Medical nutrition therapy for a patient presenting with a chylothorax

No Abstrac

Deregulation of the Maize Marketing System of Swaziland and Implications for Food Security

Recent shortfalls in the supply of maize in the Kingdom of Swaziland have exacerbated the country's growing food insecurity and led to fresh calls for full deregulation of the maize marketing system. The proponents of deregulation believe that it eliminates inefficient production and service units by transferring resources to their best alternative uses. While the theoretical foundations for that position are not questionable, no studies have to date explicitly investigated the effects of the current arrangements and the potential effects of full deregulation. This paper reports on a study that examined the welfare effects of the regulation of the country's maize industry and considered the likely impacts of full deregulation of the industry. Using a partial equilibrium model, the study established that the current market arrangements for the maize industry are distortionary and make the maize marketing system of Swaziland highly uncompetitive. The results show that high efficiency losses result from the misallocation of productive resources and that these have been rising over the years. Consumption deadweight losses were also shown to be equally serious and put at risk the attainment of food security for the generality of the Swazi population. The paper sees deregulation as an important practical step to improve the competitiveness of the maize industry and enhance food security through creating the basis for more effective management of the internal maize distribution channel in Swaziland.Crop Production/Industries, Food Security and Poverty, D6, F13, I3, L5, Q18,

Symptom screening rules to identify active pulmonary tuberculosis: Findings from the Zambian South African Tuberculosis and HIV/AIDS Reduction (ZAMSTAR) trial prevalence surveys.

BACKGROUND: High tuberculosis (TB) burden countries should consider systematic screening among adults in the general population. We identified symptom screening rules to be used in addition to cough ≥2 weeks, in a context where X-ray screening is not feasible, aiming to increase the sensitivity of screening while achieving a specificity of ≥85%. METHODS: We used 2010 Zambia South Africa Tuberculosis and HIV/AIDS Reduction (ZAMSTAR) survey data: a South African (SA) training dataset, a SA testing dataset for internal validation and a Zambian dataset for external validation. Regression analyses investigated relationships between symptoms or combinations of symptoms and active disease. Sensitivity and specificity were calculated for candidate rules. RESULTS: Among all participants, the sensitivity of using only cough ≥2 weeks as a screening rule was less than 25% in both SA and Zambia. The addition of any three of six TB symptoms (cough <2 weeks, night sweats, weight loss, fever, chest pain, shortness of breath), or 2 or more of cough <2 weeks, night sweats, and weight loss, increased the sensitivity to ~38%, while reducing specificity from ~95% to ~85% in SA and ~97% to ~92% in Zambia. Among HIV-negative adults, findings were similar in SA, whereas in Zambia the increase in sensitivity was relatively small (15% to 22%). CONCLUSION: High TB burden countries should investigate cost-effective strategies for systematic screening: one such strategy could be to use our rule in addition to cough ≥2 weeks

Die Reg van die Kind op Kontak met Beide Ouers: Opmerkings na Aanleiding van Onlangse Ontwikkelinge in die Nederlandse Reg

This contribution discusses the amendment to section 1:  377a lid 1 BW of 1 March 2009, in Dutch law.  According to this provision a child has the right to have contact with both parents as well as with those who have sufficient close personal links with the child.  The parent who is not responsible for the physical care of the child has the right and obligation to have contact with the child.  The question whether the South African law, through the provisions of section 28 of the Constitution and the Children's Act, provides such a right and obligation, is investigated.  Even though the conclusion is reached that the South African law indirectly provides such right and obligation, it is argued that the explicit recognition thereof in the Children's Act would provide a statutory legal duty on parents to have and maintain contact with their child.  This would enhance legal certainty.  Attention is also given to the enforcement of such right of the child.   

