Relational experiences of community members participating in a rural health initiative with interprofessional students

Background. A South African faculty of health sciences created a forum for the community to voice their relational experiences with interprofessional students through visual projections. No other studies that explore such experiences using the Mmogo method could be located. Objective. To gain an understanding of the relational experiences of community members participating in Lifestyle-groups as part of a rural health initiative with interprofessional student groups. Methods. The Mmogo method is a qualitative, structured, observation technique. Participants constructed visual projections representing specific relationships. Thereafter, during a group discussion, participants explained the meaning of their projections. The visual data were analysed according to their literal presentation and subjective, symbolic meaning. A thematic analysis was used for the transcribed data. Results. Thirteen of the 24 visual projections were of a quality that allowed visual analysis; all 24 members participated in the discussions. Light was identified as an overarching theme to represent the community-student interaction. Sub-themes and categories associated with light were healthier lifestyles (knowledge sharing, lifestyle transformation, improved health outcomes), solidarity (reciprocity, collaboration, person centredness, multidimensional approach) and affirmation (gratitude and acceptance). Conclusion. Though some statements by participants related to health education as opposed to health dialogue highlighted areas requiring improvement, the findings correlated with the outcomes prescribed for students by this rural health initiative. Emotional connections in relational experiences could facilitate higher levels of self-efficacy in communities. The question is whether a stronger emphasis on health dialogue can be a catalyst for improved self-efficacy

Using ceftazidime-avibactam for persistent carbapenem-resistant Serratia marcescens infection highlights antimicrobial stewardship challenges with new beta-lactam-inhibitor combination antibiotics

The newer beta-lactam-inhibitor combination (BLIC) antibiotics are available in South Africa (SA) for the treatment of carbapenem-resistant Enterobacterales infections. We describe the successful use of ceftazidime-avibactam (CA) for the treatment of a child with persistent carbapenem-resistant Serratia marcescens bacteraemia, and the challenges faced using this lifesaving antibiotic, including access to susceptibility testing, procurement process, cost and complexity of deciding when, how and for how long to use it. Furthermore, the burden of carbapenem resistance is increasing in SA, and inappropriate use of CA and other newer BLIC antibiotics, such as ceftolozane-tazobactam, will inevitably endanger their longevity. A careful balance must be struck between removing unnecessary obstacles and delays in initiating these antibiotics for life-threatening infections, and additional antimicrobial stewardship-guided interventions aimed at preserving their therapeutic use

Health professions students' interprofessional experiences on a rural learning platform

HEALTH PROFESSIONS STUDENTS’ LEARNING EXPERIENCES ON A RURAL COLLABORATIVE LEARNING PLATFORM ABSTRACTA Faculty of Health Sciences launched a rural collaborative learning platform to cultivate interprofessional key competencies and to improve health outcomes. The purpose of the study was to describe health sciences students’ experiences of an rural collaborative learning platform. Health professions students created digital stories reflecting on their collaborative learning experiences. Purposive sampling resulted in 23 submissions. Qualitative analysis of content identified themes and categories. Three themes, namely, metaphor, critical consciousness and professional socialisation, were identified. The metaphor categories, Journey, Setting world ablaze, Water, and Puzzle, represent students’ desire to use visual cues to describe their experiences. Transformation, Personal development and Empathy signified critical consciousness. Collaborative practice, Values, Reflective practice, and Key competencies relate to professional socialisation. The researchers gained understanding of students’ experiences on an rural collaborative learning platform. Through digital stories, students became aware of professional interdependency, which linked their experiences to key interprofessional competencies.

A comparison of multiple luminescence chronometers at Voordrag, South Africa

A suite of 10 samples collected from an 11 m thick colluvial sequence at Voordrag, KwaZulu-Natal, South Africa, have been used to undertake a comparison of different luminescence methods. Good agreement is found between single grain quartz optically stimulated luminescence (OSL) and single grain K-feldspar post-infrared infrared-stimulated luminescence (post-IR IRSL) ages, with the exception of the basal samples where the quartz OSL signal is saturated. Multiple grain quartz OSL consistently yields ages older than single grain OSL methods. Multiple grain feldspar ages derived from the IRSL50 signal are underestimated due to anomalous fading. A previously published radiocarbon chronology yields ages that are younger than those from single grain quartz OSL and post-IR IRSL, and this is most likely due to contamination with younger carbon. Identifying the effect of saturation on the quartz OSL signal remains challenging when quartz is dated in isolation. However, using a paired quartz/feldspar dating approach is an effective way of identifying the impact of saturation on the OSL signal

Favourable outcomes for the first 10 years of kidney and pancreas transplantation at Wits Donald Gordon Medical Centre, Johannesburg, South Africa

Background. It is important for centres participating in transplantation in South Africa (SA) to audit their outcomes. Wits Donald Gordon Medical Centre (WDGMC), Johannesburg, SA, opened a transplant unit in 2004. The first 10 years of kidney and pancreas transplantation were reviewed to determine outcomes in respect of recipient and graft survival.Methods. A retrospective review was conducted of all kidney-alone and simultaneous kidney-pancreas (SKP) transplants performed at WDGMC from 1 January 2004 to 31 December 2013, with follow-up to 31 December 2014 to ensure at least 1 year of survival data. Information was accessed using the transplant registers and clinical records in the transplant clinic at WDGMC. The Kaplan-Meier method was used to estimate 1-, 5- and 10-year recipient and graft survival rates for primary (first graft) kidney-alone and SKP transplants.Results. The overall 10-year recipient and graft survival rates were 80.4% and 66.8%, respectively, for kidney-alone transplantation. In the kidney-alone group, children tended towards better recipient and graft survival compared with adults, but this was not statistically significant. In adults, recipient survival was significantly better for living than deceased donor type. Recipient and graft survival were significantly lower in black Africans than in the white (largest proportion in the sample) reference group. For SKP transplants, the 10-year recipient survival rate was 84.7%, while kidney and pancreas graft survival rates were 73.1% and 43.2%, respectively.Conclusion. Outcomes of the first 10 years of kidney and pancreas transplantation at WDGMC compare favourably with local and international survival data

Inflammation and salt in young adults: the African-PREDICT study

Purpose: Low-grade inflammation and a diet high in salt are both established risk factors for cardiovascular disease. High potassium (K+) intake was found to counter increase in blood pressure due to high salt intake and may potentially also have protective anti-inflammatory effects. To better understand these interactions under normal physiological conditions, we investigated the relationships between 22 inflammatory mediators with 24-h urinary K+ in young healthy adults stratified by low, medium and high salt intake (salt tertiles). We stratified by ethnicity due to potential salt sensitivity in black populations. Methods: In 991 healthy black (N = 457) and white (N = 534) adults, aged 20–30 years, with complete data for 24-h urinary sodium and K+, we analysed blood samples for 22 inflammatory mediators. Results: We found no differences in inflammatory mediators between low-, mid- and high-sodium tertiles in either the black or white groups. In multivariable-adjusted regression analyses in white adults, we found only in the lowest salt tertile that K+ associated negatively with pro-inflammatory mediators, namely interferon gamma, interleukin (IL) -7, IL-12, IL-17A, IL-23 and tumour necrosis factor alpha (all p ≤ 0.046). In the black population, we found no independent associations between K+ and any inflammatory mediator. Conclusion: In healthy white adults, 24-h urinary K+ associated independently and negatively with specific pro-inflammatory mediators, but only in those with a daily salt intake less than 6.31 g, suggesting K+ to play a protective, anti-inflammatory role in a low-sodium environment. No similar associations were found in young healthy black adults