Screening for gestational diabetes: examining a breakfast meal test

Objective: This study was performed to analyse the carbohydrate quantity of the non-standardised breakfast meal test consumed as part of a screening test for gestational diabetes.Design: A prospective descriptive design was utilised.Setting: Screening for gestational diabetes was performed in the High-Risk Antenatal Clinic at Tygerberg Academic Hospital, Cape Town, South Africa.Subjects: Fifty pregnant women who met the local selection criteria for diabetes screening.Outcome measures: The contents of the patient-provided breakfast meal tests were evaluated individually for total carbohydrate amount and compared with the 75 grams of carbohydrate provided by the oral glucose tolerance test (OGTT).Results: The median carbohydrate amount was 71 g but the range (55–145 g) was wide. Only seven meals (14%) fell within 10% of the 75 g carbohydrate target.Conclusion: The patient-provided breakfast meal showed wide variation in carbohydrate amount. If a meal test is to be used instead of the formal OGTT a carefully measured, prepared, palatable, readily available product would need to be sourced and provided.Layman’s summary: It is necessary to screen for the development of diabetes during pregnancy. The standard test with 75 g of glucose is unpalatable and is sometimes replaced by a meal test. However, when this meal test is provided by the women themselves without standardisation, the sugar and starch quantities are too variable. Careful consideration needs to be given to an alternative screening test if it is to be reliable.Strong lay message: Non-standardised screening meal tests for gestational diabetes should not be used.Keywords: gestational diabetes, meal test, screenin

Blood ordering practices in the management of ectopic pregnancy at Groote Schuur hospital

The International Society for Burns Injuries (ISBI) has published guidelines for the management of multiple or mass burns casualties, and recommends that 'each country has or should have a disaster planning system that addresses its own particular needs.' The need for a national burns disaster plan integrated with national and provincial disaster planning was discussed at the South African Burns Society Congress in 2009, but there was no real involvement in the disaster planning prior to the 2010 World Cup; the country would have been poorly prepared had there been a burns disaster during the event. This article identifies some of the lessons learnt and strategies derived from major burns disasters and burns disaster planning from other regions. Members of the South African Burns Society are undertaking an audit of burns care in South Africa to investigate the feasibility of a national burns disaster plan. This audit (which is still under way) also aims to identify weaknesses of burns care in South Africa and implement improvements where necessary

Blood ordering practices in the management of ectopic pregnancy at Groote Schuur hospital

No Abstract

The initial impact of the COVID-19 pandemic on the diagnosis of new cancers at a large pathology laboratory in the public health sector, Western Cape Province, South Africa

Background. The COVID-19 pandemic has disrupted cancer diagnostic services. A decline in the number of new cancers being diagnosed over a relatively short term implies a delay in diagnosis and subsequent treatment. This delay is expected to have a negative effect on cancerrelated morbidity and mortality. The impact of the pandemic on the number of new cancer diagnoses in our setting is unknown.Objectives. To assess the impact of COVID-19 on the number of new cancers diagnosed at our institution in the first 3 months following the implementation of lockdown restrictions, by focusing on common non-cutaneous cancers.Methods. A retrospective laboratory-based audit was performed at a large anatomical pathology laboratory in Western Cape Province, South Africa. The numbers of new diagnoses for six common cancers (breast, prostate, cervix, large bowel, oesophagus and stomach) from 1 April 2020 to 30 June 2020 were compared with the corresponding period in 2019.Results. Histopathological diagnoses for the six cancers combined decreased by 193 (–36.3%), from 532 new cases in the 2019 study period to 339 in the corresponding period in 2020. Substantial declines were seen for prostate (–58.2%), oesophageal (–44.1%), breast (–32.9%), gastric (–32.6%) and colorectal cancer (–29.2%). The smallest decline was seen in cervical cancer (–7%). New breast cancers diagnosed by cytopathology declined by 61.1%.Conclusions. The first wave of the COVID-19 pandemic and the associated response resulted in a substantial decline in the number of new cancer diagnoses, implying a delay in diagnosis. Cancer-related morbidity and mortality is expected to rise as a result, with the greatest increase in mortality expected from breast and colorectal cancer

“Managing Staff WFH in Crisis Times” - How Are Teacher Education Managers Supporting Staff Working Remotely at an Odel College?

The sudden onslaught of the Covid-19 pandemic changed how university managers operate. Staff working from home (WFH) needed support and teacher education managers (TEM) played an important role in giving such support. This study is underpinned by the crisis leadership theory and ubuntu-oriented management style. The aim of this exploratory study is to ascertain the support strategies provided by TEM to staff WFH during the Covid-19 pandemic. To achieve the aim, this study investigates motivational support TEM provided to staff WFH during the pandemic. The aim included establishing which stress management techniques TEM used to support staff WFH and explore communicative tools used to support staff WFH.  The constructivist-interpretivist lens is foregrounding the qualitative single case research, exploring the kind of support that six distance managers provided to staff WFH at an open distance e-learning university. Results revealed that staff WFH were acknowledged and rewarded for hard work and excellence. Several web-based video-conferencing sessions were offered through online Teams webinars, seminars, workshops and stress management techniques. Further research needs to be undertaken to determine, through a mixed-method design, how TEM employed stress management techniques for staff WFH, which may yield different results

The effect of carbohydrate dose and timing on timed effort and time to exhaustion within a simulated cycle race in male professional cyclists

