The effects of a language barrier in a South African district hospital

The original publication is available at http://www.samj.org.zaCITATION: Schlemmer, A., Mash, B. 2006. The effects of a language barrier in a South African district hospital. South African Medical Journal, 96(10):1080-1087.Background. Communication between health workers and patients at Hottentots Holland Hospital (HHH) is hindered by staff and patients not speaking the same language. HHH is a district hospital in the Cape Town Metropolitan District of the Western Cape where staff mainly speak Afrikaans or English and a large number of patients mainly Xhosa. Objectives. The study aimed to explore the effects of this language barrier on health workers and patients at HHH. Design. Three focus group interviews were held with 21 members of staff and 5 in-depth patient interviews were conducted. Results. The language barrier was found to interfere with working efficiently, create uncertainty about the accuracy of interpretation, be enhanced by a lack of education or training, cause significant ethical dilemmas, negatively influence the attitudes of patients and staff towards each other, decrease the quality of and satisfaction with care, and cause cross-cultural misunderstandings. Conclusion. The effects of the language barrier were considerable and persistent despite an official language policy in the province. The training and employment of professional interpreters as well as teaching of basic Xhosa to staff are recommended.Publisher’s versio

An assessment of organisational values culture and performance in Cape Town's primary healthcare services

Objectives: Improving the quality of primary health care in South Africa is a national priority and the Western Cape Department of Health has identified staff and patient experience as a key component. Its strategic plan, Vision 2020, espouses caring, competence, accountability, integrity, responsiveness and respect as the most important organisational values. This study aimed to measure the personal values of staff, as well as current and desired organisational values. Design: A cross-sectional survey used the cultural values assessment tool. Data were analysed by the Barrett Value Centre. Setting and subjects: Staff and managers at five community health centres in the Cape Town Metropole. Outcome measures: Personal values, current and desired organisational values, organisational entropy and organisational scorecard. Results: In total, 154 staff members completed the survey. Participants reported personal values that are congruent with a move towards more patient-centred care. The top 10 current organisational values were not sharing information, cost reduction, community involvement, confusion, control, manipulation, blame, power, results orientation, hierarchy, long hours and teamwork. Desired organisational values were open communication, shared decision-making, accountability, staff recognition, leadership development and professionalism. Organisational entropy was high at 36% of all values. Only teamwork and community involvement were found in both the current and desired culture. The organisational scorecard showed a lack of current focus on finances, evolution and patient experience. Conclusion: The organisational culture of the Metro District Health Services is currently not well aligned with the values expressed in Vision 2020, and the goal of delivering patient-centred care

Photodesorption of CO ice

At the high densities and low temperatures found in star forming regions, all molecules other than H2 should stick on dust grains on timescales shorter than the cloud lifetimes. Yet these clouds are detected in the millimeter lines of gaseous CO. At these temperatures, thermal desorption is negligible and hence a non-thermal desorption mechanism is necessary to maintain molecules in the gas phase. Here, the first laboratory study of the photodesorption of pure CO ice under ultra high vacuum is presented, which gives a desorption rate of 3E-3 CO molecules per UV (7-10.5 eV) photon at 15 K. This rate is factors of 1E2-1E5 larger than previously estimated and is comparable to estimates of other non-thermal desorption rates. The experiments constrains the mechanism to a single photon desorption process of ice surface molecules. The measured efficiency of this process shows that the role of CO photodesorption in preventing total removal of molecules in the gas has been underestimated.Comment: 5 pages, 4 figures, accepted by ApJ

Room temperature emission at 1.6 µm from InGaAs quantum dots capped with GaAsSb

Room temperature photoluminescence at 1.6 µm is demonstrated from InGaAs quantum dots capped with an 8 nm GaAsSb quantum well. Results obtained from various sample structures are compared, including samples capped with GaAs. The observed redshift in GaAsSb capped samples is attributed to a type II band alignment and to a beneficial modification of growth kinetics during capping due to the presence of Sb. The sample structure is discussed on the basis of transmission electron microscopy results.This work was supported by the Spanish MCyT under NANOSELF project TIC2002-04096, by CAM project GR/MAT/0726/2004, by the SANDiE Network of excellence (Contract No. NMP4-CT-2004-500101) and the Junta de Andalucía (Group Tep-0120). J.M.R. acknowledges support through a Ramón y Cajal grant. TEM measurements were carried out at DME-SCCYT, UCA.Peer reviewe

