Interest in and Willingness to Use Complementary, Alternative and Traditional Medicine among Academic and Administrative University Staff in Bloemfontein, South Africa

Background: Healthcare systems worldwide are changing and the use of complementary, alternative and traditional medicine (CAM) form part ofthis transformation. South Africa has a large number of CAM practitioners, but they are not included in the official healthcare system. The aim of thisstudy was to determine the perception and usage of CAM among the academic and administrative staff of the University of the Free State (UFS) in Bloemfontein, South Africa.Methods: A questionnaire was compiled and sent electronically to all the academic and administrative staff of the UFS who had a university emailaddress, to be completed online.Results: The response rate was 5.5%, with most of the respondents from the Faculty of Health Sciences. The respondents (n=165) were mainly women of 41–60 years of age with more than one tertiary qualification. Most of the respondents were in good health and considered CAM as moderately helpful and mostly safe. Most of the CAM recommendations were not from a medical physician. The respondents wanted alternatives to certain medications, such as antibiotics. They also had good previous experience with CAM and felt that conventional treatment was not always effective to treat their problems. They identified a need for CAM in the health system.Conclusion: The study has limitations due to the data collection method and the low response rate. The results showed that the respondents favored a more integrated healthcare system including different CAM therapies, and that conventional doctors should be better informed about these therapies and its uses.Keywords: perceptions; usage; complementary medicine; alternative medicine; traditional medicine; university staff

Inhibisie van osteoklastvorming en beenresorpsie deur poli-onversadigde vetsure in RAW 264.7 muismonosiete

Inhibition of osteoclast differentiation and bone resorption by polyunsaturated fatty acids in RAW 264.7 murine macrophages. This study investigated the effects of polyunsaturated fatty acids on osteoclast formation and bone resorption in RAW 264.7 murine pre-osteoclasts. Data obtained suggests an inhibitory effect of these compounds on osteoclastogenesis and bone resorption in the cell line tested. Beenhermodellering in volwassenes is ‘n fisiologiese proses wat die sintese van beenmatriks deur osteoblaste en die resorpsie (afbraak) van been deur osteoklaste behels. Osteoklaste ontstaan deur die samesmelting van hematopoïetiese selle van monosiet-makrofaagafkoms en speel ‘n deurslaggewende rol in beenhermodellering. Osteoklast-ooraktiwiteit kan die afbraak van been in verskeie patologiese toestande tot gevolg hê. Kliniese- en dierestudies het aangedui dat sommige poli-onversadigde vetsure ‘n voordelige effek op been kan hê. Die doel van hierdie proefstudie was om te bepaal of omega-3 en omega-6 poli-onversadigde vetsure osteoklastvorming vanaf RAW 264.7 monosiete moduleer en daardeur die aantal volwasse resorberende osteoklaste kan beïnvloed. Monosiet/makrofaag-muisselle (RAW 264.7 pre-osteoklaste) is teen 1.5x104 selle/putjie in steriele 24-put plaatjies in die aanwesigheid van 15 ng/ml muisreseptor-aktiveerder van NFκBligand (RANKL) gesaai. RANKL is noodsaaklik vir osteoklastvorming vanaf voorgangerselle. Etanol (oplosmiddelkontrole), die omega-6 poli-onversadigde vetsure aragidoonsuur en gammalinoleensuur asook die omega-3 poli-onversadigde vetsure eikosapentaënöesuur en dokosaheksaënöesuur is by die selkulture teen konsentrasies van 5–20 μg/ml gevoeg. Palmitiensuur, ‘n versadigde vetsuur, teen ‘n konsentrasie van 20 μg/ml is as positiewe kontrole vir inhibisie van osteoklastvorming gebruik. Na vyf dae inkubasie is osteoklastvorming geëvalueer deur van tartraat-weerstandigesuurfosfatase (TRAP)-kleuring gebruik te maak. TRAP-positiewe selle met vyf of meer kerne word as veelkernige osteoklaste beskou. Soortgelyke eksperimente is uitgevoer op plaatjies wat bedek is met ‘n sintetiese anorganiese beenoppervlak. Na sewe dae inkubasie is die selle afgewas en resorpsie van die oppervlak met behulp van mikroskoopfoto’s waargeneem. Die persentasie resorpsie-oppervlak is daarna met behulp van toepaslike rekenaarsagteware bepaal. Verder is RAW 264.7 selle op beenskyfies gesaai om die effek van poli-onversadigde vetsure op die degradering van organiese en anorganiese beenkomponente te evalueer. Na nege dae is die gekondisioneerde media afgetrek en die hoeveelheid Ca2+ en kollageenfragmente, beendegraderingsprodukte onderskeidelik afkomstig vanaf die anorganiese en organiese komponente van beenafbraak, deur gepaste kolorimetriese metodes bepaal. Resultate van hierdie studie het getoon dat die vorming van veelkernige osteoklaste deur die blootstelling aan poli-onversadigde vetsure by konsentrasies van 5–20 μg/ml geïnhibeer word. Blootstelling aan al die vetsure het tot inhibering van osteoklastvorming gelei met die grootste effek by die hoogste vetsuurkonsentrasies. Dokosaheksaënöesuur (omega-3) het die mees betekenisvolle inhiberende effek oor al die konsentrasies getoon en eikosapentaënöesuur die minste. Resorpsieholtes op die gesimuleerde beenplaatjies was kleiner waar die selle aan aragidoonsuur en dokosaheksaënöesuur blootgestel was in vergelyking met dié van die oplosmiddelkontrole, wat moontlik aan die laer voorkoms van volwasse veelkernige osteoklaste toegeskryf kan word. ‘n Afname in die beendegraderingsprodukte is ook waargeneem waar selle blootgestel is aan aragidoonsuur en dokosaheksaënöesuur in vergelyking met die oplosmiddelkontrole. Die resultate ondersteun die vermoede dat poli-onversadigde vetsure die vorming van volwasse osteoklaste inhibeer en daardeur ‘n beenbeskermende effek tot gevolg mag hê. Verdere navorsing is nodig om duidelikheid oor die meganismes wat hier betrokke is, te verkry. Hierdie navorsing is deur die Mediese Navorsingsraad en die Navorsings-ontwikkelingsprogram (Universiteit van Pretoria) befonds.falsefalsefalsePublishedPublishedPublishedSouth AfricaSouth AfricaSouth Afric

