The use of VTE prophylaxis in relation to patient risk profiling(TUNE-IN) Wave 2 Study

KMBackground: The TUNE-IN (The Use of VTE prophylaxis in relatioN to patiEnt risk profiling) study evaluated venous thromboembolism (VTE) risk assessment and prophylaxis in private medical and surgical inpatients in Gauteng Province, South Africa. The study concluded that of the 608 patients enrolled, 54.1% were clinically evaluated to be at risk for VTE. A VTE risk assessment model (RAM), the Caprini score, increased the rate to 74.6%. Objectives: TUNE-IN Wave 2, an extension of TUNE-IN, was conducted on a national level including the public sector, focusing on surgical inpatients. Methods. The study was a national, prospective, non-interventional, multisite, epidemiological disease registry enrolling 453 surgical inpatients. The perceived clinical VTE risk, VTE risk score on Caprini RAM, VTE prophylaxis and clinical details were documented during a baseline visit. A bleeding risk score was provided. Results: Of the cohort, 269 patients (59.4%) were assessed to be at risk for VTE before applying the RAM. All patients (100%), however, were at risk on the RAM score. Early mobilisation and assessment of the VTE risk as low were the most frequent reasons for non-prescription of prophylaxis. Only 15 patients in the private and 2 in the public sector were assessed as having a bleeding risk. Chemoprophylaxis differed between the healthcare sectors, with low-molecular-weight heparin predominating in the private sector and unfractionated heparin being prescribed only in the public sector. Conclusion: VTE risk assessment and prophylaxis need to improve in both the public and the private sectors. A formal RAM will improve identification of patients at risk of VTE

The clinical and biochemical effects of riboflavin and nicotinamide supplementation upon Bantu school children using maize meal as carrier medium

A comprehensive clinical, biochemical and technological investigation was undertaken to establish the feasibility of ,enriching maize meal with riboflavin and nicotinamide. It was clear from the results that the addition of these vitamins to, maize satisfied all the prerequisites of a -scientifically sound enrichment scheme, as laid down by the NNRI. It was found that the addition of 1 mg of riboflavin and 10 mg of nicotinamide per 400 g maize ,meal was adequate to effectively reduce the incidence of .subclinical deficiency of these two vitamins among Bantu schoolchildren. Since the enrichment was found to be -effective, as well as technologically and economically jeasible, it is strongly recommended that a compulsory national maize enrichment scheme be introduced with the .least possible delay

The megaproject sponsor as leader

CITATION: Louw, W., et al. 2018. The megaproject sponsor as leader. South African Journal of Industrial Engineering, 29(3):173-187, doi:10.7166/29-3-2058.The original publication is available at http://sajie.journals.ac.zaENGLISH ABSTRACT: The importance of the sponsor role, including its contribution to the success or failure of a project, is widely recognised in the project management literature. References to the sponsor’s leadership, and the substantial component it represents in the profile of the sponsor, are equally prevalent in the literature reviewed. A megaproject is a large-scale, complex venture that typically costs US$1 billion or more, takes many years to develop and build, involves multiple public and private stakeholders, is transformational, and influences millions of people. Executive sponsors are primarily allocated to projects of strategic importance that are complex, carry a considerable degree of risk, and are very visible. A megaproject is thus entitled to a sponsor from the executive (most senior) ranks within an organisation. Rather than joining the debates on complexity and leadership in the project management literature, this paper explains how leadership theories are used to identify instruments that can assist in the assessment of the leadership style and traits/attributes of a sponsor. A framework is then proposed to identify assessment instruments to evaluate the leadership style and leader traits/attributes of a project sponsor.AFRIKAANSE OPSOMMING: Die belangrikheid van die rol van die bestuursborg, insluitend die bydrae wat hy/sy maak tot die sukses of faling van ’n projek word wyd erken in die projekbestuur literatuur. Verwysings na die leierskapsrol van die bestuursborg asook die wesenlike komponent wat dit uitmaak van die profiel van die bestuursborg word bykans net soveel aangetref in die literatuur. ’n Megaprojek word gedefinieer as ’n grootskaalse, komplekse onderneming wat tipies 1 miljard Amerikaanse dollar of meer kos, etlike jare neem om te ontwikkel en te bou, veelvuldige publieke en privaat belanghebbendes betrek, transformasioneel van aard is, en miljoene mense beïnvloed. Uitvoerende bestuursborge word hoofsaaklik aangewys vir projekte van strategiese aard wat kompleks is, ’n beduidende hoeveelheid risiko dra, en uitsonderlik sigbaar is. Dit is dus duidelik dat ’n megaprojek geregtig is op ’n bestuursborg vanuit die uitvoerende en mees senior bestuursvlakke van ’n organisasie. Eerder as om aan te sluit by die debatte oor kompleksiteit en leierskap in die projekbestuur literatuur, dui hierdie artikel aan tot welke mate leierskapsteorieë benut kan word om instrumente te identifiseer wat kan meehelp in die evaluering van leierskapstyle asook die leierskap eienskappe/ attribute van ’n bestuursborg. Ter afsluiting word ’n raamwerk voorgestel om assesseringsinstrumente te identifiseer vir die evaluering van leierskapstyle en leier eienskappe/ attribute.http://sajie.journals.ac.za/pub/article/view/2058Publisher's versio

