NICPRINT-50, Being some account of the history of the printing, packaging and newspaper industry of South Africa, and of the National Industrial Council for Printing, prepared to mark the Jubilee of the Council 1919-1969

The National Industrial Council of the Printing and Newspaper Industry of South Africa celebrates its Golden Jubilee in 1969 and this thesis was undertaken primarily to examine and record the Socio-economic effects of its work. To set the achievements of the Council in perspective it was proposed to preface the record with a brief sketch of the industry itself, but what was intended as an introduction has grown into a major part of the finished work which therefore contains more history and less economics than originally planned. It is hoped that the work will be no less acceptable for this change of emphasis

Down-regulation of human osteoblast PTH/PTHrP receptor mRNA in end-stage renal failure

Down-regulation of human osteoblast PTH/PTHrP receptor mRNA in end-stage renal failure.BackgroundResistance to the action of parathyroid hormone (PTH) has been demonstrated in end-stage renal failure and is considered to be important in the pathogenesis of secondary hyperparathyroidism. The mechanism of resistance is unknown. However, altered regulation of cellular PTH/PTH-related protein (PTH/PTHrP) receptor (PTH1R) has been assumed to be important.MethodsWe have used in situ hybridization to examine PTH1R mRNA expression by osteoblasts in human bone and have compared the expression in high- and low-turnover renal bone disease, high-turnover nonrenal bone disease (healing fracture callus and Pagetic bone), and normal bone. Bone biopsies were formalin fixed, ethylenediaminetetraacetic acid decalcified, and paraffin wax embedded. A 1.8kb PTH1R cDNA probe, labeled with 35S, was used, and the hybridization signal was revealed by autoradiography. The density of signal over osteoblasts was quantitated using a semiautomated Leica™ image analysis software package.ResultsThe mean density of PTH1R mRNA signal over osteoblasts in renal high-turnover bone was only 36% of that found in nonrenal high-turnover bone (P < 0.05) and 51% of that found in normal bone (P < 0.05). Osteoblast PTH1R mRNA signal in adynamic bone from individuals with diabetes mellitus was 28% of normal bone (P < 0.05) and 54% of that found in renal high-turnover bone (P < 0.05).ConclusionsThese results demonstrate a down-regulation of osteoblast PTH1R mRNA in end-stage renal failure in comparison to normal and high-turnover bone from otherwise healthy individuals, and provide an insight into the mechanisms of “skeletal resistance” to the actions of PTH

After-exercise heart rate variability is attenuated in postmenopausal women and unaffected by estrogen therapy

Delayed heart rate (HR) recovery in the immediate postexercise period has been linked to adverse cardiovascular prognosis. The after effects of an acute bout of exercise on HR modulation in postmenopausal women (PMW) and the influence of estrogen therapy are unknown.In 13 sedentary PMW (54 ± 2 y, mean ± SEM), we assessed HR variability (HRV) -an index of HR modulation-and the influence of estrogen therapy on HRV. HRV in the frequency domain was quantified during supine rest and again 60 minutes after treadmill exercise for 45 minutes, at 60% VO2peak. PMW were studied before and after 4 weeks of oral estradiol. To obtain reference values for the after effects of exercise on HRV in healthy young women, 14 premenopausal women (PreM) completed the identical exercise protocol.Compared with PreM, PMW demonstrated lower high frequency (vagal modulation) and total HRV (P < 0.05) at rest. In PreM, all HRV values were similar before and after exercise. In contrast, in PMW after exercise, despite having identical HR to PreM, high frequency and total HRV were all lower (all P ≤ 0.01) compared with pre-exercise HRV values. Estrogen therapy had no effect on pre or postexercise values for HRV.When compared with PreM, PMW have identical HR, but lower vagal HR modulation at rest and delayed HRV recovery after exercise. Estrogen does not restore baseline HRV or accelerate HRV recovery postexercise, suggesting aging rather than estrogen deficiency per se may lower HRV in PMW

Learner success and digital technologies

This entry examines the role digital technologies play in learner success, both as a factor that impacts on learner success and in the context of digital technology’s role in institutional initiatives and supports designed to enhance learner success. The common goal of learners and educational institutions is that a learner will achieve their educational goals within that institution. When a learner withdraws from the institution this represents a loss of opportunity for that individual to achieve those goals, a loss to the institution in terms of mission and income, as well as a loss to society with regard to the benefits that accrue from an educated populace. Where students do not exit the institution, but progress through a programme without achieving the success of which they are capable, this also represents a loss of potential for the individual, the institution, and society. Learner success is impacted by both learner characteristics and institutional structures and processes. Institutions can enhance learner success through strategic initiatives and the targeted deployment of effective learner supports (Thomas, Hill, O’Mahony, & Yorke, 2017). In most cases such initiatives and supports are mediated through digital technologies, as their use now permeates most forms of teaching and learning activity

An ArcGIS Tool for Modeling the Climate Envelope with Feed-Forward ANN

This paper is about the development and the application of an ESRI ArcGIS tool which implements multi-layer, feed-forward artificial neural network (ANN) to study the climate envelope of species. The supervised learning is achieved by backpropagation algorithm. Based on the distribution and the grids of the climate (and edaphic data) of the reference and future periods the tool predicts the future potential distribution of the studied species. The trained network can be saved and loaded. A modeling result based on the distribution of European larch (Larix decidua Mill.) is presented as a case study

