A diabetes profile of the eight districts in the public health sector, Eastern Cape Province, South Africa

Background. The International Diabetes Federation (IDF) recently reported that there are 1.8 million South Africans with diabetes, and estimates an additional undiagnosed population of 69% of the total number of diabetics. The African continent is expected to see the highest increase in diabetes globally by 2045. Healthcare measures to manage this surge in diabetes and its related complications should be tailored to Africa’s unique challenges; however, the epidemiolocal data essential for policy development are lacking. Bridging the data gap will guide funding distribution and the creation of evidence-based initiatives for diabetes.Objectives. To investigate the frequency, age proportion and distribution of new patients diagnosed with diabetes in the public healthcare sector of Eastern Cape (EC) Province, South Africa (SA).Methods. All data collected to date were obtained from the EC District Health Information System. According to the information collected from the Department of Health, diabetes-related data collection fields were implemented in 2013, which resulted in this 4-year study. Additional open-source data on population estimates, mortality and medical aid coverage were provided by Statistics SA.Results. Of the eight districts in the province, O R Tambo was recorded as having the highest average proportion of new patients diagnosed with diabetes. A positive correlation was found between the calculated incidence of disease and the diabetes mortality rate.Conclusions. The study showed an annual growth in the incidence of diabetes in the EC since 2014, and highlights the issue of an increasing burden of diabetes in the rural population. This increase is consonant with predictions by authoritative bodies on the growing burden of diabetes in Africa. The pattern of distribution highlights the deprived district of O R Tambo contradicting the well-known link between diabetes and urbanisation

Distribution, incidence, prevalence and default of patients with diabetes mellitus accessing public healthcare in the 11 districts of KwaZulu-Natal, South Africa

Background. The global increase in the prevalence of diabetes mellitus is most marked in African countries. The District Health Information System (DHIS) is the primary data collection system of the Department of Health in KwaZulu-Natal Province (KZN), South Africa. Data are routinely collected at all public healthcare facilities in the province and are aggregated per facility.Objective. To investigate the distribution, incidence and prevalence of diabetes in the public healthcare sector of KZN.Methods. Data collected by the DHIS for all patients with diabetes in KZN from 1 January 2010 to 31 December 2014 inclusive were analysed. Additional open-source databases were accessed to enable further exploration of the data collected.Results. The study showed that the majority (38.7%) of patients with diabetes on the public sector register were from the district of eThekwini. Positive correlations were found between the prevalence of diabetes, the mortality rate and the number of defaulters (patients with diabetes who did not return for regular treatment).Conclusions. Provincial estimates of the prevalence of diabetes in this study were higher than the known national prevalence. This may be due to the large proportion of Indians in KZN, who have a genetic predisposition to diabetes mellitus. However, allowance must be made for possible inaccurate data collection at source with miscounting of individuals. This study supports the global trend of an association between diabetes and urbanisation and highlights the need for regular diabetes screening and education, particularly in the public healthcare domain

Feedback as a means to improve clinical competencies: Consultants’ perceptions of the quality of feedback given to registrars

Background. Effective supervision by consultants in postgraduate medical education involves the process of feedback. Giving feedback may be challenging for consultants who have no formal training in this process, which may be further compounded in heterogeneous diverse settings.Objective. To explore consultants’ perceptions of feedback to registrars in a multicultural, multilingual diverse academic hospital setting.Methods. Thirty-seven consultants consented to completing a questionnaire on what, when, where, how often, and how feedback was provided, as well as on the type and effect of feedback to registrars. Descriptive statistics were used to analyse the data. Differences between groups were calculated using Pearson’s χ² test for independent variables, with a p-value of <0.05 regarded as being statistically significant.Results. Only 40% of consultants reported that they provided feedback often or always and 62.2% reported that standards were not predetermined and communicated to registrars. When feedback was provided, it was based on concrete observations of performance (78.4%), it incorporated a plan for improvement (72.9%) and it supplied information on techniques performed incorrectly (72.9%). Only 40.5% of consultants provided feedback on procedures performed correctly. Moreover, only half of the consultants believed they were proficient at giving feedback.Conclusion. Consultants need to develop the art of giving feedback through appropriate training so that they are more comfortable and proficient with the various aspects of feedback, leading to a positive effect on enhancing registrar training