A key performance limitation affecting professional endurance cycling is carbohydrate storage and utilisation (Pöchmüller, Schwingshack, Colombani & Hoffmann, 2016, Journal of the International Society of Sports Nutrition, 13). Muscle glycogen stores alone are inefficient at maintaining optimal blood glucose levels beyond two hours of exercise; consequently, exogenous CHO is commonly used to counteract this (Jeukendrup, 2011, Journal of Sports Sciences, 21, 91-99). High concentrations of CHO can cause drops in blood glucose, excessive glycogen utilisation and gastrointestinal discomfort (GID) (Jeukendrup, 2011). Therefore, the aim of this study was to determine if frequent, smaller CHO feedings would be preferable to large, bolus CHO feedings on time trial cycling performance. With institutional ethics approval, 5 professional cyclists completed a 4h simulated cycle ride with 3 timed efforts in a randomised, cross-over, double blind design study. Each timed effort occurred in the last 10 min of each hour (TE1, TE2, TE3); participants were asked to cycle with maximum effort for this time. There was also a final effort at the end of the 4th hour to replicate a sprint finish. This was measured as time to exhaustion (TTE). Two interventions were used; a frequent feed (F) where participants drank 20g maltodextrin in 300ml flavoured water solution 3 times per hour and a bolus feed (B) where participants drank 60g maltodextrin solution once per hour. Heart rate, power output, GID, perceived exertion (RPE), blood lactate and blood glucose were recorded before and after TE1, TE2, TE3 and TTE. Wilcoxen signed rank test and Cohen’s D was performed to study differences between interventions and effect sizes.In the F intervention, average watts were significantly higher at TE2 (P<0.05 d=0.75) and TE3 (P<0.05 d=1.21) and the RPE was lower TE1 (P≥0.05 d=1.12), TE2 (P<0.05, d=1.12) and TTE (P≥0.05 d=1.12) compared to B. There was no significant difference between any other variables. The results suggest that despite power output being higher, RPE was lower in the F intervention. Gut absorption of CHO is limited to 1g/h (Jeukendrup, 2011), which may help explain these findings. This is one of the first studies to look at concentration and timing of CHO consumption in endurance cycling. Regular feeds of 20g CHO may be more beneficial on power output and RPE in endurance cycling compared to hourly 60g feeds

Fruit anatomy of the genus Bupleurum (Apiaceae) in northeastern China and notes on systematic implications

The fruit anatomy of all eight species of the genus Bupleurum L. mentioned in the most recent literature from northeastern China was studied for the first time. The eight species were divided into two groups based on the shape of the mericarps in transverse section. The first group (round mericarps without prominent ribs) includes B. longiradiatum and B. komarovianum, and the second group (angular mericarps with prominent ribs) includes B. angustissimum, B. bicaule, B. chinense, B. euphorbioides, B. scorzonerifolium and B. sibiricum. The second group can be further subdivided into group 2a (large vittae, very small vascular bundles) — B. euphorbioides and B. sibiricum, and group 2b (small vittae, large vascular bundles) — B. angustissimum, B. bicaule, B. chinense and B. scorzonerifolium. This result closely supports the traditional classification system which was based on gross morphology (plant height; leaf shape and size; involucre number, size and shape). The only exception is that B. komarovianum should not be close to the second group, but close to B. longiradiatum. Group 1 corresponds with Bupleurum sect. Longifolia and group 2 with sect. Eubupleura; group 2a with ser. Ranunculoides and group 2b with ser. Falcata. Fruit anatomical characters seem to have potential for evaluating infrageneric relationships in the genus Bupleurum

Self-efficacy enhanced in a cross-cultural context through an initiative in under-resourced schools in KwaZulu-Natal, South Africa

This paper discusses the Khanyisa Programme, an initiative in KwaZulu-Natal, South Africa, where learners from under-resourced schools are supported by teachers and high achievers in Grade 11 and 12 from a previously advantaged state school under apartheid. A qualitative, evaluative study was undertaken to identify key elements in the ongoing success of the programme and collect participant suggestions for improvement. The findings, discussed within the framework of self-efficacy theory, identified enormous gains by Khanyisa learners, leading to vastly improved career prospects

Praziquantel: its use in control of schistosomiasis in sub-Saharan Africa and current research needs

Treatment with praziquantel (PZQ) has become virtually the sole basis of schistosomiasis control in sub-Saharan Africa and elsewhere, and the drug is reviewed here in the context of the increasing rate that it is being used for this purpose. Attention is drawn to our relative lack of knowledge about the mechanisms of action of PZQ at the molecular level, the need for more work to be done on schistosome isolates that have been collected recently from endemic areas rather than those maintained in laboratory conditions for long periods, and our reliance for experimental work mainly on Schistosoma mansoni, little work having been done on S. haematobium. There is no evidence that resistance to PZQ has been induced in African schistosomes as a result of its large-scale use on that continent to date, but there is also no assurance that PZQ and/or schistosomes are in any way unique and that resistant organisms will not be selected as a result of widespread drug usage. The failure of PZQ to produce complete cures in populations given a routine treatment should therefore solicit considerable concern. With few alternatives to PZQ currently available and/or on the horizon, methods to monitor drug-susceptibility in African schistosomes need to be devised and used to help ensure that this drug remains effective for as long a time as possibl