An evaluation of the use of blood metabolite concentrations as indicators of nutritional status in free-ranging indigenous goats

The aim of this study was to determine whether blood metabolite concentrations in free-ranging indigenous goats are sensitive to expected variations in nutrient supply, and whether they could be used to evaluate different kidding seasons at two locations subject to similar seasonal variations in terms of nutrient supply. Monthly blood samples were taken over a period of one year. At Delftzyl farm, where a winter kidding season (June) was practised, glucose concentrations decreased from February onwards and reached their lowest levels just prior to the kidding season. Plasma glucose concentrations increased sharply after parturition and subsequently decreased until the end of lactation. Glucose concentrations were lower in lactating does than in non-lactating does during the first two months of lactation. In contrast, glucose concentrations during lactation in does at Loskop farm, where kidding took place during spring (October), did not differ from those recorded during the four months following weaning, and neither were there differences between lactating and non-lactating does. Glucose concentrations during lactation at Loskop farm were also higher than at Delftzyl farm. The different responses can be attributed to the fact that lactation at Loskop farm coincided with peak nutrient availability during the summer period of vegetative growth, whereas lactation at Delftzyl farm coincided with low nutrient availability and quality during the winter period of plant dormancy. Plasma urea concentrations were also elevated during the last month of pregnancy and the first two months of lactation at this location, and were higher during lactation than those recorded at the summer kidding site, indicating that body protein reserves may have been catabolized to support gluconeogenesis in these animals. Plasma cholesterol concentrations were higher in lactating goats than in non-lactating goats at Delftzyl farm but not at Loskop farm. Cholesterol concentrations during lactation were also higher at Delftzyl than at Loskop. This suggests that body adipose tissue reserves were catabolized during the winter lactation at Delftzyl farm. These results indicate that lactating does at Delftzyl farm were unable to maintain glucose homeostasis during pregnancy and lactation without significant catabolism of body reserves, and suggests that the winter kidding practised there was inappropriate in relation to the available nutrient supply. It was concluded that the plasma concentrations of all the blood metabolites studied were sensitive to seasonal changes in nutrient supply, and that they could be of use as a management tool in free-ranging farming systems in which conventional methods of nutritional assessment are difficult to apply. (South African Journal of Animal Science, 2000, 30(2): 115-120

Utilisation of maternity services by black women in rural and urban areas of the Orange Free State

An epidemiological survey was undertaken to evaluate the utilisation of maternal services for black women in the Orange Free State. Two hundred and forty clusters were selected from the rural (farms) and urban (local authorities) black population and eight households were interviewed in each cluster. Information was gathered from 237 rural women (from 959 households) and 168 urban women (from 926 households) who had delivered a baby or aborted during the preceding year. Antenatal care was received by 71 % of the rural women and 87% of the urban women. Rural women delivered at home in 60% of cases while 37% delivered in hospitals. Only 23% of urban women delivered at home while 67% of their deliveries were conducted in hospitals. Nurses supervised deliveries in both instances in more than 60% of cases, but in rural areas traditional midwives managed 26% of the confinements. The conclusions are that the maternity service was largely provided by nurses and was predominantly limited to hospitals and homes. It is recommended that the quality of service be upgraded and more emphasis placed on midwife obstetric units

Studies of apple bud dormancy and branching under conditions of inadequate winter chilling