Manufacturing doubt: assessing the effects of independent vs industry-sponsored messaging about the harms of fossil fuels, smoking, alcohol, and sugar sweetened beverages

Background Manufacturers of harmful products engage in misinformation tactics long employed by the tobacco industry to emphasize uncertainty about scientific evidence and deflect negative attention from their products. This study assessed the effects of one type of tactic, the use of "alternative causation" arguments, on public understanding. Methods In five trials (one for each industry) anonymized Qualtrics panel respondents were randomized to receive a message on the risk in question from one of four industry sponsored organizations (exposure), or from one of four independent organizations (control), on risks related to alcohol, tobacco, fossil fuel and sugar sweetened beverages. Logistic regression models were used to evaluate the effect of industry arguments about uncertainty on the primary outcome of public certainty about product risk, adjusting for age, gender and education. The results from all five trials were pooled in a random-effects meta-analysis. Findings In total, n=3284 respondents were exposed to industry-sponsored messaging about product-related risks, compared to n=3297 exposed to non-industry messages. Across all industries, exposure to industry-sponsored messages led to greater reported uncertainty or false certainty about risk, compared to non-industry messages [Summary odds ratio (OR) 1·60, confidence interval (CI) 1·28-1·99]. The effect was greater among those who self-rated as not/slightly knowledgeable (OR 2·24, CI 1·61-3·12), or moderately knowledgeable (OR 1·85, CI 1·38-2·48) compared to those very/extremely knowledgeable (OR 1·28, CI 1·03-1·60). Conclusions This study demonstrates that exposure to industry sponsored messages which appear intended to downplay risk significantly increases uncertainty or false certainty, with the effect being greater in less knowledgeable participants

Complete Genome Sequences of Virus Strains Isolated from Bottle A of the South African Live Attenuated Bluetongue Virus Vaccine

This is a report of the complete genome sequences of plaque-selected isolates of five virus strains included in bottle A of the South African Onderstepoort Biological Products commercial live attenuated bluetongue virus vaccine

Patterns of rabies cases in South Africa between 1993 and 2019, including the role of wildlife

DATA AVAILABILITY STATEMENT : The data that support the findings of this study are openly available in DALRRD. (2019). Rabies Data South Africa from http://www.daff.gov.za/daffweb3/Branches/Agricultural-Production-Health-Food-Safety/Animal-Health/Epidemiology/diseasedatabase], reference number [17].Rabies is a global viral zoonosis endemic to South Africa, resulting in fatal encephalitis in warm-blooded animals, including humans. The loss of human lives and economic losses in rural areas through loss of livestock are substantial. A review was conducted of all confirmed animal rabies cases in South Africa from 1993 to 2019, with a total of 11 701 cases identified to species level to assess the role that wildlife plays in the epidemiology of rabies. A spatio-temporal cluster analysis using a discrete Poisson space-time probability model, accounting for underlying estimated dog and livestock densities, identified 13 significant clusters (p < .05). These included four long-term clusters lasting more than 8 years in duration and seven short-term clusters lasting less than 2 years, with the remaining two clusters being of intermediate length. Outside of these endemic clusters, wildlife outbreaks in the remainder of South Africa were often less than one and a half years in duration most likely due to the rapid decline of wildlife vectors, especially jackals associated with rabies infection. Domestic dogs accounted for 59.8% of cases, with domestic cats (3.2%), livestock (21.1%) and wildlife (15.8%) making up the remainder of the cases. Yellow mongoose (Cynictis penicillata) was the most frequently affected wildlife species, followed by bat-eared fox (Otocyon megalotis), black-backed jackal (Canis mesomelas), meerkat (Suricata suricatta) and aardwolf (Proteles cristatus). Rabies in wildlife species followed different spatial distributions: black-backed jackal cases were more common in the north-western parts of South Africa, yellow mongoose cases more frequent in central South Africa, and bat-eared fox and aardwolf cases were more frequent in southern and western South Africa. Clusters often spanned several provinces, showing the importance of coordinated rabies control campaigns across administrative boundaries, and high-risk areas were highlighted for rabies in South Africa.The South African Veterinary Association Wildlife Group.http://wileyonlinelibrary.com/journal/tbedhj2023Centre for Veterinary Wildlife StudiesProduction Animal StudiesVeterinary Tropical Disease

