Is the iPhone an accurate and useful tool for the monitoring of spinal deformity?

The progression of spinal deformity is traditionally monitored by spinal surgeons using the Cobb method on hardcopy radiographs with a protractor and pencil. The rotation of the spine and ribcage (rib hump) in scoliosis is measured with a simple hand-held inclinometer (Scoliometer). The iPhone and other smart phones have the capability to accurately sense inclination, and can therefore be used to measure Cobb angles and rib hump angulation. The purpose of this study was to quantify the performance of the iPhone compared to a standard protractor for measuring Cobb angles and the Scoliometer for measuring rib humps. The study concluded that the iPhone is a clinically equivalent measuring tool to the traditional protractor and Scoliomete

The conduct of Australian Indigenous primary health care research focusing on social and emotional wellbeing: a systematic review

Objectives and importance of study: Values and ethics: guidelines for ethical conduct in Aboriginal and Torres Strait Islander health research (Values and ethics) describes key values that should underpin Aboriginal and Torres Strait Islander (Indigenous)-focused health research. It is unclear how research teams address this document in primary health care research. We systematically review the primary health care literature focusing on Indigenous social and emotional wellbeing (SEWB) to identify how Values and ethics and community preferences for standards of behaviour (local protocols) are addressed during research. Systematic review in accordance with PRISMA Guidelines and MOOSE Guidelines for Meta-Analyses and Systematic Reviews of Observational Studies. We searched four databases and one Indigenous-specific website for qualitative, quantitative and mixed-method studies published since Values and ethics was implemented (2003). Included studies were conducted in primary health care services, focused on Indigenous SEWB and were conducted by research teams. Using standard data extraction forms, we identified actions taken (reported by authors or identified by us) relating to Values and ethics and local protocols. A total of 25 studies were included. Authors of two studies explicitly mentioned the Values and ethics document, but neither reported how their actions related to the document's values. In more than half the studies, we identified at least three actions relating to the values. Some actions related to multiple values, including use of culturally sensitive research processes and involving Indigenous representatives in the research team. Local protocols were rarely reported. Addressing Values and ethics appears to improve research projects. The academic community should focus on culturally sensitive research processes, relationship building and developing the Indigenous research workforce, to facilitate acceptable research that affects health outcomes. For Values and ethics to achieve its full impact and to improve learning between research teams, authors should be encouraged to report how the principles are addressed during research, including barriers and enablers that are encountered

The quality of Australian Indigenous primary health care research focusing on social and emotional wellbeing: a systematic review

Objectives and importance of the study: Primary health care research focused on Aboriginal and Torres Strait Islander (Indigenous) people is needed to ensure that key frontline services provide evidence based and culturally appropriate care. We systematically reviewed the published primary health care literature to identify research designs, processes and outcomes, and assess the scientific quality of research focused on social and emotional wellbeing. This will inform future research to improve evidence based, culturally appropriate primary health care. Systematic review in accordance with PRISMA and MOOSE guidelines. Four databases and one Indigenous-specific project website were searched for qualitative, quantitative and mixed-method published research. Studies that were conducted in primary health care services and focused on the social and emotional wellbeing of Indigenous people were included. Scientific quality was assessed using risk-of-bias assessment tools that were modified to meet our aims. We assessed community acceptance by identifying the involvement of community governance structures and representation during research development, conduct and reporting. Data were extracted using standard forms developed for this review. We included 32 articles, which reported on 25 studies. Qualitative and mixed methods were used in 18 studies. Twelve articles were judged as high or unclear risk of bias, four as moderate and five as low risk of bias. Another four studies were not able to be assessed as they did not align with the risk-of-bias tools. Of the five articles judged as low risk of bias, two also had high community acceptance and both of these were qualitative. One used a phenomenological approach and the other combined participatory action research with a social-ecological perspective and incorporated 'two-way learning' principles. Of the 16 studies where a primary outcome was identified, eight aimed to identify perceptions or experiences. The remaining studies assessed resources, or evaluated services, interventions, programs or policies. We were unable to identify primary outcomes in eight studies. Conducting Indigenous-focused primary health care research that is scientifically robust, culturally appropriate and produces community-level outcomes is challenging. We suggest that research teams use participatory, culturally sensitive approaches and collaborate closely to plan and implement high-quality research that incorporates local perspectives. Research should result in beneficial outcomes for the communities involved

Patient medication knowledge and adherence to asthma pharmacotherapy: a pilot study in rural Australia

Asthma is a chronic disease with both inflammatory and bronchoconstrictive elements and often requires multiple medications. Most asthma regimens include medications with different therapeutic modes of action and a number of different medication delivery devices. To effectively participate in their asthma management, patients need to recognize each of their medication types, understand their purpose, adhere to their treatment regimen, and be proficient in using the required delivery devices. This study evaluated patient knowledge of asthma pharmacotherapy and adherence. An interview study was undertaken in two rural locations, in Australia, to elicit participants' knowledge, use, and inhalation device technique. Of participants, 75.9% used preventer medication and the remaining 24.1% used reliever medication only. Of those using preventer medication, 82.5% could distinguish their preventer from a range of asthma medicines. Metered dose inhalers (MDIs) were used by 80% of participants; 23% used a Turbuhaler®; 24% used an Accuhaler®; and 5% used an MDI with a spacer device. The study established poor medication knowledge, suboptimal device technique, and disturbing levels of adherence with management recommendations. Asthma education strategies need to be modified to engage patients with low asthma knowledge to achieve improved patient outcomes. Further, strategies need to motivate patients to use preventer medication during times when they feel well