Thesis (MScAgric)--University of Stellenbosch, 2002.ENGLISH ABSTRACT: In order to study the dormancy of apple buds in conditions of inadequate chilling a number of trails were done during 2000 and 2001. Year-old, unbranched shoots of 'Royal Gala', 'Braeburn', 'Cripps' Pink' and 'Granny Smith' apple were harvested randomly from bearing commercial orchards in the Koue Bokkeveld [33°S, 945m, ca.1300 Utah model chili units (CU)) and Elgin (34 "S, 305m, ca.750CU) regions of the Western Cape, South Africa, respectively. Shoots were chilled at 5-rC. Two replicate bundles were removed from the cold room, prepared and forced at 25°C with continuous illumination until budburst had occurred on at least 25% of the shoots per bundle. The change in the rate of budburst over time was calculated for each orchard and to this response; either a linear or a quadratic function was fitted. Poorly correlated variables were selected that best describe these functions. Using these variables, the orchards were separated into cluster groupings that represented a dormancy pattern. The first split separated the lower chilling requirement cultivars from the higher cultivars. The second and third split separated the orchards according to area differences. The clusters representing the warmer area orchards initially entered deeper into dormancy before exiting. The clusters for the colder area immediately had an increased budburst rate. This data confirm that the chilling requirement includes a period of dormancy induction. An important genotype and environment interaction, other than cold unit accumulation, was observed that could be responsible for terminating bud dormancy. Terminal apple buds from 'Royal Gala' Braeburn', 'Cripps' Pink' and 'Granny Smith' apples were cut from orchards in the Koue Bokkeveld and Elgin regions of the Western Cape, South Africa. Buds were harvested every two weeks during the dormant period. The buds were cut in half and leaf scales removed before the water potential were measured. Fresh and dry weights of the buds were also determined. The data presented confirms the changes in availability of free water in dormant buds and that it could be measured in this way. A definite influence of temperature was illustrated. The water potential from buds in a cold production area (Koue Bokkeveld) behaved more "normally" - water is in a bound form during most of the winter and change to an available form later in winter - whereas buds from a warmer production area did not change much in water potential or content. In the trial, two-year-old proleptic-branched shoots, ca. 500mm long, were selected from a 'Royal Gala' orchard in the Koue Bokkeveld region in the Western Cape, South Africa. During the dormancy period of 2000, shoots received two cold treatments; chilling in a cold room at 5-7°C and the natural chilling received in the field. In 2001, the trail was repeated, but only with the field chilling. The shoots received five dormant pruning treatments: control (not pruned), pruning back to the fourth lateral (heading) before or after chilling; and removal of the 2nd and 3rd laterals (thinning) before or after chilling. After pruning and chilling treatments, the shoots were removed from the orchard or cold room every two weeks and forced in a growth chamber. The rate of bud burst (1/days to 50% bud burst) was calculated for the terminal buds of the lateral shoots. Laterals were categorisation according to position: the terminal extension shoot, the 4th lateral, and all other laterals were pooled. Removing distal tissue by pruning (heading more than thinning) promoted bud burst on laterals. Pruning before chilling was more effective than after chilling. The correlative phenomena that inhibit bud burst on proximal shoots within two-yearold branches were manipulated by pruning. The branching response of one-year-old unbranched shoots, 0.5m long, from 'Royal Gala' and 'Cripps' Pink' apple and 'Rosemary' pear were studied after physical manipulation treatments. Shoots for treatment a to d were re-orientated from either a horizontal or vertical position or left in the original position as control, treatment e to h involved the same re-orientation of shoots and were headed. The amount of growth (in mm) from each node was recorded as well as the position from the terminal bud. The 'Cripps' Pink' had a definite shift in the acrotonic branching pattern (for headed and unheaded), towards a more basitonic response. The reduced effect on 'Royal Gala' and 'Rosemary' suggest a difference in genotype response to the treatments as well as