Includes bibliography. / The focal point of this study emanates from both personal observations formed in public library branch work and questions raised in the subject literature to the effect that tension appears to exist between the wants of the majority of users and the perception of the dominant goals of the public library by their staff, resulting in differing views as to the book selection policy of this institution. Book selection policies have been taken to reflect the attitudes of library staff towards users' wants in terms of their adherence to the tenets of Anglo-American public library objectives.

The study focused on the challenges of teaching at-risk learners at secondary schools. A qualitative investigation based on interviewing and observation was conducted with sixteen teachers teaching at-risk learners. Findings revealed that pre-service teacher training does not prepare teachers adequately to teach learners at risk constructively. Findings also revealed that at-risk learners have no control over themselves due to lack of parental support as parents show no commitment and support for their children’s education. Interventions to counter challenges with teaching at-risk learners relate to applicable preservice teacher training to engage with at-risk learners constructively and continuous in-service teacher training as professional development to empower teachers to engage with at-risk learners appropriately. At-risk learners must value second-chance education opportunities with schools ensuring that a supportive school culture prevails. The study contributes to the discourse on effective teaching practices to support at-risk learners for acceptable academic attainment. / Educational Management and Leadership / M. Ed. (Education Management)

Around the world, managing the behavioural rights of teachers and learners in schools remains a complex problem for all involved in the teaching and learning situation. From a legal standpoint, the crux of this study relates to why school managers and teachers feel disempowered by learners’ rights. Over and above the duty of all citizens not to infringe on other peoples’ human rights (e.g. the horizontal application of the Bill of Rights contained in Section 2 of the Constitution, SA, 1996), teachers also have a legal obligation to promote and protect learners’ rights (e.g. a vertical application of the Bill of Rights contained in Section 2 of the Constitution, SA, 1996). It is this extra mandate that results in teachers feeling disempowered by learners’ rights. Learners’ rights are protected because teachers are representative of the state and, as such, the vertical application of human rights arises where learners are protected against any possible abuse of power. Moreover, a further ‘imbalance’ is created by children’s rights (Section 28, SASA, 1996). In particular, their right to protection and to having their best interests is regarded as of paramount importance. The study examined the role of the principal, SMT, SGB and RCL in managing the behavioural rights of teachers and learners. A qualitative investigation at three public high schools in the North Metropolitan District of Cape Town was done. Data were collected by means of document analysis as well as by in-depth interviews with five teachers and five RCL members at each of the three participating schools. The findings of the study revealed that the behavioural rights of teachers and learners are managed by the school management leadership style, by the ineffective support from teacher unions, by the functionality of the SGB, by the muted voice of the RCL and in a conflicting manner by some parents. The study recommends that principals, SMTs, SGBs and RCLs be empowered in order for them to manage the behavioural rights of teachers and learners effectively. The principals, SMTs, SGBs and RCLs that adopt a democratic leadership style which favours support, collaboration and conflict resolution can thus take firm hold of a golden opportunity – the opportunity to sustain and promote the managing of the behavioural rights of teachers and learners. / Educational Leadership and Management / M. Ed. (Educational Management)

