Year in review 2007: Critical Care – cardiology

This review summarises key research papers in the fields of cardiology and intensive care published during 2007 in Critical Care. To create a context and for comparison with the papers described in the review, we cite studies on the same subject published in other journals. The papers have been grouped into four categories: venous oximetry, cardiac surgery, perioperative fluid optimisation, and haemodynamic monitoring

Year in review 2008: Critical Care - cardiology

We review key research papers in cardiology and intensive care published during 2008 in Critical Care. We quote studies on the same subject published in other journals if appropriate. Papers have been grouped into three categories: (a) cardiovascular biomarkers in critical illness, (b) haemodynamic management of septic shock, and (c) haemodynamic monitoring

Do statins have a role in preventing or treating sepsis?

Statins have a variety of properties that are independent of their lipid lowering ability. These anti-inflammatory, antioxidant, immunomodulatory, and antiapoptotic features have been collectively referred to as pleiotropic effects. Severe sepsis is an intense infection-induced inflammatory syndrome that ultimately results in organ dysfunction. Because so many cascades are triggered during sepsis, merely blocking a single component may be insufficient to arrest the inflammatory process. A growing body of evidence suggests that statins may indeed have a protective effect against severe sepsis and reduce the rate of infection-related mortality. This novel primary prevention concept may have far-reaching implications for the future management of serious infections. Moreover, it was recently shown that statins potentially improve outcome after the onset of sepsis. The stage is now set for randomized clinical trials that will determine the precise role, if any, that statins may have in preventing and treating sepsis

Statins, bugs and prophylaxis: intriguing possibilities

Statin therapy may represent a potential prophylactic intervention in certain high-risk scenarios, for example in pandemic influenza and in those undergoing aggressive medical treatments. Emerging data indicate a potential prophylactic role in these high-risk groups

Statin therapy in critical illness : an international survey of intensive care physicians' opinions, attitudes and practice

Background Pleotropic effects of statins on inflammation are hypothesised to attenuate the severity of and possibly prevent the occurrence of the host inflammatory response to pathogen and infection-related acute organ failure. We conducted an international survey of intensive care physicians in Australia, New Zealand (ANZ) and United Kingdom (UK). The aims of the survey were to assess the current prescribing practice patterns, attitudes towards prescribing statin therapy in critically ill patients and opinions on the need for an interventional trial of statin therapy in critically ill patients. Methods Survey questions were developed through an iterative process. An expert group reviewed the resulting 26 items for face and content validity and clarity. The questions were further refined following pilot testing by ICU physicians from Australia, Canada and the UK. We used the online Smart SurveyTM software to administer the survey. Results Of 239 respondents (62 from ANZ and 177 from UK) 58% worked in teaching hospitals; most (78.2%) practised in ‘closed’ units with a mixed medical and surgical case mix (71.0%). The most frequently prescribed statins were simvastatin (77.6%) in the UK and atorvastatin (66.1%) in ANZ. The main reasons cited to explain the choice of statin were preadmission prescription and pharmacy availability. Most respondents reported never starting statins to prevent (65.3%) or treat (89.1%) organ dysfunction. Only a minority (10%) disagreed with a statement that the risks of major side effects of statins when prescribed in critically ill patients were low. The majority (84.5%) of respondents strongly agreed that a clinical trial of statins for prevention is needed. More than half (56.5%) favoured rates of organ failure as the primary outcome for such a trial, while a minority (40.6%) favoured mortality. Conclusions Despite differences in type of statins prescribed, critical care physicians in the UK and ANZ reported similar prescription practices. Respondents from both communities agreed that a trial is needed to test whether statins can prevent the onset of new organ failure in patients with sepsis

Creating and maintaining a commercially viable executive coaching practice in South Africa

Background: The executive coaching industry is growing internationally and in South Africa. As is typical of small businesses, many struggle to survive. Factors contributing to small business success have been researched, but research in the context of the executive coaching industry in South Africa is sparse. Aim: The aim of this study was to investigate the factors that contribute to creating and maintaining a commercially viable executive coaching practice by examining executive coaching businesses through the lens of a standard business model template consisting of value network, value architecture, value proposition and value finance dimensions. Method: A qualitative methodology was followed to gather data from executive coaches in South Africa. Data from two focus groups (eight participants) and four semi-structured interviews were analysed using deductive content analysis to ascertain the nature of executive coaching practices in terms of a standard business model template. Results: The most significant factors contributing to a successful executive coaching business include forming alliances, leveraging previous experience, employing multiple income streams and evolving as business owner. Significant factors that present challenges include the lack of a business strategy, finding clients and underestimating earnings potential. These findings could assist aspiring and established executive coaches to plan and structure their coaching business. Executive coach training providers could incorporate these findings into their curricula to prepare new coaches for the realities of running a coaching business. Conclusion: Empirical evidence of factors that contribute to successful executive coaching businesses may help guide coaches to a more realistic view of the profession, in the process contributing to the maturing of the growing executive coaching industry in South Africa

Unlocking the potential of harvester on-board-computer data in the South African forestry value chain

