DIE GEMEENSKAPSWERKDIENSTE VAN DIE PRIVATE WELSYNSEKTOR: ’N PROFIEL MET IMPLIKASIES

The practical implications of the significant changes in social and welfare policy that occurred from 1994 to 1999, are as yet unknown. This is mainly due to the lack of empirical research data on this issue. This deficiency was partly addressed in a study on the nature of the private welfare sector’s community work services in the North West Province during 2000.The aim of the study was to compile a profile of the Province’s community work services and to utilise this profile in the formulation of guidelines for improved future service delivery.In the study, both community work theory and the South African social and welfare policies were used in the development of a classification framework for community work services. This framework formed the basis of a questionnaire that was sent to all private welfare organisations in the Province. The collected data was analysed and, together with policy dictates, used for the development of guidelines.It was firstly found that there was a discernable move towards targeting policy designated client systems. However, the services did still not fully comply with policy requirements or South Africa’s considerable development needs. Certain deficiencies in the service delivery process were also identified. Therefore, guidelines for addressing both these imbalances and deficiencies were formulated. It was thirdly found that the new classification framework could be constructively used in both further research and in practice

The microbiological quality of rainwater used for toilet flushing, cleaning and watering the garden- pilot study 2005

Regenwater opgevangen in reservoirs en toegepast voor onder andere toiletspoeling is vaak fecaal verontreinigd en bevat soms ziekteverwekkende bacterien. Om het infectierisico bij toepassing van dit water te kunnen schatten is aanvullend onderzoek nodig waarbij ziekteverwekkers worden gekwantificeerd en getypeerd en waarbij onderzocht wordt in welke mate gebruikers worden blootgesteld aan het besmette water.Regenwater is aanvankelijk onbesmet, maar bij afstromen langs oppervlakken en tijdens opslag in reservoirs kan besmetting optreden met micro-organismen die ziekte bij de mens kunnen veroorzaken. Dit kan gebeuren wanneer bijvoorbeeld vogelfeces van het dak wordt gespoeld of ratten of andere dieren toegang hebben tot het reservoir of open leidingen. Onderzoek van opgevangen hemelwater op vier verschillende locaties in Nederland toonde de aanwezigheid van de indicatoren voor fecale verontreiniging, bacterien van de coligroep, E. coli en enterococcen, in respectievelijk 28, 27 en 27 van de 28 onderzochte monsters aan. De potentieel ziekteverwekkende bacterien Campylobacter en Legionella pneumophila werden elk een maal op een locatie aangetroffen. Aeromonas en Clostridium perfringens, die ook ziekte bij de mens kunnen veroorzaken, werden in respectievelijk 20 en 23 van de 28 monsters gevonden. Salmonella en Vibrio werden op geen van de locaties aangetroffen. De aanwezigheid van ziekteverwekkende micro-organismen in regenwater toegepast voor toiletspoeling kan negatieve gevolgen voor de volksgezondheid hebben. Op basis van de verkregen resultaten is het nog niet mogelijk om het risico op het oplopen van een infectie bij blootstelling aan dit water te schatten omdat daarvoor nog aanvullende typerings- en blootstellingsgegevens nodig zijn.Rainwater collected in reservoirs and used for toilet flushing, for example, is often fecally contaminated and sometimes contains pathogenic bacteria. Estimating risk of infection caused by use of this water, will require additional research for enumerating and typing pathogens and for determining exposure to the contaminated water. Rainwater at the source is not contaminated with potential human pathogenic micro-organisms, but may become so at surface run-off and during storage in containers. This may occur when bird faeces runs off roofs, or rats or other animals have access to rainwater reservoirs or open mains. Examination of collected rainwater at four different sites in the Netherlands showed the presence of faecal indicator bacteria as total coliforms, E. coli and intestinal enterococci in 28, 27 and 27, respectively, of the 28 samples examined. Each of the potential human pathogenic bacteria, Campylobacter and Legionella pneumophila, was detected once at one sampling site. Aeromonas and Clostridium perfringens, which may also cause disease in humans, were detected in 20 and 23 of the 28 tested samples, respectively. Salmonella and Vibrio were not detected in any of the samples. The presence of potential pathogenic micro-organisms in rainwater used for toilet flushing may have adverse health effects. However, on the basis of the above results, and because additional typing and exposure data are required, it is not yet possible to estimate the risk of infection at exposure to this water.VROM Inspecti

The microbiological quality of rainwater used for toilet flushing, cleaning and watering the garden- pilot study 2005

