An adapted triage tool (ETAT) at Red Cross War Memorial Children’s Hospital Medical Emergency Unit, Cape Town: An evaluation

Objective. To evaluate the efficacy of an adapted Emergency Triage Assessment and Treatment (ETAT) tool at a children’s hospital. Design. A two-armed descriptive study. Setting. Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods. Triage data on 1 309 children from October 2007 and July 2009 were analysed. The number of children in each triage category (red (emergency), orange (urgent or priority) and green (non-urgent)) and their disposal were evaluated. Results. 1. The October 2007 series: 902 children aged 5 days - 15 years were evaluated. Their median age was 20 (interquartile range (IQR) 7 - 50) months, and 58.8% (n=530) were triaged green, 37.5% (n=338) orange and 3.8% (n=34) red. Over 90% of children in the green category were discharged (478/530), while 32.5% of children triaged orange (110/338) and 52.9% of children triaged red (18/34) were admitted. There was a significant increase in admission rate for each triage colour change from green through orange to red after adjustment for age category (risk ratio (RR) 2.6; 95% confidence interval (CI) 2.2 - 3.1). 2. The July 2009 cohort: 407 children with a median age of 22 months (IQR 7 - 53 months) were enrolled. Twelve children (2.9%) were triaged red, 187 (45.9%) orange and 208 (51.1%) green. A quarter (101/407) of the children triaged were admitted: 91.7% (11/12) from the red category and 36.9% (69/187) from the orange category were admitted, while 89.9% of children in the green category (187/208) were discharged. After adjusting for age category, admissions increased by more than 300% for every change in triage acuity (RR 3.2; 95% CI 2.5 - 4.1). Conclusions. The adapted ETAT process may serve as a reliable triage tool for busy paediatric medical emergency units in resource-constrained countries and could be evaluated further in community emergency settings

An adapted triage tool (ETAT) at Red Cross War Memorial Children’s Hospital Medical Emergency Unit, Cape Town: An evaluation

Objective. To evaluate the efficacy of an adapted Emergency Triage Assessment and Treatment (ETAT) tool at a children’s hospital. Design. A two-armed descriptive study. Setting. Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods. Triage data on 1 309 children from October 2007 and July 2009 were analysed. The number of children in each triage category (red (emergency), orange (urgent or priority) and green (non-urgent)) and their disposal were evaluated. Results. 1. The October 2007 series: 902 children aged 5 days - 15 years were evaluated. Their median age was 20 (interquartile range (IQR) 7 - 50) months, and 58.8% (n=530) were triaged green, 37.5% (n=338) orange and 3.8% (n=34) red. Over 90% of children in the green category were discharged (478/530), while 32.5% of children triaged orange (110/338) and 52.9% of children triaged red (18/34) were admitted. There was a significant increase in admission rate for each triage colour change from green through orange to red after adjustment for age category (risk ratio (RR) 2.6; 95% confidence interval (CI) 2.2 - 3.1). 2. The July 2009 cohort: 407 children with a median age of 22 months (IQR 7 - 53 months) were enrolled. Twelve children (2.9%) were triaged red, 187 (45.9%) orange and 208 (51.1%) green. A quarter (101/407) of the children triaged were admitted: 91.7% (11/12) from the red category and 36.9% (69/187) from the orange category were admitted, while 89.9% of children in the green category (187/208) were discharged. After adjusting for age category, admissions increased by more than 300% for every change in triage acuity (RR 3.2; 95% CI 2.5 - 4.1). Conclusions. The adapted ETAT process may serve as a reliable triage tool for busy paediatric medical emergency units in resource-constrained countries and could be evaluated further in community emergency settings

Biophysical Parameters Can Induce Epithelial-to-Mesenchymal Phenotypic and Genotypic Changes in HT-29 Cells: A Preliminary Study