On the equivalence of two deformation schemes in quantum field theory

Two recent deformation schemes for quantum field theories on the two-dimensional Minkowski space, making use of deformed field operators and Longo-Witten endomorphisms, respectively, are shown to be equivalent.Comment: 14 pages, no figure. The final version is available under Open Access. CC-B

Prediction of low-keV monochromatic images from polyenergetic CT scans for improved automatic detection of pulmonary embolism

Detector-based spectral computed tomography is a recent dual-energy CT (DECT) technology that offers the possibility of obtaining spectral information. From this spectral data, different types of images can be derived, amongst others virtual monoenergetic (monoE) images. MonoE images potentially exhibit decreased artifacts, improve contrast, and overall contain lower noise values, making them ideal candidates for better delineation and thus improved diagnostic accuracy of vascular abnormalities. In this paper, we are training convolutional neural networks~(CNN) that can emulate the generation of monoE images from conventional single energy CT acquisitions. For this task, we investigate several commonly used image-translation methods. We demonstrate that these methods while creating visually similar outputs, lead to a poorer performance when used for automatic classification of pulmonary embolism (PE). We expand on these methods through the use of a multi-task optimization approach, under which the networks achieve improved classification as well as generation results, as reflected by PSNR and SSIM scores. Further, evaluating our proposed framework on a subset of the RSNA-PE challenge data set shows that we are able to improve the Area under the Receiver Operating Characteristic curve (AuROC) in comparison to a na\"ive classification approach from 0.8142 to 0.8420.Comment: 4 pages, ISBI 202

Infrared spectroscopy of solid CO-CO2 mixtures and layers

The spectra of pure, mixed and layered CO and CO2 ices have been studied systematically under laboratory conditions using infrared spectroscopy. This work provides improved resolution spectra (0.5 cm-1) of the CO2 bending and asymmetric stretching mode, as well as the CO stretching mode, extending the existing Leiden database of laboratory spectra to match the spectral resolution reached by modern telescopes and to support the interpretation of the most recent data from Spitzer. It is shown that mixed and layered CO and CO2 ices exhibit very different spectral characteristics, which depend critically on thermal annealing and can be used to distinguish between mixed, layered and thermally annealed CO-CO2 ices. CO only affects the CO2 bending mode spectra in mixed ices below 50K under the current experimental conditions, where it exhibits a single asymmetric band profile in intimate mixtures. In all other ice morphologies the CO2 bending mode shows a double peaked profile, similar to that observed for pure solid CO2. Conversely, CO2 induces a blue-shift in the peak-position of the CO stretching vibration, to a maximum of 2142 cm-1 in mixed ices, and 2140-2146 cm-1 in layered ices. As such, the CO2 bending mode puts clear constraints on the ice morphology below 50K, whereas beyond this temperature the CO2 stretching vibration can distinguish between initially mixed and layered ices. This is illustrated for the low-mass YSO HH46, where the laboratory spectra are used to analyse the observed CO and CO2 band profiles and try to constrain the formation scenarios of CO2.Comment: Accepted in A&

A data mining approach to the SAR values over large MR image repositories

Purpose: In magnetic resonance imaging, the radiofrequency energy absorption arises as one of the main safety concerns, being mainly related with increased body temperature. Monitoring radiofrequency absorption is achieved by the estimation of specific absorption rate (SAR), whose implementation lies on equipment manufacturers, which in turn are not totally enlightening about its calculus. This work presents an exploratory approach of whole-body SAR values stored in DICOM metadata aiming to find correlation with body weight, body mass index (BMI), gender and pulse sequences for abdominal/pelvic (17.812 series) and head (29.907 series) studies. Methods and Materials: All studies were acquired in a 3 Tesla scanner with high-performance gradients. Data were extracted using Dicoogle, a DICOM metadata mining tool. Several DICOM tags were analysed (e.g. patient weight, height, gender, sequence name). For each study type, specifically weighted pulse sequences were related with weight, BMI and gender through boxplot diagrams, statistical and effect size analysis. Results: SAR limits were never exceeded. Generally, SAR values tended to decrease with increasing body weight and BMI values for abdominal/pelvic studies. On the other hand, head studies showed different trends regarding distinct pulse sequences. SAR values tend to be higher in male individuals (p<0,05). As expected, turbo spin echo sequences present the highest SAR values. The values found for echo gradient spoiled sequence (FLASH) were also high. Conclusion: It is confirmed that SAR estimates are related with the analysed variables. An individual examination of pulse sequences is recommended to observe trends regarding weight, BMI or gender.publishe