Medical students' perceptions of their development of ‘soft skills' Part II : The development of ‘soft skills' through ‘guiding and growing'

BackgroundThis paper reports on medical students' views on the ways in which their ‘soft skills' were developed. It is the result of a study on soft skills among two groups of students before and after curriculum reform at the School of Medicine of the University of Pretoria. One of the aims of the reform was to provide more teaching and learning opportunities for the development of soft skills. Soft skills include professional interpersonal and social skills, communication skills, and professional and ethical attitudes.MethodsAs symbolic interactionism was used as the theoretical framework to guide the research, qualitative methods were used to collect the data. A purposive-theoretical sample of 42 final-year medical students from the traditional curriculum and 49 from the reformed curriculum was recruited. Data were collected by means of focus groups, individual in-depth interviews and autobiographical sketches. ResultsThe same categories of comments emerged from the data collected from the study participants from both the traditional and the reformed curriculum. The students ascribed their behaviour related to soft skills to personality and innate features. They had varying opinions on whether soft skills could be taught, but there was as a strong feeling that teaching should focus on principles and guidelines for dealing with difficult situations. They believed that, in the end, they should take responsibility for their own development of soft skills. Most participants felt they could at least grow through exposure to teaching activities and the observation of role models. They also indicated that they had developed their soft skills and constructed their own identity through their interaction with others. Their definition of situations was shaped by their interactions with doctors and educators, fellow students and other health professionals. Interaction with patients was considered the most important. For both groups of students their third year was a watershed, as it is the first year of more intensive patient contact and the beginning of serious learning from interaction with patients. The views on the development of soft skills differed very little between the traditional and reformed curriculum groups, except that students who had followed the reformed curriculum felt more prepared through the increased teaching and training efforts. Further consideration needs to be given to the intention of the changed curriculum compared to the actual effect. The way in which the participants in the study described their development of soft skills could be categorised as a complex interplay between ‘being' and ‘becoming'. Instead of using the word ‘acquisition' of soft skills, ‘development' seemed to be more appropriate. The metaphor of ‘guiding' and ‘growing' also captures the development of these skills better than the terms ‘teaching' and ‘learning'.ConclusionTeaching activities in the clinical years should be adapted with a view to facilitating the students' professional growth. New models for the development of medical educators should be created and institutional barriers should be investigated.For full text, click here: SA Fam Pract 2006;48(8):15-15

