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If it isn’t written down, then it didn’t happen: documentation in obstetric anaesthesia
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Perioperative management of caesarean section-related haemorrhage in a maternal near-miss population: a retrospective study
Full text linkBackground: Maternal near-miss (MNM) is a risk stratification for maternal morbidity. The purpose of this study was to describe the perioperative care given in the management of this particular population of women who have undergone a caesarean section (CS).Methods: This was a retrospective, descriptive study at a single tertiary institute over a one-year period (1 January to 31 December 2018) at the Chris Hani Baragwanath Academic Hospital. The aim of this study was to describe the anaesthetic and surgical management of CS-related haemorrhage in an MNM population. The primary objectives were to determine the MNM rate from CS-related obstetric haemorrhage during the study period and to describe the intervention strategies employed in perioperative management for women with CS-related obstetric haemorrhage. The secondary objectives were to determine factors associated with massive transfusion and major estimated blood loss. The primary outcome was the MNM rate for CS deliveries.Results: A total of 8 306 women had CS of whom 105 (1.26%) were classified as MNM due to bleeding during and after the procedure. The median age was 28, with a median parity of 2 (44%), and overall estimated median (IQR) blood loss volume of 1 800 (1 200–2 100) ml. The leading cause of haemorrhage was postpartum haemorrhage (87%). Eighteen (17%) of the women had relook surgery for postpartum CS sepsis. Age and parity of ≥ 3 had a univariate association with major estimated blood loss. The use of general anaesthesia and parity of ≥ 3 had an adjusted association with the institution of massive transfusion protocol (adjusted odds ratio [aOR] 5.28, 95% confidence interval [CI] 1.03–27.01 and aOR 3.88, 95% CI 1.47–10.25, respectively).Conclusion: MNM from bleeding during or after a CS occurred in approximately 1 in 80 women who delivered by CS. These women required multiple interventions to arrest the haemorrhage and to achieve haemodynamic stability. Women with a higher parity and undergoing general anaesthesia were associated with severe bleeding. Approximately 1 in 4 women required an exploratory laparotomy and less than 7% required a hysterectomy
Parents’ Education Level and Parental Engagement in Management of Students Discipline in Public Day Secondary Schools in Kitui County, Kenya
Full text linkStudent discipline is a global issue. Parental engagement in management of learner discipline has remained low. This study examined the effect of parents’ education level on their participation in management of learners’ discipline in public day secondary schools in Kitui County, Kenya. The hypothesis was: there is no relationship between parents’ level of education and their engagement in management of student discipline. Descriptive survey design was adopted. The sample included 70 public day secondary schools, 70 Principals, 70 Parents’ Teachers’ Association (PTA) chairpersons, 86 Form three class teachers and 354 Form three students obtained by purposive sampling, simple random sampling and stratified proportionate sampling. The instruments were questionnaires, interview guide and focus group discussions. Data was analyzed using descriptive and inferential statistics. The significance level was set at alpha = 0.05. Pearson’s correlation coefficient test results indicated a strong positive correlation (r=0.714, P < 0.05) hence the hypothesis was rejected and conclusion was made that parental education level affects management of students’ discipline since parents with low level of educational attainment were less engaged. Recommendations were made that: The school board of management could organize workshops to equip parents with skills on parental engagement, the Ministry of Education could establish a policy on parental home supervision. The Teachers Service Commission could organize in-service training programs to equip teachers with skills for sensitizing parents on parental engagement. Principals could use annual general meetings to sensitize parents about the educational policy on parental involvement in relation to student discipline
Institutional Factors Inuencing Churches to Sponsor Public Schools in Turbo Division, Uasin Gishu County
