15 research outputs found

    The morphological and molecular characteristics of skeletal muscle in athletes with acquired training intolerance

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    Bibliography: leaves 272-358.The hypothesis, upon which this thesis is based, is that repeated bouts of damage-inducing, prolonged, endurance training and racing, over a number of years, may exceed the biological limits of the repair and adaptation process, resulting in maladaptation of the skeletal muscle and malfunctioning of the system

    Nutritional supplements for people being treated for active tuberculosis

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    CITATION: Grobler, L. et al. 2016. Nutritional supplements for people being treated for active tuberculosis. Cochrane Database of Systematic Reviews, 6:CD006086, doi:10.1002/14651858.CD006086.pub4.The original publication is available at https://www.cochranelibrary.comBackground: Tuberculosis and malnutrition are linked in a complex relationship. Tuberculosis may cause undernutrition through increasedmetabolic demands and decreased intake, and nutritional deficiencies may worsen the disease, or delay recovery by depressing important immune functions. At present, there is no evidence-based nutritional guidance for adults and children being treated for tuberculosis. Objectives: To assess the effects of oral nutritional supplements in people being treated with antituberculous drug therapy for active tuberculosis.https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006086.pub4/fullPublisher's versio

    Embedded Librarianship Seminar

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    Librarianship is changing, and has to change. Librarians need to master new technologies for managing and delivering information; engage with knowledge and information and moving beyond one-shot instruction. It is essential to establish new relationships with information users and the community in which we practice. The name given to this change is ‘Embedded librarianship’ (Shumaker, 2012). In order to investigate the Embedded Librarianship model at the University of Pretoria Library Services (UPLS), a one day seminar was organised. This seminar consisted of vibrant, 10-minute Show & Tell sessions, provides excellent opportunites for a number of librarians to share their best practices, experience and ideas on this thrilling topic. The programme addressed embedded librarianship in context of the following focus areas: information literacy; embedded projects and research support.Papers presented at the Embedded Librarianship seminar, Auditorium, Merensky Library, University of Pretoria, 31 October 2012mn2013cp201

    The epidemiology of tuberculosis in health care workers in South Africa: a systematic review

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    Background: In South Africa, workplace acquired tuberculosis (TB) is a significant occupational problem among health care workers. In order to manage the problem effectively it is important to know the burden of TB in health care workers. This systematic review describes the epidemiology of TB in South African health care workers. Methods: A comprehensive search of electronic databases [MEDLINE, EMBASE, Web of Science (Social Sciences Citation Index/Science Citation Index), Cochrane Library (including CENTRAL register of Controlled Trials), CINAHL and WHO International Clinical Trials Registry Platform (ICTRP)] was conducted up to April 2015 for studies reporting on any aspect of TB epidemiology in health care workers in South Africa. Results: Of the 16 studies included in the review, ten studies reported on incidence of active TB disease in health care workers, two report on the prevalence of active TB disease, two report on the incidence of latent TB infection, three report on the prevalence of latent TB infection and four studies report on the number of TB cases in health care workers in various health care facilities in South Africa. Five studies provide information on risk factors for TB in health care workers. All of the included studies were conducted in publicly funded health care facilities; predominately located in KwaZulu-Natal and Western Cape provinces. The majority of the studies reflect a higher incidence and prevalence of active TB disease in health care workers, including drug-resistant TB, compared to the surrounding community or general population. Conclusions: There is relatively little research on the epidemiology of TB in health care workers in South Africa, despite the importance of the issue. To determine the true extent of the TB epidemic in health care workers, regular screening for TB disease should be conducted on all health care workers in all health care facilities, but future research is required to investigate the optimal approach to TB screening in health care workers in South Africa. The evidence base shows a high burden of both active and latent TB in health care workers in South Africa necessitating an urgent need to improve existing TB infection, prevention and control measures in South African health care facilities

    Maintained cerebral oxygenation during maximal self-paced exercise in elite Kenyan runners

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    The purpose of this study was to analyze the cerebral oxygenation response to maximal self-paced and incremental exercise in elite Kenyan runners from the Kalenjin tribe. On two separate occasions, 15 elite Kenyan distance runners completed a 5-km time trial (TT) and a peak treadmill speed test (PTS). Changes in cerebral oxygenation were monitored via near-infrared spectroscopy through concentration changes in oxy- and deoxyhemoglobin (Δ[O2Hb] and Δ[HHb]), tissue oxygenation index (TOI), and total hemoglobin index (nTHI). During the 5-km TT (15.2 ± 0.2 min), cerebral oxygenation increased over the first half (increased Δ[O2Hb] and Δ[HHb]) and, thereafter, Δ[O2Hb] remained constant (effect size, ES = 0.33, small effect), whereas Δ[HHb] increased until the end of the trial (P < 0.05, ES = 3.13, large effect). In contrast, during the PTS, from the speed corresponding to the second ventilatory threshold, Δ[O2Hb] decreased (P < 0.05, ES = 1.51, large effect), whereas Δ[HHb] continued to increase progressively until exhaustion (P < 0.05, ES = 1.22, large effect). Last, the TOI was higher during the PTS than during the 5-km TT (P < 0.001, ES = 3.08; very large effect), whereas nTHI values were lower (P < 0.001, ES = 2.36, large effect). This study shows that Kenyan runners from the Kalenjin tribe are able to maintain their cerebral oxygenation within a stable range during a self-paced maximal 5-km time trial, but not during an incremental maximal test. This may contribute to their long-distance running success.Sin financiación3.004 JCR (2015) Q1, 12/82 Sport Sciences; Q2, 27/83 PhysiologyUE