Discovery: an interactive resource for the rational selection and comparison of putative drug target proteins in malaria

<p>Abstract</p> <p>Background</p> <p>Up to half a billion human clinical cases of malaria are reported each year, resulting in about 2.7 million deaths, most of which occur in sub-Saharan Africa. Due to the over-and misuse of anti-malarials, widespread resistance to all the known drugs is increasing at an alarming rate. Rational methods to select new drug target proteins and lead compounds are urgently needed. The Discovery system provides data mining functionality on extensive annotations of five malaria species together with the human and mosquito hosts, enabling the selection of new targets based on multiple protein and ligand properties.</p> <p>Methods</p> <p>A web-based system was developed where researchers are able to mine information on malaria proteins and predicted ligands, as well as perform comparisons to the human and mosquito host characteristics. Protein features used include: domains, motifs, EC numbers, GO terms, orthologs, protein-protein interactions, protein-ligand interactions and host-pathogen interactions among others. Searching by chemical structure is also available.</p> <p>Results</p> <p>An <it>in silico</it> system for the selection of putative drug targets and lead compounds is presented, together with an example study on the bifunctional DHFR-TS from <it>Plasmodium falciparum</it>.</p> <p>Conclusion</p> <p>The Discovery system allows for the identification of putative drug targets and lead compounds in Plasmodium species based on the filtering of protein and chemical properties.</p

Effects of a dual CCR3 and H1-antagonist on symptoms and eosinophilic inflammation in allergic rhinitis

<p>Abstract</p> <p>Background</p> <p>The CC-chemokine receptor-3 (CCR3) has emerged as a target molecule for pharmacological intervention in allergic inflammation.</p> <p>Objective</p> <p>To examine whether a dual CCR3 and H₁-receptor antagonist (AZD3778) affects allergic inflammation and symptoms in allergic rhinitis.</p> <p>Methods</p> <p>Patients with seasonal allergic rhinitis were subjected to three seven days' allergen challenge series. Treatment with AZD3778 was given in a placebo and antihistamine-controlled design. Symptoms and nasal peak inspiratory flow (PIF) were monitored in the morning, ten minutes post challenge, and in the evening. Nasal lavages were carried out at the end of each challenge series and α₂-macroglobulin, ECP, and tryptase were monitored as indices of allergic inflammation.</p> <p>Results</p> <p>Plasma levels of AZD3778 were stable throughout the treatment series. AZD3778 and the antihistamine (loratadine) reduced rhinitis symptoms recorded ten minutes post challenge during this period. AZD3778, but not the anti-histamine, also improved nasal PIF ten minutes post challenge. Furthermore, scores for morning and evening nasal symptoms from the last five days of the allergen challenge series showed statistically significant reductions for AZD3778, but not for loratadine. ECP was reduced by AZD3778, but not by loratadine.</p> <p>Conclusions</p> <p>AZD3778 exerts anti-eosinophil and symptom-reducing effects in allergic rhinitis and part of this effect can likely be attributed to CCR3-antagonism. The present data are of interest with regard to the potential use of AZD3778 in allergic rhinitis and to the relative importance of eosinophil actions to the symptomatology of allergic rhinitis.</p> <p>Trial registration</p> <p>EudraCT No: 2005-002805-21.</p

Do Lions Panthera leo Actively Select Prey or Do Prey Preferences Simply Reflect Chance Responses via Evolutionary Adaptations to Optimal Foraging?