Distribution, incidence, prevalence and default of patients with diabetes mellitus accessing public healthcare in the 11 districts of KwaZulu-Natal, South Africa

Background. The global increase in the prevalence of diabetes mellitus is most marked in African countries. The District Health Information System (DHIS) is the primary data collection system of the Department of Health in KwaZulu-Natal Province (KZN), South Africa. Data are routinely collected at all public healthcare facilities in the province and are aggregated per facility.Objective. To investigate the distribution, incidence and prevalence of diabetes in the public healthcare sector of KZN.Methods. Data collected by the DHIS for all patients with diabetes in KZN from 1 January 2010 to 31 December 2014 inclusive were analysed. Additional open-source databases were accessed to enable further exploration of the data collected.Results. The study showed that the majority (38.7%) of patients with diabetes on the public sector register were from the district of eThekwini. Positive correlations were found between the prevalence of diabetes, the mortality rate and the number of defaulters (patients with diabetes who did not return for regular treatment).Conclusions. Provincial estimates of the prevalence of diabetes in this study were higher than the known national prevalence. This may be due to the large proportion of Indians in KZN, who have a genetic predisposition to diabetes mellitus. However, allowance must be made for possible inaccurate data collection at source with miscounting of individuals. This study supports the global trend of an association between diabetes and urbanisation and highlights the need for regular diabetes screening and education, particularly in the public healthcare domain

Implementation of Low Cost Automatic Gear Suggestion System

The present automatic transmission is fully mechanically controlled and costs very high. But the proposed gear suggestion mechanism design makes driving much easier and to achieve efficient driving. It is similar to other transmission system on vehicle as it allows an internal combustion engine, best suited to run at high rotational speed to provide torque outputs necessary for vehicular travel. By this system the manual mechanical gear-shifting system will remain unchanged because it suggests the gear change based on increased speed. This article touches on a PIC microcontroller and a Proximity sensor. The main advantage of using mid-range microcontroller is that it is of low-cost and reliable. This technique can also be used to identify the gear position. DOI: 10.17762/ijritcc2321-8169.16045

Effects of personality traits on mindful self-care practices of healthcare workers

Background: Coronavirus disease 2019 (COVID-19) placed healthcare professionals (HCPs) at a higher risk for stress-related conditions. Implementing a brief online mindfulness-based intervention (MBI) was hypothesised to transform the HCPs’ ability to cope with stress by enhancing their self-care. Aim: This study aimed to explore the impact of an online MBI on HCPs’ self-care practices and determine if personality traits were a moderating variable. Setting: An online MBI was implemented for HCPs working in South Africa during the COVID-19 pandemic lockdowns. Methods: A quantitative study design included a pre-assessment and post-assessment component, which allowed paired comparison and regression analysis to confer correlations. Data were collected via two validated instruments: the Mindful Self-Care scale-2018 and the Big Five Personality test. Results: Forty-nine HCPs participated in the study. Significant improvements were found in all the major self-care subscales post-intervention (p 0.05). No significant associations were found between the personality traits and self-care except for neuroticism, which appeared to be an essential moderating variable. Conclusion: An online MBI significantly impacted health professionals’ ability to care for themselves, despite their personality styles. Contribution: The impact of an online MBI on HCPs’ self-care during the most intense time of stress and with a cohort of people known to be the most vulnerable to stress, namely those with neuroticism to date, has not been commented on

The Whole is Greater than the Sum: A Longitudinal Study of Demographic Influences on Medical Student Assessment Scores

