Barriers to acute stroke care at a tertiary hospital in the Western Cape

Background Stroke guidelines recommend treatment of acute stroke as a medical emergency. In many countries prolonged delays occur before patients with acute stroke receive medical attention. Only a small percentage of patients are assessed in hospital within the time window for reperfusion therapy. There is limited available published data concerning barriers to acute stroke care in South African patients. The aim of this study was to determine the pre-hospital barriers and in-hospital delays to emergency care for patients presenting to Groote Schuur Hospital (GSH) with acute stroke. Methods Eligible patients included were those with a clinical and radiological diagnosis of acute stroke who presented to GSH Emergency Unit and required admission for more than 24 hours. The study was a prospective, observational study with two components: a semi structured interviewer administered questionnaire and a record review of ischaemic stroke patients’ clinical notes within 48 hours of admission to GSH. GSH is a tertiary/academic level hospital in Cape Town, Western Cape province, South Africa. Recruitment took place over a 6-week period. Results Demographics: 50 patients were included, with a median age of 61,5 (IQR 44,7 – 70,2) years; gender: females, 29 (58%). Ethnicity: Mixed African ancestry 38 (76%), Black 11 (22%). Pre- hospital barriers: The median distance to hospital was 12,7 (IQR 10,2 – 17,6) km. Most patients 32 (64%) called for assistance immediately. Frequent reasons cited for delays: waiting for improvement, 7 (38,9%) and failure of symptom recognition 4 (22%). Most patients used their own private transport, 32 (64%) and half of the patients (25) presented directly to GSH. In- hospital delays: The median time interval from arrival at the Emergency Unit to doctor assessment for all the patients was 67,5 (IQR 19,75 – 128,5) minutes. The median door to CT brain time interval for all patients was 5,1 (IQR 1,7 – 10,2) hours and 3,1 (IQR 0,8 – 9,6) hours for those patients that arrived within the thrombolysis time window. Only 21 of 50 patients were referred and assessed by the stroke unit team. Only 3 of the 21 patients received intravenous thrombolysis and none received mechanical thrombectomy. Conclusion: There majority of the patients who arrived at GSH early after symptom onset used their own private transport and lived close to hospital. Pre-hospital barriers were failure to recognize symptoms, patients hoping for clinical improvement, delays in ambulance transport and routing via secondary hospitals. In hospital delays were prolonged door to doctor assessment and door to CT Brain time intervals

AWG Champion, Zulu Nationalism and `Separate Development' in South Africa, 1965 -1975

This is a historical study of AWG Champion, the former leader of the Industrial and Commercial Workers' Union (ICU) and provincial President of the African National Congress, in the politics of Zululand and Natal from 1965 to 1975. The study examines the introduction of the Zulu homeland and how different political forces in that region of South Africa responded to the idea of a Zulu homeland during the period under review. It also deals with Champion's political alienation from the ANC. This dissertation is also a study of the development of Zulu ethnic nationalism within the structures of apartheid or separate development, the homelands. Issues running throughout the study are the questions of how and why Champion tried and failed to manipulate `separate development' in order to build a Zulu ethnic political base.HistoryM.A. (History

TEKNIK PASCA PANEN PAPRIKA (Capsicum annum var. grossum L) DI AGROWISATA PUNCAK BUKITCATU BEDUGUL-BALI: Post-Harvesting Technique of Paprica (Capcisum annum var. grossum L) at Bukitcatu Peak Agritourism, Bedugul Bali

Fruit and vegetable commodities are very easily damaged when harvested because of the respiration and transpiration processes in the fruit. The most effective way to reduce respiration rate is by lowering the product temperature and packaging method. One way of packaging using plastic packaging. The selection of the thickness of the plastic packaging is critical because it is related to the permeability of the plastic to environmental conditions. The purpose of this fieldwork practice is to find out good post-harvest techniques for paprika plants in Agrowisata Puncak Bukit Catu Tabanan, Bali. The method used is a field study by collecting data through direct observation, namely direct interviews with all relevant parties, practice, and documentation, as well as literature study by taking data from the company and comparing it with theory. The result of this study are post-harvest handling of paprika commodities including sorting, namely separating damaged fruit, grading, namely separating paprika according to its size, washing, storing, packaging, and transporting

Monitoring changes in vegetation distribution to ascertain the extent of degradation in the savannas of Nkonkobe Local Municipality, Eastern Cape, South Africa