Occupational respiratory diseases in South Africa results from SORDSA, 1997- 1999

Objectives. To describe the nature and extent of work-related respiratory diseases reported to the national Surveillance of Work-related and Occupational Respiratory Diseases in South Africa (SORDSA) reporting scheme. The causative agents and industrial categories in which they occurred are also characterised.Design. Voluntary monthly reporting of newly diagnosed cases by pulmonologists, occupational medicine practitioners and occupational health nurses.Setting. Medical and occupational health referral centres in the nine provinces of South Africa.Subjects. Cases were workers from non-mining industries or ex-miners, suffering from a newly diagnosed occupational respiratory disease, reported to SORDSA between October 1996 and December 1999.Outcome measures. Frequencies of reported occupational respiratory disease by year, reporting source, province and sex. Frequencies of short- and long-latency diseases by industry and causative agent.Results. There was incomplete reporting coverage of the nine provinces in the first 3 years. Reporting was most comprehensive from Gauteng, KwaZulu-Natal and the Western Cape. Diseases with long latency periods made up 76.2% of the cases. Pneumoconiosis, even in non-mining industries, was the most frequently reported disease, followed by inhalation accidents. Occupational asthma was the fourth most reported disease. Apart from the prominence of pneumoconiosis, the results obtained by . SORDSA are similar to those from a British occupational lung disease surveillance scheme. This study showed that newly diagnosed cases of occupational lung disease occurred in many industries and were caused by a variety of agents.Conclusion. SORDSA has contributed insight into the nature, extent and distribution of occupational respiratory diseases in South Africa. It has also highlighted important causes of occupational respiratory diseases in South Africa, as well as hazardous industries. The data indicate that South Africa has a widespread occupational lung disease problem, and provide a platform for targeted prevention strategies

Verapamil-Sensitive Transport of Quinacrine and Methylene Blue via the Plasmodium falciparum Chloroquine Resistance Transporter Reduces the Parasite's Susceptibility to these Tricyclic Drugs.

BACKGROUND: It is becoming increasingly apparent that certain mutations in the Plasmodium falciparum chloroquine resistance transporter (PfCRT) alter the parasite's susceptibility to diverse compounds. Here we investigated the interaction of PfCRT with 3 tricyclic compounds that have been used to treat malaria (quinacrine [QC] and methylene blue [MB]) or to study P. falciparum (acridine orange [AO]). METHODS: We measured the antiplasmodial activities of QC, MB, and AO against chloroquine-resistant and chloroquine-sensitive P. falciparum and determined whether QC and AO affect the accumulation and activity of chloroquine in these parasites. We also assessed the ability of mutant (PfCRT(Dd2)) and wild-type (PfCRT(D10)) variants of the protein to transport QC, MB, and AO when expressed at the surface of Xenopus laevis oocytes. RESULTS: Chloroquine resistance-conferring isoforms of PfCRT reduced the susceptibility of the parasite to QC, MB, and AO. In chloroquine-resistant (but not chloroquine-sensitive) parasites, AO and QC increased the parasite's accumulation of, and susceptibility to, chloroquine. All 3 compounds were shown to bind to PfCRT(Dd2), and the transport of QC and MB via this protein was saturable and inhibited by the chloroquine resistance-reverser verapamil. CONCLUSIONS: Our findings reveal that the PfCRT(Dd2)-mediated transport of tricyclic antimalarials reduces the parasite's susceptibility to these drugs

Access to influenza immunisation services by HIV positive patients in the UK.

Influenza is an important cause of morbidity in HIV positive adults, who may be more susceptible and more likely to develop severe disease.(1,2) Annual influenza immunisation is recommended for all HIV positive adults in the UK, supported by British HIV Association (BHIVA) guidelines,(1) with evidence for reasonably good uptake (3). HIV services do not receive specific funding to provide immunisation; and the National Flu Immunisation Programme offers this instead via Primary Care and pharmacies.(4) Whether this meets the needs of people living with HIV has not been evaluated. This article is protected by copyright. All rights reserved