Helicobacter pylori prevalence in non-ulcer dyspepsia ethnic and socio-economic differences

Helicobacter pylori is an important cause of gastritis and a number of therapeutic. trials suggest that it may be important in the genesis of duodenal ulcer recurrence. The reported prevalence of gastric colonisation by the organism varies considerably. The aiIn of this cross-sectional survey was to determine its prevalence in non-ulcer dyspeptics and to determine whether this is influenced by age, race, sex, socio-economic status, educational level and the nwnber of persons sharing accommodation. One hundred and sixty-nine patients underwent endoscopy; biopsy speciInens were taken from the antrwn and H. pylori status was determined histologically. Gastric colonisation was found in 106 patients (63%). The prevalence showed a marked ethnic difference: 40% in whites and 71% in coloureds (P < 0,001). The ethnic groups were characterised by significant differences in socio-economic status (P < 10-6), educational level (P < 10-6), number of persons sharing accommodation (P < 10-6 ) and age (P < 0,001). These same differences were found when comparing the H. pylori-positive and negative groups, but were less marked and could be attributed to the marked differences between ethnic groups. We conclude that H. pylori prevalence differs between the ethnic groups studied. This may be because of varying degrees of exposure risk

The A-ring reduction of 11-ketotestosterone is efficiently catalysed by AKR1D1 and SRD5A2 but not SRD5A1

Testosterone and its 5α-reduced form, 5α-dihydrotestosterone, were previously thought to represent the only active androgens in humans. However, recent studies have shown that the potent androgen, 11-ketotestosterone, derived from the adrenal androgen precursor, 11β-hydroxyandrostenedione, may in fact serve as the primary androgen in healthy women. Yet, despite recent renewed interest in these steroids, their downstream metabolism has remained undetermined. We therefore set out to investigate the metabolism of 11-ketotestosterone by characterising the 5α- or 5β-reduction commitment step. We show that inactivation of 11-ketotestosterone is predominantly driven by AKR1D1, which efficiently catalyses the 5β-reduction of 11-ketotestosterone, committing it to a metabolic pathway that terminates in 11-ketoetiocholanolone. We demonstrate that 5α-reduction of 11-ketotestosterone is catalysed by SRD5A2, but not SRD5A1, and terminates in 11-ketoandrosterone, but is only responsible for a minority of 11-ketotestosterone inactivation. However, as 11-ketoetiocholanolone is also generated by the metabolism of the glucocorticoid cortisone, 11-ketoandrosterone should be considered a more specific urinary marker of 11-ketotestosterone production

Early non-psychotic deviant behaviour as an endophenotypic marker in bipolar disorder, schizo-affective disorder and schizophrenia

