The effects of a language barrier in a South African district hospital

The original publication is available at http://www.samj.org.zaCITATION: Schlemmer, A., Mash, B. 2006. The effects of a language barrier in a South African district hospital. South African Medical Journal, 96(10):1080-1087.Background. Communication between health workers and patients at Hottentots Holland Hospital (HHH) is hindered by staff and patients not speaking the same language. HHH is a district hospital in the Cape Town Metropolitan District of the Western Cape where staff mainly speak Afrikaans or English and a large number of patients mainly Xhosa. Objectives. The study aimed to explore the effects of this language barrier on health workers and patients at HHH. Design. Three focus group interviews were held with 21 members of staff and 5 in-depth patient interviews were conducted. Results. The language barrier was found to interfere with working efficiently, create uncertainty about the accuracy of interpretation, be enhanced by a lack of education or training, cause significant ethical dilemmas, negatively influence the attitudes of patients and staff towards each other, decrease the quality of and satisfaction with care, and cause cross-cultural misunderstandings. Conclusion. The effects of the language barrier were considerable and persistent despite an official language policy in the province. The training and employment of professional interpreters as well as teaching of basic Xhosa to staff are recommended.Publisher’s versio

Using an unmanned aerial vehicle to evaluate nitrogen variability and height effect with an active crop canopy sensor

Ground-based active sensors have been used in the past with success in detecting nitrogen (N) variability within maize production systems. The use of unmanned aerial vehicles (UAVs) presents an opportunity to evaluate N variability with unique advantages compared to ground-based systems. The objectives of this study were to: determine if a UAV was a suitable platform for use with an active crop canopy sensor to monitor in-season N status of maize, if UAV’s were a suitable platform, is the UAV and active sensor platform a suitable substitute for current handheld methods, and is there a height effect that may be confounding measurements of N status over crop canopies? In a 2013 study comparing aerial and ground-based sensor platforms, there was no difference in the ability of aerial and ground-based active sensors to detect N rate effects on a maize crop canopy. In a 2014 study, an active sensor mounted on a UAV was able to detect differences in crop canopy N status similarly to a handheld active sensor. The UAV/active sensor system (AerialActive) platform used in this study detected N rate differences in crop canopy N status within a range of 0.5–1.5 m above a relatively uniform turfgrass canopy. The height effect for an active sensor above a crop canopy is sensor- and crop-specific, which needs to be taken into account when implementing such a system. Unmanned aerial vehicles equipped with active crop canopy sensors provide potential for automated data collection to quantify crop stress in addition to passive sensors currently in use

Phase III study of nilotinib versus best supportive care with or without a TKI in patients with gastrointestinal stromal tumors resistant to or intolerant of imatinib and sunitinib

Background This phase III open-label trial investigated the efficacy of nilotinib in patients with advanced gastrointestinal stromal tumors following prior imatinib and sunitinib failure. Patients and methods Patients were randomized 2:1 to nilotinib 400 mg b.i.d. or best supportive care (BSC; BSC without tyrosine kinase inhibitor, BSC+imatinib, or BSC+sunitinib). Primary efficacy end point was progression-free survival (PFS) based on blinded central radiology review (CRR). Patients progressing on BSC could cross over to nilotinib. Results Two hundred and forty-eight patients enrolled. Median PFS was similar between arms (nilotinib 109 days, BSC 111 days; P=0.56). Local investigator-based intent-to-treat (ITT) analysis showed a significantly longer median PFS with nilotinib (119 versus 70 days; P=0.0007). A trend in longer median overall survival (OS) was noted with nilotinib (332 versus 280 days; P=0.29). Post hoc subset analyses in patients with progression and only one prior regimen each of imatinib and sunitinib revealed a significant difference in median OS of >4 months in favor of nilotinib (405 versus 280 days; P=0.02). Nilotinib was well tolerated. Conclusion In the ITT analysis, no significant difference in PFS was observed between treatment arms based on CRR. In the post hoc subset analyses, nilotinib provided significantly longer median O