Abstracts in English, Afrikaans and Xhosa / This research aimed at investigating the challenges white teachers face in the socialisation of diverse learners in a former Model C school in the northern suburbs of Cape Town. The research involved a literature review conceptualising democracy, human rights, diversity, equality and socialisation, in addition to the concepts of white fragility and the theoretical perspective of Bourdieu’s ‘habitus’. The empirical investigation consisted of interviews to gather data. The findings revealed the perspectives of the teachers and their understanding of the socialisation of diverse learners in a democracy. Based on these findings, recommendations were made for the school and the Department of Basic Education to develop a system to incorporate in schools, in order to enhance socialisation and the transformation of former Model C schools. As the title states, this study was focused on the challenges white teachers experience relating to the transition to democracy. The context of a former Model C school is a complex scenario, where the values and norms of a dominant culture have formed, and continue to form, a critical part of the school climate and culture. The research findings revealed that since the transformation process started in 1994, ‘ex-Model C’ schools have assumed different characteristics and encountered challenges depending on their demographical location. Teachers need to address both social and educational aims, especially as the findings suggest that the schools, and particularly the teachers, are unclear about how diversity contributes to norms and values. This reflects in the tendency to remain focused on a dominant white culture, with which the teachers identify as ‘normal’. / Hierdie navorsing het ten doel gehad om die uitdagings wat wit onderwysers ten opsigte van die sosialisering van diverse leerders in ʼn gewese model C-skool in die noordelike voorstede van Kaapstad trotseer, te ondersoek. Die navorsing het ʼn literatuuroorsig behels waarvolgens demokrasie, menseregte, diversiteit, gelykheid en sosialisering gekonseptualiseer word, benewens die konsepte van wit broosheid en die teoretiese perspektief van Bourdieu se “habitus”. Die empiriese ondersoek het bestaan uit onderhoude om data in te samel. Die bevindinge het onderwysers se perspektiewe en hul begrip van die sosialisering van diverse leerders in ʼn demokrasie onthul. Op grond van hierdie bevindinge is aanbevelings gedoen vir die skool en die Departement van Basiese Onderwys rakende die ontwikkeling van ʼn stelsel om in skole te inkorporeer ten einde sosialisering en die transformasie van gewese model C-skole te bevorder. Soos wat die titel aandui, het hierdie studie gefokus op die uitdagings wat wit onderwysers ervaar ten opsigte van die oorgang na demokrasie. Die konteks van ʼn gewese model C-skool is ʼn komplekse scenario, waar die waardes en norme van ʼn dominante kultuur ʼn noodsaaklike deel van die skoolklimaat en -kultuur gevorm het (en dit is steeds die geval). Die navorsingsbevindinge het getoon dat sedert die transformasieproses in 1994 begin het, “eks-model C”-skole verskillende eienskappe aangeneem het en uitdagings teëgekom het afhangende van hul demografiese ligging. Onderwysers moet sowel sosiale as opvoedingsdoelwitte bereik, veral aangesien die navorsingsresultate daarop dui dat daar onduidelikheid onder die skole, en veral die onderwysers, is oor hoe diversiteit bydra tot norme en waardes. Dit blyk uit die neiging om gefokus te bly op ʼn dominante wit kultuur waarmee die onderwysers identifiseer as “normaal”. / Olu phando lujolise ekuphandeni imingeni ejongene nootitshala abamhlophe ekuhlanganiseni ngokwezentlalo abafundi beentlanga ezahlukeneyo kwisikolo esasifudula siyiModel C kumahlomela edolophu asemantla esixeko saseKapa. Uphando lwenza uphononongo loluncwadi oluchaza ngedemokhrasi, amalungelo oluntu, ukungafani, ulingano noqheliso lwezentlalo, kwakunye nobuthathaka babamhlophe neenkalo zokucinga ngokwethiyori ka Bourdieu ekuthiwa yi’habitus’. Uphando olusekelwe kubungqina baquka iindliwano ndlebe ekuqikeleleni idatha. Okufunyanisiweyo kwadiza iimbono zootitshala nendlela abaluqonda ngayo uqheliso lwezentlalo lwabafundi abangafaniyo kwimeko yedemokhrasi. Okufunyanisiweyo kwakhokelela ekwenziweni kweengcebiso kwisikolo nakweSebe Lemfundo Esisiseko ukuba kuphuhliswe inkqubo yokubandakanya ezikolweni, ngenjongo yokukhulisa uqheliso lwezentlalo nenguqu yezikolo ezazifudula ziziModel C. Njengoko nesihloko sisitsho, esi sifundo sagxininisa kwimingeni ejongene nootitshala kwixesha lenguqu eya kwidemokhrasi. Imeko yesikolo esasifudula siyiModel C yimeko enzima, apho iinqobo zokucinga nezithethe zenkcubeko eyongameleyo zibumbe, kwaye zisaqhuba ukubumba inxalenye emandundu yesimo sentlalo nenkcubeko yesikolo. Okufunyaniswe kuphando kwadiza ukuba okoko kwaqala inkqubo yenguqu ngowe-1994, izikolo ezazifudula ziziiModel C zaba neempawu ezahlukileyo kwaye zajongana nemingeni ngokuxhomekeke kwiindawo ezimi kuzo. Ootitshala badinga ukuhlangabeza iinjongo zentlalo nemfundo, ngakumbi, ngokokutsho kophando, izikolo, ngakumbi ootitshala, bengacacelwanga kukuba ukungafani kuncedisa njani kwiinqobo zokucinga nezithethe. Oku kubonakala kumkhwa wokungagungqi kwinkcubeko yabamhlophe neyongameleyo, le ootitshala bayithatha ngokuba ‘yeyesiqhelo’. / Educational Studies / M. Ed. (Socio-Education)

