Factors that influence patient empowerment in inpatient chronic care: early thoughts on a diabetes care intervention in South Africa

Abstract Background The burden of non-communicable diseases is growing rapidly in low- and middle-income countries. Research suggests that health interventions that aim to improve patient self-management and empower patients to care actively for their disease will improve health outcomes over the long-term. There is, however, a gap in the literature about the potential role of the inpatient setting in supporting chronic care. This is particularly important in low-and-middle income countries where hospitals may be a rare prolonged point of contact between patient and health provider. The aim of this small scale, exploratory study was to understand what factors within the inpatient setting may affect patients’ feelings of empowerment in relation to their chronic disease care and provides recommendations for future inpatient-based interventions to support self-management of disease. Methods This study was based in a public, academic hospital in South Africa. Eighteen qualitative, semi-structured interviews were conducted with multiple participants with experience of diabetes care: inpatients and health professionals such as nurses, endocrinologists, and dieticians. Findings were analysed using a broad, exploratory, thematic approach, guided by self-management and chronic care literature. Results Interviews with both patients and providers suggest that patients living in low socio-economic contexts are likely to struggle to access appropriate healthcare information and services, and may often have financial and emotional priorities that take precedence over their chronic illness. Younger people may also be more dependent on their family and community, giving them less ability to take control of their disease care and lifestyle. In addition, hospital care remains bound by an acute care model; and the inpatient setting of focus is characterised by perceived staff shortages and ineffective communication that undermine the implementation of patient empowerment-focused interventions. Conclusions Patient and provider contexts are likely to make supporting patient engagement in long-term chronic care difficult in lower income settings. However, knowledge of these factors can be harnessed to improve chronic care interventions in South Africa and other similar countries

Lemurs in Cacao: Presence and Abundance within the Shade Plantations of Northern Madagascar

© 2019 S. Karger AG, Basel. The recognition that much biodiversity exists outside protected areas is driving research to understand how animals survive in anthropogenic landscapes. In Madagascar, cacao (Theobroma cacao) is grown under a mix of native and exotic shade trees, and this study sought to understand whether lemurs were present in these agroecosystems. Between November 2016 and March 2017, discussions with farmers, nocturnal reconnaissance surveys and camera traps were used to confirm the presence of lemurs in the Cokafa and Mangabe plantations near Ambanja, north-west Madagascar. Four species of lemur were encountered in nocturnal surveys: Mirza zaza, Phaner parienti, Microcebussp. and Cheirogaleussp. with encounter rates of 1.2, 0.4, 0.4 and 0.3 individuals/km, respectively. The presence of Lepilemur dorsalis was confirmed by camera trap. This is the first time lemurs have been studied in cacao plantations, and understanding how these threatened animals use anthropogenic landscapes is vital for their conservation

Inhibition of Thrombin Receptor Signaling on alpha-Smooth Muscle Actin(+) CD34(+) Progenitors Leads to Repair After Murine Immune Vascular Injury

OBJECTIVE: The goal of this study was to use mice expressing human tissue factor pathway inhibitor (TFPI) on α-smooth muscle actin (α-SMA)(+) cells as recipients of allogeneic aortas to gain insights into the cellular mechanisms of intimal hyperplasia (IH). METHODS AND RESULTS: BALB/c aortas (H-2(d)) transplanted into α-TFPI-transgenic (Tg) mice (H-2(b)) regenerated a quiescent endothelium in contrast to progressive IH seen in C57BL/6 wild-type (WT) mice even though both developed aggressive anti-H-2(d) alloresponses, indicating similar vascular injuries. Adoptively transferred Tg CD34(+) (but not CD34(-)) cells inhibited IH in WT recipients, indicating the phenotype of α-TFPI-Tg mice was due to these cells. Compared with syngeneic controls, endogenous CD34(+) cells were mobilized in significant numbers after allogeneic transplantation, the majority showing sustained expression of tissue factor and protease-activated receptor-1 (PAR-1). In WT, most were CD45(+) myeloid progenitors coexpressing CD31, vascular endothelial growth factor receptor-2 and E-selectin; 10% of these cells coexpressed α-SMA and were recruited to the neointima. In contrast, the α-SMA(+) human TFPI(+) CD34(+) cells recruited in Tg recipients were from a CD45(-) lineage. WT CD34(+) cells incubated with a PAR-1 antagonist or taken from PAR-1-deficient mice inhibited IH as Tg cells did. CONCLUSIONS: Specific inhibition of thrombin generation or PAR-1 signaling on α-SMA(+) CD34(+) cells inhibits IH and promotes regenerative repair despite ongoing immune-mediated damage