Rainwater collected in reservoirs and used for toilet flushing, for example, is often fecally contaminated and sometimes contains pathogenic bacteria. Estimating risk of infection caused by use of this water, will require additional research for enumerating and typing pathogens and for determining exposure to the contaminated water. Rainwater at the source is not contaminated with potential human pathogenic micro-organisms, but may become so at surface run-off and during storage in containers. This may occur when bird faeces runs off roofs, or rats or other animals have access to rainwater reservoirs or open mains. Examination of collected rainwater at four different sites in the Netherlands showed the presence of faecal indicator bacteria as total coliforms, E. coli and intestinal enterococci in 28, 27 and 27, respectively, of the 28 samples examined. Each of the potential human pathogenic bacteria, Campylobacter and Legionella pneumophila, was detected once at one sampling site. Aeromonas and Clostridium perfringens, which may also cause disease in humans, were detected in 20 and 23 of the 28 tested samples, respectively. Salmonella and Vibrio were not detected in any of the samples. The presence of potential pathogenic micro-organisms in rainwater used for toilet flushing may have adverse health effects. However, on the basis of the above results, and because additional typing and exposure data are required, it is not yet possible to estimate the risk of infection at exposure to this water.Regenwater opgevangen in reservoirs en toegepast voor onder andere toiletspoeling is vaak fecaal verontreinigd en bevat soms ziekteverwekkende bacterien. Om het infectierisico bij toepassing van dit water te kunnen schatten is aanvullend onderzoek nodig waarbij ziekteverwekkers worden gekwantificeerd en getypeerd en waarbij onderzocht wordt in welke mate gebruikers worden blootgesteld aan het besmette water.Regenwater is aanvankelijk onbesmet, maar bij afstromen langs oppervlakken en tijdens opslag in reservoirs kan besmetting optreden met micro-organismen die ziekte bij de mens kunnen veroorzaken. Dit kan gebeuren wanneer bijvoorbeeld vogelfeces van het dak wordt gespoeld of ratten of andere dieren toegang hebben tot het reservoir of open leidingen. Onderzoek van opgevangen hemelwater op vier verschillende locaties in Nederland toonde de aanwezigheid van de indicatoren voor fecale verontreiniging, bacterien van de coligroep, E. coli en enterococcen, in respectievelijk 28, 27 en 27 van de 28 onderzochte monsters aan. De potentieel ziekteverwekkende bacterien Campylobacter en Legionella pneumophila werden elk een maal op een locatie aangetroffen. Aeromonas en Clostridium perfringens, die ook ziekte bij de mens kunnen veroorzaken, werden in respectievelijk 20 en 23 van de 28 monsters gevonden. Salmonella en Vibrio werden op geen van de locaties aangetroffen. De aanwezigheid van ziekteverwekkende micro-organismen in regenwater toegepast voor toiletspoeling kan negatieve gevolgen voor de volksgezondheid hebben. Op basis van de verkregen resultaten is het nog niet mogelijk om het risico op het oplopen van een infectie bij blootstelling aan dit water te schatten omdat daarvoor nog aanvullende typerings- en blootstellingsgegevens nodig zijn

The validity and precision of the leicester cough questionnaire in COPD patients with chronic cough

Background: A validated instrument to assess the effects of chronic cough on health status in patients with chronic obstructive pulmonary disease (COPD) is currently not available. The Leicester Cough Questionnaire (LCQ) is a cough-specific health status questionnaire which is originally validated for a population of general patients presenting with chronic cough. We examined the psychometric performance of the LCQ in patients with COPD and chronic productive cough. Methods: Concurrent validity, internal consistency, reproducibility and responsiveness were determined. The St. George's Respiratory Questionnaire (SGRQ) and the Short Form-36 (SF-36) were used as external criteria. Questionnaires were completed at the start of the study. After 2 and 12 weeks the LCQ was repeated, together with a global rating of change. Results: In total 54 patients were included. Concurrent validity analysis showed significant correlations between corresponding domains of the LCQ and the SGRQ (r(s) - 0.31 to - 0.60). Corresponding domains of the LCQ and the SF-36 showed weaker correlations (r(s) 0.04 to 0.41). Internal consistency was adequate for two of the three domains (Cronbach's alpha 0.74 - 0.86). Test-retest reliability in stable patients was high (intraclass correlation coefficients 0.79 - 0.93). The mean difference after two weeks was 0.73 (+/- 1.75). Responsiveness analysis indicated that the LCQ was able to detect changes after 12 weeks. Conclusion: The LCQ is a valid, reliable, responsive instrument to measure health status in COPD patients with chronic productive cough

Discontinuation of a randomised controlled trial in general practice due to unsuccessful patient recruitment.

BACKGROUND: A randomised controlled trial (RCT) in general practice, recruiting incident patients with (sub)acute sciatica, was discontinued because of insufficient recruitment. AIM: To describe factors that influenced the recruitment process and ultimately led to discontinuation of this trial, and to enable others to learn from this experience. DESIGN & SETTING: A pragmatic RCT was designed to compare two pain medication prescription strategies for treatment of (sub)acute sciatica in general practice. After 1 year of patient recruitment, the trial was prematurely terminated. METHOD: To analyse the underperforming recruitment, patient information systems of 20 general practices were screened twice a month to search for eligible patients and identify reasons for non-eligibility. Secondly, after study termination, an open question was distributed to the participating GPs for their views on the recruitment process. RESULTS: A total of 116 GPs from 37 general practices collaborated in the trial. Only eight of 234 patients were included after 12 months. The 22 GPs who offered their opinion on the main reasons for unsuccessful recruitment considered that these were the low incidence rate and strict eligibility criteria, a strong patient and/or GP preference, and time constraints. CONCLUSION: For this RCT, multiple factors were related to recruitment problems but it remains unknown which determinants prevailed. As the research question is unanswered but remains relevant, it is recommended that GPs' daily practice is taken into account when designing an RCT, a pilot study should be performed for feasibility of recruitment, and GP assistants should be involved at an early stage

