Dietary strategies to treat hyperhomocysteinaemia based on the biochemistry of homocysteine: a review

Hyperhomocysteinaemia is implicated in various diseases, including cardiovascular disease and cancer. Several conditions influence the concentration of homocysteine (Hcy), including demographic, genetic and lifestyle factors. With regard to the latter, dietary components may be manipulated as Hcy can be remethylated to methionine by folate, or metabolised by other one-carbon nutrients, such as betaine and its precursor, choline. This metabolic interplay enables the nutritionist or dietitian to be able to lower Hcy concentrations cost-effectively by tailoring an individual’s diet, or by food enrichment and fortification strategies. Evidence supports the safety and benefits of Hcy reduction by simple dietary intervention. B vitamins, and betaine and choline intake lower Hcy, whereas methionine and certain beverages (coffee, tea and alcohol) increase it. Therefore, dietary determinants of Hcy raise the prospect of a simple, inexpensive and safe means of treating and/or preventing diseases contingent on this sulphur- containing protein. Keywords: alcohol, B vitamins, coffee, homocysteine, lipotropics, te

The relationship between personality types and reward preferences

Abstract: Research has shown that total rewards models structured according to individual preferences, positively influence efforts to attract, retain and motivate key employees. Yet, this is seldom done. Structuring total rewards models according to the preferences of employee segments is a viable alternative to accommodate individual preferences. Research purpose: The primary aim of the study was to determine the relationship between personality types and reward preferences. The secondary aim was to determine the reward preferences for different demographic groups. Motivation for the study: An enhanced understanding of reward preferences for different employee segments will enable employers to offer more competitive reward options to their employees. This may, in turn, have a positive impact on retention. Research design, approach and method: Two measuring instruments, the MBTI® Form GRV and the Rewards Preferences Questionnaire, were distributed electronically to 5 000 potential respondents. The results from 589 sets of questionnaires were used in the data analyses. Primary and secondary factor analyses were done on the items in the Rewards Preferences Questionnaire. Main findings/results: The study confirmed that individuals with certain personality types and personality preferences, have different preferences for certain reward categories. There was a stronger relationship between reward preferences and personality preferences than for reward preferences and personality types. Preferences for reward categories by different demographic groups were confirmed. The significant difference in reward preferences between Black and White respondents in particular was noteworthy, with Black respondents indicating significantly higher mean scores for all reward categories than White respondents. Finally, a total rewards framework influenced by the most prominent preferences for reward categories, was designed..

The relationship between personality types and reward preferences

Abstract: Research has shown that total rewards models structured according to individual preferences, positively influence efforts to attract, retain and motivate key employees. Yet, this is seldom done. Structuring total rewards models according to the preferences of employee segments is a viable alternative to accommodate individual preferences. Research purpose: The primary aim of the study was to determine the relationship between personality types and reward preferences. The secondary aim was to determine the reward preferences for different demographic groups. Motivation for the study: An enhanced understanding of reward preferences for different employee segments will enable employers to offer more competitive reward options to their employees. This may, in turn, have a positive impact on retention. Research design, approach and method: Two measuring instruments, the MBTI® Form GRV and the Rewards Preferences Questionnaire, were distributed electronically to 5 000 potential respondents. The results from 589 sets of questionnaires were used in the data analyses. Primary and secondary factor analyses were done on the items in the Rewards Preferences Questionnaire. Main findings/results: The study confirmed that individuals with certain personality types and personality preferences, have different preferences for certain reward categories. There was a stronger relationship between reward preferences and personality preferences than for reward preferences and personality types. Preferences for reward categories by different demographic groups were confirmed. The significant difference in reward preferences between Black and White respondents in particular was noteworthy, with Black respondents indicating significantly higher mean scores for all reward categories than White respondents. Finally, a total rewards framework influenced by the most prominent preferences for reward categories, was designed..

The status quo of research on South Africa’s water resource management institutions

The South African water resource management institutional landscape has seen some dramatic changes since the new dispensation came into power in 1994. Not only have legislation and policies changed, but there has also been a significant increase in the number of non-state actors in the policy development process. Water resource governance has therefore become more complex and its regulatory component is being implemented by a number of legislative institutions: catchment management agencies, water user associations, irrigation boards, and international water management bodies. Policy development is influenced by a myriad of non-state actors, scientists included. A comprehensive literature review of research on water resource management institutions published between 1997 and 2011 shows that scientists are focusing predominantly on catchment management agencies and aspects regarding their institutionalisation and organisational functionality. There is much less of a focus on other entities, such as advisory committees, international water management bodies, irrigation boards, the water tribunal and water user associations. What the review has also revealed is that research on water resource management institutions has been conducted predominantly by scientists from the natural sciences. There is therefore an evident need for a research focus on water resource management institutions other than catchment management agencies. In addition, there should be a focus on informal aspects of water resource governance and new theoretical developments, also from disciplines other than the natural sciences, in the fields of water resource governance and politics.Keywords: Water resource management institutions, literature review, catchment management agencies,water user associations, legislation, irrigation boards, catchment forums, international water management bodie

Transcatheter management of adult aortic coarctation with “Railway” technique

We report the case of a 21-year-old man with complete atresia of the aorta who underwent percutaneous aortic intervention and successfully recanalize the atresia of the aorta with the artery “Railway” technique. A fully atretic aorta poses a challenge for a percutaneous solution and is often subject to open repair, considering the risk of perforation and technical failure. However, our case demonstrates that a strategic and structured approach is safe and successful to even tackle complete aortic atresia without complications such as rupture or bleeding