Research on coursing predators has revealed that actions throughout the predatory behavioral sequence (using encounter rate, hunting rate, and kill rate as proxy measures of decisions) drive observed prey preferences. We tested whether similar actions drive the observed prey preferences of a stalking predator, the African lion Panthera leo. We conducted two 96 hour, continuous follows of lions in Addo Elephant National Park seasonally from December 2003 until November 2005 (16 follows), and compared prey encounter rate with prey abundance, hunt rate with prey encounter rate, and kill rate with prey hunt rate for the major prey species in Addo using Jacobs' electivity index. We found that lions encountered preferred prey species far more frequently than expected based on their abundance, and they hunted these species more frequently than expected based on this higher encounter rate. Lions responded variably to non-preferred and avoided prey species throughout the predatory sequence, although they hunted avoided prey far less frequently than expected based on the number of encounters of them. We conclude that actions of lions throughout the predatory behavioural sequence, but particularly early on, drive the prey preferences that have been documented for this species. Once a hunt is initiated, evolutionary adaptations to the predator-prey interactions drive hunting success

Degradation of communal rangelands in South Africa: towards an improved understanding to inform policy

In South Africa, the relative extent of range degradation under freehold compared to communal tenure has been strongly debated. We present a perspective on the processes that drive rangeland degradation on land under communal tenure. Our findings are based on literature as well as extensive field work on both old communal lands and ‘released’ areas, where freehold farms have been transferred to communal ownership. We discuss the patterns of degradation that have accompanied communal stewardship and make recommendations on the direction policy should follow to prevent further degradation and mediate rehabilitation of existing degraded land.Keywords: communal rangelands, land degradation, rehabilitation, social systemsAfrican Journal of Range &amp; Forage Science 2013, 30(1&amp;2): 57–6

3D Reconstruction of VZV Infected Cell Nuclei and PML Nuclear Cages by Serial Section Array Scanning Electron Microscopy and Electron Tomography

Varicella-zoster virus (VZV) is a human alphaherpesvirus that causes varicella (chickenpox) and herpes zoster (shingles). Like all herpesviruses, the VZV DNA genome is replicated in the nucleus and packaged into nucleocapsids that must egress across the nuclear membrane for incorporation into virus particles in the cytoplasm. Our recent work showed that VZV nucleocapsids are sequestered in nuclear cages formed from promyelocytic leukemia protein (PML) in vitro and in human dorsal root ganglia and skin xenografts in vivo. We sought a method to determine the three-dimensional (3D) distribution of nucleocapsids in the nuclei of herpesvirus-infected cells as well as the 3D shape, volume and ultrastructure of these unique PML subnuclear domains. Here we report the development of a novel 3D imaging and reconstruction strategy that we term Serial Section Array-Scanning Electron Microscopy (SSA-SEM) and its application to the analysis of VZV-infected cells and these nuclear PML cages. We show that SSA-SEM permits large volume imaging and 3D reconstruction at a resolution sufficient to localize, count and distinguish different types of VZV nucleocapsids and to visualize complete PML cages. This method allowed a quantitative determination of how many nucleocapsids can be sequestered within individual PML cages (sequestration capacity), what proportion of nucleocapsids are entrapped in single nuclei (sequestration efficiency) and revealed the ultrastructural detail of the PML cages. More than 98% of all nucleocapsids in reconstructed nuclear volumes were contained in PML cages and single PML cages sequestered up to 2,780 nucleocapsids, which were shown by electron tomography to be embedded and cross-linked by an filamentous electron-dense meshwork within these unique subnuclear domains. This SSA-SEM analysis extends our recent characterization of PML cages and provides a proof of concept for this new strategy to investigate events during virion assembly at the single cell level

High frequency of Plasmodium falciparum chloroquine resistance marker (pfcrt T76 mutation) in Yemen: An urgent need to re-examine malaria drug policy