Neutralisation treatment of AMD at affordable cost

Acid mine drainage (AMD) has for many years been a major environmental challenge associated with the mining industry, especially in the Eastern, Central and Western mining basins of Gauteng. The aims of this article are to: (i) demonstrate the suitability of the sequencing batch reactor (SBR) system for both neutralisation of free acid and removal of iron(II), often the main component in AMD, using limestone, the cheapest alkali, followed by lime treatment for removal of heavy metals, and partial sulphate removal through gypsum crystallisation; (ii) compare the alkali cost of the alternative SBR system where limestone and lime are used for treatment, with conventional lime treatment, and (iii) present the capital cost of the SBR system.The conclusions of this study are that: (i) precipitated calcium carbonate can be used for complete removal of iron(II) in an SBR system within 90 min reaction time; (ii) lime can be used for complete removal of heavy metals after pre-treatment with precipitated calcium carbonate; (iii) the alkali cost for treatment of AMD from the Western Basin will amount to R2.80/m3 in the case of limestone/lime treatment compared to R5.83/m3 if only lime is used; (iv) the alkali cost for treatment of 85 Mℓ/d acid mine water from both the Western and Central Basins will amount to R60 m./a in the case of limestone/lime treatment compared to R136.9 m./a if only lime is used; and (v) the capital cost for the SBR system amounts to R3.5 m. per Mℓ/d.Keywords: Acid mine drainage, sequencing batch reactor, neutralisation, limeston

Characterisation of different GLRaV-3 variant infections by determining virus concentration ratios and miRNA expression profiles

Grapevine leafroll disease (GLD) is present in all grape-growing regions of the world and is considered the most significant grapevine viral disease. Grapevine leafroll-associated virus 3 (GLRaV-3) is considered the primary cause of GLD and in South African vineyards five genetic variant groups (I, II, III, VI and VII) have been confirmed. Biological distinctions between GLRaV-3 variants have not been fully validated. By characterising virus concentration and stress-responsive microRNA expression in GLRaV-3 infected plants, this study aimed to glean a better understanding of the possible biological distinctions between GLRaV-3 variants. Quantitative reverse transcription PCR was utilised for virus concentration ratio (VCR) determination and miRNA quantitation in GLRaV-3 positive and negative grapevines grown under greenhouse and field conditions. This study found statistically significant differences in VCRs in plants singly infected with different GLRaV-3 variants. Interestingly, no difference in mean VCRs were observed between data sets, despite notable differences in plant age, duration of GLRaV-3 infection, scion/rootstock combination and growing conditions. Several miRNAs showed statistically significant expression modulation between infected and healthy samples. miRNA expression between data sets varied substantially and a greater overall miRNA response was observed in plants with more established GLRaV-3 infections. The lack of significant differences in mean VCRs between data sets, coupled with the consistent modulation of certain miRNAs in plants that have likely been infected for longer is a promising result. This finding could indicate that successful inhibition of further virus replication by plant defence mechanisms occurred, and that these miRNAs are implicated in this response

Contaminants of Emerging Concern (CECs) and male reproductive health: challenging the future with a double-edged sword

Approximately 9% of couples are infertile, with half of these cases relating to male factors. While many cases of male infertility are associated with genetic and lifestyle factors, approximately 30% of cases are still idiopathic. Contaminants of emerging concern (CECs) denote substances identified in the environment for the first time or detected at low concentrations during water quality analysis. Since CEC production and use have increased in recent decades, CECs are now ubiquitous in surface and groundwater. CECs are increasingly observed in human tissues, and parallel reports indicate that semen quality is continuously declining, supporting the notion that CECs may play a role in infertility. This narrative review focuses on several CECs (including pesticides and pharmaceuticals) detected in the nearshore marine environment of False Bay, Cape Town, South Africa, and deliberates their potential effects on male fertility and the offspring of exposed parents, as well as the use of spermatozoa in toxicological studies. Collective findings report that chronic in vivo exposure to pesticides, including atrazine, simazine, and chlorpyrifos, is likely to be detrimental to the reproduction of many organisms, as well as to sperm performance in vitro. Similarly, exposure to pharmaceuticals such as diclofenac and naproxen impairs sperm motility both in vivo and in vitro. These contaminants are also likely to play a key role in health and disease in offspring sired by parents exposed to CECs. On the other side of the double-edged sword, we propose that due to its sensitivity to environmental conditions, spermatozoa could be used as a bioindicator in eco- and repro-toxicology studies

Physical activity during school recess : a systematic review

Context: Interest has increased in examining the physical activity levels of young people during school recess. Identifying correlates of their recess physical activity behaviors is timely, and would inform school-based physical activity programming and intervention development. The review examined the correlates of children\u27s and adolescent\u27s physical activity during school recess periods. Evidence acquisition: Asystematicsearchofsixelectronicdatabases,referencelists,andpersonal archives identified 53 studies (47 focused on children) published between January 1990 and April 2011 that met the inclusion criteria. Data were analyzed in 2011. Correlates were categorized using the social-ecological framework. Evidence synthesis: Forty-four variables were identified across the four levels of the social- ecological framework, although few correlates were studied repeatedly at each level. Positive associ- ations were found of overall facility provision, unfixed equipment, and perceived encouragement with recess physical activity. Results revealed that boys were more active than girls. Conclusions: Providing access to school facilities, providing unfixed equipment, and identifying ways to promote encouragement for physical activity have the potential to inform strategies to increase physical activity levels during recess periods