55 research outputs found

    A critical examination of the contextual relevance of industrial psychology training at a University in the Western Cape

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    Magister Commercii (Industrial Psychology) - MCom(IPS)The dominant influence of Western and European psychology on the African educational system brought about a specific point of view for the teaching curriculum (Heleta, 2016), which also spilled over into the workplace and job training practices. The present study gave a brief review of the history and development of the Industrial Psychology curriculum in South African higher education institutions. It also highlighted the dominant influence of Western and European psychology on the African educational system that brought about a non-African (i.e. Western scientific model) psychological discipline in the teaching curriculum. The study sought to examine the contextual relevance of Industrial Psychology training at a University in the Western Cape. Furthermore, the study investigated how the concepts and frameworks of Euro-Western Industrial Psychology affect graduates entering into a multi-cultural work context. The need was found for a teaching and learning curriculum that prepares students with multi-cultural knowledge, thus enabling graduates to embrace a diverse work environment. The researcher followed a qualitative research design with semi-structured interviews to collect data. The method of thematic analyses was used and the themes identified manually from the transcribed interviews. The researcher followed a qualitative research design with semi-structured interviews to collect data. The method of thematic analyses was used and the themes identified manually from the transcribed interviews. The researcher followed a qualitative research design with semi-structured interviews to collect data. The method of thematic analyses was used and the themes identified manually from the transcribed interviews. The researcher followed a qualitative research design with semi-structured interviews to collect data. The method of thematic analyses was used and the themes identified manually from the transcribed interviews. These themes were analysed to provide findings from which relevant conclusions could be drawn. The findings varied due to diverse groups of participants with differing workplace expectations. However, participants agreed on the need for introducing more African examples in the teaching and learning of Industrial Psychology, to ensure the curriculum is applicable to a work context of a developing country such as South Africa. Ethical considerations of the study did adhere to the guidelines from the Ethics Committee of the particular University. Recommendations were made to help other universities in South Africa see the need for not only contextualising the curriculum of Industrial Psychology, but redefining teaching techniques in line with expectations from the industry. Ethical considerations of the study did adhere to the guidelines from the Ethics Committee of the particular University. Recommendations were made to help other universities Ethical considerations of the study did adhere to the guidelines from the Ethics Committee of the particular University. Recommendations were made to help other universities in South Africa see the need for not only contextualising the curriculum of Industrial Psychology, but redefining teaching techniques in line with expectations from the industry. These themes were analysed to provide findings from which relevant conclusions could be drawn. The findings varied due to diverse groups of participants with differing workplace expectations. However, participants agreed on the need for introducing more African examples in the teaching and learning of Industrial Psychology, to ensure the curriculum is applicable to a work context of a developing country such as South Africa. Ethical considerations of the study did adhere to the guidelines from the Ethics Committee of the particular University. Recommendations were made to help other universities in South Africa see the need for not only contextualising the curriculum of Industrial Psychology, but redefining teaching techniques in line with expectations from the industry. Ethical considerations of the study did adhere to the guidelines from the Ethics Committee of the particular University. Recommendations were made to help other universities Ethical considerations of the study did adhere to the guidelines from the Ethics Committee of the particular University.Ethical considerations of the study did adhere to the guidelines from the Ethics Committee of the particular University. Recommendations were made to help other universities in South Africa see the need for not only contextualising the curriculum of Industrial Psychology, but redefining teaching techniques in line with expectations from the industry. The researcher followed a qualitative research design with semi-structured interviews to collect data. The researcher followed a qualitative research design with semi-structured interviews to collect data. The method of thematic analyses was used and the themes identified manually from the transcribed interviews. Ethical considerations of the study did adhere to the guidelines from the Ethics Committee of the particular University. Recommendations were made to help other universities in South Africa see the need for not only contextualising the curriculum of Industrial Psychology, but redefining teaching techniques in line with expectations from the industry. Recommendations were made to help other universities in South Africa see the need for not only contextualising the curriculum of Industrial Psychology, but redefining teaching techniques in line with expectations from the industry