Savanna degradation is an environmental problem occurring in most countries around the world and it poses threats to biodiversity conservation, the food industry, and other economic sectors. According to FAO, South Africa’s rangelands exhibit the highest rate of fragmentation in comparison to range ecosystems in neighbouring countries including Lesotho and Swaziland, and consensus among researchers is that communal rangelands are more degraded than commercial rangelands. Although researchers and communities have identified the occurrence of land degradation in communal savannas at a local scale, land degradation has been poorly estimated because little has been done to quantify the extent and dynamics of perceived and observed changes associated with land degradation. The main goal of this study is to provide empirical insights on the direction of changes in the communal savannas of Nkonkobe Local Municipality in order to inform policy formulation and implementation. Additional to the communal sites is a private farm included for comparative analysis of trends in communal and commercial savannas. Landsat imagery was used to map, assess, and quantify the extent of land degradation in Nkonkobe Local Municipality, over a period of 30 years between 1984 and 2014. Field investigations were undertaken in June 2015 to acquire reference data to guide supervised classification of Landsat images. Three algorithms (Mahalanobis-distance, Minimum-distance, and Maximum likelihood classification) were compared to identify a classifier that produced the best results. The maximum likelihood classifier produced the best results with classification accuracy levels of 95.24 percent, 89.66 percent, and 95.65 percent for Honeydale Farm, Thyume, and Sheshegu respectively. Regression analysis revealed that both communal and private lands have experienced statistically significant increases in bush encroachment and decreases in surface water. Communal savannas have been confronted more by expansion of built-up area, decrease in open grassland, abandonment of arable land, soil erosion, and a steady invasion by Acacia Karroo compared to the privately owned commercial farm. The land cover changes measured through this investigation suggest an environmental shift that threatens biodiversity and agricultural activity. The study provides empirically informed insights about the direction to which these savannas are changing with the hope that the findings will prompt formulation and implementation of effective policies

ANALISIS PERILAKU AGRESIF PADA TAYANGAN KARTUN TOM & JERRY KARYA HANNA BARBERA: Penelitian Analisis Isi Video Tayangan Animasi untuk Anak Usia Dini

Penelitian ini dilatarbelakangi oleh perkembangan teknologi yang semakin pesat, sehingga setiap individu mampu mempelajarinya dengan mudah, salah satunya adalah anak. Televisi maupun Youtube terdapat beberapa konten yang disajikan termasuk menonton film kartun. Film kartun merupakan film yang ditujukan untuk anak, karena film tersebut menampilkan tokoh karakter yang unik, menarik, dan juga lucu yang sangat menghibur bagi siapa saja yang menonton. Namun ada sebagian orangtua film kartun keliru dipilih sebagai tayangan anak-anak seperti pada kartun Tom & Jerry. Kartun Tom & Jerry banyak menampilkan tayangan berperilaku agresif yang dimana akan berpengaruh pada perilaku meniru / imitatif anak. Oleh karena itu perlu dilakukan penelitian terhadap Kartun Tom & Jerry terkait perilaku agresif. Pada penelitian ini berfokus untuk menganalisis perilaku agresif pada tayangan kartun Tom & Jerry anak usia 5—6 tahun. Penelitian ini menggunakan pendekatan kualitatif. Teknik pengumpulan data yang digunakan adalah observasi terhadap isi konten animasi kartun. Hasil penelitian memperlihatkan bahwa adanya perilaku agresif yang ditunjukkan dalam tayangan kartun Tom & Jerry. Kemudian hasil penelitian memperlihatkan bahwa dari tayangan tersebut ada beberapa perilaku agresif yang sering banyak muncul dalam setiap episode ialah perilaku agresif fisik terdapat perilaku memukul, mencekik, menendang, dan melempar. Pada perilaku agresif verbal terdapat perilaku membuat jebakan, dan mengejek. Sehingga film kartun Tom & Jerry ini tidak dijadikan tontonan anak usia dini, karena akan berpengaruh pada perilakunya. ------- This research is motivated by the rapid development of technology; so that every individual can learn it easily, one of which is a child. Television and Youtube have some content that is presented including watching cartoons. Cartoon films are films aimed at children; because these films feature unique, interesting, and funny characters that are very entertaining for anyone who watches them. However, some parents mistakenly choose cartoon films as children's shows, such as the Tom & Jerry cartoon. Tom & Jerry cartoons display a lot of aggressive behavior which will affect children's 'imitative behavior. Therefore, it is necessary to do research on Tom & Jerry Cartoons related to aggressive behavior. This study focuses on analyzing aggressive behavior in Tom & Jerry cartoons for children aged 5-6 years. This study uses a qualitative approach. The data collection technique used is the observation of the content of animated cartoon content. The results of the study show that aggressive behavior is shown in the cartoon Tom & Jerry. Then the results of the study show that from these shows several aggressive behaviors that often appear in every episode, namely physical aggressive behavior including hitting, choking, kicking, and throwing behavior. In verbal aggressive, behavior there is the behavior of making traps and mocking. So that the cartoon Tom & Jerry is not used as a spectacle for young children; because it will affect their behavior

