The relationship of overweight and obesity to the motor performance of children living in South Africa

Objectives: This study aimed to determine the relationship between overweight and obesity and the motor performance of nine- to 13-year-old South African children.Design: The study used a one-way cross-sectional design based on baseline measurements.Settings and subjects: The research group comprised 280 Grade 4, 5 and 6 learners (128 boys and 152 girls) from two schools that represented a distribution of socio-economic status, race and gender.Outcome measures: Anthropometric [(body mass index (BMI) and fat percentage] and motor performance measurements (fine manual control, manual coordination, body coordination and strength and agility) were obtained by means of the Fitnessgram and the Bruininks-Oseretsky Test of Motor Proficiency-II. International age-specific cut-off points were used to classify the children’s body composition as normal weight, overweight or obese. Data were analysed by means of descriptive statistics, correlation matrices and analysis of variance, followed by a Tukey post hoc analysis.Results: The results showed that running speed and agility decreased significantly with an increase in BMI. Muscular strength also decreased significantly with a smaller practical significance, while fine manual control, manual coordination, and body coordination showed the weakest relationship to BMI. Analysis of variance showed significant relationships between BMI and running speed and agility (p-value < 0.05). These relationships were influenced differently by gender and ethnicity.Conclusion: The motor performance of young South African children was negatively influenced by overweight and obesity. Intervention strategies are recommended to reduce the consequences of overweight and obesity in the overall development of such children.S Afr Fam Pract 2012;54(5):429-43

The Impact of Surface Coal Mining on the Pre- and Post-Mining Agricultural Potential of the Grassland Biome of Southern Africa

Surface mining of coal is widespread in the grassland areas of the Mpumalanga Province in South Africa, and is the main cause of many environmental impacts in this agriculturally important region. To ensure healthy and productive vegetation after the reclamation process, disturbed soils need to be ameliorated and re-vegetated with locally adapted grass species to protect, preserve and improve soils for future agricultural use. To date, soil compaction is regarded as one of the main factors that cause severe restrictions in the effective rooting depth of plants, and the level of compaction is strongly influenced by altered soil water contents, soil texture, soil structure and often non-existing organic matter contents. Imported organic materials and enhanced plant root development may lead to reduced effects of soil compaction and an increased amount of moisture in the soil profile, which becomes available for plant growth during the growing season. This research focussed on the various amelioration aspects to alleviate and mitigate soil compaction to promote sustainable vegetation establishment and production to reinstate the agricultural potential of the disturbed environment. With associated soil amelioration, an increase in biomass production, of selected plant species was noted to be 52% higher on soil that was amended with 40 t/ha of organic amendment, in comparison to the soil that did not receive any. The correct selection of species with a known root structure and basic management requirement has, therefore, the potential to be useful in creating an organically rich, alleviated and more sustainable soil environment to ensure improved rehabilitation results of surface coal mines. It can be concluded, that sufficient data has shown that reclaimed surface coal mine soils can serve as a valuable resource to the animal production industry as well as to local communities, if managed correctly

A case control study of breast cancer risk and exposure to injectable progestogen contraceptives

No Abstract

Grass Diversity and Pasture Quality Baseline Assessement in Central Madagascar

Poaceae family contributes to Madagascar’s biodiversity hotspot with 217 of 541 grass species endemic to the island, although their forage value is unknown, at least in the scientific literature. Our research aims 1) to describe the diversity of native and endemic grasses thereby recognising the role of grass species diversity in forage and ecosystem management and 2) to provide new knowledge about pasture management based on the relationship between grazing capacity and productivity within experimental pastureland plots under different fire and grazing treatments. Our study seeks to provide information to inform improvements in livestock nutrition via grazing management of natural pastures in central Madagascar, specifically around the Ankafobe, Ibity and Itremo Protected Areas. Sampling in different grassy habitats was undertaken to develop a grass checklist and overview of grass diversity across the project sites. Further, in the communal and experimental pastures standardised grass surveys were carried out to compare grazing capacity and biomass productivity in the experimental pastures. Our regional survey recorded 123 Poaceae species during the first year: including 90% native species (of which 34% were endemic) and 10% introduced species. Thirty species, all C4 and belonging to PACMAD clade, are found within established pasture grasslands. Across communal pastures the most frequently recorded species and thus most frequently grazed are Loudetia simplex, Aristida rufescens, Panicum luridum, Schizachyrium sanguineum, Hyparrhenia rufa and Aristida tenuissima – these species are predominantly associated with fire. The grazing capacity baseline, at about 0.7 to 0.8 ha/zebu/year, is similar across all experimental sites that are also characterised by having a similar climate, acidic soils with low nitrogen and phosphorus, and., Annual biomass production appears to be driven by fire frequency: at both Itremo and Ankafobe, where fire is an annual occurrence, biomass yield is 2.4-2.9t/ha whereas at Ibity, where fire frequency is fire every 3-4 years, biomass productivity is 6.9t/ha. However, it is unclear how these productivity estimates relate to forage quality; the relationship will be the subject of future work