Youth Centres such as Faure Youth Centre provide a challenge to questions such as violence and crime. This qualitative research journey started at Faure Youth Centre using narrative pastoral care and counselling and participatory action research to assist the young people there to find alternative ways of standing against violence and crime. Changing circumstances at Faure however, paved the way for the research to follow another direction. This resulted in different voices to emerge and for my family to receive an unexpected `gift' in the process. The `gift' that my pastoral care and counselling at Faure gave to my family initiated a process of change in us and transformed it into a spiralling journey of challenging patriarchal practices and finding alternative ways of living. / Practical Theology / M.Th. (Practical Theology)

As sometime course facilitator of the Marriage Preparation Course of my faith community, an Anglican Church of Southern Africa, I had become curious as to what meaning the couples had constructed of their participation in these courses, particularly relating to both the content and style of facilitating the Course. The research finding determined that the main value of the Course had been that the group discussions enabled couples to explore their personal positions on a number of issues related to marriage. The adoption of participative action research as a broad model for the Course is recommended to encourage the engagement between premarital couples and the course facilitator to create/find knowledges and practices that will prepare them for marriage. Furthermore, the course facilitator should adopt a not-knowing, curious stance toward the elements of marriage under discussion, employing the narrative tools of externalisation and deconstructive questioning to facilitate the couples' meaning-making. / Practical Theology / M.Th.(Specialization in Pastoral Therapy)

Thesis (MComm)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: FoodBank South Africa is an non-profit organisation formed to establish a national network of community foodbanks in urban and rural areas of South Africa, with all participants working towards the common goal of eliminating hunger and food insecurity. FoodBank Cape Town was the first of these community foodbanks launched in South Africa on 2 March 2009. The operations of FoodBank Cape Town include sourcing food and redistributing it to agencies (social services organisations running feeding programmes). Currently the majority of the food is sourced from the retail sector and then redistributed to approximately two hundred agencies. The logistics involved in both sourcing and distributing food are vital to the efficient functioning of FoodBank Cape Town. Since the costs associated with these logistics operations are very high, streamlining these operations has been identified as a priority area for efficiency improvement. The focus in this thesis is on the distribution logistics involved, specifically focussing on a facility location problem according to which FoodBank Cape Town can establish local distribution depots to which it delivers food and from which the agencies collect food assigned to them. A mixed-integer programming model is formulated for the above facility location problem and small test instances of the problem are solved using different exact and approximate solution methods in order to identify a suitable solution methodology for the full (large-scale) FoodBank Cape Town facility location problem. The full facility location problem is solved approximately by means of a meta-heuristic solution method in the more highly constrained instances, while an exact method is selected for solving the lesser constrained instances. The problem is first solved based on the distances between the warehouse and the depots as well as the distances between the agencies and the depots, for the twenty four instances where 17 to 40 depots are