Atopic dermatitis: tacrolimus vs. topical corticosteroid use

Atopic dermatitis (AD), the dermatological manifestation of the atopic diathesis, has a variety of clinical presentations. It is a chronic and relapsing inflammatory disorder, requiring a multifaceted treatment approach. Topical corticosteroids are the backbone of therapy. However, concerns over adverse drug reactions associated with their long-term application limit their use. Tacrolimus, on the other hand, has been shown to be effective in stabilising the symptoms of AD in the long-term setting, without the side-effects that hamper the use of topical corticosteroids. Long-term safety data up to ten years are available in the literature. Despite this, the US Food and Drug Administration (FDA) black box warning of possible malignancies has resulted in much debate among experts. The main focus of this article is to compare the safety and efficacy of topical corticosteroids to calcineurin inhibitors, particularly tacrolimus. Furthermore, the aim is to evaluate the place of tacrolimus in AD therapy. A brief overview of the condition and other treatment modalities will also be discussed.Keywords: atopic dermatitis, tacroliums, topical corticosteroid us

From implementation to revising simulation integration into undergraduate physiotherapy training

Background. Careful consideration of an increasingly underprepared tertiary student population, the limited use of simulation in South African (SA) healthcare education and a changing healthcare education milieu is required from SA educators when implementing, evaluating and revising simulation integration. Objectives. To develop a conceptual framework for the integration of simulation in the SA undergraduate physiotherapy programme. Methods. A non-experimental descriptive research design was used. A purposive sample of 15 healthcare educationalists from SA and abroad were approached to participate in a modified Delphi survey, informed by the results obtained from a systematic review identifying simulation integration framework elements. Data were analysed as percentages, with feedback provided to panel members following each round. Results. Data saturation was achieved after round 3, with a response rate of 73.3% (n=11). The main findings suggested that student preparation prior to simulation-based learning experiences (SBLEs) should include orientation to SBLE logistics and expectations (73%), and could include informal assessment of theory (64%). Inclusion of the feedback/debriefing process (82%), methods (100%) and timing (85%) as part of student and educator preparation were also deemed essential. Panel members agreed that programme evaluation in line with stakeholder feedback (92%) is vital for guiding adjustments to the programme that is integrating simulation. Conclusion. The developed conceptual framework indicates the necessity of student and educator preparation to ensure optimal SBLE participation and outcome achievement. Programme sustainability should be ensured through programme evaluation and adjustment, in line with stakeholder feedback, best practice and accrediting professional body guidelines

How to plan for simulation integration into undergraduate physiotherapy training

Background. The benefits of simulation in healthcare education are undeniable, and in the current healthcare climate, a drastic change in delivering healthcare training is critical. Therefore, integration of simulation is essential, and necessitates detailed planning and well-trained educators. Objectives. To develop a conceptual framework for the integration of simulation in South African (SA) undergraduate physiotherapy programmes. Methods. A non-experimental descriptive research design using a modified Delphi survey was conducted. Results from a systematic review identifying simulation integration framework elements informed the Delphi survey. A purposive sample of 15 healthcare educationalists from SA and abroad were approached to participate. Data were analysed as percentages, and feedback was provided to panel members following each round. Results. A response rate of 73.3% (n=11) was achieved. Planning was explored as one of the themes. Both institutional- and discipline-specific needs analyses were identified as essential (93%), and societal needs were useful to consider (64%). Resource identification and sharing (84%) were regarded as vital, and expert collaboration in curriculum development (79%) with scaffolded skills integration (75%) was advised. The necessity for trained facilitators (93%) and educator role identification (71%) was evident. Statements related to mastery learning/deliberate practice and the use of simulation for assessment purposes yielded the least consensus. Conclusion. A constructively aligned curriculum based on both student and institutional needs and resource availability in guiding simulation integration was regarded as essential. Educator competency in both the development and delivery of the programme, especially debriefing methods, is vital for optimising student learning

System dynamics as a tool for exploring greenhouse gas emission mitigation potential in freight transport

In this study, system dynamics modelling is used to evaluate the impacts of decisions made by different decision makers in the freight subsector on the performance of the sector, as measured in terms of greenhouse gas (GHG) emissions, direct job creation, water usage and various externality costs. The focus is on gaining a deeper understanding of opportunities for reducing GHGs, and particularly on the shift of freight from road to rail. Transport of processed food along the Cape Town-Gauteng corridor is used as a case study. Decision makers considered include the freight owners and those responsible for decisions around the vehicle fleet. In the model, decision makers respond to a number of aspects of system performance, including cost, system reliability and taxes. These aspects inform their decision to shift freight on or off rail, or to invest in efficiency interventions. Decisions made in one year impact on overall system performance, which may change a decision maker?s actions in the following year. This paper describes in detail the structure of the model and how it functions. It also discusses the necessary input data, and how this was gathered. Finally, simulation results are presented and discussed.Paper presented at the 34th Annual Southern African Transport Conference 6-9 July 2015 "Working Together to Deliver - Sakha Sonke", CSIR International Convention Centre, Pretoria, South Africa.The Minister of Transport, South AfricaTransportation Research Board of the US