Objective: To determine and compare the incidence of early non-psychotic deviant behaviour (i.e. under the age of ten) in Afrikaner patients with bipolar disorder, schizo-affective disorder and schizophrenia. Methods: Patients with bipolar disorder, schizo-affective disorder and schizophrenia were interviewed using a structured questionnaire probing for early deviant childhood behaviour starting before the age of 10 years. Information from close family members was also obtained where possible. Seven areas of possible deviance were probed into: social dysfunction, unprovoked aggression, extreme anxiety, chronic sadness, extreme odd behaviours, attention impairment and learning difficulties. Demographic data included: age, marital status, gender, and years of formal education. The following clinical features were also recorded: age of onset of illness and suicide attempts. Results: A total of 74 patients diagnosed with bipolar disorder, 43 patients diagnosed with schizo-affective disorder and 80 patients diagnosed with schizophrenia were interviewed. Early deviant behaviour was statistically more prevalent in schizophrenia (65%) and schizo-affective disorder (60,5%), than in the bipolar group (21,6%). Deviant childhood behaviour was grouped into 3 clusters: social functioning impairment cluster (social isolation, aggression, extreme odd behavior), mood/anxiety cluster (extreme fears, chronic sadness) and a cognitive impairment cluster (attention impairment, learning disability). Bipolar patients showed significantly less social functioning and cognitive impairment compared to patients with schizo-affective disorder and schizophrenia. Conclusion: Our findings suggest that early deviant behaviour may be a possible endophenotypic marker in schizophrenia and schizoaffective disorder. Keywords: early non-psychotic deviant behaviour, endophenotype, bipolar disorder, schizo-affective disorder, schizophrenia South African Psychiatry Review Vol. 8(4) 2005: 153-15

DrinkWise, enjoy responsibly: News frames, branding and alcohol

This article examines the communicative activities and press coverage of the alcohol industry-funded social-change organisation DrinkWise. Established in 2005, DrinkWise funds health research in universities, runs public health campaigns and engages in public relations activities. We use a framing analysis to examine the way DrinkWise frames problems, judgements and solutions related to alcohol consumption and policy. The aim of this analysis is to examine how journalistic practice legitimises DrinkWise and facilitates the organisation’s communicative activities. In addition, we consider how DrinkWise’s representation in the press works alongside the organisation’s array of communicative activities to facilitate the commercial objectives of the alcohol industry. We draw on the implications of this analysis to conceptualise how distinct forms of communicative work – such as academic research, policy-making, journalism and marketing, advertising and public relations – are interconnected

Knee movement patterns of injured and uninjured adolescent basketball players when landing from a jump: A case-control study

BACKGROUND: A common knee injury mechanism sustained during basketball is landing badly from a jump. Landing is a complex task and requires good coordination, dynamic muscle control and flexibility. For adolescents whose coordination and motor control has not fully matured, landing badly from a jump can present a significant risk for injury. There is currently limited biomechanical information regarding the lower limb kinetics of adolescents when jumping, specifically regarding jump kinematics comparing injured with uninjured adolescents. This study reports on an investigation of biomechanical differences in landing patterns of uninjured and injured adolescent basketball players. METHODS: A matched case-control study design was employed. Twenty-two basketball players aged 14–16 years participated in the study: eleven previously knee-injured and eleven uninjured players matched with cases for age, gender, weight, height and years of play, and playing for the same club. Six high-speed, three-dimensional Vicon 370 cameras (120 Hz), Vicon biomechanical software and SAS Version 8 software were employed to analyse landing patterns when subjects performed a "jump shot". Linear correlations determined functional relationships between the biomechanical performance of lower limb joints, and paired t-tests determined differences between the normalised peak biomechanical parameters. RESULTS: The average peak vertical ground reaction forces between the cases and controls were similar. The average peak ground reaction forces between the cases and controls were moderately correlated (r = -0.47). The control (uninjured) players had significantly greater hip and knee flexion angles and significantly greater eccentric activity on landing than the uninjured cases (p < 0.01). CONCLUSION: The findings of the study indicate that players with a history of knee injuries had biomechanically compromised landing techniques when compared with uninjured players matched for gender, age and club. Descriptions (norms) of expected levels of knee control, proprioceptive acuity and eccentric strength relative to landing from a jump, at different ages and physical developmental stages, would assist clinicians and coaches to identify players with inappropriate knee performance comparable to their age or developmental stage