located. The model is then developed further to incorporate the cost of distribution. This cost-based facility location model is solved with a view to minimise the cost of food distribution from the warehouse to the depots and the cost of food distribution incurred by each agency to collect food from its assigned depot. A basic vehicle routing technique is applied to the cost-based facility location solution and the associated costs of the distribution are updated. This cost-based solution updating process is performed iteratively until the solution converges. Since the cost of food distribution depends on the vehicle fleet composition used, a vehicle fleet composition comparison of possible FoodBank Cape Town vehicles is performed to determine the most desirable vehicle fleet composition to be used for the distribution of food to depots. The results of the FoodBank Cape Town facility location problem and vehicle fleet composition comparison are presented and recommendations are made to FoodBank Cape Town regarding the preferred number of depots, the location of these depots and the preferred vehicle fleet composition. / AFRIKAANSE OPSOMMING: FoodBank South Africa is ’n nie-winsgewende organisasie wat ten doel het om ’n nasionale netwerk van gemeenskapsvoedselbanke in stedelike en landelike gebiede van Suid-Afrika op die been te bring, waarin al die deelnemers die gemeenskaplike doel nastreef om honger en voedselonsekerheid te elimineer. Foodbank Cape Town was die eerste van hierdie gemeenskapsvoedselbanke in Suid-Afrika en is op 2 Maart 2009 gestig. Die take van Foodbank Cape Town sluit in die versameling van voedsel en die verspreiding daarvan aan agentskappe (gemeenskapsorganisasies wat voedingsprogramme bestuur). Die oorgrote meerderheid voedsel is tans uit die kleinhandelsektor afkomstig en word aan ongeveer tweehonderd agentskappe versprei. Die logistiek wat met hierdie versamelings- en verspreidingsprosesse gepaard gaan, is sentraal tot die doeltreffende funksionering van FoodBank Cape Town. Aangesien die kostes verbonde aan hierdie logistieke prosesse baie hoog is, is hierdie aktiwiteite as ’n prioriteitsarea vir verbetering geidentifiseer. Die fokus in hierdie tesis val op die logistiek verbonde aan die verspreiding van voedsel deur FoodBank Cape Town, en meer spesifiek op die probleem van die plasing van ’n aantal lokale verspreidingsdepots waar FoodBank Cape Town voedsel kan aflewer en waar die agentskappe dan voedsel wat aan hulle toegeken is, kan gaan afhaal. ’n Gemengde heeltallige-programmeringsmodel word vir die bogenoemde plasingsprobleem geformuleer en klein gevalle van die model word deur middel van beide eksakte en benadere oplossingstegnieke opgelos om sodoende ’n geskikte oplossingsmetode vir die volle (grootskaalse) Food- Bank Cape Town plasingsmodel te identifiseer. Die volle plasingsmodel word aan die hand van ’n metaheuristiese oplossingstegniek benaderd opgelos vir hoogsbeperkte gevalle van die model, terwyl minder beperkte gevalle van die model eksak opgelos word. Die plasingsmodel word eers met die oog op die minimering van afstande tussen die pakhuis en verspreidingsdepots sowel as tussen die verspreidingsdepots en agentskappe vir die vier-en-twintig gevalle van die plasing van 17 tot 40 verspreidingsdepots opgelos. Die model word dan verder ontwikkel om ook die koste van die verspreiding van voedsel in ag te neem. Die koste-gebaseerde plasingsmodel word opgelos met die doel om die voedselbankkoste van voedselverspreiding vanaf die pakhuis na die lokale verspreidingsdepots sowel as die agentskapkoste van die afhaal van voedsel vanaf verspreidingsdepots te minimeer. ’n Basiese voertuigroeteringstegniek word op die koste-gebaseerde plasingsmodel toegepas en die verspreidingskoste word dienooreenkomstig aangepas. Hierdie aanpassingsproses van die koste-gebaseerde oplossing word herhaal totdat die oplossing konvergeer. Aangesien die koste van voedselverspreiding afhang van die voertuigvlootsamestelling, word ’n vergelyking tussen moontlike vlootsamestellings vir FoodBank Cape Town getref om die mees geskikte samestelling van voertuie vir die verspreiding van voedsel te vind. Die resultate van die FoodBank Cape Town verspreidingsdepot-plasingsprobleem en vlootsamestellingsvergelyking word aangebied en ’n aanbeveling word aan FoodBank Cape Town gemaak in terme van ’n geskikte aantal verspreidingsdepots, waar hierdie depots geleë behoort te wees, en ’n geskikte voertuigvlootsamestelling vir die verspreiding van voedsel.