Thesis (MScFor)--Stellenbosch University, 2019.ENGLISH ABSTRACT: The South African forest industry is in a state of change from motor-manual to fully mechanised harvesting systems. This is predominately driven by health and safety concerns related to motor-manual harvesting systems, and the need to enhance systems productivity and product quality.Through the use of technologically advanced harvesting machinery with on-board computing systems, and standardised and compatible data collection software, all mechanised processing operations are able to produce real-time (time-stamped) data related to almost every action or function of the machine. The software referred to above is the Standard for Forest Communication (StanForD) first developed by Skogforsk in 1987, as a standard for managing the information flow from the forest machines through the value chain.Although most machines in South Africa are compatible with the StanForD systems, the usefulness of the concept remains under-utilised due to limited understanding of the interface between harvester heads and the computing systems. This includes validating the integrity and accuracy of the data emanating from the system, and that is firmly embedded in quality assurance and computer calibration. The objective of this study is to propose and develop an applicable bark deduction method for Pinuspatula in the Mpumalanga Highveld region of South Africa for more precise log volume calculations. This was accomplished by modelling historical P. patulabark thickness data from the Mpumalanga Highveld region to obtain bark thickness estimates for the two methods of bark deduction to be assessed that are available on the Ponsse Opti OBC system. Three trials were run: T1 (status quo no bark deduction function), T2 (length-based [LB] bark deduction method) and T3 (diameter-class length-based [DLB] bark deduction method). The two bark deduction methods were implemented successfully, and the harvester`s under bark (UB) diameter measurements compared well with manual measured UB diameter measurements which was derived through the novel application of photogrammetry technology. Results showed that if no bark deduction method is used the harvester over-estimates stem volume by 13.7% and 14.6% for each of two respective bark deduction methods. Furthermore, by the nature of P. patula bark being extremely thick at the base of the tree stem, means this over-estimation is even greater for butt logs. The harvester over-iv estimated the log volume of the first plywood log cut by 20.8% for T1, where through the implementation of a bark deduction method the volume estimation was improved to an under-estimation of only 1.6% and 0.2% for T2 and T3 respectively. The results of this study show that by not implementing bark deduction methods the harvester`s log volume estimations are grossly over-estimated and the usefulness of theharvester`s data for value chain management is lost.AFRIKAANSE OPSOMMING: Moderne sny-tot-lengte ontginnings masjiene is ‘n hoogs gesofistikeerd en word beheer deur tegnologies gevorderde aanboord rekenaars. Hierdie rekenaars word bedryf deur `n data format die Standaard for Forest Communication (StanForD) wat aanvanklik in 1987 ontwikkel is deur Skogforsk. Die formaat dien as die data standard vir inligtingsvloei vanaf die ontginnings masjien dwarsdeur die waardeketting tot by die saagmeul. Alhoewel die meeste ontginnings masjiene in Suid-Afrika versoenbaar is met die StanForD data formaat word die bruikbaarheid van die konsep nie ten volle benut nie. Dit is as gevolg van die gebrekkige kennis t.o.v die interaksie tussen die masjien se rekenaar en die ontginnings masjien se sny kop. Dit sluit die bekragtiging van die integriteit en akkuraatheid van die data wat uit die sisteem voortspruit met spesifieke klem op masjien kalibrasie. Die doel van hierdie studie is om ‘n toepaslike bas-dikte-verminderings-metode vir Pinus patula in die Mpumalanga Hoëveld streek van Suid-Afrika vir meer presiese blok volume berekeninge te ontwikkel. Dit was vermag deur die modellering van geskiedkundige data P. patula bas diktheid vir die Mpumulanga Hoeveld streek om die nodige geskatte waardes van bas diktheid te verkry vir die twee beskikbare metodes van bas vermindering wat op die Ponsse Opti aanboord rekenarsisteem beskikbaar was te assesseer. Drie streekproewe was uitgevoer naamlik; T1 (geen bas vermiderings metode), T2 (lengte gebaseerde bas dikte vermindering) en T3 (diameter-klas lengte gebaseerde bas dikte vermindering). Die twee bas verminderings metodes was suksesvol geïmplimenteer en die masjien se blok onder bas deursnee metings was vergelyk met die fisiese gemeete onder bas deursnee meetings wat verkry is deur die gebruik van fotogrammetrie tegnologie.Resultate het gewys dat as daar geen bas verminderings metode gebruik word nie oorskat die masjien se volume skatting met 13.68% en 14.59% vir onderskeidelik T2 en T3 oorskat word. P. patula se bas is verskriklik dik op die onderste gedeelte van die stem wat beteken dat die oorskatting nog groter is vir blokke wat onder op die stam hul oorsprong het. Die masjien het die blok volume vir die eerste veneer blok wat vanuit die stam gesny word vir T1 met 20.81% oorskat as geen bas dikte vermindering metode gebruik word nie, en met die implementiering van `n bas dikte vermindering metode is die volume skatting verbeter na ‘n onderkskatting van slegs 1.59% en 0.18% vir T2 en T3 onderskeidelik. Die resultate van die studie beklemtoon dat deur nie bas verminderings metodes te implimenteer nie word blok volumes oorskat waardeur die bruikbaarheid van die ontginnings masjien se data vir bestuur van die bosbou waardeketting verlore gaan.Master