Interstellar OH+, H2O+ and H3O+ along the sight-line to G10.6-0.4

We report the detection of absorption lines by the reactive ions OH+, H2O+ and H3O+ along the line of sight to the submillimeter continuum source G10.6$-$0.4 (W31C). We used the Herschel HIFI instrument in dual beam switch mode to observe the ground state rotational transitions of OH+ at 971 GHz, H2O+ at 1115 and 607 GHz, and H3O+ at 984 GHz. The resultant spectra show deep absorption over a broad velocity range that originates in the interstellar matter along the line of sight to G10.6$-$0.4 as well as in the molecular gas directly associated with that source. The OH+ spectrum reaches saturation over most velocities corresponding to the foreground gas, while the opacity of the H2O+ lines remains lower than 1 in the same velocity range, and the H3O+ line shows only weak absorption. For LSR velocities between 7 and 50 kms$^{-1}$ we estimate total column densities of $N$(OH+) $> 2.5 \times 10^{14}$ cm$^{-2}$, $N$(H2O+) $\sim 6 \times 10^{13}$ cm$^{-2}$ and $N$(H3O+) $\sim 4.0 \times 10^{13}$ cm$^{-2}$. These detections confirm the role of O$^+$ and OH$^+$ in initiating the oxygen chemistry in diffuse molecular gas and strengthen our understanding of the gas phase production of water. The high ratio of the OH+ by the H2O+ column density implies that these species predominantly trace low-density gas with a small fraction of hydrogen in molecular form

Strong absorption by interstellar hydrogen fluoride: Herschel/HIFI observations of the sight-line to G10.6-0.4 (W31C)

We report the detection of strong absorption by interstellar hydrogen fluoride along the sight-line to the submillimeter continuum source G10.6-0.4 (W31C). We have used Herschel's HIFI instrument, in dual beam switch mode, to observe the 1232.4763 GHz J=1-0 HF transition in the upper sideband of the Band 5a receiver. The resultant spectrum shows weak HF emission from G10.6-0.4 at LSR velocities in the range -10 to -3 km/s, accompanied by strong absorption by foreground material at LSR velocities in the range 15 to 50 km/s. The spectrum is similar to that of the 1113.3430 GHz 1(11)-0(00) transition of para-water, although at some frequencies the HF (hydrogen fluoride) optical depth clearly exceeds that of para-H2O. The optically-thick HF absorption that we have observed places a conservative lower limit of 1.6E+14 cm-2 on the HF column density along the sight-line to G10.6-0.4. Our lower limit on the HF abundance, 6E-9 relative to hydrogen nuclei, implies that hydrogen fluoride accounts for between ~ 30 and 100% of the fluorine nuclei in the gas phase along this sight-line. This observation corroborates theoretical predictions that - because the unique thermochemistry of fluorine permits the exothermic reaction of F atoms with molecular hydrogen - HF will be the dominant reservoir of interstellar fluorine under a wide range of conditions.Comment: Accepted for publication in Astronomy and Astrophysics (Herschel special issue). This revised version corrects a typographic error in the HTML abstract, in which the lower limit on the HF abundance (should be 6E-9) was previously misstated. The abstract in the PDF version is correct and the latter has not been modifie

Iron bioavailability in two commercial cultivars of wheat: a comparison between wholegrain and white flour and the effects of nicotianamine and 2'-deoxymugineic acid on iron uptake into Caco-2 cells

Iron bioavailability in unleavened white and wholegrain bread made from two commercial wheat varieties was assessed by measuring ferritin production in Caco-2 cells. The breads were subjected to simulated gastrointestinal digestion and the digests applied to the Caco-2 cells. Although Riband grain contained a lower iron concentration than Rialto, iron bioavailability was higher. No iron was taken up by the cells from white bread made from Rialto flour or from wholegrain bread from either variety, but Riband white bread produced a small ferritin response. The results probably relate to differences in phytate content of the breads, although iron in soluble monoferric phytate was demonstrated to be bioavailable in the cell model. Nicotianamine, an iron chelator in plants involved in iron transport, was a more potent enhancer of iron uptake into Caco-2 cells than ascorbic acid or 2'-deoxymugineic acid, another metal chelator present in plants