Thesis (MBA)--Stellenbosch University, 2005 / ENGLISH ABSTRACT: Strong scientific evidence suggests that global warming is altering the world's climate and that this phenomenon is being accelerated as a result of human activities. Climate change is affecting weather patterns and, in addition to demonstrated sea-level rise, these in turn have and are likely to continue having significant, mostly negative, impacts - both economic and loss of life - on governments, industries and people. Ocean levels rose between 15 and 20 centimeters in the 20th century, mostly as a result of melting glaciers and thermal expansion of the oceans. The International Panel on Climate Change (IPCC, 2001a: 16) in its 2001 estimate suggests a potential rise in average sea level from nine to 88 centimeters from 1990 to 2100. Areas of risk in the City of Cape Town are residential property, infrastructure and beaches in low-lying areas. These areas are likely to be impacted as a result of increasing sea-level rise and increasing severity and frequency of storms. This study seeks to • demonstrate that sufficient evidence exists to compel decision-makers in the City of Cape Town that climate change and the impacts of sea-level rise and increasing frequency and severity of storms need to be considered in development planning; and • test cost-benefit analysis (through climate change impact analysis) as a tool for decision-makers to consider adaptation measures, using Langebaan as a case study. The research comprises a comprehensive literature study of the impacts of climate change, particularly with respect to coastal areas. A case study based on the eroding beaches at Langebaan is used to test cost-benefit analysis as a tool for decision-makers in dealing with the impacts. Despite the uncertainties associated with the impacts of climate change (time, place and extent) the issues of sea-level rise and severe storms seem to warrant further investigation, especially at a local level. This study provides local context to a global problem and makes recommendations for decision-makers in the City of Cape Town. Climate impact analysis (incorporating cost-benefit analysis) is suggested as a tool to quantify avoided damages at vulnerable coastal sites in the City of Cape Town. In conclusion, the impacts of climate change are a complex and multivariate problem. However, there are a number of identified vulnerable areas along the coastline of the City of Cape Town and using tools like climate impact analysis and cost-benefit analysis may assist in identifying, costing and managing these economic risks before the problem becomes unmanageable - a case for quantifying avoided damage. / AFRIKAANSE OPSOMMING: Sterk wetenskaplike bewyse bestaan dat globale verwarming besig is om die wêreld se klimaat te verander en hierdie verskynsel word versnel deur die mens se handelinge. Klimaatsverandering affekteer weerpatrone en bykomend tot gedemonstreerde stygende seevlakke, sal dit waarskynlik 'n langdurige en meestal negatiewe impak - beide ekonomies en lewensverlies - op regerings, industrieë en mense hê. Seevlakke het in die twintigste eeu met tussen 15 en 20 sentimeter gestyg, meestal as gevolg van smeltende ysberge en hitte uitsetting van die oseane. Die 'International Panel on Climate Change' (IPCC, 2001a: 16) het in hul skatting 'n waarskynlike seevlak styging van tussen 9 en 88 sentimeters voorspel vir die tydperk 1990 - 2100. Risikogebiede in die Stad Kaapstad is residensiële gebiede, infrastruktuur en strande in laagliggende gebiede. Hierdie gebiede sal ge-affekteer word deur stygende seevlakke en groter en meer gereelde storms. Hierdie studie poog om • te demonstreer dat voldoende bewyse bestaan om besluitnemers van die Stad Kaapstad te oortuig dat weerveranderinge en die impak van seevlakstygings en toenemende storms in aanmerking geneem moet word in ontwikkelings beplanning; en • koste-voordeel analises (deur klimaatsverandering impak analises) te beproef as 'n hulpmiddel vir besluitnemers om aanpasbare maatreëls te oorweeg, deur Langebaan as 'n voorbeeld te gebruik. Ten spyte van onsekerhede wat saamgaan met die impak van klimaatverandering (tyd, plek en omvang) regverdig die problem van stygende seevlakke en erge storms verdere ondersoek, meer spesifiek op plaaslike vlak. Hierdie studie gee plaaslike konteks aan 'n globale probleem en maak aanbevelings aan beplanners van die Stad Kaapstad. Klimaat impak analises word as hulpmiddel voorgestel om vermybare skades by kwesbare kusgebiede in die Stad Kaapstad te kwantifiseer. Ten slotte: die impak van klimaatsverandering is 'n komplekse probleem met baie fasette. Nietemin is daar verskere sensitiewe areas langs die kus van Stad Kaapstad, en klimaat impak analises en koste-voordeel analises kan help met die identifisering, kosteberekening en bestuur van hierdie ekonomiese risiko areas, voordat dit onhanteerbaar raak.