Abstract The literature on academic success has contributed to our understanding of positive and negative influences on learners' accomplishments. With some exceptions, however, their subjects have been school pupils, who represent the community at large. Relatively few studies have examined tertiary education students, and these studies generally focus on subsets of a particular factor in isolation. Taking a systems theory view, we addressed the question: What factors regarding the learner contribute to the teaching and learning 'system'? Using mixed methods, this longitudinal study explores a range of demographic characteristics that influenced the assessment scores of medical students through their five-year curriculum. For the initial analysis we used the general linear model. A generalised estimating equation was used to analyse the characteristics collectively to assess their influence relative to each other. Students' and staff members' opinions on these factors were also explored through thematic analysis. Of the nine factors investigated, only four appeared statistically to exert independent influences on students' academic achievements. These four influences (high school attended, previous higher education experience, the sequence of tests through the years, final school-leaving marks) seemed to A Longitudinal Study of Demographic Influences on Assessment Scores 29 apply throughout the five year course. The variety of our interviewees' responses helped us to understand the nuances of these influences. While not negating the findings of studies on isolated factors, this study does also challenge the validity of such analyses. The use of a different methodology -two layers of statistical analysis, plus qualitative dataallowed us to demarcate which of the factors examined appeared to be of overall significance in the system related to student achievement in assessments, and to understand why that might be so

“For most of us Africans, we don’t just speak”: a qualitative investigation into collaborative heterogeneous PBL group learning

Collaborative approaches such as Problem Based Learning (PBL) may provide the opportunity to bring together diverse students but their efficacy in practice and the complications that arise due to the mixed ethnicity needs further investigation. This study explores the key advantages and problems of heterogeneous PBL groups from the students’ and teachers’ opinions. Focus groups were conducted with a stratified sample of second year medical students and their PBL teachers. We found that students working in heterogeneous groupings interact with students with whom they don’t normally interact with, learn a lot more from each other because of their differences in language and academic preparedness and become better prepared for their future professions in multicultural societies. On the other hand we found students segregating in the tutorials along racial lines and that status factors disempowered students and subsequently their productivity. Among the challenges was also that academic and language diversity hindered student learning. In light of these the recommendations were that teachers need special diversity training to deal with heterogeneous groups and the tensions that arise. Attention should be given to create ‘the right mix’ for group learning in diverse student populations. The findings demonstrate that collaborative heterogeneous learning has two sides that need to be balanced. On the positive end we have the ‘ideology’ behind mixing diverse students and on the negative the ‘practice’ behind mixing students. More research is needed to explore these variations and their efficacy in more detail

Overcoming cross-cultural group work tensions: mixed student perspectives on the role of social relationships

As universities worldwide rapidly internationalise, higher education classrooms have become unique spaces for collaboration between students from different countries. One common way to encourage collaboration between diverse peers is through group work. However, previous research has highlighted that cross-cultural group work can be challenging and has hinted at potential social tensions. To understand this notion better, we have used robust quantitative tools in this study to select 20 participants from a larger classroom of 860 students to take part in an in-depth qualitative interview about cross-cultural group work experiences. Participant views on social tensions in cross-cultural group work were elicited using a unique mediating artefact method to encourage reflection and in-depth discussion. In our analysis of emergent interview themes, we compared student perspectives on the role of social relationships in group work by their academic performance level. Our findings indicated that all students interviewed desired the opportunity to form social relationships with their group work members, but their motivations for doing so varied widely by academic performance level

Lipids Regulate Lck Protein Activity through Their Interactions with the Lck Src Homology 2 Domain.

Lymphocyte-specific protein-tyrosine kinase (Lck) plays an essential role in T cell receptor (TCR) signaling and T cell development, but its activation mechanism is not fully understood. To explore the possibility that plasma membrane (PM) lipids control TCR signaling activities of Lck, we measured the membrane binding properties of its regulatory Src homology 2 (SH2) and Src homology 3 domains. The Lck SH2 domain binds anionic PM lipids with high affinity but with low specificity. Electrostatic potential calculation, NMR analysis, and mutational studies identified the lipid-binding site of the Lck SH2 domain that includes surface-exposed basic, aromatic, and hydrophobic residues but not the phospho-Tyr binding pocket. Mutation of lipid binding residues greatly reduced the interaction of Lck with the chain in the activated TCR signaling complex and its overall TCR signaling activities. These results suggest that PM lipids, including phosphatidylinositol 4,5-bisphosphate and phosphatidylinositol 3,4,5-trisphosphate, modulate interaction of Lck with its binding partners in the TCR signaling complex and its TCR signaling activities in a spatiotemporally specific manner via its SH2 domain.1175Ysciescopu