    MicroRNA-146a is upregulated by and negatively regulates TLR2 signaling

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    TLR signaling is a crucial component of the innate immune response to infection. MicroRNAs (miRNAs) have been shown to be upregulated during TLR signaling. Specifically, microRNA-146a (miR-146a) plays a key role in endotoxin tolerance by downregulating interleukin-1 receptor-associated kinase 1 (IRAK-1). The aim of this study was to assess the role of miR-146a in the TLR2 signaling and development of bacterial lipoprotein (BLP) self-tolerance and cross-tolerance to bacteria. Expression of miR-146a increased in a dose- and time-dependent manner in BLP-stimulated human THP-1 promonocytic cells. In BLP-tolerised cells miR-146a was even further upregulated in response to BLP re-stimulation (p,0.001). Restimulation of BLP-tolerised cells with heat-killed gram-negative Salmonella typhimurium (S. typhimurium), but not grampositive Staphylococcus aureus (S. aureus), led to significant overexpression of miR-146a (p,0.05). Transfection of naive cells with a miR-146a mimic substantially suppressed TNF-a production (p,0.05). Furthermore, overexpression of miR-146a resulted in strong reduction in IRAK-1 and phosphorylated IkBa expression in naive and S. typhimurium-stimulated THP-1 cells. Collectively, miR-146a is upregulated in response to BLP and bacterial stimulation in both naive and BLP-tolerised cells. Overexpression of miR-146a induces a state analogous to tolerance in BLP-stimulated cells and therefore may represent a future target for exogenous modulation of tolerance during microbial infection and sepsi

    The impact of routine open nonsuction drainage on fluid accumulation after thyroid surgery: a prospective randomised clinical trial.

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    Background: Thyroid drains following thyroid surgery are routinely used despite minimal supportive evidence. Our aim in this study is to determine the impact of routine open drainage of the thyroid bed postoperatively on ultrasound-determined fluid accumulation at 24 hours. Methods: We conducted a prospective randomised clinical trial on patients undergoing thyroid surgery. Patients were randomly assigned to a drain group (n = 49) or a no-drain group (n = 44) immediately prior to wound closure. Patients underwent a neck ultrasound on day 1 and day 2 postoperatively. After surgery, we evaluated visual analogue scale pain scores, postoperative analgesic requirements, self-reported scar satisfaction at 6 weeks and complications. Results: There was significantly less mean fluid accumulated in the drain group on both day 1, 16.4 versus 25.1 ml (P-value = 0.005), and day 2, 18.4 versus 25.7 ml (P-value = 0.026), following surgery. We found no significant differences between the groups with regard to length of stay, scar satisfaction, visual analogue scale pain score and analgesic requirements. There were four versus one wound infections in the drain versus no-drain groups. This finding was not statistically significant (P = 0.154). No life-threatening bleeds occurred in either group. Conclusions: Fluid accumulation after thyroid surgery was significantly lessened by drainage. However, this study did not show any clinical benefit associated with this finding in the non-emergent setting. Drains themselves showed a trend indicating that they may augment infection rates. The results of this study suggest that the frequency of acute life-threatening bleeds remains extremely low following abandoning drains. We advocate abandoning routine use of thyroid drains. Trial registration: ISRCTN94715414

    Polyunsaturated fatty acids for the primary and secondary prevention of cardiovascular disease

