The Role Of The Multidisciplinary Team Meeting in An Antiretroviral Treatment Programme

The importance of adherence in the management of patients on combination antiretroviral therapy has been well documented.1-6 However, for  sustainability of the overall programme adequate patient ‘tracking’ is required in order to understand where the programme may be failing

Delays by people living with HIV/AIDS in accessing antiretroviral therapy

Objective: To understand, by qualitative enquiry, the underlying reasons and narratives for patients that delay in accessing antiretroviral treatment.Design: A qualitative design was used, where patients were interviewed using the free attitude interview technique, after being selected based on a screening question: “How long did it take you to present at a clinic or hospital for treatment after receiving your human immunodeficiency virus-positive result?”Setting and subjects: Eight patients from the human immunodeficiency virus clinic at Potchefstroom were interviewed.Outcome measures: The interviews were transcribed verbatim and organised into themes.Results: The following themes were identified: stigma and discrimination, ignorance and lack of perceived risk of infection, denial and healthcare system constraints. These are discussed and quotations from the interviewed patients included.Conclusion: This qualitative study has contributed to an understanding of why patients delay in accessing highly active antiretroviral therapy. Some of the reasons supplied by patients have been documented globally. Others are poignantly coloured by personal stories. By understanding patients’ perspectives and feelings, emphasis can be placed on the reduction of stigma, denial, practical clinic constraints and appropriate types of health education.Keywords: qualitative research, delays, access, antiretroviral drugs, ARV

Short message service (SMS) language and written language skills: educators’ perspectives

SMS language is English language slang, used as a means of mobile phone text messaging. This practice may impact on the written language skills of learners at school. The main aim of this study was to determine the perspectives of Grade 8 and 9 English (as Home Language) educators in Gauteng regarding the possible influence of SMS language on certain aspects of learners’ written language skills. If an influence was perceived by the educators, their perceptions regarding the degree and nature of the influence were also explored. A quantitative research design, utilising a questionnaire, was employed. The sample of participants comprised 22 educators employed at independent secondary schools within Gauteng, South Africa. The results indicated that the majority of educators viewed SMS language as having a negative influence on the written language skills of Grade 8 and 9 learners. The influence was perceived as occurring in the learners’ spelling, punctuation, and sentence length. A further finding was that the majority of educators address the negative influences of SMS language when encountered in written tasks.Keywords: English Home Language teaching; SMS language; text messaging; written language skill

Inkwisatoriese en akkusatoriese elemente in die Amerikaanse pleitonderhandelingsproses: rigtingwyser of waarskuwingsteken?

Uit teks: Dit word algemeen aanvaar dat die prosedure van pleitonderhandelinge die hele strafproses hervorm het en is die belangrikste hiervan dat koste bespaar word en tyd meer effektief gebruik kan word. Dit dien as belangrike middel tot beskikking van die aanklaer en die verdediging. Pleitonderhandelinge kan ook bydra tot uitskakeling van onskuldigbevindings by ’n verhoor op bloot ’n tegniese punt. Die prosedure beperk ook tot ’n groot mate die omvang van regsprekende beamptes se diskresie by vonnisoplegging en bring mee dat die beskuldigde persoonlik ook by die proses betrek word

Immunotherapy of Crohn's disease.

Although the initiating events of Crohn's disease are unknown, models of experimental colitis have provided new insights in the immunologically mediated pathways of mucosal inflammation. In Crohn's disease activated mucosal T lymphocytes produce proinflammatory cytokines within the mucosal compartment. With this understanding, there has been a shift in past years from the use of unspecific anti-inflammatory agents (corticosteroids, aminosalicylates) to the use of immunomodulatory drugs (azathioprine, methotrexate). Moreover, novel strategies have been designed for specific targets in Crohn's disease, in particular T lymphocytes and cytokines. In an open label study treatment of steroid-refractory Crohn's disease with anti- CD4+ antibodies was well tolerated and showed clinical benefit. However, a sustained depletion of the CD4+ cells precluded further clinical trials. In controlled clinical studies, anti-tumour necrosis factor (TNF-alpha) antibodies induced complete remissions and few side effects were observed. One study suggested efficacy in active Crohn's disease of recombinant interleukin-10. Long term treatment studies will have to answer questions about the indications for use, benefit and toxicity. Altogether, these results hold promise for future management of Crohn's disease, where disease-modifying interventions and strategies that effectively maintain disease remission will play a key role

Infliximab treatment induces apoptosis of lamina propria T lymphocytes in Crohn's disease