Smallholder Zebu and Forage Production Development in Central Madagascar

Poverty in the Central Highlands of Madagascar is partly driven by inefficient exploitation of native forages and poor livestock nutrition. Zebus are of importance as cultural symbols, but this tradition has grown disconnected from agricultural policy. This project is working with three central highland communities near the protected areas of Itremo, Ibity and Ankafobe, to boost rangeland productivity and trial management methods which will support key forage grasses and improve livestock nutrition. A severe nitrogen deficiency compounded by extremely acidic soil conditions and low phosphorus is observed across the three sites. The lowest grazing capacity of an estimated 0.7 livestock unit per hectare and biomass production of 1600 kg/ha is observed at Ankafobe, the highest elevation windy site with fires that are almost annual. Low production is due to acidic soils with a lack of phosphorus as well as likely iron toxicity. The project works with 90 households owning a total 150 female zebu, 1-5 per household. The project initiated 3 demonstration farms to show the planting of sorghum for silage, harvesting of the native grasses for hay, and building a secure barn meeting at least minimum animal care standards, using local materials to protect the livestock from the weather and theft which is sadly perceived to be common. In the first year the project produced the highest yields in the most remote and fertile site of Itremo, with 365 kg of sorghum silage from 0.5 ha and 165 kg of Brachiaria hay from 0.5 ha. Five households based in the milk producing region of eastern Ibity have completed new barns. Fifty percent of households at Ibity successfully fed silage and hay to their zebu for the first time. Madagascar remains famous for subsistence farming and rural poverty with a long-term decline in livestock, but substantial opportunity nevertheless exists for integrated crop and livestock production, alongside the protection of biodiversity in nearby forests

Principles for transformative ocean governance

With a focus on oceans, we collaborated across ecological, social and legal disciplines to respond to the United Nations call for transformation in the ‘2030 Agenda for Sustainable Development’. We developed a set of 13 principles that strategically and critically connect transformative ocean research to transformative ocean governance (complementing the UN Decade for Ocean Science). We used a rigorous, iterative and transparent consensus-building approach to define the principles, which can interact in supporting, neutral or sometimes conflicting ways. We recommend that the principles could be applied as a comprehensive set and discuss how to learn from their interactions, particularly those that reveal hidden tensions. The principles can bring and keep together partnerships for innovative ocean action. This action must respond to the many calls to reform current ocean-use practices which are based on economic growth models that have perpetuated inequities and fuelled conflict and environmental decline

Prescribing indicators at primary health care centers within the WHO African region: a systematic analysis (1995-2015)

Abstract Background Rational medicine use is essential to optimize quality of healthcare delivery and resource utilization. We aim to conduct a systematic review of changes in prescribing patterns in the WHO African region and comparison with WHO indicators in two time periods 1995–2005 and 2006–2015. Methods Systematic searches were conducted in PubMed, Scopus, Web of science, Africa-Wide Nipad, Africa Journals Online (AJOL), Google scholar and International Network for Rational Use of Drugs (INRUD) Bibliography databases to identify primary studies reporting prescribing indicators at primary healthcare centres (PHCs) in Africa. This was supplemented by a manual search of retrieved references. We assessed the quality of studies using a 14-point scoring system modified from the Downs and Black checklist with inclusions of recommendations in the WHO guidelines. Results Forty-three studies conducted in 11 African countries were included in the overall analysis. These studies presented prescribing indicators based on a total 141,323 patient encounters across 572 primary care facilities. The results of prescribing indicators were determined as follows; average number of medicines prescribed per patient encounter = 3.1 (IQR 2.3–4.8), percentage of medicines prescribed by generic name =68.0 % (IQR 55.4–80.3), Percentage of encounters with antibiotic prescribed =46.8 % (IQR 33.7–62.8), percentage of encounters with injection prescribed =25.0 % (IQR 18.7–39.5) and the percentage of medicines prescribed from essential medicines list =88.0 % (IQR 76.3–94.1). Prescribing indicators were generally worse in private compared with public facilities. Analysis of prescribing across two time points 1995–2005 and 2006–2015 showed no consistent trends. Conclusions Prescribing indicators for the African region deviate significantly from the WHO reference targets. Increased collaborative efforts are urgently needed to improve medicine prescribing practices in Africa with the aim of enhancing the optimal utilization of scarce resources and averting negative health consequences

