Vitamin D status of older South Africans

Objective: To detennine the vitamin D status of older 'coloured' South Africans who had not sustained a fracture. Design: Cross-sectional analytic study. Methods: A random sample of 200 non-institutionalised subjects in Cape Town aged ≥65 years was drawn using a two-stage cluster design. Trained fieldworkers interviewed subjects to obtain demographic, dietary and lifestyle data, to draw fasting blood samples for the analysis of serum 25-hydroxyvilamin D (25(OH)D) and other biochemical parameters. and to take anthropometric measurements. Results: Seventeen per cent of the subjects (95% Cl: 11.4 - 22.6%) had serum 25(OH)D levels in the deficient range for the elderly < 10 nglml); 7.5% (95% Cl: 3.611.4%) had concentrations in the moderately severe range of deficiency < 8 nglml). Sixty-three per cenl of the subjects had raised serum alkaline phosphatase concentrations. Regression modelling showed neither a sex difference in 25(OH)D levels nor a sex-age interaction; however, a negative association with age was found (r = -0.18; P < 0.05). Mean oral vitamin D intake was low (3.6 (SO = 2.7) µg and 2.8 (SO = 1.7) µg for men and women, respectively), but no association between dietary vitamin D intake and serum 25(OH)D was found. Conclusions: The prevalence of suboptimal vitamin D status was high. However, the interpretation of the data, with regard to bone health, is limited by the crosssectional design of the study. Further investigation is required to detennine the potential benefits of intervention in this age group.S Afr Med J 1996; 86: 1406-141

Effect of enrichment of maize meal with nicotinic acid and riboflavin upon the Vitamin and protein nutritional status of young school-going and pre-school children

A series of experiments was undertaken to investigate the feasibility of enriching maize meal with nicotinic acid and riboflavin. First the necessary level of enrichment was established and then the efficacy of such enrichment of maize was tested in the field on children and young adults. This report deals with the results of an experiment designed to establish whether such an enrichment scheme would have any detrimental effects on· young growing children with marginal protein calorie malnutrition. As in the previous experiments, a marked improvement in the nicotinic acid and riboflavin status was found in the experimental group. These biochemical findings were in conformity with the improvement in clinical status found. Moreover, such enrichment did not have any noticeable adverse effects. The hypothesis that vitamin enrichment could cause growth stimulation, and thus aggravate an existing marginal protein deficiency state, could not in any way be substantiated. The enrichment of maize meal with riboflavin and nicotinic acid during milling has been shown conclusively to be highly effective in improving the vitamin nutritional status while at the same time not harming the protein nutritional status of young children. Since the previous experiments proved it to be economically and technologically feasible, it is now strongly recommended that such an enrichment scheme be introduced on a national basis with the least possible delay.S. Afr. Med. J., 48, 1641 (1974)

An Anatomy Massive Open Online Course as a Continuing Professional Development Tool for Healthcare Professionals

Massive open online courses (MOOCs) remain a novel and under-evaluated learning tool within anatomical and medical education. This study aimed to provide valuable information by using an anatomy MOOC to investigate the demographic profile, patterns of engagement and self-perceived benefits to healthcare professionals. A 21-item survey aimed at healthcare professionals was embedded into the Exploring Anatomy: The Human Abdomen MOOC, in April 2016. The course attracted 2711 individual learners with 94 of these completing the survey, and 79 of those confirming they worked full- or part-time as healthcare professionals. Variations in use across healthcare profession (allied healthcare professional, nurse or doctor) were explored using a Fisher’s exact test to calculate significance across demographic, motivation and engagement items; one-way ANOVA was used to compare self-perceived benefits. Survey data revealed that 53.2% were allied healthcare professionals, 35.4% nurses and 11.4% doctors. Across all professions, the main motivation for enrolling was to learn new things in relation to their clinical practice, with a majority following the prescribed course pathway and utilising core, and clinically relevant, material. The main benefits were in relation to improving anatomy knowledge, which enabled better support for patients. This exploratory study assessing engagement and self-perceived benefits of an anatomy MOOC has shown a high level of ordered involvement, with some indicators suggesting possible benefits to patients by enhancing the subject knowledge of those enrolled. It is suggested that this type of learning tool should be further explored as an approach to continuing professional, and interprofessional, education