Exploring the future of data-driven product design

Connected devices present new opportunities to advance design through data collection in the wild, similar to the way digital services evolve through analytics. However, it is still unclear how live data transmitted by connected devices informs the design of these products, going beyond performance optimisation to support creative practices. Design can be enriched by data captured by connected devices, from usage logs to environmental sensors, and data about the devices and people around them. Through a series of workshops, this paper contributes industry and academia perspectives on the future of data-driven product design. We highlight HCI challenges, issues and implications, including sensemaking and the generation of design insight. We further challenge current notions of data-driven design and envision ways in which future HCI research can develop ways to work with data in the design process in a connected, rich, human manner

Replication capacity of viruses from acute infection drives HIV-1 disease progression.

CAPRISA, 2017.Abstract available in pdf

Anti-nicastrin monoclonal antibodies elicit pleiotropic anti-tumour pharmacological effects in invasive breast cancer cells

The goal of targeted cancer therapies is to specifically block oncogenic signalling, thus maximising efficacy, while reducing side-effects to patients. The gamma-secretase (GS) complex is an attractive therapeutic target in haematological malignancies and solid tumours with major pharmaceutical activity to identify optimal inhibitors. Within GS, nicastrin (NCSTN) offers an opportunity for therapeutic intervention using blocking monoclonal antibodies (mAbs). Here we explore the role of anti-nicastrin monoclonal antibodies, which we have developed as specific, multi-faceted inhibitors of proliferation and invasive traits of triple-negative breast cancer cells. We use 3D in vitro proliferation and invasion assays as well as an orthotopic and tail vail injection triple-negative breast cancer in vivo xenograft model systems. RNAScope assessed nicastrin in patient samples. Anti-NCSTN mAb clone-2H6 demonstrated a superior anti-tumour efficacy than clone-10C11 and the RO4929097 small molecule GS inhibitor, acting by inhibiting GS enzymatic activity and Notch signalling in vitro and in vivo. Confirming clinical relevance of nicastrin as a target, we report evidence of increased NCSTN mRNA levels by RNA in situ hybridization (RNAScope) in a large cohort of oestrogen receptor negative breast cancers, conferring independent prognostic significance for disease-free survival, in multivariate analysis. We demonstrate here that targeting NCSTN using specific mAbs may represent a novel mode of treatment for invasive triple-negative breast cancer, for which there are few targeted therapeutic options. Furthermore, we propose that measuring NCSTN in patient samples using RNAScope technology may serve as companion diagnostic for anti-NCSTN therapy in the clinic