Penerapan Teori Disciplined Profesional Respons Theory Ida Jean Orlando Pada Ny.P.M Dengan Chronic Kidney Disease Di Ruang Cempaka RSUD Prof. Dr. W.Z. Johanes Kupang

Latar Belakang: Chronic Kidney Diseases (CKD) merupakan gangguan fungsi ginjal yang progresif dan tidak dapat pulih kembali, dimana tubuh tidak mampu memelihara metabolisme, gagal memelihara keseimbangan cairan dan elektrolit yang berakibat pada peningkatan ureum.World Health Organization (WHO) menyebutkan pertumbuhan jumlah penderita CKD pada tahun 2014 telah meningkat 50% dari tahun sebelumnya dan menjadi masalah besar didunia karena sulit untuk disembuhkan. Tujuan: Untuk mengetahui penerapan asuhan keperawatan pada pasien dengan Kronic Kidney Disease (CKD) menggunakan pendekatan model Teori Ida Jean Orlando Di Ruangan Cempaka RSUD. Prof. W.Z. Johanes Kupang. Metode: Rancangan studi adalah studi kasus. Dilaksanakan pada tanggal 4-7 Maret 2022 di ruangan Cempaka RSUD. Prof. Dr. W. Z. Johanes Kupang terhadap Ny.P.M, pengambilan data melalui wawancara, pemeriksaan fisik dan studi dokumentasi, lalu data dianalisa dengan pendekatan teori Sister Callista Roy. Hasil: Hasil pengkajian ditemukan Ny.M.P mengeluh pasien mengeluh sesak nafas, pasien mengatakan badan terasa lemah, seluru badan dalam keadaan bengkak,pasien mengatakan bahwa badannya bengkak sudahdua minggu,seluruh badan terasa kesemutan dan sebagian dari aktivitas pasien di bantu oleh keluarga pasien seperti makan dan minum. Diagnose keperawatan yang ditegakan adalah Pola nafas tidak efektif berhubungan dengan hambatan upaya nafas dan Resiko perfusi renal tidak efektif berhubungan dengan faktor resiko disfungsi ginjal. Intervensi keperawatan diberikan dengan Manajemen jalan napas, Manajemen cairan dan Pencegahan syok. Implementasi keperawatan dilaksanakan sesuai dengan perencanaan keperawatan yang telah ditetapkan. Hasil evaluasi Ny.M.P telah mampu menerima dan mengikut anjuran perawat melalui pemberian dukungan dan edukasi yang telah diberikan. Simpulan: perawat dalam memberikan pelayanan keperawatan profesional kepada penderita Kronic Kidney Disease (CKD) dapat menerapkan Teori Ida Jean Orland

A systematic study of the effect of chemical promotors on the precipitated Fe-based Fischer-Tropsch synthesis catalyst

In recent years, research interest on improving the catalytic properties of precipitated Febased Fischer-Tropsch synthesis (FTS) catalysts has grown immensely. In particular the effect of promoters on these type of catalysts has attracted much attention. Classical promoters such as copper, potassium and silica are nowadays employed for preparing commercially used FTS catalysts. The promoted catalysts are the catalysts of choice and have been shown to possess chemical properties that improve the catalytic properties of Fe-based Fischer- Tropsch synthesis catalysts. In this thesis we attempted to systematically study effects caused by these promoters as well as the effect of indium as a promoter for Fe. Silica which is often used as a structural promoter and often forms a large portion of the catalyst was added in significantly small amounts and its chemical promotional ability was investigated. It was found that increasing the loading of silica affected the carburization and the reduction properties of the precipitated Fe-based Fischer Tropsch synthesis catalyst. This had an effect on the Fe/Cu and Fe/K2O contacts when the loading was increased. With regard to this study, it was found that silica decreased the activity of the catalyst and shifted the hydrocarbon selectivity to low weight hydrocarbons. All catalysts used in these studies were characterized using N2 physisorption, TPR, DRIFTS, XPS and XRD. Indium was also evaluated as a chemical promoter to a precipitated Fe-based Fischer- Tropsch synthesis catalyst since it is believed that it may induce similar chemical effects as that found for copper. Indeed, it was observed that indium does possess some similar chemical properties to that of copper and also that it affected the precipitated Fe-based Fischer-Tropsch synthesis catalyst in similar ways to copper. It was also instead realized that indium acted as a poorer promoter than Cu for the Fe-based Fischer-Tropsch synthesis catalyst and this was attributed to indium having a low melting point than copper. It was also found that indium acted as a poorer promoter when it was added as a co-promoter to an iron catalyst that contained potassium and silica. It was found that indium lowered the activity of the Fischer-Tropsch synthesis reaction as well as the Water Gas Shift reaction. This was related to a decrease in surface area of the catalyst after the addition of indium. The selectivity was shifted to the production of heavy weight hydrocarbons due to the Fe/K2O contact being promoted. Characterisation techniques such as N2 physisorption, TPR and DRIFTS were employed to elucidate the findings

