The reproductive biology and habit at requirements of aloe peglerae, a montane endemic aloe of the Magaliesberg mountain range, South Africa.

In this study I investigated the reproductive biology and pollination ecology of Aloe peglerae, an endangered endemic succulent species of the Magaliesberg Mountain Range in South Africa. The aim was to determine the pollination system of A. peglerae, the effects of flowering plant density on plant reproduction and the suitable microhabitat conditions for this species. Aloe peglerae possesses floral traits that typically conform to the bird-pollination syndrome. Pollinator exclusion experiments showed that reproduction is enhanced by opportunistic avian nectar-feeders, mainly the Cape Rock-Thrush (Monticola rupestris) and the Dark-capped Bulbul (Pycnonotus tricolor). Insect pollinators did not contribute significantly to reproductive output. Small-mammals were observed visiting flowers at night, however, the importance of these visitors as pollinators was not quantified in this study. Interannual variation in flowering patterns dictated annual flowering plant densities in the population. The first flowering season represented a typical mass flowering event resulting in high seed production, followed by a second low flowering year of low seed production. Reproductive success was significantly related to flowering plant densities at a spatial scale of 30.0-35.0m in 2011, corresponding to the scale at which flowering plant density influenced diurnal (bird) visitation rates (25.0-40.0m). In the second flowering season, neither plant reproduction nor diurnal visitation rates were related to flowering plant densities. Nocturnal (small-mammal) visitation rates were not related to flowering plant densities in both years and this is perceived to be a reflection of the smaller home/forage range of small-mammals. However, further investigation is required to confirm the hypothesis that small-mammal visitations contribute to reproductive success in A. peglerae. Aloe occupancy was generally associated with “safe site” microhabitat conditions (i.e. high rock cover, low grass cover and biomass). This is expected to be a fire-survival strategy of A. peglerae, where the persistence of individual plants in less vulnerable microsites over time is favoured. However, plant morphology might also confer adaptations, such as vegetative recovery at the apical meristem, to tolerate the harsh effects of fire

Addressing the needs of clinical teachers: action research

It is important to recognise the barriers that face teachers and provide solutions Selected participants were invited to be part of one of two focus groups If clinical teachers\u27 concerns can be addressed, learners\u27 experiences may improve Positive comments included clinical teachers liking the teaching they were asked to do Improved communication between the school and clinicians was frequently raised as an issue The participants have ownership of the solutions which provided value to their contributio

Approaches to derive dietary variables in exploring diet-health relationship: a methodological review

What dietary variables can be derived from dietary assessment data to explore the diet-health relationship

Evaluation of prescription medication changes following sleeve gastrectomy surgery

Abstract Objective The increasing global prevalence of obesity, coupled with its association with chronic health conditions and rising healthcare costs, highlights the need for effective interventions; however, despite the availability of treatment options, the ongoing success of primary interventions in maintaining long‐term weight loss remains limited. This study examined the prescription medication dispensing changes following sleeve gastrectomy in Australians aged 45 years and over. Methods In a retrospective analysis of 847 bariatric surgery patients from the New South Wales 45 and Up Study, the assessment of medication patterns categorizing into three groups: gastrointestinal, metabolic, cardiorespiratory, musculoskeletal, and nervous systems was conducted. Each drug class was analyzed, focusing on patients with dispensing records within the 12 months before surgery. This study employed interrupted time‐series analysis to compare pre‐ and post‐surgery medication usage. Results With a predominantly female population (76.9%) and an average age of 57.2 (standard deviation 5.71), there were statistically significant reductions in both unique medications (12.5% decrease, p = 0.004) and total medications dispensed (15.9% decrease, p = 0.003) from 12 months before surgery to 13–24 months after bariatric surgery. All medication categories, except opioids, showed reductions. Notably, the most significant reductions were observed in diabetes (38.6%), agents acting on the renin‐angiotensin system (40.4%), lipid modifying agents (26.5%), anti‐inflammatory products (46.3%), and obstructive airway diseases (53.3%) medications during this time frame. Conclusion These findings suggest that sleeve gastrectomy provides an effective therapeutic intervention for patients with comorbidities requiring multiple medications, especially for obesity‐related diseases such as diabetes, cardiovascular, respiratory and musculoskeletal disorders

Opening the Black Box of an mHealth Patient-Reported Outcome Tool for Diabetes Self-Management: Interview Study Among Patients With Type 2 Diabetes

BackgroundMobile health (mHealth) tools are used to collect data on patient-reported outcomes (PROs) and facilitate the assessment of patients’ self-management behaviors outside the clinic environment. Despite the high availability of mHealth diabetes tools, there is a lack of understanding regarding the underlying reasons why these mHealth PRO tools succeed or fail in terms of changing patients’ self-management behaviors. ObjectiveThis study aims to identify the factors that drive engagement with an mHealth PRO tool and facilitate patients’ adoption of self-management behaviors, as well as elicit suggestions for improvement. MethodsThis qualitative study was conducted within the context of a randomized controlled trial designed to evaluate the efficacy of an mHealth PRO tool (known as i-Matter) versus usual care regarding reduction in glycated hemoglobin (HbA1c) levels and adherence to self-management behaviors at 12 months among patients with uncontrolled type 2 diabetes. Patients randomized to i-Matter participated in semistructured interviews about their experiences at the 3-, 6-, 9-, and 12-month study visits. A qualitative analysis of the interviews was conducted by 2 experienced qualitative researchers using conventional qualitative content analysis. ResultsThe sample comprised 71 patients, of whom 67 (94%) completed at least one interview (n=48, 72% female patients; n=25, 37% identified as African American or Black; mean age 56.65 [SD 9.79] years). We identified 4 overarching themes and 6 subthemes. Theme 1 showed that the patients’ reasons for engagement with i-Matter were multifactorial. Patients were driven by internal motivating factors that bolstered their engagement and helped them feel accountable for their diabetes (subtheme 1) and external motivating factors that helped to serve as reminders to be consistent with their self-management behaviors (subtheme 2). Theme 2 revealed that the use of i-Matter changed patients’ attitudes toward their disease and their health behaviors in 2 ways: patients developed more positive attitudes about their condition and their ability to effectively self-manage it (subtheme 3), and they also developed a better awareness of their current behaviors, which motivated them to adopt healthier lifestyle behaviors (subtheme 4). Theme 3 showed that patients felt more committed to their health as a result of using i-Matter. Theme 4 highlighted the limitations of i-Matter, which included its technical design (subtheme 5) and the need for more resources to support the PRO data collected and shared through the tool (subtheme 6). ConclusionsThis study isolated internal and external factors that prompted patients to change their views about their diabetes, become more engaged with the intervention and their health, and adopt healthy behaviors. These behavioral mechanisms provide important insights to drive future development of mHealth interventions that could lead to sustained behavior change