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    Background: Evidence on the health effects of total polyunsaturated fatty acids (PUFA) is equivocal. Fish oils are rich in omega-3 PUFA and plant oils in omega-6 PUFA. Evidence suggests increasing PUFA-rich foods, supplements or supplemented foods can reduce serum cholesterol, but may increase body weight, so overall cardiovascular effects are unclear. Objectives: To assess effects of increasing PUFA intake on cardiovascular disease (CVD) and all-cause mortality in adults. Search method: We searched CENTRAL, MEDLINE and Embase to April 2017 and ClinicalTrials.com and World Health Organization International Clinical Trials Registry Platform to September 2016, without language restrictions. We checked trials included in relevant systematic reviews. Selection criteria: We included randomised controlled trials (RCTs) comparing higher with lower PUFA intakes in adults with or without CVD that assessed effects over ≥12 months. We included full-text, abstracts, trials registry entries and unpublished data. Outcomes were all-cause mortality, CVD mortality and events, risk factors (blood lipids, adiposity, blood pressure), and adverse events. We excluded trials where we could not separate effects of PUFA intake from other dietary, lifestyle or medication interventions. Data collection and analysis: Two authors independently screened titles/abstracts, assessed trials for inclusion, extracted data, and assessed risk of bias. We wrote to authors of included studies for further data. Meta-analyses used random-effects analysis, sensitivity analyses included fixed-effects and limiting to low summary risk of bias. We assessed GRADE quality of evidence. Main result: We included 49 RCTs randomising 24,272 participants, with duration of one to eight years. Twelve included trials were at low summary risk of bias, 33 recruited participants without cardiovascular disease. Baseline PUFA intake was unclear in most trials, but 3.9% to 8% of total energy intake where reported. Most trials gave supplemental capsules, but eight gave dietary advice, eight gave supplemental foods such as nuts or margarine, and three used a combination of methods to increase PUFA. Increasing PUFA intake probably has little or no effect on all-cause mortality (risk 3.4% vs 3.3% in primary prevention, 11.7% vs 11.5% in secondary prevention, risk ratio (RR) 0.98, 95% confidence interval (CI) 0.89 to 1.07, 24 trials in 19290 participants), but probably reduces risk of CVD events from 5.8% to 4.9% in primary prevention, 23.3% to 20.8% in secondary prevention (RR 0.89, 95% CI 0.79 to 1.01, 20 trials in 17,073 participants), both moderate quality evidence. Increasing PUFA may reduce risk of CHD events from 13.4% to 7.1% primary prevention, 14.3% to 13.7% secondary prevention (RR 0.87, 95% CI 0.72 to 1.06, 15 trials, 10,076 participants), CHD death (5.2% to 4.4% primary prevention, 6.8% to 6.1% secondary prevention, RR 0.91, 95% CI 0.78 to 1.06, 9 trials, 8810 participants) and may slightly reduce stroke risk (2.1% to 1.5% primary prevention, RR 0.91, 95% CI 0.58 to 1.44, 11 trials, 14,742 participants), but has little or no effect on cardiovascular mortality (RR 1.02, 95% CI 0.82 to 1.26, I2 31%, 16 trials, 15,107 participants) all low quality evidence. Effects of increasing PUFA on major adverse cardiac and cerebrovascular events and atrial fibrillation are unclear as evidence is of very low quality. Event outcomes were all downgraded for indirectness, as most events occurred in men in westernised countries. Increasing PUFA intake reduces total cholesterol (MD -0.12 mmol/L, 95% CI -0.23 to -0.02, I2 79%, 8072 participants, 26 trials) and probably decreases triglycerides (TG, MD -0.12 mmol/L, 95% CI -0.20 to -0.04, I2 50%, 3905 participants, 20 trials), but has little or no effect on HDL (MD -0.01 mmol/L, 95% CI -0.02 to 0.01, I2 0%, 4674 participants, 18 trials) and LDL (MD -0.01 mmol/L, 95% CI -0.09 to 0.06, I2 44%, 3362 participants, 15 trials). Increasing PUFA probably causes slight weight gain (MD 0.76 kg, 95% CI 0.34 to 1.19, I2 59%, 7100 participants, 12 trials). Effects of increasing PUFA on serious adverse events such as pulmonary embolism and bleeding are unclear as the evidence is of very low quality. Authors' conclusions: Increasing PUFA intake probably reduces risk of CVD events, may reduce risk of CHD events and CHD mortality,and may slightly reduce stroke risk, but has little or no effect on all-cause or CVD mortality. The mechanism may be via lipid reduction, but increasing PUFA probably slightly increases weight

    Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease

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    Background: Researchers have suggested that omega-3 polyunsaturated fatty acids from oily fish (long-chain omega-3 (LCn3), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), as well as from plants (alpha-linolenic acid (ALA)) benefit cardiovascular health. Guidelines recommend increasing omega-3-rich foods, and sometimes supplementation, but recent trials have not confirmed this. Objectives: To assess effects of increased intake of fish- and plant-based omega-3 for all-cause mortality, cardiovascular (CVD) events, adiposity and lipids. Search methods: We searched CENTRAL, MEDLINE and Embase to April 2017, plus ClinicalTrials.gov and World Health Organization International Clinical Trials Registry to September 2016, with no language restrictions. We handsearched systematic review references and bibliographies and contacted authors. Selection criteria: We included randomised controlled trials (RCTs) that lasted at least 12 months and compared supplementation and/or advice to increase LCn3 or ALA intake versus usual or lower intake. Data collection and analysis: Two review authors independently assessed studies for inclusion, extracted data and assessed validity. We performed separate random-effects meta-analysis for ALA and LCn3 interventions, and assessed dose-response relationships through meta-regression. Main results: We included 79 RCTs (112,059 participants) in this review update and found that 25 were at low summary risk of bias. Trials were of 12 to 72 months' duration and included adults at varying cardiovascular risk, mainly in high-income countries. Most studies assessed LCn3 supplementation with capsules, but some used LCn3- or ALA-rich or enriched foods or dietary advice compared to placebo or usual diet. Meta-analysis and sensitivity analyses suggested little or no effect of increasing LCn3 on all-cause mortality (RR 0.98, 95% CI 0.90 to 1.03, 92,653 participants; 8189 deaths in 39 trials, high-quality evidence), cardiovascular mortality (RR 0.95, 95% CI 0.87 to 1.03, 67,772 participants; 4544 CVD deaths in 25 RCTs), cardiovascular events (RR 0.99, 95% CI 0.94 to 1.04, 90,378 participants; 14,737 people experienced events in 38 trials, high-quality evidence), coronary heart disease (CHD) mortality (RR 0.93, 95% CI 0.79 to 1.09, 73,491 participants; 1596 CHD deaths in 21 RCTs), stroke (RR 1.06, 95% CI 0.96 to 1.16, 89,358 participants; 1822 strokes in 28 trials) or arrhythmia (RR 0.97, 95% CI 0.90 to 1.05, 53,796 participants; 3788 people experienced arrhythmia in 28 RCTs). There was a suggestion that LCn3 reduced CHD events (RR 0.93, 95% CI 0.88 to 0.97, 84,301 participants; 5469 people experienced CHD events in 28 RCTs); however, this was not maintained in sensitivity analyses - LCn3 probably makes little or no difference to CHD event risk. All evidence was of moderate GRADE quality, except as noted. Increasing ALA intake probably makes little or no difference to all-cause mortality (RR 1.01, 95% CI 0.84 to 1.20, 19,327 participants; 459 deaths, 5 RCTs),cardiovascular mortality (RR 0.96, 95% CI 0.74 to 1.25, 18,619 participants; 219 cardiovascular deaths, 4 RCTs), and it may make little or no difference to CHD events (RR 1.00, 95% CI 0.80 to 1.22, 19,061 participants, 397 CHD events, 4 RCTs, low-quality evidence). However, increased ALA may slightly reduce risk of cardiovascular events (from 4.8% to 4.7%, RR 0.95, 95% CI 0.83 to 1.07, 19,327 participants; 884 CVD events, 5 RCTs, low-quality evidence), and probably reduces risk of CHD mortality (1.1% to 1.0%, RR 0.95, 95% CI 0.72 to 1.26, 18,353 participants; 193 CHD deaths, 3 RCTs), and arrhythmia (3.3% to 2.6%, RR 0.79, 95% CI 0.57 to 1.10, 4,837 participants; 141 events, 1 RCT). Effects on stroke are unclear. Sensitivity analysis retaining only trials at low summary risk of bias moved effect sizes towards the null (RR 1.0) for all LCn3 primary outcomes except arrhythmias, but for most ALA outcomes, effect sizes moved to suggest protection. LCn3 funnel plots suggested that adding in missing studies/results would move effect sizes towards null for most primary outcomes. There were no dose or duration effects in subgrouping or meta-regression. There was no evidence that increasing LCn3 or ALA altered serious adverse events, adiposity or lipids, although LCn3 slightly reduced triglycerides and increased HDL. ALA probably reduces HDL (high- or moderate-quality evidence). Authors' conclusions: This is the most extensive systematic assessment of effects of omega-3 fats on cardiovascular health to date. Moderate- and high-quality evidence suggests that increasing EPA and DHA has little or no effect on mortality or cardiovascular health (evidence mainly from supplement trials). Previous suggestions of benefits from EPA and DHA supplements appear to spring from trials with higher risk of bias. Low-quality evidence suggests ALA may slightly reduce CVD event risk, CHD mortality and arrhythmia

    Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

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    Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

    Introduction of a Preoperative Protocol for Management of Iron-Deficiency Anemia in Patients undergoing Elective Colorectal Surgery

