Osteosarcoma presentation stages at a tumour unit in South Africa

Background. Osteosarcoma is the most common malignant bonetumour found in children and adolescents. Changed treatment protocols have resulted in improved survival and the opportunity for limb salvage surgery. Despite these advances, the outcome is mainly determined by the stage of disease at presentation, making early referral to a tumour unit essential.Methods. Between July 2009 and October 2011, 25 consecutive patients were diagnosed with biopsy-confirmed osteosarcoma. Their records were reviewed and information extracted regarding clinical presentation, histological subtype and stage of disease.Results. Twenty-four patients met the inclusion and exclusion criteria. Conventional osteosarcoma was the most common histological diagnosis encountered; 16 out of 24 (66.7%) patients had metastases at presentation; 6 of the remaining had advanced local disease with very large tumours or pathological fractures that precluded limb salvage surgery.Conclusion. The great majority of patients referred to our tumour unit present with locally advanced or metastatic disease, which limits treatment options and adversely affects survival. Increased awareness, a high index of suspicion and appropriate early referral is crucial to enable limb salvage surgery and increase disease-free survival rates

Small and micro enterprises – aspects of knowledge, attitudes and practices of managers\' and food handlers\' knowledge of food safety in the proximity of Tygerberg Academic Hospital, Western Cape

Objective. This study determined hazard analysis and critical control point (HACCP) awareness among managers of food-producing small and micro enterprises (SMEs) as well as selected aspects of the knowledge, attitude and practices of respective food handlers regarding food safety. Setting. SMEs within a 30 km range of Tygerberg Academic Hospital. Methods. SMEs were divided into two categories: those providing food to clients at risk of illness (N = 64) and to clients free of illness (N = 81). SMEs were randomly selected and managers/employees completed validated questionnaires regarding HACCP (145 managers) and food safety (159 food handlers). Results. Only 6% of managers reported awareness of HACCP being mandatory in South Africa. More than 70% of managers and food handlers had received no formal training regarding food safety. The perception that food safety control should focus on general cleanliness still prevailed among 57.2% of managers. Food handlers achieved an unsatisfactory score (46.0%) on the basic principles of food safety. Ignorance among food handlers regarding important risk factors was as follows: ways of identifying contaminated food likely to cause food poisoning (77.5%), period of keeping prepared food safe (50.9%), correct way of cooling food (63.1%) or reheating food (84.9%), reason for checking date codes (68.1%) and use of a thermometer (90.6%). There was no significant difference in the results obtained between food handlers in SMEs providing food to healthy clients or clients at risk of illness. Conclusion. Creating awareness and understanding of HACCP among managers of SMEs and education regarding the control of risk factors remain crucial.South African Journal Clinical Nutrition Vol. 20 (2) 2007: pp. 50-6

Development and testing of recipes suitable for patients with chronic renal failure

Objectives: The main objectives of the study were to develop and test recipes that meet the nutritional requirements of and are acceptable to patients with chronic renal failure. The secondary objectives were to  determine gender and racial differences in the participants’ responsesduring consumer sensory testing. Design: This was a descriptive study with an analytical component. Materials and methods: Patients on haemodialysis (n = 42) and continuous ambulatory peritoneal dialysis (n = 3) from Tygerberg Academic Hospital were included. Data were collected in three phases with census sampling: 1) the development and adaptation of recipes; 2) sensory testing with the nine-point hedonic scale; and 3) the rating of recipes, final nutritional analysis and the allocation of renal exchanges. Results: Recipes were developed and adapted to suit the needs of the target population. Forty-five patients took part in the sensory evaluation (acceptance, appearance, smell, texture and taste) of 30 recipes. Twenty-three recipes were deemed acceptable (> 80% of the participants scored ≥ 6 out of 9). Significant differences were found between the male and female subgroups for Fish and Vegetable Pie (p = 0.031), Chicken Pilaf (p = 0.008) and Date Fingers (p = 0.002) and between the black and Westernised subgroups for Rice Salad (p = 0.006), Wheat and Mushroom Casserole (p = 0.022), Curried Wheat Salad (p = 0.043) and Coconut Ice (p = 0.005). The 23 recipes were nutritionally analysed and renal exchanges were allocated. Conclusion: The 23 recipes that were acceptable to the study participants are recommended for inclusion in the RenalSmart software program. The recipes are suitable for patients following a Westernised diet.Keywords: sensory evaluation, chronic renal failure, 9-point Hedonic scal

The REPAIRER Reporting System for Integrating Human Factors into SMS in Aviation Maintenance

Acknowledging the FAA’s well-known PEAR model, and the influence of the dirty dozen in aviation maintenance, the authors examine a tracking and reporting system that fulfills FAA requirements for safety management systems in aviation maintenance organizations. Implications and suggestions for a robust safety management system which encompasses human factors and ORM, applicable to an aviation maintenance environment are presented, with the inclusion of specific risk hazards. The resulting safety reporting system proposed addresses both consistency and reliability challenges, unique to the aviation maintenance environment. Using the four pillars of safety as a foundation, the REPAIRER strategy procedures serves as the safety policy pillar, through the examination and rating of potential risk hazards, based on the dirty dozen. The resulting reporting system leverages aviation maintenancespecific factors to identify and correct for human errors, improving the reliability of maintenance procedures, enhancing safety practices, and ultimately creating a greater state of operational readiness

