a joint programme within a groundbreaking-breaking and flexible academic structure in Europe. This Erasmus+ project is focused on delivering new multi-disciplinary, transnational, cross-sectional future skills-orientated modules and learning pathways that address societal challenges. In this paper, we present the current work of DIFUCH to develop an innovative programme underpinned by Challenge Based Learning (CBL) that addresses local and global societal challenges and strengthens interactions between education, research, and external stakeholders for a positive effect on our communities. This project facilitates the improvement of learning outcomes vis-à-vis university learners' perception of social responsibility, their ability to deal with complex societal challenges from social and economic stability to global warming, their ability to put knowledge into practice, team building and communications skills.This work has been supported by Erasmus Plus KA2 within the project 2021-1-PT01-KA220-HED-000023536.info:eu-repo/semantics/publishedVersio

In patients with severe uncontrolled asthma, does knowledge of adherence and inhaler technique using electronic monitoring improve clinical decision making? A protocol for a randomised controlled trial

Introduction: Many patients with asthma remain poorly controlled despite the use of inhaled corticosteroids and long-acting beta agonists. Poor control may arise from inadequate adherence, incorrect inhaler technique or because the condition is refractory. Without having an objective assessment of adherence, clinicians may inadvertently add extra medication instead of addressing adherence. This study aims to assess if incorporating objectively recorded adherence from the Inhaler Compliance Assessment (INCA) device and lung function into clinical decision making provides more cost-effective prescribing and improves outcomes. Methods and analysis: This prospective, randomised, multicentre study will compare the impact of using information on adherence to influence asthma treatment. Patients with severe uncontrolled asthma will be included. Data on adherence, inhaler technique and electronically recorded peak expiratory flow rate will be used to promote adherence and guide a clinical decision protocol to guide management in the active group. The control group will receive standard inhaler and adherence education. Medications will be adjusted using a protocol based on Global Initiativefor Asthma (GINA) recommendations. The primary outcome is the between-group difference in the proportion of patients who have refractory disease and are prescribed appropriate medications at the end of 32 weeks. A co-primary outcome is the difference between groups in the rate of adherence to salmeterol/fluticasone inhaler over the last 12 weeks. Secondary outcomes include changes in symptoms, lung function, type-2 cytokine biomarkers and clinical outcomes between both groups. Cost-effectiveness and cost-utility analyses of the INCA device intervention will be performed. The economic impact of a national implementation of the INCA-SUN programme will be evaluated. Ethics and dissemination:The results of the study will be published as a manuscript in peer-reviewed journals. The study has been approved by the ethics committees in the five participating hospitals. Trial registration NCT02307669; Pre-results

Comparing Oncological and Perioperative Outcomes of Open versus Laparoscopic versus Robotic Radical Nephroureterectomy for the Treatment of Upper Tract Urothelial Carcinoma: A Multicenter, Multinational, Propensity Score-Matched Analysis

OBJECTIVES To identify correlates of survival and perioperative outcomes of upper tract urothelial carcinoma (UTUC) patients undergoing open (ORNU), laparoscopic (LRNU), and robotic (RRNU) radical nephroureterectomy (RNU). METHODS We conducted a retrospective, multicenter study that included non-metastatic UTUC patients who underwent RNU between 1990-2020. Multiple imputation by chained equations was used to impute missing data. Patients were divided into three groups based on their surgical treatment and were adjusted by 1:1:1 propensity score matching (PSM). Survival outcomes per group were estimated for recurrence-free survival (RFS), bladder recurrence-free survival (BRFS), cancer-specific survival (CSS), and overall survival (OS). Perioperative outcomes: Intraoperative blood loss, hospital length of stay (LOS), and overall (OPC) and major postoperative complications (MPCs; defined as Clavien-Dindo > 3) were assessed between groups. RESULTS Of the 2434 patients included, 756 remained after PSM with 252 in each group. The three groups had similar baseline clinicopathological characteristics. The median follow-up was 32 months. Kaplan-Meier and log-rank tests demonstrated similar RFS, CSS, and OS between groups. BRFS was found to be superior with ORNU. Using multivariable regression analyses, LRNU and RRNU were independently associated with worse BRFS (HR 1.66, 95% CI 1.22-2.28, p = 0.001 and HR 1.73, 95%CI 1.22-2.47, p = 0.002, respectively). LRNU and RRNU were associated with a significantly shorter LOS (beta -1.1, 95% CI -2.2-0.02, p = 0.047 and beta -6.1, 95% CI -7.2-5.0, p < 0.001, respectively) and fewer MPCs (OR 0.5, 95% CI 0.31-0.79, p = 0.003 and OR 0.27, 95% CI 0.16-0.46, p < 0.001, respectively). CONCLUSIONS In this large international cohort, we demonstrated similar RFS, CSS, and OS among ORNU, LRNU, and RRNU. However, LRNU and RRNU were associated with significantly worse BRFS, but a shorter LOS and fewer MPCs

Biological and prognostic implications of biopsy upgrading for high-grade upper tract urothelial carcinoma at nephroureterectomy

Objectives Technical limitations of ureteroscopic (URS) biopsy has been considered responsible for substantial upgrading rate in upper tract urothelial carcinoma (UTUC). However, the impact of tumor specific factors for upgrading remain uninvestigated. Methods Patients who underwent URS biopsy were included between 2005 and 2020 at 13 institutions. We assessed the prognostic impact of upgrading (low-grade on URS biopsy) versus same grade (high-grade on URS biopsy) for high-grade UTUC tumors on radical nephroureterectomy (RNU) specimens. Results This study included 371 patients, of whom 112 (30%) and 259 (70%) were biopsy-based low- and high-grade tumors, respectively. Median follow-up was 27.3 months. Patients with high-grade biopsy were more likely to harbor unfavorable pathologic features, such as lymphovascular invasion (p &lt; 0.001) and positive lymph nodes (LNs; p &lt; 0.001). On multivariable analyses adjusting for the established risk factors, high-grade biopsy was significantly associated with worse overall (hazard ratio [HR] 1.74; 95% confidence interval [CI], 1.10-2.75; p = 0.018), cancer-specific (HR 1.94; 95% CI, 1.07-3.52; p = 0.03), and recurrence-free survival (HR 1.80; 95% CI, 1.13-2.87; p = 0.013). In subgroup analyses of patients with pT2-T4 and/or positive LN, its significant association retained. Furthermore, high-grade biopsy in clinically non-muscle invasive disease significantly predicted upstaging to final pathologically advanced disease (&gt;= pT2) compared to low-grade biopsy. Conclusions High tumor grade on URS biopsy is associated with features of biologically and clinically aggressive UTUC tumors. URS low-grade UTUC that becomes upgraded to high-grade might carry a better prognosis than high-grade UTUC on URS. Tumor specific factors are likely to be responsible for upgrading to high-grade on RNU