time of treatment.AFRIKAANSE OPSOMMING: Ter wille van die navorsing oor die invloed van gebrekige koue op dormansie van apple knoppe en die gepaardgaande probleme is 'n reeks proewe gedoen gedurende 2000 en 2001. Jaar oue onvertakte lote van 'Royal Gala', 'Braeburn' , 'Cripps' Pink' en 'Granny Smith' appels is ewekansig geoes vanaf komersieële boorde in die Koue Bokkeveld [33°S, 945m, ca.1300 Utah koue eenhede (CU)] en Elgin (34°S, 305m, ca.750CU) omgewings van die Wes Kaap , Suid Afrika. Die lote is daarna verkoel gehou by 5- 7°C. Lote is elke twee weke vanuit die koue kamer geneem en geforseer met 25°C en deurlopend belig. Die aantal knoppe wat groenpunt bereik het is genoteer totdat 25% van die lote begin bot. Die verandering oor tyd vir elke boord is bereken en 'n liniëre of kwadratiese funksie is daarop gepas. Swak gekorreleerde waardes is gekies wat die funksies die beste beskryf. D.m.v hierdie die waardes is die boorde in groepe ingedeel wat 'n dormansie patroon verteenwoordig. Na die eerste vedeeling is die hoë en lae koue behoefte kultivars geskei. In opvolgende verdelings is die boorde verder in die twee areas geskei met elk 'n spesifieke dormansie patroon. Die groepe wat die warmer area se boorde bevat het aanvanklik dieper in dormansie in beweeg voor dit 'n styging in groei potensiaal getoon het. Die groepe vanaf die kouer produksie area het onmiddelik 'n verhooging in bot tempo getoon. Die data bevestig dat 'n koue behoefte 'n periode van dormansie induksie insluit. 'n Belangrike kultivaromgewing- interaksie, ten spyte van koue eenhede akkumulasie, is waargeneem wat verantwoordlik kan wees vir beëindiging van dormansie. Om die verandering van water status in dormante appel knoppe te bestudeer, was die volgende proef uitgevoer. Terminale apple knoppe van dieselfde vier kultivars en vanaf die selfde twee areas in die Wes Kaap as bogenoemde, is elke tweede week gedurende die winter 2001 gesny vanaf komersieële boorde. Daarna is die knoppe middel deur gesny en die skudblare verwyder voor die vars massa gemeet en daarna die waterpotensiaal bepaal is. Die data het bevestig dat daar veranderings in beskikbaarheid van vry water in dormante knoppe gedurende dormansie plaasvind. 'n Definitiewe invloed van temperatuur op waterpotensiaal is geïllustreer. Die waterpotensiaal van knoppe in die kouer produksie area toon 'n meer normale respons (gedurende die winter is die water in 'n gebonde vorm, wat later in die winter na vry water verander). Daar teenoor is daar in die knoppe van die warm produksie area nie veel verandering in waterpotensiaal of water massa getoon nie. Gedurende die winter van 2000 is twee jaar oue proleptiese vertakte 'Royal Gala' lote, ongeveer 500mm lank, gekies vanaf 'n boord in die Koue Bokkeveld. Die lote is verdeel en het twee koue behandelings ontvang. Koue kamer by 5-T'C en natuurlike koue in die boord. In 2001 is net die natuurlike koue behandeling herhaal. Daar is vyf dormante snoei behandeling op die lote gedoen; kontrole (geen), snoei terug tot die vierde lateraal voor en na die koue; verwydering van die 2de en 3de laterale voor en na koue. Na koue en snoei is die lote verwyder en in die groeikamer geforseer by 25°C en met konstante illuminasie. Die tempo waarteen die laterale gebot het is bereken (1\dae to 50% groen punt) waarna die laterale in klasse gedeel is; terminale knop, die vierde lateraal en die res van die laterale saam. Verwydering van distale weefsel d.m.V. snoei verhoog die tempo waarteen laterale knoppe groenpunt bereik. Snoei voor die koue behandeling was meer effektief as daarna. Die korrelatiewe fenomeen wat bot inhibeer van proksimale lote kan gemanipuleer word in die twee jaar apple loot. Die vertakkings gedrag van een jaar oue onvertakte 'Royal Gala', 'Cripps' Pink' apple en 'Rosemary' peer lote, 0.5m lank, is ondersoek na fisiese manipulasies gedoen is gedurende mid winter 2000. Vir die eerste vier behandelings (a,b,c,d) is die lote in 'n horisontale of vertikale possisie gelos as kontrole, of horisontale of vertikale gebuig en daar gehou d.m.v. binddraad. Behandelings e tot h het dieselfde behels maar die lote is ook nog in die helfte deur gesny (getop). Die hoeveelheid groei in mm vir elke node is aangeteken asook die posisie vanaf die terminale knop. Die 'Cripps' Pink' het 'n definitiewe veskuiwing vanaf 'n akrotoniese na 'n basitoniese vertakkingspatroon getoon. Die reaksies op die manipulasies of die gebrek daaraan ('Royal Gala' en 'Rosemary' ) kan 'n aanduiding wees dat genotipes verskillend reageer op die behandelings asook op die tyd wat dit gedoen was

