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The purpose of the present study was to determine the relationship between a subject's percepteptanalysis as revealed by certain indices of the Rorschach and marital success or failure.

The American Dream is an established theme in much American literature from the beginning to the present. In dealing with this major theme, three critics, Leo Marx, Henry Nash Smith, and R. W, B. Lewis have evolved a cohesive definition of this complex and ambiguous vision. Three major components define the Dream: a pastoral dream of a new, fertile Eden, a success dream of financial prosperity, and a dream of world brotherhood to be realized in the new continent. These three components are examined individually in three novels by Bernard Malamud, A New Life, The Natural, and The Assistant. In these novels, Malamud asserts the failure of the American Dream, but envisions the rise of a new humanity and morality that could lead to the salvation of the American people and to a time where dreams could be reborn.

The primary purpose of this paper is to evaluate student and teaching faculty response to the formal procedures used at a large university to officially warn students who are in danger of failing, and to study the relationship of this process to such factors as college entrance examinations and subsequent grades.

The problem of academic failure has been of real concern to the administration and faculty at Syracuse University. The study at hand is concerned specifically with the problem in the College of Home Economics. Through a study of the data known about students at the time of entrance into the College, it was thought that a better basis for selection night be recommended for the admission of students to the College. Such questions as the following arise in the mind of the research worker: 1. Do the group psychological tests given at the University at the time of entrance give us one basis by which we may predict probable academic success or failure? 2. Are the known high school quartiles dependable bases for selection of successful students? 3. Are there factors in the family backgrounds of these students that.may be significant in their selection? 4. Does an objective personality test have validity as a predictive factor in the success of a student? 5. Do we have any anecdotal records that reveal significant differences in personal adjustment between successful and failed students? 6. Are we able to predict the probable success of failed students upon readmission? 7. Do we have any combination of factors that may be significant in predicting the probable success of a student?

This thesis is located within the field of Information Systems implementation. More specifically it focuses within Information Systems at the issues associated with implementation of business proves-based change. There is much evidence, both theoretical and empirical, to suggest that there are a high percentage of Information Systems and Business Process implementation failures (Meredith 1981, Lucas 1981, Walsham 1993, Land et al 1989). The aim of this thesis is twofold. Firstly to analyse the reasons behind the failures in process-based change implementations and secondly to provide a solution that will enable companies to overcome some of the problems and thus reduce the number of these failures. This research is based on a joint project between IBM PSS and the University if Plymouth. The research focuses specifically on the implementation of process-based change occurring in IBM Product Support Services (PSS). PSS is primarily responsible for the maintenance of IBM and non-IBM hardware and software and the selling of services associated with them. In order to understand what happens during implementation the researcher participated in three action research projects. All three projects were part of an IBM world-wide Business Process Re-engineering project called Customer Relationship Management. To ensure the validity of this action research process the researcher has closely followed the guidance compiled by Eden and Huxham. This research will present a framework that has been developed to improve the management of implementation projects. The framework is based on a synthesis of theoretical evidence and empirical findings. The empirical findings have been developed from investigating the reasons for failure in the three action research projects. All findings were analysed using the ‘Grounded Theory’ approach. The framework consists of five dominant themes, which are senior management commitment, analysis of problem situation, project planning and management, proves focus and user involvement. In the researchers view the problem of unsuccessful implementation is a complex one which may only begin to be improved when all the themes are addressed together as a whole. In order to test the themes of the framework a process for application was required. The process developed for using the framework involves applying a focus group at project initiation and questionnaires throughout the course of the project. The purpose of the focus group is to understand the themes of the themes of the framework within the context of the particular problem situation being investigated. The questionnaire is used to audit each theme of the framework to identify potential areas of implementation weakness. T-test analysis is carries out on the questionnaire results to measure whether any changes between questionnaires results are statistically significant. The framework was successfully applied to a fourth project. The T-test results indicated that applying the framework to the project throughout the course of the implementation had significantly improved the implementation. The originality of this research is in the framework and its application. This thesis will describe the history of implementation successes and failures at IBM, survey appropriate implementation theory and describe the synthesis and testing of the framework.