Crop Updates 2008 - Farming Systems

This session covers thirty nine papers from different authors: PLENARY 1. Developments in grain end use, Dr John de Majnik, New Grain Products, GRDC, Mr Paul Meibusch, New Farm Products and Services, GRDC, Mr Vince Logan, New Products Executive Manager, GRDC PRESENTATIONS 2. Global warming potential of wheat production in Western Australia: A life cycle assessment, Louise Barton1, Wahid Biswas2 and Daniel Carter3, 1School of Earth & Geographical Sciences, The University of Western Australia, 2Centre of Excellence in Cleaner Production, Division of Science and Engineering, Curtin University of Technology, 3Department of Agriculture and Food 3. How much fuel does your farm use for different farm operations? Nicolyn Short1, Jodie Bowling1, Glen Riethmuller1, James Fisher2 and Moin Salam1, 1Department of Agriculture and Food, 2Muresk Institute, Curtin University of Technology 4. Poor soil water storage and soil constraints are common in WA cropping soils, Stephen Davies, Jim Dixon, Dennis Van Gool and Alison Slade, Department of Agriculture and Food, Bob Gilkes, School of Earth and Geographical Sciences, University of Western Australia 5. Developing potential adaptations to climate change for low rainfall farming system using economic analysis tool. STEP, Megan Abrahams, Caroline Peek, Dennis Van Gool, Daniel Gardiner and Kari-Lee Falconer, Department of Agriculture and Food 6. What soil limitations affect the profitability of claying on non-wetting sandplain soils? David Hall1, Jeremy Lemon1, Harvey Jones1, Yvette Oliver2 and Tania Butler1, 1Department of Agriculture and Food, 2CSIRO Div Sustainable Ecology, Perth 7. Farming systems adapting to a variable climate; Two case studies, Kari-Lee Falconer, Department of Agriculture and Food 8. Importance of accounting for variation in crop yield potential when making fertiliser decisions, Michael Robertson and Yvette Oliver, CSIRO Sustainable Ecosystems, Floreat 9. Soil acidity is a widespread problem across the Avon River Basin, Stephen Carr1, Chris Gazey2, David York1 and Joel Andrew1, 1Precision SoilTech, 2Department of Agriculture and Food 10. The use of soil testing kits and ion-selective electrodes for the analysis of plant available nutrients in Western Australian soils, Michael Simeoni and Bob Gilkes School of Earth and Geographical Sciences, University of Western Australia 11. Redlegged earth mite resistance and integrated strategies for their control in Western Australia, Mangano G. Peter and Micic Svetlana, Department of Agriculture and Food 12. The economics of treating soil pH (liming), Chris Gazey, Steve Davies, Dave Gartner and Adam Clune, Department of Agriculture and Food, 13. Health benefits – A future differentiator for high value grains, Matthew Morell, Theme Leader, CSIRO Food Futures Flagship 14. Carbon in Sustralian cropping soils – We need to be realistic, Alan Umbers (M Rur Sc), GRDC/DAFF Sustainable Industries Initiative Project 15. AGWEST® Bartolo bladder clover (Trifolium spumosum) − a low cost annual pasture legume for the wheat/sheep zone, Angelo Loi, Brad Nutt and Clinton Revell, Department of Agriculture and Food 16. Maximising the value of point based soil sampling: Monitering trends in soil pH through time, Joel Andrew1, David York1, Stephen Carr1 and Chris Gazey2, 1Precision SoilTech, 2Department of Agriculture and Food 17. Improved crop root growth and productivity with deep ripping and deep placed lime, Stephen Davies1, Geoff Kew2*, Chris Gazey1, David Gartner1 and Adam Clune1, 1Department of Agriculture and Food, 2School of Earth and Geographical Sciences University of Western Australia, *Presenting author 18. The role of pastures in hosting Root Lesion Nematode (RLN, Pratylenchus neglectus), Vivien Vanstone, Ali Bhatti and Ming Pei You, Department of Agriculture and Food 19. To rip or not to rip. When does it pay? Imma Farre, Bill Bowden and Stephen Davies, Department of Agriculture and Food 20. Can yield be predicted from remotely sensed data, Henry Smolinski, Jane Speijers and John Bruce, Department of Agriculture and Food 21. Rotations for profit, David McCarthy and Gary Lang, Facey Group, Wickepin, WA 22. Rewriting rules for the new cropping economics, David Rees, Consultant, Albany 23. Reducing business risk in Binnu! – A case study, Rob Grima, Department of Agriculture and Food 24. Does improved ewe management offer grain farmers much extra profit? John Young, Farming Systems Analysis Service, Ross Kingwell, Department of Agriculture and Food, and UWA, Chris Oldham, Department of Agriculture and Food RESEARCH HIGHLIGHTS 25. Crop establishment and productivity with improved root zone drainage, Dr Derk Bakker, Research Officer, Department of Agriculture and Food 26. Will wheat production in Western Australia be more risky in the future? Imma Farre and Ian Foster, Department of Agriculture and Food PAPERS 27. Building farmers’ adaptive capacity to manage seasonal variability and climate change, David Beard, Department of Agriculture and Food 28. Precision placement increases crop phosphorus uptake under variable rainfall: Simulation studies, Wen Chen1 2, Richard Bell1, Bill Bowden2, Ross Brennan2, Art Diggle2 and Reg Lunt2, 1School of Environmental Science, Murdoch University, 2Department of Agriculture and Food 29. What is the role of grain legumes on red soil farms? Rob Grima, Department of Agriculture and Food 30. Fertiliser placement influences plant growth and seed yield of grain crops at different locations of WA, Qifu Ma1, Zed Rengel1, Bill Bowden2, Ross Brennan2, Reg Lunt2 and Tim Hilder2, 1Soil Science & Plant Nutrition, University of Western Australia, 2Department of Agriculture and Food 31. A review of pest and disease occurrences for 2007, Peter Mangano and Dusty Severtson, Department of Agriculture and Food 32. Effect of stocking rates on grain yield and quality of wheat in Western Australia in 2007, Shahajahan Miyan, Sam Clune, Barb Sage and Tenielle Martin, Department of Agriculture and Food 33. Storing grain is not ‘set and forget’ management, Chris Newman, Department of Agriculture and Food 34. Improving understanding of soil plant available water capacity (PAWC): The WA soil water database (APSoil), Yvette Oliver, Neal Dalgliesh and Michael Robertson, CSIRO Sustainable Ecosystems 35. The impact of management decisions in drought on a low rainfall northern wheatbelt farm, Caroline Peek and Andrew Blake, Department of Agriculture and Food 37. Cullen – A native pasture legume shows promise for the low-medium rainfall cropping zone, Megan Ryan, Richard Bennett, Tim Colmer, Daniel Real, Jiayin Pang, Lori Kroiss, Dion Nicol and Tammy Edmonds-Tibbett, School of Plant Biology, The University of Western Australia and Future Farm Industries CRC 38. Climate risk management tools – useful, or just another gadget? Lisa Sherriff, Kari-Lee Falconer, Daniel Gardiner and Ron McTaggart Department of Agriculture and Food 39. Benefits of crop rotation for management of Root Lesion Nematode (RLN, Pratylenchus neglectus), Vivien Vanstone, Sean Kelly and Helen Hunter, Department of Agriculture and Foo