The Impact of Stereotype Threat on Workplace Discrimination against Arabs and Muslims: A Qualitative Meta-Analysis

No abstract available

Case Study: Nutritional management of a patient at high risk of developing refeeding syndrome

The following case study was discussed during the fourth-year dietetics evaluation process at North-West University, Potchefstroom Campus. It is a reflection of the opinion of the dietitians, students and lecturers involved, describes the actions taken during the nutritional management of the case, and is based on current literature and guidelines relevant to the topic

Nonsurgical repair of the ascending aorta: why less is more

Objective: Advanced endovascular options for acute and chronic pathology of the ascending aorta are emerging; however, several problems with stent grafts placed in the ascending aorta have been identified in patients unsuitable for surgical repair, such as migration and erosion at aorta interface. Method: Among the six cases analysed in this report, three were treated with a stent graft in the ascending aorta to manage chronic dissection in the proximal aorta; dimensions of those stent grafts varied between 34 and 45 mm in diameter, and from 77 to 100 mm in length. Three patients, matched by age, sex and their nature of pathology, were subjected to the focal closure of a single communicating entry by the use of an occluding device (Amplatzer ASD and PFO occluders between 14 and 18 mm disc diameter) with similar Charlson comorbidity score. Results: Both conceptually different nonsurgical management strategies were technically feasible; however, with stent grafts, an early or delayed erosion to full re-dissection was documented with stent grafts, in contrast to complete seal, with an induced remodelling and a long-term survival after the successful placing of coils and occluder devices. Moreover, aortic root motion was not impaired by the focal occlusion of a communication with an occluder, while free motion was impeded after stent graft placement. Conclusions: The intriguing observation in our small series was that stent grafts placed in the ascending aorta portends the risk of an either early (post-procedural) or delayed migration and erosion of aortic tissues at the landing site or biological interface between 12 and 16 months after the procedure, a phenomenon not seen with the use of focal occluding devices up to 5 years of follow-up. Obviously, the focal approach avoids the erosion of the aortic wall as the result of minimal interaction with the biological interface, such as a diseased aortic wall. Potential explanations may be related to a reduced motion of the aortic root after the placement of stent graft in the ascending aorta, whereas the free motion of aortic root was preserved with an occluder. The causality of erosion may however not be fully understood, as besides the stiffness and radial force of the stent graft, other factors such as the induced inflammatory reactions of aortic tissue and local adhesions within the chest may also play a role. With stent grafts failing to portend long-term success, they may still have a role as a temporizing solution for elective surgical conversion. Larger datasets from registries are needed to further explore this evolving field of interventions to the ascending aorta

Aortic intervention guided by contrast-enhanced transoesophageal ultrasound while waiting for cardiac transplantation: a case report

Background: Aortic complications can occur during left ventricular assist devices (LVAD) insertion and its treatment remains challenging. Percutaneous aortic interventions can be an alternative to surgery in such high-risk cases. Case summary: We present a patient with idiopathic dilated cardiomyopathy and advanced heart failure requiring LVAD insertion as a bridge to transplant, who developed an aortic pseudoaneurysm below the anastomosis of the LVAD tube. He was treated by percutaneously coiling under contrast-enhanced transoesophageal echocardiographic (TOE) guidance and safely reached destination (heart transplantation) a year later. Discussion: LVADs provide haemodynamic support for patients with advanced heart failure waiting for heart transplantation. Although uncommon, aortic complications can develop after LVAD insertion and are life-threatening. Percutaneous aortic interventions are feasible in such cases to promote thrombosis and shrinkage of aneurysmal spaces, hence potentially reducing the risk of sudden death. Contrast-enhanced TOE can be easily and safely used to both monitor the intervention by improving anatomic target definition, guide and wire positioning, and assess early results

Aortic haemodynamics and wall stress analysis following arch aneurysm repair using a single-branched endograft

Introduction: Thoracic endovascular aortic repair (TEVAR) of the arch is challenging given its complex geometry and the involvement of supra-aortic arteries. Different branched endografts have been designed for use in this region, but their haemodynamic performance and the risk for post-intervention complications are not yet clear. This study aims to examine aortic haemodynamics and biomechanical conditions following TVAR treatment of an aortic arch aneurysm with a two-component single-branched endograft. Methods: Computational fluid dynamics and finite element analysis were applied to a patient-specific case at different stages: pre-intervention, post-intervention and follow-up. Physiologically accurate boundary conditions were used based on available clinical information. Results: Computational results obtained from the post-intervention model confirmed technical success of the procedure in restoring normal flow to the arch. Simulations of the follow-up model, where boundary conditions were modified to reflect change in supra-aortic vessel perfusion observed on the follow-up scan, predicted normal flow patterns but high levels of wall stress (up to 1.3M MPa) and increased displacement forces in regions at risk of compromising device stability. This might have contributed to the suspected endoleaks or device migration identified at the final follow up. Discussion: Our study demonstrated that detailed haemodynamic and biomechanical analysis can help identify possible causes for post-TEVAR complications in a patient-specific setting. Further refinement and validation of the computational workflow will allow personalised assessment to aid in surgical planning and clinical decision making