Thesis (M. Th.)--University of Stellenbosch, 2006. / ENGLISH ABSTRACT: This research aims to establish if church-going young people adhere to the principle of ‘no sex before marriage’, or if there are competing ‘voices’ and pressures that young people succumb to. Are they practising risky sexual behaviour, with multiple partners, using no protection or experiencing sexual violence? We conducted a survey in order to understand the gravity of the challenge, and to identify ways in which the Anglican Church might become more effective in dealing with issues of sexuality among young people. The field research was undertaken between October 2004 and January 2005 and involved a detailed questionnaire survey (with 1,306 responses analysed), and three different focus group discussions. Respondents were between 12 and 19 years of age, both male and female, and demographically representative of the Anglican Church of Cape Town Diocese. It is hoped that the results of this survey will be informative for church leaders and those involved in ministry with young people. Our research reveals that church-going young people are not excluded from the risks faced by others in society. Of the respondents 30.5% have had sex (40% Male and 21% Female; Black 44%, White 26% and Coloured 30%). This is irrespective of geographical location (32% Rural and 30% Urban). Young people are practising vaginal, oral and anal sex or any combination. During their first sexual experience, only 35% used contraceptives. Ninety percent of their first partners are friends or schoolmates and when it came to venue, 75% had sex at home or at their partner’s place. Casual sex was common and 33% of those who have had sex have been with four or more sexual partners. Sexual violence also occurred as 6% of the respondents were forced to have sex (Black 7.1%, White 6.5% and Coloured 5.4%). Of this coerced group, 12% have themselves demanded sex from somebody else. There is thus a gap between the Church’s traditional teaching of ‘no sex before marriage’ and the realities of the way in which our young people live. Hence, we should no longer hide our heads in the sand and pretend that our young people are not at risk. This research has certainly identified several areas of concern. Nonetheless, it has also revealed encouraging information, as young people are interested in changing the situation. In order to increase its effectiveness in addressing the sexuality of young people, the Anglican Church should be prepared to act decisively. The approach recommended from this study should be multifaceted, given the increasingly complex landscape in which young people live. There is an urgent need to support young people in building healthy relationships. Parental workshops are an important intervention in order to enable parents to communicate with their children about sexuality, using an ageappropriate approach. Peer education should be adopted: that is training key opinion leaders in each church so that they can provide positive peer pressure. In addition, the church should take a stand against sexual messages seen in the media; silence implies consent. The church must clearly communicate its opposition to these unhealthy sexual messages to society at large. / AFRIKAANSE OPSOMMING: The doel van die navorsing is om jongmense war kerklik meelewend is se siening en persepsies oor die standpunt van die Anglikaanse kerk, naamlik geen seks voor die huwelik , te ondersoek en te toets aan die hand van sekere teologiese kriteria. Dit wil vasstel of daar ander moontlike faktore of stemme is wat jongmense se standpunt oor seks en seksualiteit bepaal. Van die belangrike vrae wat ondersoek is: beoefen jongmense hoë risiko, seksuele gedrag met meervoudige bedmaats? Tree hulle genoegsaam voorkomend op? Is hulle blootgestel aan seksueel-geweldadige gedrag? ‘n Empiriese ondersoek (Oktober 2004 en Januarie 2005) is geloots ten einde die uitdagings waarvoor die Anglikaanse Kerk ten opsigte van seks-onderrig te staan kom, vas te stel. Die projek beoog om die kerk se bediening op te skerp en meer relevant gefokus te raak op die seksuele orientasie van jongmense. ‘n Vraelys is opgestel en uitgestuur.Drie verskillende diskussiegroepe was betrokke.1306 response is ontleed. Respondente was tussen 12 en 19 jaar, gender-gemeng en demografies verteenwoordigend van die Anglikaanse Kerk se bedieningsopset binne die Cape Town Diocese. Die navorsing toon duidelik dat jongmense aan risikos blootgestel is met implikasies vir die MIV pandemie. Van die respondente het 30.5% seks gehad (40% mans; 21% vrouens; swart 44%; wit 26% en bruin 30%). Wat geografiese verspreiding aan betref (stad 30%, platteland 32%) was daar nie beduidende verskille nie. Daar bestaan ‘n kombinasie van seks-praktyke, vanaf vaginale, orale en anale seks. Gedurende die eerste seks-ervaring het net 35% kontraseptiewe middels/metodes gebruik. 90% van die eerste bedmaats was maats, vriende of skoolmaats. 75% van die kontakte het tuis plaas gevind. Toevallige seks was algemeen en 33% van die respondente het seks met vier of meer pesone gehad. Seksuele geweld kom voor. 6% van die repondent was geforseer om seks te beoefen (swart 7.1%; wit 6.5%; bruin 5.4%). Vanuit hierdie groep het 12% seks geeis van iemand anders. Daar bestaan ‘n groot gaping tussen die leer van die kerk: geen seks voor die huwelik en die lewensrealiteit van jongmense. Jongmense is belis ‘n hoë risikogroep. Die navoring het verkeie areas geïdentifiseer wat dringend die kerk se aandag verg. Van belang is die feit dat jongmense duidelik ‘n behoefte toon aan konstruktiewe begeleiding. Ten einde the problematiek van seksuele gedrag onder jongmense in die kerk sinvol aan te spreek, sal relevante programme ontwikkel moet word wat multi-faktoreel gestruktureer en kontekstueel moet wees. ‘n Belangrike bedieningstrategie is die skep van ouerbegeleidingsgroepe en werkswinkels ten einde ouers toe te rus hoe om sinvol met jongmense oor seksuele gedrag en seksualiteit te kommunikeer. Daar moet gefokus word op verskillende ouderdomsgroepe en hoe om jongmense by te staan om gesonde verhoudinge te bou. Die seksopvoeding en voorligting moet jongmense inskakel. Leiers onder jongmense wat kan help, moet geïdentifiseer word en ook opgelei word. Destruktiewe groepsdruk moet aangespreek word. Die kerk sal ook leiding moet gee oor die wyse waarop die media seksualiteit hanteer. Op hiedie wyse moet die kerk betrokke raak by die publieke diskoers en negatiewe tendens aanspreek.

Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: BACKGROUND Post anesthesia discharge criteria scoring systems have been used successfully to aid discharge from the post anesthetic care unit (PACU) for over 40 years. They do not replace, but rather act in conjunction with good clinical judgment, and provide concise, standardized documentation of a patient’s readiness for discharge. 1,2,3,4,5 In order to improve patient safety, provide clear documentation and to aid future audit, a discharge criteria scoring system was developed for use in our PACU (Addendum A). It is a modification of the Aldrete Scoring System and the modified Post Anesthetic Discharge Scoring System (PADSS) proposed by Chung.1 There is a steadily increasing patient burden on the existing medical infrastructure in South Africa. Tygerberg Academic Hospital is no exception, and because of the high demand on our theatre services, optimal efficiency is essential. We speculated that our discharge criteria scoring system might increase the efficiency of our PACU when compared to the traditional time based system. The more healthy patients, undergoing minor procedures, could potentially spend less time in PACU, allowing the nurses to focus on problem cases. Increasing the speed of transit might also help prevent delays in theatre due to lack of bed space in PACU. Our primary endpoint was to compare the duration of time spent by patients in the PACU at Tygerberg Academic Hospital, from the moment they are admitted, to the time they are discharged to the ward, before and after the introduction of a discharge criteria scoring system. While planning the audit, one of the factors that staff identified as contributing to delayed discharge from PACU, was the time it took for the wards to collect their patients. A secondary objective, therefore, was to assess the amount of time that elapsed between calling the ward to collect the patient, and the patient leaving PACU. METHODS AND MATERIALS Prior to commencing the audit, approval was obtained from the Human Research Ethics Committee of the Faculty of Health Sciences of the University of Stellenbosch and Tygerberg Academic Hospital. The Audit, its purpose and possible benefits, was discussed with representatives of the nurses working in PACU, and written consent was obtained from those who would be involved in the data collection (Addendum B). Audit forms (Addendum C), collection boxes, and posters reminding staff to participate in the audit were prepared. Our first audit was performed over approximately a week in August 2012. During this period, the traditional time-based discharge system was still in operation. Data was captured from 327 patients. Audit forms were placed in a collection box, which was cleared daily by the primary investigator. The discharge criteria scoring system was introduced to the PACU staff in January 2013. The nurses were trained in its use, and a one month period was allowed for all involved to become accustomed to the new system. A second audit was performed in February 2013, again over a week, during which we gathered data from 313 patients. RESULTS The median value of the time spent by patients in the PACU decreased from 1 hour 25 minutes, to 1 hour 15 minutes, after introduction of the discharge criteria scoring system. This was statistically significant (p-value = 0.003). The median time between calling the ward to collect a patient, and the patient leaving recovery, was 15 minutes. CONCLUSION The main finding of the study was that the introduction of a discharge criteria scoring system decreased the median duration of time spent by patients in the post anesthetic care unit at Tygerberg Academic Hospital. / AFRIKAANSE OPSOMMING: AGTERGROND Puntestelsels as ontslag kriteria na narkose, word vir die afgelope 40 jaar suksesvol gebruik as maatstaf om pasiënte uit die herstelkamer te ontslaan. Hierdie kriteria vervang nie goeie kliniese oordeel nie, maar is ’n addisionele hulpmiddel om te bepaal of die pasiënt gereed is vir ontslag en om noukeurige, gestandardiseerde dokumentasie te verseker. 