Perceptions, expectations, apprehensions and realities of graduating South African optometry students (PEAR study, 2006)

The objective of this study was to establish the perceptions, expectations, apprehensions and realities of South Africa optometry students completing their undergraduate studies in 2006. Copies of a questionnaire containing relevant information were distributed to all graduating students at the four Universities offering Optometry. The responses were coded and analyzed. The respondents (N=143), representing 77% of the graduating students included 27.3% males and 72.7% females, aged 20 to 37 years (mean = 23.34 ± 2.75). About a third (32.9%) of the respondents considered opening their own practice as the best way of entering into practice. Also, this mode of practice was considered as providing the greatest fulfilment for their personal (60.8%) and professional (53.8%) goals as well as offering long  term financial security (43.7%). Many (56.6%) have secured employment before graduation. Upon graduation, 43.4% would like to join a franchise.  Many (79.7%) felt that Government was not offering sufficient opportunities for optometrists. The majority, (70.6%) felt that the South African optometry profession is fastly becoming saturated and this was of great concern to many (31.5%). About half, (50.3%) have plans to go overseas to practice and the most common destinations were the UK (36.1%) and Australia (15%).  The mean minimum monthly salary expected as new graduates was between R9 500 and R11 500 in the public and private sectors respectively. On a response scale, the future of optometry in South Africa was scored as 6.59 ± 1.92. Findings in this study may be useful to all stake holders in optometric education in South Africa, as they may reflect the future of the optometry profession in the country

Perceived needs and satisfaction with care in people with multiple sclerosis: A two-year prospective study

<p>Abstract</p> <p>Background</p> <p>Considering the costs of multiple sclerosis (MS), it is crucial that the health-related services supplied are in accordance with needs as they are perceived by people with MS (PwMS). Satisfaction with care is related to quality of care and can provide health care providers with the means for improvement. The aim was to explore the perceived needs and satisfaction with care amongst PwMS over a two-year period, also taking sex and disease severity into consideration.</p> <p>Methods</p> <p>The sample consisted of 219 outpatients at a MS specialist clinic. Data on perceived needs and satisfaction with care were collected every six months using a questionnaire which included various dimensions of care. The data was analysed for the whole sample and on an individual level, as well as in subgroups with regard to sex and disease severity.</p> <p>Results</p> <p>There were no statistically significant variations in the proportion of PwMS with perceived needs concerning different health-related services during the study period. However, individual variations were found with regard to both perceived needs and satisfaction with care. Few PwMS perceived a continuous need for a specific service. However, the majority perceived a need for rehabilitation, assistive devices, transportation service for the disabled, psychosocial support/counselling and information on social insurance/vocational rehabilitation at least sometimes. Severe MS was associated with a greater perceived need for almost all the services studied and women experienced a need for psychosocial support/counselling to a greater extent than men. In relation to the different categories of health care staff, PwMS were most satisfied with nurses with regard to all dimensions of care. They were least satisfied with the availability of psychosocial support/counselling; and information about social insurance/vocational rehabilitation.</p> <p>Conclusion</p> <p>Despite the large proportion of individuals with mild disease severity in our sample, a considerable number of needs were identified of which many, on an individual level, varied over time. Key services demanded by PwMS were identified. Also the level of satisfaction with care varied and areas with a potential for improvement were identified such as the availability of rehabilitation services including an increase in the supply of psychosocial support and counselling.</p

The E-cadherin repressor slug and progression of human extrahepatic hilar cholangiocarcinoma

<p>Abstract</p> <p>Objectives</p> <p>This study explored the expression and function of Slug in human extrahepatic hilar cholangiocarcinoma (EHC) to identify its role in tumor progression.</p> <p>Methods</p> <p>The expression of Snail and Slug mRNA in 52 human tissue samples of EHC was investigated. The mRNA of Snail and Slug were quantified using reverse transcriptase-PCR, and correlations with E-cadherin expression and clinicopathological factors were investigated. We then investigated transfection of Slug cDNA in endogenous E-cadherin-positive human EHC FRH0201 cells, selectively induced the loss of E-cadherin protein expression, and then small interfering RNA (siRNA) for inhibition of Slug expression in endogenous Slug-positive human EHC QBC939 cells, selectively induced the loss of Slug protein expression. A Boyden chamber transwell assay was used for invasion.</p> <p>Results</p> <p>Slug mRNA was overexpressed in 18 cases (34.6%) of EHC compared with adjacent noncancerous tissue. E-Cadherin protein expression determined in the same 52 cases by immunohistochemistry was significantly down-regulated in those cases with Slug mRNA overexpression (P = 0.0001). The tumor and nontumor ratio of Slug mRNA was correlated with nodal metastasis(p = 0.0102), distant metastasis (p = 0.0001)and Survival time(p = 0.0443). However, Snail mRNA correlated with neither E-cadherin expression nor tumor invasiveness. By inhibiting Slug expression by RNA interference, we found that reduced Slug levels upregulated E-cadherin and decreased invasion in QBC939 cell. When the QBC939 cells was infected with Slug cDNA,, significant E-cadherin was downregulated and increased invasion in QBC939 cell.</p> <p>Conclusions</p> <p>The results suggested that Slug expression plays an important role in both the regulation of E-cadherin expression and in the acquisition of invasive potential in human EHC. Slug is possibly a potential target for an antitumor therapy blocking the functions of invasion and metastasis in human EHCs.</p