Sodium reduction regulations in South Africa – the consumer perspective

The prevalence of adult hypertension has increased at an alarming rate in recent years in South Africa. Salt reduction legislation is considered a cost-effective way to reduce this burden, as salt is a driver of hypertension. This cross-sectional, descriptive study aimed to determine consumers’ awareness of, and perceptions towards, the salt legislation, and their salt consumption habits. An interviewer-administered survey was used to gather data from literate adult consumers (N=583) at four randomly selected shopping malls in the Tygerberg Health sub-district, City of Cape Town. More than half (56.9%) of all participants tried to consume less salt because they thought it was healthier (38.3%) yet processed foods were a major source of salt in their diets (50.4%). Only 16.5% of participants were aware of the national salt legislation. Almost half of participants (47.9%) thought the legislation would affect the taste of food negatively, yet 80.9% have not noticed a change after implementation of the first phase of the legislation. To conclude, regulating manufacturers of food products could facilitate a reduction in population salt intake. An integrative strategy and collaboration between all stakeholders with regards to legislation, labelling and health education is needed in order to achieve health targets for population salt reduction

Energy cost associated with moving platforms.

Background: Previous research suggests motion induced fatigue contributes to significant performance degradation and is likely related to a higher incidence of accidents and injuries. However, the exact effect of continuous multidirectional platform perturbations on energy cost (EC) with experienced personnel on boats and other seafaring vessels remains unknown. Objective: The objective of this experiment was to measure the metabolic ECs associated with maintaining postural stability in a motion-rich environment. Methods: Twenty volunteer participants, who were free of any musculoskeletal or balance disorders, performed three tasks while immersed in a moving environment that varied motion profiles similar to those experienced by workers on a mid-size commercial fishing vessel (static platform (baseline), low and high motions (HMs)). Cardiorespiratory parameters were collected using an indirect calorimetric system that continuously measured breath-by-breath samples. Heart rate was recoded using a wireless heart monitor. Results: Results indicate a systematic increase in metabolic costs associated with increased platform motions. The increases were most pronounced during the standing and lifting activities and were 50% greater during the HM condition when compared to no motion. Increased heart rates were also observed. Discussion: Platform motions have a significant impact on metabolic costs that are both task and magnitude of motion dependent. Practitioners must take into consideration the influence of motion-rich environments upon the systematic accumulation of operator fatigue

Tuberculosis among older adults in Zambia: Burden and characteristics among a neglected group

BACKGROUND: The 2010 Global Burden of Disease estimates show that 57% of all TB deaths globally occurred among adults older than 50 years of age. Few studies document the TB burden among older adults in Southern Africa. We focused on adults older than 55 years to assess the relative TB burden and associated demographic factors. METHODS: A cross sectional nationally representative TB prevalence survey conducted of Zambian residents aged 15 years and above from 66 clusters across all the 10 provinces of Zambia. Evaluation included testing for TB as well as an in-depth questionnaire. We compared survey data for those aged 55 and older to those aged 15-54 years. Survey results were also compared with 2013 routinely collected programmatic notification data to generate future hypotheses regarding active and passive case finding. RESULTS: Among older adults with TB, 30/ 54 (55.6%) were male, 3/27 (11.1%) were HIV infected and 35/54 (64.8%) lived in rural areas. TB prevalence was higher in those aged ≥55 (0.7%) than in the 15-54 age group (0.5%). Males had higher rates of TB across both age groups with 0.7% (15-54) and 1.0% (≥55) compared with females 0.4% (15-54) and 0.6% (≥55). In rural areas, the prevalence of TB was significantly higher among older than younger adults (0.7% vs 0.3%), while the HIV infection rate was among TB patients was lower (11.1% vs 30.8%). The prevalence survey detected TB in 54/7484 (0.7%) of older adults compared to 3619/723,000 (0.5% ) reported in 2013 programmatic data. CONCLUSION: High TB rates among older adults in TB endemic areas justify consideration of active TB case finding and prevention strategies

Evidence for high sugar content of baby foods in South Africa

Background. Early-life exposure to excess sugar affects eating behaviour and creates a predisposition to non-communicable diseases (NCDs). While reducing sugar consumption has been high on the public health agenda, little is known about the sugar content of baby foods.Objectives. To describe and analyse the sugar content of baby foods in South Africa (SA).Methods. A cross-sectional study was conducted to analyse the sugar content of baby foods. The study sample included commercially available baby foods targeted at children aged <12 months, sold in supermarkets and by other major retailers in SA. Primary data were obtained from the packaging, and sugar content was compared with recommended intake guidelines. Bivariate analyses were conducted to determine whether there were any associations between the sugar content, added sugar and the characteristics of foods.Results. Over 70% of products were sweet in taste, with one in four containing added sugars. Sugar content was high in 78% of the foods sampled. Over 80% of cereals and pureed desserts contained added sugar. Fewer than 10% of pureed composite meal and pureed fruit and vege­table categories contained added sugar. Most products adhered to SA labelling standards, but none had front-of-pack nutritional information.Conclusions. The SA baby food market is characterised by products with a high sugar content, promoting an environment that encourages development of sweet-taste preferences and in the long term contributing to the rising burden of NCDs. There is an urgent need for mandatory regulation of sugar in baby foods.Â