Development and validation of the medication regimen simplification guide for residential aged CarE (MRS GRACE)

Background: Residents of aged care facilities use increasingly complex medication regimens. Reducing unnecessary medication regimen complexity (eg, by consolidating the number of administration times or using alternative formulations) may benefit residents and staff. Objective: To develop and validate an implicit tool to facilitate medication regimen simplification in aged care facilities. Method: A purposively selected multidisciplinary expert panel used modified nominal group technique to identify and prioritize factors important in determining whether a medication regimen can be simplified. The five prioritized factors were formulated as questions, pilot-tested using non-identifiable medication charts and refined by panel members. The final tool was validated by two clinical pharmacists who independently applied the tool to a random sample of 50 residents of aged care facilities to identify opportunities for medication regimen simplification. Inter-rater agreement was calculated using Cohen’s kappa. Results: The Medication Regimen Simplification Guide for Residential Aged CarE (MRS GRACE) was developed as an implicit tool comprising of five questions about 1) the resident; 2) regulatory and safety requirements; 3) drug interactions; 4) formulation; and 5) facility and follow-up considerations. Using MRS GRACE, two pharmacists independently simplified medication regimens for 29/50 and 30/50 residents (Cohen’s kappa=0.38, 95% CI 0.12–0.64), respectively. Simplification was possible for all residents with five or more administration times. Changing an administration time comprised 75% of the two pharmacists’ recommendations. Conclusions: Using MRS GRACE, two clinical pharmacists independently simplified over half of residents’ medication regimens with fair agreement. MRS GRACE is a promising new tool to guide medication regimen simplification in aged care.Esa YH Chen, Janet K Sluggett, Jenni Ilomäki, Sarah N Hilmer, Megan Corlis, Leonie J Picton, Laura Dean, Christopher P Alderman, Nicholas Farinola, Joy Gailer, Jane Grigson, Andrew R Kellie, Peter JC Putsey, Solomon Yu, J Simon Bel

Implementation of child-centred outcome measures in routine paediatric healthcare practice: a systematic review

BACKGROUND: Person-centred outcome measures (PCOMs) are commonly used in routine adult healthcare to measure and improve outcomes, but less attention has been paid to PCOMs in children’s services. The aim of this systematic review is to identify and synthesise existing evidence of the determinants, strategies, and mechanisms that influence the implementation of PCOMs into paediatric healthcare practice. METHODS: The review was conducted and reported in accordance with PRISMA guidelines. Databased searched included CINAHL, Embase, Medline, and PsycInfo. Google scholar was also searched for grey literature on 25th March 2022. Studies were included if the setting was a children’s healthcare service, investigating the implementation or use of an outcome measure or screening tool in healthcare practice, and reported outcomes relating to use of a measure. Data were tabulated and thematically analysed through deductive coding to the constructs of the adapted-Consolidated Framework for Implementation Research (CFIR). Results were presented as a narrative synthesis, and a logic model developed. RESULTS: We retained 69 studies, conducted across primary (n = 14), secondary (n = 13), tertiary (n = 37), and community (n = 8) healthcare settings, including both child self-report (n = 46) and parent-proxy (n = 47) measures. The most frequently reported barriers to measure implementation included staff lack of knowledge about how the measure may improve care and outcomes; the complexity of using and implementing the measure; and a lack of resources to support implementation and its continued use including funding and staff. The most frequently reported facilitators of implementation and continued use include educating and training staff and families on: how to implement and use the measure; the advantages of using PCOMs over current practice; and the benefit their use has on patient care and outcomes. The resulting logic model presents the mechanisms through which strategies can reduce the barriers to implementation and support the use of PCOMs in practice. CONCLUSIONS: These findings can be used to support the development of context-specific implementation plans through a combination of existing strategies. This will enable the implementation of PCOMs into routine paediatric healthcare practice to empower settings to better identify and improve child-centred outcomes. TRIAL REGISTRATION: Prospero CRD 42022330013

'It was as if the dots hadn't been joined up': bereaved families experiences of end of life care on an acute stroke ward: a qualitative investigation

Background and Aims: Despite significant improvements in survival, severe stroke remains a major cause of mortality. Acute stroke settings have a key role at the end of people’s lives following a severe stroke. Ensuring appropriate, timely, high quality, person-centred, safe and effective end-of-life care in these settings is a professional priority. This study aimed to illuminate bereaved family members’ experiences of end-of-life care in an acute stroke setting following implementation of an end-of-life care training intervention. Methods: A qualitative exploratory study using in-depth, semi-structured, face to face, digitally recorded interviews was conducted. Nine bereaved (> three months) family members, all women, participated. Interviews were fully transcribed and analysed using thematic analysis. Results: The analysis identified three major themes: the variable nature and quality of interaction with healthcare staff; doing care at the end of life and toward the realisation of a certain manner of good death. Findings illuminated some positive end-of-life care practices following a severe stroke in terms of recognising dying and family members’ support, care and engagement in decision-making. However, a pressing need for improved, timely, proactive and regular interaction with family members of people dying imminently in the acute stroke care setting was identified. Conclusions: End-of-life stroke care in the busy, noisy, fast paced acute hospital environments is not without challenge for many reasons. Furthermore, interacting with the family members of imminently dying people is delicate, difficult territory. Yet these are places where people die and the manner of a person’s dying casts an indelible mark on those who live on