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    Preoperative anaemia is a risk factor for poorer postoperative outcomes and patients undergoing colorectal cancer surgery frequently have iron-deficiency anaemia. The aim of this project was to implement a preoperative anaemia management protocol for elective colorectal surgery patients. An organisational development project was undertaken according to the Senior and Swailes organisational development model. A protocol for early detection of iron-deficiency anaemia, and treatment with intravenous iron replacement, for colorectal cancer patients was developed and implemented via a multidisciplinary team-based approach. Patient data was collected pre- and post-intervention to assess the impact of the project. Implementation of the project resulted in increased rates of detection of preoperative iron-deficiency anaemia in the post-intervention cohort, with 71% of patients undergoing ferritin testing, compared to 30% of the pre-intervention cohort. Mean postoperative haemoglobin levels were significantly lower in patients with uncorrected anaemia, whereas those patients who underwent iron replacement therapy preoperatively had similar postoperative results to non-anaemic patients. Overall, postoperative transfusion rates decreased from 10% to 4% following introduction of the protocol. Successful introduction of a perioperative anaemia management protocol has resulted in reduced preoperative anaemia rates in colorectal cancer patients. Expansion of the inclusion criteria could potentially lead to improved outcomes for additional categories of surgical patients

    Longitudinal extent of acidification effects of plantation forest on benthic macroinvertebrate communities in soft water streams: evidence for localised impact and temporal ecological recovery

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    Plantation conifer forest can increase the risk of acidification in acid-sensitive catchments with consequences for macroinvertebrates and ecosystem functioning. This study compared headwater streams in forested and non-forested catchments to appraise the distance required for the acid effect on macroinvertebrates to diminish downstream. Strict criteria were followed in the selection of paired streams, including similarities in elevation, aspect, stream order, geographical proximity, geology and soil type, with no inflowing tributaries in the first 2.5 km and no major land-use other than plantation forest and moorland. Consequently two headwater streams (one forested, one non-forested) drained Ordovician sedimentary geology and two headwater streams (one forested, one non-forested) drained Old Red Sandstone (ORS) were selected. All streams drained peaty soils. Up to six sites at 500 m intervals were sampled in triplicate by multihabitat kick sampling. Ecological impact and recovery from acid effects involved the entire macroinvertebrate community, but varied between seasons. Acid-sensitive Ephemeroptera revealed marked effects of episodic acidification, with Baetis rhodani and Rhithrogena semicolorata found to be transient between seasons. The increase in acid-sensitive ephemeropteran species with increasing distance downstream indicates the finite effects of forest mediated acidification on soft water streams in Ireland. Ecological impact appears, therefore, to be localised within the catchment, with ecological recovery occurring a short distance downstream. This is the first study to have reported such results

    Multiple Regulatory Pathways Associated with High-Level Ciprofloxacin and Multidrug Resistance in Salmonella enterica Serovar Enteritidis: Involvement of ramA and Other Global Regulatorsâ–¿

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    Mechanisms of antibiotic resistance were examined in nalidixic acid-resistant Salmonella enterica serovar Enteritidis field isolates displaying decreased susceptibility to ciprofloxacin and in in vitro-derived ciprofloxacin-resistant mutants (104-cip and 5408-cip). All field isolates harbored a single gyrA mutation (D87Y). Deletion of acrB and complementation with wild-type gyrA increased quinolone susceptibility. Selection for ciprofloxacin resistance was associated with the development of an additional gyrA (S83F) mutation in 104-cip, novel gyrB (E466D) and parE (V461G) mutations in 5408-cip, overexpression of acrB and decreased susceptibility to nonquinolone antibiotics in both mutants, and decreased OmpF production and altered lipopolysaccharide in 104-cip. Complementation of mutated gyrA and gyrB with wild-type alleles restored susceptibility to quinolones in 104-cip and significantly decreased the ciprofloxacin MIC in 5408-cip. Complementation of parE had no effect on quinolone MICs. Deletion of acrB restored susceptibility to ciprofloxacin and other antibiotics tested. Both soxS and marA were overexpressed in 104-cip, and ramA was overexpressed in 5408-cip. Inactivation of each of these global regulators lowered ciprofloxacin MICs, decreased expression of acrB, and restored susceptibility to other antibiotics. Mutations were found in soxR (R20H) and in soxS (E52K) in 104-cip and in ramR (G25A) in 5408-cip. In conclusion, both efflux activity and a single gyrA mutation contribute to nalidixic acid resistance and reduced ciprofloxacin sensitivity. Ciprofloxacin resistance and decreased susceptibility to multiple antibiotics can result from different genetic events leading to development of target gene mutations, increased efflux activity resulting from differential expression of global regulators associated with mutations in their regulatory genes, and possible altered membrane permeability
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