STATEMENT OF PROBLEM. Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic material has been reported to possess remarkably high flexural strength; however, after sintering zirconium dioxide (ZrO2) frameworks and fixed partial dentures, some may not fit properly when trying them on their master cast. PURPOSE. The objective of this study was to investigate joining fully sintered YTZ-P by various methods including adhesive cements or fusion with intervening materials. MATERIALS AND METHODS. 216 specimens were used in this study; bars were fabricated from Vita In-Ceram YZ blocks and three bars were joined using dental cements; RelyX Unicem 2 Clicker and Multilink Automix, or fusing them with VM9, Infusion Glass, Boron Oxide, Aluminum Oxide, LUDOX, Colloidal Zirconia and Mullite Zirconia. The load to failure in Newtons was determined using a 3-point bending test. RESULTS. Sandblasted bars for RelyX (64.38N, RelyX-A-Sb) and Multilink (48.58N, M-Sb) wasn’t significantly higher compared to as-sintered groups (45.87N, RelyX-A) and (34.69N, M-A). Coating the bars with Monobond-Plus had a significantly higher load to failure 123.22N, RelyX-A-MP and 136.06N, M-MP compared to as-sintered and sandblasted groups. VM9 at an end firing temperature (EFT) of 1200 °C was significantly higher (228.97N, V-5) compared to lower fusing temperatures. Glass at an end firing temperature of 1200 °C was significantly higher (460.32N, G-6) compared to lower fusing temperatures. Frit at an end firing temperature of 1200 °C was significantly higher (214.52N, F-6) compared to lower fusing temperatures. Optical microscopy showed that Glass group G-6 (1200°C, EFT) had a thickness range from .09 to 0.03 mm while for Glass-A (1050°C, EFT) it was 0.5 mm. CONCLUSIONS. Within the limitations of this study, we concluded that sandblasted bars didn’t significantly increase the means load to failure values compared to as-sintered groups. Coating the bars with Monobond-Plus had a significantly higher load to failure compared to as-sintered and sandblasted groups. VM9, Glass and Frit at an end firing temperature of 1200 °C showed significantly higher means load to failure compared to lower fusing temperature groups. / 2018-09-28T00:00:00Z

A Research report submitted to the Faculty of Health Sciences, Department of Internal Medicine, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the Degree of Master of Medicine in the Division of Cardiology. 2017 / INTRODUCTION The field of medicine has been challenged by the dual epidemic of heart failure and renal insufficiency. There is an increasing need to identify these patients at an early stage so as to delay progression to renal damage. Furthermore there is a lack of local data assessing the relationship between heart failure and renal dysfunction. AIMS • To identify the prevalence of renal dysfunction in patients attending the heart failure clinic at Charlotte Maxeke Johannesburg Academic hospital (Cardiorenal syndrome Type II) • To evaluate the relationship between severity of heart failure and severity of renal dysfunction • To compare heart failure with reduced ejection fraction (HFREF) variables between patients with and without renal dysfunction. METHODOLOGY This study is a single center retrospective study of patients attending Charlotte Maxeke Johannesburg Academic Hospital Heart Failure Clinic. Heart failure patients included in this study were those with an ejection fraction < 50% as this is an accepted definition for HFREF. Patients with HFREF were analyzed specifically for the following; presence of renal dysfunction, Ejection Fraction (EF), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Haemoglobin (HB), New York Heart Association (NYHA) functional class, furosemide dose , six minute walk test (6MWT) and Minnesota Living with Heart Failure Questionnaire (MLFQ) score . Presence of renal dysfunction was identified based on the glomerular filtration rate (eGFR) value of less than 60ml/min/1.73m2 as this is the threshold eGFR below which complications of renal impairment appear. The eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) abbreviated formula: (186.3 X serum creatinine) -1.154 x (age) -0.203 x (0.742 if female) x (1.212 if African) The control group consisted of patients attending the clinic who did not have renal dysfunction. RESULTS A total 242 files were reviewed. Forty-two files were excluded from the study due to lack of adequate study data recorded in the file. Data was collected and entered into a database, which was analyzed using the Statistics/Data Analysis Program (STATA) Version 10.0. The mean age of the study group was 53.3 years (SD± 15.05) with the youngest subject being 21 years old and the oldest subject aged 85 years. The mean SBP was 119mmHg and the mean DBP was 75mmHg. The mean eGFR was 72.01 ml/min/1.73m2. The overall prevalence of low eGFR (<60ml/min/1.73m2) in the sample population was 34.5 %. The prevalence in female and male patients with a low eGFR was 35% and 33.6% respectively. Analysis of MLFQ, 6MWT, DBP and age yielded a positive correlation with eGFR, which was statically significant (p<0.05). An insignificant correlation was obtained comparing eGFR with SBP (p=0.07), EF (p=0.69) and HB (p=0.79). The Analysis of Variance Test (ANOVA), showed a significant correlation between eGFR values across the different NYHA functional classes (p 0.012). Thus it was found that the higher the NYHA class (clinically worse) was associated with worse renal function. The mean eGFR for NYHA I was 77.05 ml/min/1.73m2, for NYHA II was 70.61 ml/min/1.73m2, for NYHA III was 64.13 ml/min/1.73m2 and NYHA IV was 50.02 ml/min/1.73m2. DISCUSSION The overall prevalence of low eGFR (<60ml/min/1.73m2) in this study was 34.5%, a finding consistent with international trials. The majority of patients in this study were in NYHA functional class I or II, thereby highlighting the fact that renal dysfunction is common in heart failure patients and starts early. Statistically significant values were also obtained between eGFR and 6MWT, MLFQ, furosemide dose, age and DBP. The patients with higher 6MWT have better effort tolerance, thereby classifying their heart failure as milder. This in effect confirms that higher eGFR patients have higher effort tolerance. Higher MLFQ scores and higher furosemide doses are inversely correlated to eGFR. The more subjective symptoms you have, and the higher doses of furosemide you need, is a reflection of the severity of the heart failure. With regards to age, there is a normal physiological decline in eGFR with increasing age. In this study a statistically significant negative correlation between eGFR and NYHA was found. Thus a higher NYHA class is associated with worse renal function. This suggests that the clinically more advanced the patient, the poorer the renal function. Also, the prevalence of low eGFR (<60ml/min/1.73m2) within each NYHA class, as expected, increased with increasing NYHA class. It was 27% for NYHA I, 38% for NYHA II, 40% for III, while class IV had 80% of low eGFR prevalence CONCLUSION The findings of this study confirm that the cardio-renal syndrome is common in a local cohort of heart failure patients. The study also suggests that renal dysfunction starts in the early stages of heart failure (NYHA I/II) and becomes more prevalent in patients with more advanced stages of heart failure. These findings highlight the need to treat heart failure patients early after presentation and more appropriately if we are to decrease complications such as renal dysfunction, thereby improving morbidity and mortality. / MT2018