Epithelial to mesenchymal transition (EMT) in cancer is the process described where cancer epithelial cells acquire mesenchymal properties which can lead to enhanced invasiveness. Three-dimensional cancer models often lack the relevant and biomimetic microenvironment parameters appropriate to the native tumour microenvironment thought to drive EMT. In this study, HT-29 epithelial colorectal cells were cultivated in different oxygen and collagen concentrations to investigate how these biophysical parameters influenced invasion patterns and EMT. Colorectal HT-29 cells were grown in physiological hypoxia (5% O2) and normoxia (21% O2) in 2D, 3D soft (60 Pa), and 3D stiff (4 kPa) collagen matrices. Physiological hypoxia was sufficient to trigger expression of markers of EMT in the HT-29 cells in 2D by day 7. This is in contrast to a control breast cancer cell line, MDA-MB-231, which expresses a mesenchymal phenotype regardless of the oxygen concentration. In 3D, HT-29 cells invaded more extensively in a stiff matrix environment with corresponding increases in the invasive genes MMP2 and RAE1. This demonstrates that the physiological environment can directly impact HT-29 cells in terms of EMT marker expression and invasion, compared to an established cell line, MDA-MB-231, which has already undergone EMT. This study highlights the importance of the biophysical microenvironment to cancer epithelial cells and how these factors can direct cell behaviour. In particular, that stiffness of the 3D matrix drives greater invasion in HT-29 cells regardless of hypoxia. It is also pertinent that some cell lines (already having undergone EMT) are not as sensitive to the biophysical features of their microenvironment

Comparing the efficacy and safety of faecal microbiota transplantation with bezlotoxumab in reducing the risk of recurrent Clostridium difficile infections:a systematic review and Bayesian network meta-analysis of randomised controlled trials

The risk of recurrent Clostridium difficile infections (RCDIs) is high when treated with standard antibiotics therapy (SAT) alone. It is suggested that the addition of faecal microbiota transplantation (FMT) or bezlotoxumab after SAT reduces the risk of RCDI. In the absence of head-to-head randomised controlled trials (RCTs), this review attempts to compare the efficacy and safety of bezlotoxumab with FMT in reducing the risk of RCDI in hospitalised patients.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Photometric compliance of standard and digital infant acuity tests

Amblyopia or “lazy eye” affects approximately 2–5% of the general population in the UK[1]. Treatment must be started as early as possible as it is less effective after age 8[2]. The current gold standards for infant acuity testing are based on printed cardboard targets (‘standard tests’) and have been in place for almost 35 years[3]. In spite of this, no national nor international standard criteria are in place to quality assure them. Electronic platforms show promise to replace card-based tests[4]. However, the fast-changing nature and photometric differences across manufacturers of electronic devices makes them potentially inaccurate when used for visual testing[5]. This work studied the photometric compliance of three standard tests (Teller cards, Keeler cards, Lea Paddles) and four electronic displays (phone, tablet, laptop and 4k monitor)

Measuring pro-poor sectoral analysis for Pakistan: trickle down?

The study aims to establish a pro-poor growth index called the ‘Poverty Equivalent Growth Rate’, which considers both the extent of sectoral growth and the benefits reaching the poor in Pakistan, using 21 household surveys between 1964 and 2011. The result reveals that despite the positive signs in agriculture growth, the growth process may not be classifiable as pro-poor. The result points out that compared with the non-poor, the poor overall benefited less from the revitalisation of agricultural processes; however, the trend was reversed during 2002 to 2011 when the poverty equivalent growth rates are higher than the growth rate of industry, manufacturing, commodity producing and services value added, which shows sectoral growth favours the poor more than non-poor in Pakistan

Social organization for improved system management and sustainable irrigated agriculture in small dams: an action research program. Final report

Irrigation management / Participatory management / Farmer participation / Irrigated farming / Sustainability / Dams / Small scale systems / Irrigation programs / Land tenure / Cropping systems / Crop yield / Research institutes / Diagnostic techniques / Organizational development / Social organization / Water users' associations

THE NEXUS between TRADE LIBERALIZATION and POVERTY: A DISAGGREGATED ANALYSIS

Decades after trade liberalization, poverty among the developing countries has continued to rise as their economies adjust to fierce and increasing external competition. This study investigates the impact of the 1988 trade reforms on poverty in Pakistan using micro-level data from 1990 to 2005. Using the feasible generalized least squares (FGLS) model in panel setting to address the problem of heteroskedasticity, we explored the impact of trade liberalization on the poverty level in Pakistan. The findings reveal that reductions in import tariffs have increased Pakistan s level of poverty. Our findings are robust and impervious to different poverty measures (i.e., headcount ratio, poverty gap, and squared poverty gap). Also, it was observed that lagged trade policies are associated with poverty in Pakistan. The rise in poverty may be attributed to the lower participation of the poor in external markets. It is recommended that policymakers enact policies that will encourage poor people to participate in external markets if they wish to benefit from trade liberalization. © 2022 AESS Publications. All Rights Reserved