1,2,3,4,5 'n Nuwe puntestelsel vir ontslag is vir die herstelkamer van Tygerberg Akademiese Hospitaal ontwikkel om pasiëntesorg en dokumentasie te verbeter, asook om ouditering in die toekoms te vergemaklik (Addendum A). Hiervoor is die Aldrete Scoring System en die gemodifiseerde PADSS, voorgestel deur Chung, aangepas. 1 Die bestaande mediese infrastruktuur in Suid-Afrika beleef tans ‘n geleidelike toename in die getal pasiënte. Tygerberg Akademiese Hospitaal is geen uitsondering nie en as gevolg van die hoë aanvraag na ons teaterdienste, is uiterste doeltreffendheid noodsaaklik. Ons vermoede was dat hierdie aangepaste puntestelsel doeltreffendheid in die herstelkamer sou verbeter in vergelyking met die meer tradisionele tyd-gebaseerde sisteem. Gesonde pasiënte wat kleiner prosedures ondergaan, sal waarskynlik na ’n korter periode ontslaan kan word wat die verpleegpersoneel in staat sal stel om meer aandag aan probleem gevalle te gee. Bespoediging van die pasiëntvloei behoort onnodige vertragings van teatergevalle weens 'n tekort aan beddens in die herstelkamer, te beperk. Die primêre doel van die studie was om te bepaal of die gebruik van die aangepaste puntestelsel as ontslag kriteria in Tygerberg Akademiese Hospitaal, die tydperk wat die pasiënt in die herstelkamer deurbring, verkort. Die herstelkamer verpleegsters het beweer dat die saal personeel ‘n lang tyd gevat het om hulle pasiente in herstelkamer te kom haal. Vervolgens is 'n sekondêre doelwit ingesluit om die tydperk te bepaal vandat die saalpersoneel in kennis gestel word, totdat die pasiënt die herstelkamer verlaat. METODE Goedkeuring is verkry van die Menslike Navorsing en Etiese Komitee van die Gesondheidswetenskap Fakulteit van die Universiteit van Stellenbosch en Tygerberg Akademiese Hospitaal voor die aanvang van die studie. Die studie, asook die doel en moontlike voordele daarvan is vooraf bepsreek met verteenwoordigers van die herstelkamer verpleegpersoneel en skriftelike toestemming is verkry van al die deelnemers wat betrokke sou wees by die data versameling (Addendum B). Oudit vorms (Addendum C), versamelhouers en inligtingsplakkate vir die betrokke personeel is voorberei. Die aanvanklike oudit is in Augustus 2012 oor 'n periode van ongeveer een week uitgevoer. Tydens hierdie oudit is die tradisionele tydgebaseerde sisteem gebruik. Inligting van 327 pasiёnte is versamel. Die oudit vorms is in die versamelbokse geplaas en is daagliks deur die primêre navorser verwyder. Die aangepaste puntestelsel as ontslag kriteria, is in Januarie 2013 in die herstelkamer geïmplementeer. Die verpleegpersoneel het opleiding ontvang waarna die aangepaste puntestelsel vir een maand gebruik is om te verseker dat die personeel vertroud is daarmee. In Februarie 2013, is ‘n tweede oudit oor ‘n tydperk van een week uitgevoer, waartydens inligting van 313 pasiёnte versamel is. RESULTATE Na die implementering van die aangepaste puntestelsel as ontslag kriteria, het die mediane tyd wat pasiënte in die herstelkamer deurbring afgeneem van 1 uur en 25 minute tot 1 uur en 15 minute. Hierdie afname is statities betekenisvol (p-waarde = 0.003) Die mediane tyd vandat die saal in kennis gestel is totdat die pasiënt die herstelkamer verlaat, was 15 minute. GEVOLGTREKKING Die hoof bevinding van die studie is dat die mediane tydperk wat die pasiënte in die herstelkamer deurbring verminder is deur die implementering van die aangepaste puntestelsel as ontslag kriteria in Tygerberg Akademiese Hospitaal.