A dissertation submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in fulfilment of requirements for the degree of Master of Science in the School of Molecular and Cell Biology. Johannesburg, 2016. / Telomeres play significant roles in maintaining genome stability, regulating cell proliferation and apoptosis. The role of telomere biology and telomerase reactivation has been studied extensively in cancers. Telomerase has been previously associated with driving chronic kidney disease (CKD) advancement and most frequently due to HIV infection. However, the mechanism by which telomerase activation contributes towards disease progression beyond its canonical function of telomere maintenance is poorly understood. Telomerase is a ribonucleoprotein whose main function is telomere maintenance. Telomerase activity is dependent on expression of the rate-limiting human telomerase reverse transcriptase (hTERT) component. In addition to telomere maintenance, hTERT is implicated in other non-telomere related functions that promote cellular proliferation. Expression of hTERT is predominantly regulated at the transcription level where variation in promoter and minisatellite (MNS16A) sequences alter its expression. This variation has been implicated to confer susceptibility to diseases such as cancer and ageing disorders in non-African populations. Data on variation and pathogenicity of telomere-associated genes in African populations is limited and warrants further research. Thus bioinformatics analysis was performed to elucidate variation within the human TERT gene and promoter in different populations. The promoter, MNS16A and relative telomere length (RTL) were also evaluated in 159 African study participants with and without CKD. TERT common variants are equally distributed across populations with limited data on connection to the effects of the variants in African populations. Further bioinformatics analyses revealed significant difference (p<0.0001) in distribution of promoter variant rs2853669 between African and non-African populations. No common promoter mutations were identified in our study population. Interestingly, the long MNS16A variant suggested to increase TERT expression was significantly overrepresented in individuals with CKD regardless of HIV status. For the first time, a strong association of the long MNS16A variant with CKD regardless of HIV status is reported, implicating MNS16A as a potential risk factor in CKD.

A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Master of Science in Medicine Johannesburg, 2005 / ABSTRACT INTRODUCTION The risk of cardiovascular disease in patients with end stage renal disease (ESRD) is far greater than in the general population. Amongst patients with ESRD, the prevalence of coronary artery disease (CAD) and congestive heart failure is approximately 40% compared with 5-12% in the general population. The excess risk is caused by multiple traditional and non-traditional risk factors for ischaemic heart disease present in these patients. There is little information on CAD and its risk factors in black haemodialysis patients as most of these studies were carried out in the white population. This study is therefore aimed at determining the risk factors for atherosclerosis in Black and non-black (White and Indian) South African patients on haemodialysis. METHODS Fifty-eight black patients and twenty-six non-black patients on haemodialysis were recruited. Sixty-three age and sex matched controls (staff, students and kidney donors) were also recruited. Fasting venous blood samples were drawn for measurement of Creactive protein, homocysteine, Lp (a), serum lipids and adiponectin. Carotid intima-media thickness and plaque occurrence was measured by B-mode ultrasonography. Echocardiography was used to determine LVH. vi RESULTS Haemodialysis (HD) patients had significantly lower total cholesterol, LDL cholesterol and triglycerides compared with controls (p<0.001; p= 0.042). Hs-CRP, adiponectin and homocysteine levels were significantly higher in patients compared with controls (p< 0.001). The prevalence of plaques was significantly higher among HD patients (32%) compared with controls (7%) X2 = 60.72 p< 0.001. LVMI was significantly higher among HD patients (194.25± 7.69gm/m2) compared with controls (93.21 ± 3.27 gm/m2) p < 0.001. No significant difference between patients (Black or Asian/White) and controls with respect to CIMT was found. CVD risk factors in black haemodialysis patients and black controls showed a similar pattern to the whole study population combined. Risk factors associated with CIMT on regression analysis were total cholesterol, LDL-cholesterol, age, Hs-CRP, family history of CKD. Risk factors associated with plaque occurrence on logistic regression analysis were age, systolic blood pressure, male gender, smoking, calcium phosphate product and serum phosphate. CONCLUSION HD patients have a high prevalence of traditional and non-traditional risk factors for atherosclerosis and this is independent of race. Traditional risk factors like lipids were much lower in ESRD patients. HD patients showed a high prevalence of atherosclerosis as measured by increased carotid intima-media thickness and plaque occurrence in carotid arteries. Hs-CRP correlated significantly with a surrogate marker of atherosclerosis (CIMT).