Full text linkThe purpose of the study was to investigate institutional factors influencing churches to sponsor public schools in Turbo Division, Uasin Gishu County. The specific objective of the study was to establish institutional roles influencing churches to sponsor public schools. In the study, the literature review was guided by the objective of the study. The study adopted descriptive survey research design. The target population was 97 public schools. The study involved 41 church sponsored schools that comprised 23 primary schools and 18 public secondary schools. The respondents were drawn from school management committee members, Head Teachers and Board of Management members. Data was collected using questionnaires, oral interviews and observations schedules. The data was analyzed using both qualitative and quantitative techniques and presented using tables and figures. The results indicated that the institutional factors that influence churches to sponsor public schools include the religion of the teachers employed in their schools, the politics of the area, the school management representations and workshop career choices. On the hand, the church sponsors fail to admit students from different faith equally. The findings indicated that gaining influence of the school management raises faith of the sponsors and hence increase in sponsorship. It was recommended that the school sponsor should come up with neutral professional service scheme in the areas like guidance and counseling, teaching of religious syllabus and chaplaincy so as to help raise their level of influence. It was also recommended that the sponsors should also keep off politics within the schools they sponsor if their level of influence has to rise
Exploring the practices and contextual factors in teaching writing skills in EFL classrooms: a case study
Full text linkThis study explored four experienced teachers’ practices and challenges in teaching writing in English as a foreign language (EFL) in a secondary school in Ethiopia. While a single secondary school was selected based on a convenient sampling technique, four EFL teachers were selected using a purposive sampling technique. The data were collected using classroom observations, stimulated recall interviews, and course document analysis and were analyzed thematically. The findings of the study revealed that the teachers employed a product-oriented approach with a focus on rhetorical features and patterns about different types of texts. Large class sizes, lack of students’ language proficiency, lack of teachers’ pedagogical competence in teaching writing, and insufficiency of instructional time to develop drafts were found to impede teachers’ classroom practices in the study context. Based on the findings, it was recommended that teachers should assist students to do their writing outside the classroom ahead of each writing lesson so that they can use the lesson time for productive learning tasks. Besides, the Ministry of Education should spread systems to offer on-job training regarding up-to-date and innovative ways of teaching writing skills
Prevalence and determinants of overweight and obesity among school children in Morogoro region, Tanzania
Full text linkBackground: Being overweight and obese involve health risks as well as possible consequences for individuals’ and communities’ social and economic well-being. It was previously considered an adult health concern, but it is now seen among children. This study aimed to determine the prevalence and determinants of overweight and obesity among school children in rural and urban areas of Morogoro region, Tanzania.
Methods: A cross-sectional study was conducted on a total of 335 parent/caregiver-child pairs, of whom 165 were from Kilosa (rural) and 170 from Morogoro (urban) districts. The main sampling unit was registered primary schools which were stratified according to ownership, whether private or government, and sampled separately. A total of four private and four public schools were sampled, two of each of the categories in each of the locations. Weight and height were measured using standard procedures and Body Mass Index (BMI) was determined. Socio-demographic information was collected using a questionnaire with structured questions. A statistical package for social sciences version 21 was used to analyze data and a regression model was used to explore the determinants of overweight and obesity.
Results: The ages of the studied children ranged from 7 to 12 years, while those of the parents/caregivers ranged from 18 to 72 years. About 19% (n=63) of the school children were overweight or obese, while 3.9% (n=13) were underweight. The prevalence of overweight/obesity was higher among private school students than in public schools 36(24.8%) vs 27(14.2%) and more or less similar prevalence’s were observed among rural (17.6%, n=34) and urban (20.0%, n=29) settings. In a multivariate analysis, eating breakfast before going to school is associated with overweight/obesity (AOR 2.23, 95% CI: 1.06-4.68). Other factors associated with overweight/obesity were school type (AOR 1.19, 95% CI: 1.55-2.60), household daily income (AOR 1.88, 95% CI: 1.68-3.15) (AOR 2.89, 95% CI: 1.76-4.11).