The asthma epidemic and our artificial habitats

BACKGROUND: The recent increase in childhood asthma has been a puzzling one. Recent views focus on the role of infection in the education of the immune system of young children. However, this so called hygiene hypothesis fails to answer some important questions about the current trends in asthma or to account for environmental influences that bear little relation to infection. DISCUSSION: The multi-factorial nature of asthma, reflecting the different ways we tend to interact with our environment, mandates that we look at the asthma epidemic from a broader perspective. Seemingly modern affluent lifestyles are placing us increasingly in static, artificial, microenvironments very different from the conditions prevailed for most part of our evolution and shaped our organisms. Changes that occurred during the second half of the 20th century in industrialized nations with the spread of central heating/conditioning, building insulation, hygiene, TV/PC/games, manufactured food, indoor entertainment, cars, medical care, and sedentary lifestyles all seem to be depriving our children from the essential inputs needed to develop normal airway function (resistance). Asthma according to this view is a manifestation of our respiratory maladaptation to modern lifestyles, or in other words to our increasingly artificial habitats. The basis of the artificial habitat notion may lie in reduced exposure of innate immunity to a variety of environmental stimuli, infectious and non-infectious, leading to reduced formulation of regulatory cells/cytokines as well as inscribed regulatory pathways. This could contribute to a faulty checking mechanism of non-functional Th2 (and likely Th1) responses, resulting in asthma and other immuno-dysregulation disorders. SUMMARY: In this piece I discuss the artificial habitat concept, its correspondence with epidemiological data of asthma and allergy, and provide possible immunological underpinning for it from an evolutionary perspective of health and disease

Prevalecia de infección chagásica en universitarios de Santa Cruz de la Sierra Bolivia

In order to learn the prevalence of Chagas' infection among students from Santa Cruz de la Sierra's universities, a random sample of 372 new students was drawn. All participants have had electrocardiograms (EKG) and serologic analysis (IHAT). 64/372 (17.2%) had serologic evidence of Chagas' infection, and from those, 10/64 (15.6%) had some EKG alterations. Among students presenting negative serologic test, 31/308 (10.1%) had EKG alterations. There was no statistical association between Chagas' infection and EKG alterations (X2=1.67, p=0.2). There was a positive association between Chagas' infection and intraventricular conduction defects and this association was higher among the students of 19 years of age or less (O.R. 10.4, pDesde una población de 4600 nuevos estudiantes de la Universidad Estatal de la ciudad de Santa Cruz de la Sierra, se tomó una muestra aleatoria de 372 estudiantes a los que se les realizó un test de hemaglutinación indirecta (HAI) para enfermedad de Chagas y un electrocardiograma (ECG) convencional. El 17.2% (64/373) tenían el test HAI positivo y de estos el 16.5% (10/64) tenían algún trastorno electrocardiográfico. En el grupo con HAI negativa el 10% (31/308) presentó alguna anormalidad electrocardiográfica. No se observó asociación entre serología positiva para la enfermedad de Chagas y alteración del ECG en general (X2=1.67 p=0.2). Se observó una asociación positiva entre serología para Chagas y trastornos de conducción intraventricular (TCIV) y ésta parece intensificarse entre los menores de 19 años con un odds ratio de 10.4 (

Chagas' infection in university students of Santa Cruz de la Sierra, Bolivia. A serologic-electrocardiographic study Prevalecia de infección chagásica en universitarios de Santa Cruz de la Sierra Bolivia

In order to learn the prevalence of Chagas' infection among students from Santa Cruz de la Sierra's universities, a random sample of 372 new students was drawn. All participants have had electrocardiograms (EKG) and serologic analysis (IHAT). 64/372 (17.2%) had serologic evidence of Chagas' infection, and from those, 10/64 (15.6%) had some EKG alterations. Among students presenting negative serologic test, 31/308 (10.1%) had EKG alterations. There was no statistical association between Chagas' infection and EKG alterations (X2=1.67, p=0.2). There was a positive association between Chagas' infection and intraventricular conduction defects and this association was higher among the students of 19 years of age or less (O.R. 10.4, pDesde una población de 4600 nuevos estudiantes de la Universidad Estatal de la ciudad de Santa Cruz de la Sierra, se tomó una muestra aleatoria de 372 estudiantes a los que se les realizó un test de hemaglutinación indirecta (HAI) para enfermedad de Chagas y un electrocardiograma (ECG) convencional. El 17.2% (64/373) tenían el test HAI positivo y de estos el 16.5% (10/64) tenían algún trastorno electrocardiográfico. En el grupo con HAI negativa el 10% (31/308) presentó alguna anormalidad electrocardiográfica. No se observó asociación entre serología positiva para la enfermedad de Chagas y alteración del ECG en general (X2=1.67 p=0.2). Se observó una asociación positiva entre serología para Chagas y trastornos de conducción intraventricular (TCIV) y ésta parece intensificarse entre los menores de 19 años con un odds ratio de 10.4 (p<0.05)

Genotoxic effect of alkaloids

Because of the increase use of alkaloids in general medical practice in recent years, it is of interest to determine genotoxic, mutagenic and recombinogenic response to different groups of alkaloids in prokaryotic and eucaryotic organisms. Reserpine, boldine and chelerythrine did not show genotoxicity response in the SOS-Chromotest whereas skimmianine showed genotixicity in the presence of a metabolic activation mixture. Voacristine isolated fromthe leaves of Ervatamia coronaria shows in vivo cytostatic and mutagenic effects in Saccharomyces cerevisiae hapioids cells. The Rauwolfia alkaloid (reserpine) was not able to induce reverse mutation and recombinational mitotic events (crossing-over and gene conversion) in yeast diploid strain XS2316