Seasonal variations in tick loads, coat characteristics, temperature-humidity index and blood metabolite profiles of extensively raised Boran cows

This study sought to determine the seasonal variations in tick loads, coat characteristics, temperature-humidity index and blood metabolite profiles of Boran cows reared in arid rangelands of South Africa. A total of 20 Boran cows of different age groups were used in this study. Tick counts, hair length, coat score, average temperature and relative humidity readings were measured twice (beginning and end) in each season (post-rainy, cold-dry, hot-dry, hot-wet). Blood samples were taken seasonally (beginning and end of the season) for the analysis of creatine kinase (CK) activity and haematological parameters (HP). Ticks were observed and counted from different anatomical sites, namely anterior (neck, head, ears, and around eyes), ventral (belly, udder, and limbs) and posterior (back and under the tail). The tick species observed from the Boran cows were Rhipicephalus evertsi evertsi (34.58percent), Amblyomma hebreaum (43.35percent), Rhipicephalus simus (4.48percent) and Rhipicephalus (Boophilus) decoloratus (17.59percent). Significant differences were observed in tick burdens at various anatomical sites, with posterior position having the highest tick loads during the post-rainy, cold-dry and hot-dry season. While the ventral position recorded the highest tick loads during the hot-wet season. It was also observed that the cattle had significantly long hair lengths during the cold-dry season. Furthermore, coat score and hair length were observed to be negatively (P70). Seasonal variations had an effect (P<0.05) on some HP (HB, HCT, MCV, MCH, EOS, and BAS). Neutrophils (-0.267) and basophils (0.268) were significantly correlated with THI. In conclusion, the Boran cows were more susceptible to tick loads during the hot seasons. Likewise, the levels of creatine kinase activity and temperature-humidity index were high during the hot-dry and hot-wet season. Therefore, seasonal variations had an effect on tick loads, coat characteristics, temperature-humidity index and blood metabolite profiles of extensively raised Boran cows

Exploring factors influencing the attitude of staff towards performance management : the case of core network field operation section in Telkom-Eastern Cape

This study explored factors that influence attitudes towards performance management among staff in the Core Network Field Operation (CNFO) of Telkom Eastern Cape. Performance management concerns achieving organisational goals efficiently and effectively. An observation by a manger that the staff were not performing optimally and were displaying a negative attitude towards performance management, necessitated an objective investigation into the reasons for such attitudes and also to be derivative of a corrective solution. This qualitative study was done in the form of a descriptive open ended survey involving geographically dispersed employees. Factual evidence gathered from the result of the study supports the literature that people have different views of performance management. A direct consequence of the different views could be in the inconsistent application of performance management. Solutions and possible corrective actions to improve employee participation and perception as sought by this study are contained in detail in the reportBusiness ManagementM. Tech. (Business Administration

Analisis Umur Piutang Usaha Pada CV. Dharmavattara di Surabaya

The main goal of a company is to gain maximum profit. Increase in profit can be made in the event of an increase in sales. Credit sale will give rise to the existence of accounts receivable owed the debtor to the creditor. Accounts receivable is crucial to the survival of the company, in fact often referred to as the breath of the company. Increase in receivables is usually followed by increased accounts receivable that are not collectible. If there is no handling of accounts receivable is good it will be very dangerous when something undesirable happens to like the debts that could not be collectible receivables amount due to the pile,tempo payments that uncontrolled and the biggest risk was to the downfall of the company because the company's cash flow is unable to cover the debts – debts of the company. Losses arising from receivables not collectible is recognized as loss on accounts receivable. Loss receivables will considerably affect the operating profit of the company. Where is the greater the costs set aside for unbilled receivables losses then the less the operating profit achieved while the company is looking for profit expectations as much as – number This research is descriptive, because it compares the existing theories with practices in companies, by showing the necessary data so that inferences can be drawn as well as the giving of advice is good for the CV Dharmavattara. The research is qualitative while the data used is quantitative data that is in the form of numbers. Results of the study concluded that the accounts receivable control by using the Receivables Aging list without doing the analysis of aged accounts receivable (aging schedule) can not help effectively for financial companies. Then the author suggests to use analysis of aged accounts receivable to be able to quickly analyze the total receivable per customer based on aged receivable