Conclusion: In conclusion, the prevalence of overweight and obesity among school children was high, while underweight was very low. The prevalence of overweight/obesity was similar in rural and urban children, indicating a nutritional transition. The potential risk factors associated with being overweight or obese were school type, household daily income, provision of breakfast and being given money to buy something to eat at school. Therefore, nutrition and healthy lifestyle education should be integrated into school programs to reduce the risk of developing diseases associated with being overweight or obese
Stone representation theorem for Boolean algebras in the topos MSet
No full textThe famous Stone representation theorem for Boolean algebras represents them as subalgebras of the powerset Boolean algebras. In this paper, we consider a Stone type representation for Boolean algebras in the functor topos SetM, for a monoid M. We find an adjunction between the category MBoo of Boolean algebras in SetM and the dual of the topos SetM. It is proved that each Boolean algebra in SetM can be embedded into a power of the two element Boolean algebra if and only if M is a group. It is also seen that in contrast to the classic case, in our class of topoi, the Stone representation theorem for Boolean algebras does not coincide with the (internal) prime ideal theorem
An assessment of the impact of participation in the Oceanographic Research Institute’s Cooperative Fish Tagging Project on angler attitudes and behaviour
No full textScientific output has proven the value of the Oceanographic Research Institute’s Cooperative Fish Tagging Project (ORI-CFTP) to biological and fisheries research, with more than 95 published manuscripts based on data from the ORI-CFTP. This study reviews the project from the perspective of participating anglers. A total of 267 members of the ORI-CFTP responded to an online survey designed to gather data on the profile of tagging members, their preferred methods of communication, attitudes towards fish tagging and fish conservation in general, changes in angling behaviour since becoming a member of the project, and support for the continuation of the ORI-CFTP. The results reveal that the ORI-CFTP has indeed made a considerable contribution towards improving the conservation ethics and behaviour of marine recreational anglers in South Africa. Improved communication with anglers— both taggers and non-taggers—through the ORI-CFTP has the potential to amplify much-needed conservation information to the broader angling community and thereby enhance environmental awareness. Recommendations on how to improve the ORI-CFTP and other angling-related citizen science projects are provided
Traditional green leafy vegetables as underutilised sources of micronutrients in a rural farming community in south-west Nigeria I: estimation of vitamin C, carotenoids and mineral contents
Full text linkObjective: To determine the micronutrient composition of fresh and boiled traditional green leafy vegetables (TGLVs).Design: Sixteen TGLVs categorised into cultivated and uncultivated vegetables were analysed for vitamin C (ascorbic acid [AA] and dehydroascorbate [DHAA]), β-carotene, lutein and minerals.Results: Basella alba had the highest AA (72 mg/100 g) content; Vernonia amygdalina (unwashed), had the highest β-carotene and lutein concentrations (14.1 and 29.0 mg/100 g, respectively); Amaranthus hybridus had the highest AA (43 mg/100 g) and β-carotene (9.3 mg/100 g) content, for cultivated sp. Celosia argentea had the highest Fe content; Zn content of all the vegetables was low, 0.4–2.6 mg/100 g. Cooking resulted in significant losses in AA content in all the samples, 19% in B. alba to 100% in Crassocephalum crepidioides. Carotenoid losses were observed in 10 samples and six samples had increased values of β-carotene (12% to 183%) and lutein (64% to double).Conclusion: Traditional green leafy vegetables studied were found to be rich in the micronutrients of interest, especially in carotenoids. Boiling of leafy vegetables, as traditionally done, led to considerable losses of the micronutrients. The micronutrient content of uncultivated leafy vegetables compared well with commonly cultivated species
The nutrient quality and labelling of ready-to-eat snack foods with health and/or nutrition claims
Full text linkBackground: Nutrition claims on food labels are used to attract attention to products. Inaccurate claims on ready-to-eat (RTE) snack food products may mislead consumers into consuming a higher volume of a seemingly ‘healthy’ product.Objectives: A study was undertaken to determine the following surrounding the packaging of RTE snack food products: (i) compliance of health and or nutrient claims; (ii) average nutrient content per snack category; (iii) accuracy of the total energy content; (iv) eligibility to make claims once the R429 legislation is implemented.Outcome measures: Nutrient content per 100 g and serving size was analysed. Claims related to nutrient content were audited.Design: An analysis was undertaken of the labels of 93 South African-produced RTE snack food products from 10 categories, displaying health and or nutrition claims.Results: Ninety-one products displayed nutrient content claims. Twenty-three (25.3%) nutrient content claims were noncompliant with the R146 legislation. Twenty-one (22.6%) displayed negative claims, three (14.3%) were ineligible. Eighteen products (19.4%) displayed endorsement claims, four (4.4%) were eligible. Sixty-four products (68.8%) displayed a higher total energy content when applying the conversion factors to the displayed macronutrient values. Only 22 (23.7%) products would be eligible to make health and/or nutrition claims once the R429 legislation is promulgated.Conclusion: A higher proportion of eligible claims were found. More than 70% of food manufacturers will need to make changes to the nutrient content or labels once the R429 legislation is implemented. A two-pronged approach of manufacturer compliance and consumer education may improve food choices and reduce the incidence of obesity and NCDs