How to plan for simulation integration into undergraduate physiotherapy training

Background. The benefits of simulation in healthcare education are undeniable, and in the current healthcare climate, a drastic change in delivering healthcare training is critical. Therefore, integration of simulation is essential, and necessitates detailed planning and well-trained educators. Objectives. To develop a conceptual framework for the integration of simulation in South African (SA) undergraduate physiotherapy programmes. Methods. A non-experimental descriptive research design using a modified Delphi survey was conducted. Results from a systematic review identifying simulation integration framework elements informed the Delphi survey. A purposive sample of 15 healthcare educationalists from SA and abroad were approached to participate. Data were analysed as percentages, and feedback was provided to panel members following each round. Results. A response rate of 73.3% (n=11) was achieved. Planning was explored as one of the themes. Both institutional- and discipline-specific needs analyses were identified as essential (93%), and societal needs were useful to consider (64%). Resource identification and sharing (84%) were regarded as vital, and expert collaboration in curriculum development (79%) with scaffolded skills integration (75%) was advised. The necessity for trained facilitators (93%) and educator role identification (71%) was evident. Statements related to mastery learning/deliberate practice and the use of simulation for assessment purposes yielded the least consensus. Conclusion. A constructively aligned curriculum based on both student and institutional needs and resource availability in guiding simulation integration was regarded as essential. Educator competency in both the development and delivery of the programme, especially debriefing methods, is vital for optimising student learning

Association of the ENPP1 rs997509 polymorphism with obesity in South African mixed ancestry learners

Background: The Ectonucleotide Pyrophosphatase Phosphodiesterase1 (ENPP1) polymorphisms have been associated with metabolic traits. There is no data on the effect of ENPP1 in South African children or adults. Objective: To investigate the role of K121Q (rs1044498), rs997509 and rs9402349 in obesity and other components of the metabolic syndrome. Design: A case-control study. Subjects: Sixty four obese and 64 lean mixed ancestry learners. Setting: Western Cape, South Africa. Main outcome measure: The EN PP1 rs997509T allele is independently associated with obesity in children of mixed ancestry from South Africa. Results: The T allele frequency of the rs997509 differed significantly between obese and controls, p=0.0100 and increased the risk of being obese, p = 0.0238. Furthermore, the estimated effect of the T allele was an increase of 8.6 cm in waist circumference, 10.2 kg in weight and a corresponding 4.9 kg/m2 in BMI. Individuals carrying both the 121Q and the T allele of rs997509 were more associated with obesity (odds ratio = 3.85, 95% CI: 1.13 to 13.09) whilst those carrying the C allele of rs997509 in the presence of 121Q were likely to be lean with odds ratio of obesity 0.41 (95% CI: 0.19 to 0.87). Conclusion: Our findings suggest that ENPP1 polymorphisms may contribute to different metabolic characteristics, all of which are associated with insulin resistance in mixed ancestry children of South Africa. However, a larger study is required to confirm findings of this study.East African Medical Journal Vol. 87 No. 8 August 201

Micro-material handling, employing e-beam coatings of copper and silver

CITATION: Matope, S., Van der Merwe, A. F. & Rabinovich, Y. I. 2012. Micro-material handling, employing e-beam coatings of copper and silver. South African Journal of Industrial Engineering, 23(1):114-121, doi:10.7166/23-1-223.The original publication is available at http://sajie.journals.ac.zaENGLISH ABSTRACT: Van der Waals forces and other adhesive forces impose great challenges on micro-material handling. Mechanical grippers fail to release micro-parts reliably because of them. This paper explores how the problematic Van der Waals forces may be used for micro-material handling purposes using surface roughnesses generated by e-beam coatings of copper and silver on silicon. An atomic force microscope, model Asylum MFP 3 D-Bio with version 6.22A software, was used to measure the forces exerted by the surfaces. A silver coating of 1.41 nm rms surface roughness value is found to exert the highest Van der Waals force, followed by a copper coating of 2.72 nm rms; a copper coating of 217 nm rms exerts the least force. This implies that, in a reliable micro-material handling system, these coatings are suitable for the interactive surfaces of the placement position, micro-gripper, and the pick-up position respectively.AFRIKAANSE OPSOMMING: Van der Waalskragte en ander bindingskragte hou steeds groot uitdagings in vir mikromateriaalhantering. As gevolg van hierdie bindingskragte stel meganiese gryptoerusting nie die mikro-partikels vry nie. Hierdie artikel ondersoek hoe die Van der Waalskragte gebruik kan word vir die mikro-materiaalhanteringsproses deur die gebruik van oppervlakgrofheid gegenereer deur n e-straal-laagbedekking van koper en silwer op silikon. n Atoomkrag mikroskoop, model Asylum MFP 3 D-Bio met weergawe 6.22A programmatuur, is gebruik om die kragte deur die oppervlakke uitgeoefen te meet. Daar is gevind dat n silwer laagbedekking met n oppervlakgrofheid van 1.41nm wortel-gemiddelde-kwadraat (wgk) die hoogste Van der Waalskrag uitoefen, gevolg deur n koper laagbedekking met n oppervlakgrofheid van 2.72nm wgk; n koper laagbedekking met n grofheid van 217nm wgk het die kleinste krag uitgeoefen. Dit impliseer dat, vir n betroubare mikro-materiaalhanteringsisteem, hierdie laagbedekkings geskik is vir die interaktiewe oppervlakke van die plasingsposisie, die mikro-gryper en die optelposisie.http://sajie.journals.ac.za/pub/article/view/223Publisher's versio