Design of a randomised controlled trial on immune effects of acidic and neutral oligosaccharides in the nutrition of preterm infants: carrot study

<p>Abstract</p> <p>Background</p> <p>Prevention of serious infections in preterm infants is a challenge, since prematurity and low birth weight often requires many interventions and high utility of devices. Furthermore, the possibility to administer enteral nutrition is limited due to immaturity of the gastrointestinal tract in the presence of a developing immune system. In combination with delayed intestinal bacterial colonisation compared with term infants, this may increase the risk for serious infections. Acidic and neutral oligosaccharides play an important role in the development of the immune system, intestinal bacterial colonisation and functional integrity of the gut. This trial aims to determine the effect of enteral supplementation of acidic and neutral oligosaccharides on infectious morbidity (primary outcome), immune response to immunizations, feeding tolerance and short-term and long-term outcome in preterm infants. In addition, an attempt is made to elucidate the role of acidic and neutral oligosaccharides in postnatal modulation of the immune response and postnatal adaptation of the gut.</p> <p>Methods/Design</p> <p>In a double-blind placebo controlled randomised trial, 120 preterm infants (gestational age <32 weeks and/or birth weight <1500 gram) are randomly allocated to receive enteral acidic and neutral oligosaccharides supplementation (20%/80%) or placebo supplementation (maltodextrin) between day 3 and 30 of life. Primary outcome is infectious morbidity (defined as the incidence of serious infections). The role of acidic and neutral oligosaccharides in modulation of the immune response is investigated by determining the immune response to DTaP-IPV-Hib(-HBV)+PCV7 immunizations, plasma cytokine concentrations, faecal Calprotectin and IL-8. The effect of enteral acidic and neutral oligosaccharides supplementation on postnatal adaptation of the gut is investigated by measuring feeding tolerance, intestinal permeability, intestinal viscosity, and determining intestinal microflora. Furthermore, short-term and long-term outcome are evaluated.</p> <p>Discussion</p> <p>Especially preterm infants, who are at increased risk for serious infections, may benefit from supplementation of prebiotics. Most studies with prebiotics only focus on the colonisation of the intestinal microflora. However, the pathways how prebiotics may influence the immune system are not yet fully understood. Studying the immune modulatory effects is complex because of the multicausal risk of infections in preterm infants. The combination of neutral oligosaccharides with acidic oligosaccharides may have an increased beneficial effect on the immune system. Increased insight in the effects of prebiotics on the developing immune system may help to decrease the (infectious) morbidity and mortality in preterm infants.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN16211826.</p

A field-theoretic approach to the Wiener Sausage

The Wiener Sausage, the volume traced out by a sphere attached to a Brownian particle, is a classical problem in statistics and mathematical physics. Initially motivated by a range of field-theoretic, technical questions, we present a single loop renormalised perturbation theory of a stochastic process closely related to the Wiener Sausage, which, however, proves to be exact for the exponents and some amplitudes. The field-theoretic approach is particularly elegant and very enjoyable to see at work on such a classic problem. While we recover a number of known, classical results, the field-theoretic techniques deployed provide a particularly versatile framework, which allows easy calculation with different boundary conditions even of higher momenta and more complicated correlation functions. At the same time, we provide a highly instructive, non-trivial example for some of the technical particularities of the field-theoretic description of stochastic processes, such as excluded volume, lack of translational invariance and immobile particles. The aim of the present work is not to improve upon the well-established results for the Wiener Sausage, but to provide a field-theoretic approach to it, in order to gain a better understanding of the field-theoretic obstacles to overcome.Comment: 45 pages, 3 Figures, Springer styl

Adolescent Victim Types Across the Popularity Status Hierarchy: Differences in Internalizing Symptoms

Previous studies have called attention to the fact that popular youth are not immune to peer victimization, suggesting there is heterogeneity in the popularity of victims. Yet, no study to date has determined whether victims with different levels of popularity status can be identified using person-oriented analysis. Such analysis is critically needed to confirm the existence of popular victims. Further, there remains a paucity of research on internalizing indices of such popular victims, especially compared to other victim and non-victim groups. To address this gap in the research literature, the current study used latent profile analysis to identify subgroups of victims based on victimization (self- and peer-report) and popularity (peer-report). This study sought to verify the existence of popular victims and to compare victim subgroups on loneliness and self-esteem. Participants were 804 Dutch adolescents (50.2% boys, M-age = 13.65 years, ranging from 11.29 to 16.75 years). The results revealed six subgroups, including a group of popular self-identified victims. Popular self-identified victims were generally less lonely than other victims, but had higher loneliness and lower self-esteem than non-victims. Implications are discussed for understanding the victimization experiences of high-status youth