Toward a Comprehensive Approach to the Collection and Analysis of Pica Substances, with Emphasis on Geophagic Materials

Pica, the craving and subsequent consumption of non-food substances such as earth, charcoal, and raw starch, has been an enigma for more than 2000 years. Currently, there are little available data for testing major hypotheses about pica because of methodological limitations and lack of attention to the problem.In this paper we critically review procedures and guidelines for interviews and sample collection that are appropriate for a wide variety of pica substances. In addition, we outline methodologies for the physical, mineralogical, and chemical characterization of these substances, with particular focus on geophagic soils and clays. Many of these methods are standard procedures in anthropological, soil, or nutritional sciences, but have rarely or never been applied to the study of pica.Physical properties of geophagic materials including color, particle size distribution, consistency and dispersion/flocculation (coagulation) should be assessed by appropriate methods. Quantitative mineralogical analyses by X-ray diffraction should be made on bulk material as well as on separated clay fractions, and the various clay minerals should be characterized by a variety of supplementary tests. Concentrations of minerals should be determined using X-ray fluorescence for non-food substances and inductively coupled plasma-atomic emission spectroscopy for food-like substances. pH, salt content, cation exchange capacity, organic carbon content and labile forms of iron oxide should also be determined. Finally, analyses relating to biological interactions are recommended, including determination of the bioavailability of nutrients and other bioactive components from pica substances, as well as their detoxification capacities and parasitological profiles.This is the first review of appropriate methodologies for the study of human pica. The comprehensive and multi-disciplinary approach to the collection and analysis of pica substances detailed here is a necessary preliminary step to understanding the nutritional enigma of non-food consumption