Understanding the barriers to a shift of processed food from road to rail through system dynamics

One of the most important greenhouse gas (GHG) mitigation opportunities identified for the freight transport sector is a mode shift from road to rail. A system dynamics model was constructed to evaluate the drivers and barriers to such a mode shift and the impact on the wider economy. This paper focuses on the decision-making process that determines the movement of corridor freight, using processed food on the Cape Town-Gauteng corridor as a case study. In order that the model was an accurate representation which would facilitate discussion amongst decision makers, stakeholders were consulted as to the most important considerations in transporting processed food, their current perception of rail and the barriers to shifting to rail. Stakeholders included not only the decision makers, which included manufacturers of processed food and major retailers, but also Transnet, logistics companies, bodies lobbying government for a switch from road to rail and other experts. The paper presents the insights gained from stakeholder engagement and describes how it informed the construction of the decision-making routines in the system dynamics model. The relative importance of different decision making criteria and the tipping points in the system have begun to be identified, together with the implications of this for achieving a road to rail shift.Paper presented at the 34th Annual Southern African Transport Conference 6-9 July 2015 "Working Together to Deliver - Sakha Sonke", CSIR International Convention Centre, Pretoria, South Africa.The Minister of Transport, South AfricaTransportation Research Board of the US

Generalized Multiplicative Extended Kalman Filter for Aided Attitude and Heading Reference System

International audienceIn this paper, we propose a “Generalized Multiplicative Extended Kalman Filter” (GMEKF) to estimate the position and velocity vectors and the orientation of a flying rigid body, using measurements from lowcost Earth-fixed position and velocity, inertial and magnetic sensors. Thanks to well-chosen state and output errors, the gains and covariance equations converge to constant values on a much bigger set of trajectories than equilibrium points as it is the case for the standard Multiplicative Extended Kalman Filter (MEKF). We recover thus the fundamental properties of the Kalman filter in the linear case, especially the convergence and optimality properties, for a large set of trajectories, and it should result in a better convergence of the estimation. We illustrate the good performance and the nice properties of the GMEKF on simulation and on experimental comparisons with a commercial system

Understanding emission reductions in the freight transport sector through system dynamics

Paper presented at the 33rd Annual Southern African Transport Conference 7-10 July 2014 "Leading Transport into the Future", CSIR International Convention Centre, Pretoria, South Africa.The National Climate Change Response White Paper presents the government’s commitment to moving to a lower carbon economy in South Africa. The White Paper requires significant greenhouse gas (GHG) emitting sectors, including transport, to define “bottom up” carbon budgets. This work forms part of the WWF low carbon frameworks transport project and explores the implications of strategies for GHG emission reductions in the freight transport sub-sector within this context. The study uses system dynamics modelling to interrogate mitigation opportunities in this sector by looking specifically at the transport of processed food along the Cape Town-Gauteng corridor. Stakeholder input from business, labour and government is used to guide the modelling process. The objectives are to explore the implications of strategies for GHG emission reductions in the freight transport sub-sector as well as its impacts on the wider economy and environment; determine the barriers to change, with a specific focus on the mode switch from road to rail; recommend appropriate measures that could ensure developments towards achieving sustainability in transportation planning; and identify possible opportunities for further research and innovation. The methodology behind the model as well as the initial casual loop diagrams for the system dynamics model are presented in this paper.This paper was transferred from the original CD ROM created for this conference. The material was published using Adobe Acrobat 10.1.0 Technology. The original CD ROM was produced by CE Projects cc. Postal Address: PO Box 560 Irene 0062 South Africa. Tel.: +27 12 667 2074 Fax: +27 12 667 2766 E-mail: [email protected]