Maternal deaths in Bloemfontein, South Africa -1986 - 1992

Objective. Determination of the maternal mortality ratio and the main causes of maternal death.Setting. Pelonomi Hospital, a tertiary care and referral hospital in Bloemfontein.Methods. Review of prospectively completed structured questionnaires on all maternal deaths from 1986 to 1992.Results. The maternal mortality ratio at our institution was 171 per 100000 live births. Haemorrhage (25%), infection (24%) and hypertensive disease (18%) were the most important causes of death. Seventy-one per cent were direct obstetric deaths and 23% indirect; in the remaining 6%, the cause was uncertain. Of all deaths, 35% were considered preventable.Conclusions. The maternal mortality ratio has decreased since our previous report for the period 1980 - 1985, and haemorrhage has replaced infection as the leading cause of death

Caffeine intake, plasma caffeine level, and kidney function: a Mendelian randomization study

Caffeine is a psychoactive substance widely consumed worldwide, mainly via sources such as coffee and tea. The effects of caffeine on kidney function remain unclear. We leveraged the genetic variants in the CYP1A2 and AHR genes via the two-sample Mendelian randomization (MR) framework to estimate the association of genetically predicted plasma caffeine and caffeine intake on kidney traits. Genetic association summary statistics on plasma caffeine levels and caffeine intake were taken from genome-wide association study (GWAS) meta-analyses of 9876 and of >47,000 European ancestry individuals, respectively. Genetically predicted plasma caffeine levels were associated with a decrease in estimated glomerular filtration rate (eGFR) measured using either creatinine or cystatin C. In contrast, genetically predicted caffeine intake was associated with an increase in eGFR and a low risk of chronic kidney disease. The discrepancy is likely attributable to faster metabolizers of caffeine consuming more caffeine-containing beverages to achieve the same pharmacological effect. Further research is needed to distinguish whether the observed effects on kidney function are driven by the harmful effects of higher plasma caffeine levels or the protective effects of greater intake of caffeine-containing beverages, particularly given the widespread use of drinks containing caffeine and the increasing burden of kidney disease

National priorities for perioperative research in South Africa

Background. Perioperative research is currently unco-ordinated in South Africa (SA), with no clear research agenda.Objective. To determine the top ten national research priorities for perioperative research in SA.Methods. A Delphi technique was used to establish consensus on the top ten research priorities.Results. The top ten research priorities were as follows: (i) establishment of a national database of (a) critical care outcomes, and (b) critical care resources; (ii) a randomised controlled trial of preoperative B-type natriuretic peptide-guided medical therapy to decrease major adverse cardiac events following non-cardiac surgery; (iii) a national prospective observational study of the outcomes associated with paediatric surgical cases; (iv) a national observational study of maternal and fetal outcomes following operative delivery in SA; (v) a steppedwedge trial of an enhanced recovery after surgery programme for (a) surgery, (b) obstetrics, (c) emergency surgery, and (d) trauma surgery; (vi) a stepped-wedge trial of a surgical safety checklist on patient outcomes in SA; (vii) a prospective observational study of perioperative outcomes after surgery in district general hospitals in SA; (viii) short-course interventions to improve anaesthetic skills in rural doctors; (ix) studies of the efficacy of simulation training to improve (a) patient outcomes, (b) team dynamics, and (c) leadership; and (x) development and validation of a risk stratification tool for SA surgery based on the South African Surgical Outcomes Study (SASOS) data.Conclusions. These research priorities provide the structure for an intermediate term research agenda

Literary ethnography of evidence-based healthcare : accessing the emotions of rational-technical discourse

In this article I revisit the idea of literary ethnography (proposed by Van de Poel-Knottnerus and Knottnerus, 1994) as a method for investigating social phenomena constituted principally through literature. I report the use of this method to investigate the topic of evidence-based healthcare, EBHC. EBHC is a field of discourse much built upon a dichotomy between rationality and emotionality. In this context literary ethnography, a particular type of discourse analysis, is valuable for allowing researchers to bring the emotional currents of technical-rational discourse into conscious awareness. In such discourses, emotions are not written out by name. The researcher must discern emotional phenomena by experiencing the discourse, and (try to) bring them into intelligible expression. As I clarify this process I develop Van de Poel-Knottnerus and Knottnerus’ method theoretically, look to destabilise the rationalityemotionality dichotomy foundational to discourse around EBHC, and so transgress its conventional lines of thought.PostprintPeer reviewe

Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening

<p>Abstract</p> <p>Background</p> <p>Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH) services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits.</p> <p>Methods</p> <p>We conducted a qualitative study using eight focus group discussions with a total of 82 participants (16 men, 46 women and 20 health workers). We aimed to better understand factors that influence usage of available reproductive health care services and how they would relate to cervical cancer screening, as well as identify feasible interventions to improve cervical cancer screening uptake.</p> <p>Results</p> <p>Barriers identified after framework analysis included ignorance about cervical cancer, cultural constructs/beliefs about the illness, economic factors, domestic gender power relations, alternative authoritative sources of reproductive health knowledge, and unfriendly health care services. We discuss how these findings may inform future planned screening programmes in the Ugandan context.</p> <p>Conclusion</p> <p>Knowledge about cervical cancer among Ugandan women is very low. For an effective cervical cancer-screening programme, awareness about cervical cancer needs to be increased. Health planners need to note the power of the various authoritative sources of reproductive health knowledge such as paternal aunts (<it>Sengas</it>) and involve them in the awareness campaign. Cultural and economic issues dictate the perceived reluctance by men to participate in women's reproductive health issues; men in this community are, however, potential willing partners if appropriately informed. Health planners should address the loss of confidence in current health care units, as well as consider use of other cervical cancer screening delivery systems such as mobile clinics/camps.</p