Initiatives across countries to reduce antibiotic utilization and resistance patterns : impact and implications

Greater accessibility to antibiotics has resulted in their excessive use, leading to increasing antimicrobial resistance (AMR) and strains on healthcare systems, with only a limited number of patients in ambulatory care treated according to guidelines. High rates of AMR are now seen across countries and continents, resulting in AMR becoming one of the most critical issues facing healthcare systems. It is estimated that AMR could potentially cause over 10 million deaths per year by 2050 unless addressed, resulting in appreciable economic consequences. There are also concerns with under-treatment especially if patients are forced to fund more expensive antibiotics as a result of AMR to first line antibiotics and do not have available funds. Over-prescribing of antibiotics is not helped by patient pressure even when physicians are aware of the issues. There is also extensive dispensing of antibiotics without a prescription; although this is now being addressed in some countries. Review interventions that have been instigated across continents and countries to reduce inappropriate antibiotic prescribing and dispensing, and associated AMR, to provide future guidance. Narrative case history approach. A number of successful activities have been instigated to reduce inappropriate prescribing and dispensing of antibiotics across sectors. These include the instigation of quality indicators, suggested activities of pharmacists as well as single and multiple interventions among all key stakeholder groups. Multiple inter-linking strategies are typically needed to enhance appropriate antibiotic prescribing and dispensing. The impact of ongoing activities need to be continually analysed to provide future direction if AMR rates, and their impact on subsequent morbidity, mortality and costs, are to be reduced

Prescribing patterns in dementia: a multicentre observational study in a German network of CAM physicians

<p>Abstract</p> <p>Background</p> <p>Dementia is a major and increasing health problem worldwide. This study aims to investigate dementia treatment strategies among physicians specialised in complementary and alternative medicine (CAM) by analysing prescribing patterns and comparing them to current treatment guidelines in Germany.</p> <p>Methods</p> <p>Twenty-two primary care physicians in Germany participated in this prospective, multicentre observational study. Prescriptions and diagnoses were reported for each consecutive patient. Data were included if patients had at least one diagnosis of dementia according to the 10th revision of the International Classification of Diseases during the study period. Multiple logistic regression was used to determine factors associated with a prescription of any anti-dementia drug including <it>Ginkgo biloba</it>.</p> <p>Results</p> <p>During the 5-year study period (2004-2008), 577 patients with dementia were included (median age: 81 years (IQR: 74-87); 69% female). Dementia was classified as unspecified dementia (57.2%), vascular dementia (25.1%), dementia in Alzheimer's disease (10.4%), and dementia in Parkinson's disease (7.3%). The prevalence of anti-dementia drugs was 25.6%. The phytopharmaceutical <it>Ginkgo biloba </it>was the most frequently prescribed anti-dementia drug overall (67.6% of all) followed by cholinesterase inhibitors (17.6%). The adjusted odds ratio (AOR) for receiving any anti-dementia drug was greater than 1 for neurologists (AOR = 2.34; CI: 1.59-3.47), the diagnosis of Alzheimer's disease (AOR = 3.28; CI: 1.96-5.50), neuroleptic therapy (AOR = 1.87; CI: 1.22-2.88), co-morbidities hypertension (AOR = 2.03; CI: 1.41-2.90), and heart failure (AOR = 4.85; CI: 3.42-6.88). The chance for a prescription of any anti-dementia drug decreased with the diagnosis of vascular dementia (AOR = 0.64; CI: 0.43-0.95) and diabetes mellitus (AOR = 0.55; CI: 0.36-0.86). The prescription of <it>Ginkgo biloba </it>was associated with sex (female: AOR = 0.41; CI: 0.19-0.89), patient age (AOR = 1.06; CI: 1.02-1.10), treatment by a neurologist (AOR = 0.09; CI: 0.03-0.23), and the diagnosis of Alzheimer's disease (AOR = 0.07; CI: 0.04-0.16).</p> <p>Conclusions</p> <p>This study provides a comprehensive analysis of everyday practice for treatment of dementia in primary care in physicians with a focus on CAM. The prescribing frequency for anti-dementia drugs is equivalent to those found in other German studies, while the administration of <it>Ginkgo biloba </it>is significantly higher.</p