Background and aims: Treatment with infliximab induces remission in about 70% of patients with steroid refractory Crohn's disease. Because Crohn's disease is considered to be mediated by uncontrolled activation of mucosal T lymphocytes, we hypothesised that infliximab could induce apoptosis of T lymphocytes. Methods: Induction of apoptosis in vivo was studied in 10 patients with therapy refractory Crohn's disease. In vitro, resting or stimulated Jurkat T cells were incubated with infliximab. Results: Infusion of infliximab (5 mg/kg) in steroid refractory patients with Crohn's disease induced a clinical response in 9/10 patients but did not influence expression of activation markers, homing receptors, memory cells, Fas expression, or Bax/Bcl-2 expression on peripheral blood T lymphocytes. In contrast, a significant increase in CD3 and TUNEL positive cells within colonic biopsies was detected 24 hours after infusion of infliximab, suggesting that infliximab stimulates apoptosis of activated T lymphocytes but not of resting T cells. To test this hypothesis, the effects of infliximab on Jurkat T cells were investigated. We observed that infliximab induced apoptosis and an increase in the Bax/Bcl-2 ratio of CD3/CD28 stimulated Jurkat T cells but not of unstimulated Jurkat cells. Conclusions: Our data indicate that infliximab treatment causes a rapid and specific increase in apoptosis of T lymphocytes in the gut mucosa. These findings may explain the rapid and sustained therapeutic effects of infliximab in Crohn's disease

Factors influencing venture capitalists' project financing decisions in South Africa

CITATION: Van Deventer, B. & Mlambo, C. 2009. Factors influencing venture capitalists' project financing decisions in South Africa. South African Journal of Business Management, 40(1):a533, doi:10.4102/sajbm.v40i1.533.The original publication is available at https://sajbm.orgThis study explores and identifies the investment criteria used by South African venture capitalists in their venture screening and evaluation processes. Using a Likert scale type of questionnaire, South African venture capitalists (VCs) were asked to rate the investment criteria identified in similar studies abroad and to report any additional criteria of their own. By evaluating the mean ratings, it was found that South African VCs consider the entrepreneur's honesty and integrity; a good expected market acceptance; and a high internal rate of return (IRR), to be the three most important criteria. The South African VCs, just like their overseas counterparts, regard management considerations to be the most important criteria group in the evaluation of new investment projects. The results of this study are deemed useful to both venture capitalists in their decision-making process and to entrepreneurs in their venture capital applications to maximise their success rate.https://sajbm.org/index.php/sajbm/article/view/533Publisher's versio

The Effect of Aggregate Particle Size on Formation of Geopolymeric Gel

Due to enhanced mechanical and chemical properties, geopolymeric materials are a potential alternative to ordinary Portland cement and high-strength cement for the construction industry. The effects of aggregate particle size on the formation and the mechanical properties of geopolymeric materials are investigated in the current work. The addition of soluble silicates to the alkaline activator was found to increase the dissolution of silicate ions from the aggregate into the geopolymer binder phase. The results indicate that the surface area of aggregate influences the strength development of a geopolymer

System performance of a 4-channel PHASAR WDM receiver operating at 1.2 Gbit/s

Phased arrays are important key components in wavelength-division multiplexing (WDM) systems. We have realized a 4-channel WDM receiver combining a phased array with photodetectors on InP with a Si bipolar transimpedance amplifier. The channels are spaced at 2.0 nm with a 1.0-nm flat passband. On chip loss was 6-7 dB and detector efficiency was better than 90%. The optical cross talk remains below -20 dB. The electrical bandwidth per channel was 1 GHz. The electrical cross talk at 1 GHz after detection is below -25 dB. We have tested this receiver in a full 4-channel syste

Evaluation of the SUNHEART Cardiology Outreach Programme

Introduction: The demand for advanced cardiac care and specialised interventions is on the increase and this results in bottlenecks and increased waiting times for patients who require advanced cardiac care. By decentralising cardiac care, and using a hub-and-spoke model, the SUNHEART Outreach Programme of cardiovascular care aims to improve access to advanced cardiac care in the Western Cape. Tygerberg Hospital is the central hub, with the fi rst spoke being Paarl Hospital. Objective: To determine the value of the SUNHEART Outreach Programme to the public health care system. Methods: An audit of patients accessing the OutreachProgramme was performed for the period May 2013 - May 2014 and consequently compared to a historical cohort of patients accessing the health care system during the preceding 6 months, from October 2012 -April 2013. Access to advanced cardiac care was measured in time to initial evaluation, time to defi nitive diagnosis or intervention and patient compliance with appointments. The value to the health care system was also assessed by performing a cost analysis of transport of patients and health care workers, as well as compliance with appointments. We documented the spectrum of disease requiring advanced cardiac care toguide future interventions. Results: Data of 185 patients were included in the audit. Sixty four patients were referred to tertiary care from October 2012 - April 2013 and 121 patients were referred to the outreach facility from May 2013 - May 2014. There was a signifi cant reduction in waiting times with the median days to appointment of the historical cohort being 85 days compared to 18 days in the Outreach Programme cohort (p<0.01). Patient compliance with appointments was signifi cantly superior in the Outreach Programme cohort (90% vs. 56%: p<0.01). Valvular (36.5%) and ischaemic heart disease (35.5%) were the major pathologies requiring access to cardiac care services. Transport costs per patient treated was signifi cantly reduced in the outreach programme cohort (R118,09 vs. R308,77). Conclusion: Decentralisation of services in the form of an Outreach Programme, with a central hub, improves access to advanced cardiac care by decreasing waiting time, improving compliance with appointments and decreasing travel costs