<p>Abstract</p> <p>Background</p> <p>Malaria remains a significant health problem in Yemen with <it>Plasmodium falciparum </it>being the predominant species which is responsible for 90% of the malaria cases. Despite serious concerns regarding increasing drug resistance, chloroquine is still used for the prevention and treatment of malaria in Yemen. This study was carried out to determine the prevalence of choloroquine resistance (CQR) of <it>P. falciparum </it>isolated from Yemen based on the <it>pfcrt </it>T76 mutation.</p> <p>Methods</p> <p>A cross-sectional study was carried out among 511 participants from four governorates in Yemen. Blood samples were screened using microscopic and species-specific nested PCR based on the 18S rRNA gene to detect and identify <it>Plasmodium </it>species. Blood samples positive for <it>P. falciparum </it>were used for detecting the <it>pfcrt </it>T76 mutation using nested-PCR.</p> <p>Results</p> <p>The prevalence of <it>pfcrt </it>T76 mutation was 81.5% (66 of 81 isolates). Coastal areas/foothills had higher prevalence of <it>pfcrt </it>T76 mutation compared to highland areas (90.5% <it>vs </it>71.8%) (p = 0.031). The <it>pfcrt </it>T76 mutation had a significant association with parasitaemia (p = 0.045). Univariate analysis shows a significant association of <it>pfcrt </it>T76 mutation with people aged > 10 years (OR = 9, 95% CI = 2.3 - 36.2, p = 0.001), low household income (OR = 5, 95% CI = 1.3 - 19.5, p = 0.027), no insecticide spray (OR = 3.7, 95% CI = 1.16 - 11.86, p = 0.025) and not sleeping under insecticide treated nets (ITNs) (OR = 4.8, 95% CI = 1.38 - 16.78, p = 0.01). Logistic regression model confirmed age > 10 years and low household income as predictors of <it>pfcrt </it>T76 mutation in Yemen <it>P. falciparum </it>isolates.</p> <p>Conclusions</p> <p>The high prevalence of <it>pfcrt </it>T76 mutation in Yemen could be a predictive marker for the prevalence of <it>P. falciparum </it>CQR. This finding shows the necessity for an in-vivo therapeutic efficacy test for CQ.<it> P. falciparum </it>CQR should be addressed in the national strategy to control malaria.</p

Comparative determination of HIV-1 co-receptor tropism by Enhanced Sensitivity Trofile, gp120 V3-loop RNA and DNA genotyping

BACKGROUND: Trofile is the prospectively validated HIV-1 tropism assay. Its use is limited by high costs, long turn-around time, and inability to test patients with very low or undetectable viremia. We aimed at assessing the efficiency of population genotypic assays based on gp120 V3-loop sequencing for the determination of tropism in plasma viral RNA and in whole-blood viral DNA. Contemporary and follow-up plasma and whole-blood samples from patients undergoing tropism testing via the enhanced sensitivity Trofile (ESTA) were collected. Clinical and clonal geno2pheno[coreceptor] (G2P) models at 10% and at optimised 5.7% false positive rate cutoff were evaluated using viral DNA and RNA samples, compared against each other and ESTA, using Cohen's kappa, phylogenetic analysis, and area under the receiver operating characteristic (AUROC). RESULTS: Both clinical and clonal G2P (with different false positive rates) showed good performances in predicting the ESTA outcome (for V3 RNA-based clinical G2P at 10% false positive rate AUROC = 0.83, sensitivity = 90%, specificity = 75%). The rate of agreement between DNA- and RNA-based clinical G2P was fair (kappa = 0.74, p < 0.0001), and DNA-based clinical G2P accurately predicted the plasma ESTA (AUROC = 0.86). Significant differences in the viral populations were detected when comparing inter/intra patient diversity of viral DNA with RNA sequences. CONCLUSIONS: Plasma HIV RNA or whole-blood HIV DNA V3-loop sequencing interpreted with clinical G2P is cheap and can be a good surrogate for ESTA. Although there may be differences among viral RNA and DNA populations in the same host, DNA-based G2P may be used as an indication of viral tropism in patients with undetectable plasma viremia