    Brain oxygenation declines in elite Kenyan runners during a maximal interval training session

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    Sin financiación2.401 JCR (2017) Q2, 27/81 Sport sciences; Q3, 45/83 Physiology1.186 SJR (2017) Q1, 435/2878 Medicine (miscellaneous), 37/285 Orthopedics and Sports Medicine, 80/554 Public Health, Environmental and Occupational Health, 29/127 Sports Science; Q2, 36/107 Physiology (medical)No data IDR 2017UE

    Alternative ways to organise delivery of health care to older adults living in aged care facilities

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    What is the aim of this review?This Cochrane review set out to determine if providing residents of aged care facilities (ACF) with the same care as usual care, just delivered in a different way (alternative models of care), is better in terms of emergency department transfers, unplanned hospital admissions, adverse events, adherence to clinical guideline-recommended care, health-related quality of life, mortality and costs. For example, are multidisciplinary teams (alternative model) a better way of delivering care to residents of ACFs compared to providing care through individual practitioners (usual care)

    Models for delivery and co-ordination of primary or secondary health care (or both) to older adults living in aged care facilities

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    BACKGROUND: The number of older people is increasing worldwide and public expenditure on residential aged care facilities (ACFs) is expected to at least double, and possibly triple, by 2050. Co-ordinated and timely care in residential ACFs that reduces unnecessary hospital transfers may improve residents' health outcomes and increase satisfaction with care among ACF residents, their families and staff. These benefits may outweigh the resources needed to sustain the changes in care delivery and potentially lead to cost savings. Our systematic review comprehensively and systematically presents the available evidence of the effectiveness, safety and cost-effectiveness of alternative models of providing health care to ACF residents.OBJECTIVES: Main objective: To assess the effectiveness and safety of alternative models of delivering primary or secondary health care (or both) to older adults living in ACFs. Secondary objective: To assess the cost-effectiveness of the alternative models.SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, five other databases and two trials registers (WHO ICTRP, ClinicalTrials.gov) on 26 October 2022, together with reference checking, citation searching and contact with study authors to identify additional studies.SELECTION CRITERIA: We included individual and cluster-randomised trials, and cost/cost-effectiveness data collected alongside eligible effectiveness studies. Eligible study participants included older people who reside in an ACF as their place of permanent abode and healthcare professionals delivering or co-ordinating the delivery of healthcare at ACFs. Eligible interventions focused on either ways of delivering primary or secondary health care (or both) or ways of co-ordinating the delivery of this care. Eligible comparators included usual care or another model of care. Primary outcomes were emergency department visits, unplanned hospital admissions and adverse effects (defined as infections, falls and pressure ulcers). Secondary outcomes included adherence to clinical guideline-recommended care, health-related quality of life of residents, mortality, resource use, access to primary or specialist healthcare services, any hospital admissions, length of hospital stay, satisfaction with the health care by residents and their families, work-related satisfaction and work-related stress of ACF staff.DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies for inclusion, extracted data, and assessed risk of bias and certainty of evidence using GRADE. The primary comparison was any alternative model of care versus usual care.MAIN RESULTS: We included 40 randomised trials (21,787 participants; three studies only reported number of beds) in this review. Included trials evaluated alternative models of care aimed at either all residents of the ACF (i.e. no specific health condition; 11 studies), ACF residents with mental health conditions or behavioural problems (12 studies), ACF residents with a specific condition (e.g. residents with pressure ulcers, 13 studies) or residents requiring a specific type of care (e.g. residents after hospital discharge, four studies). Most alternative models of care focused on 'co-ordination of care' (n = 31). Three alternative models of care focused on 'who provides care' and two focused on 'where care is provided' (i.e. care provided within ACF versus outside of ACF). Four models focused on the use of information and communication technology. Usual care, the comparator in all studies, was highly heterogeneous across studies and, in most cases, was poorly reported. Most of the included trials were susceptible to some form of bias; in particular, performance (89%), reporting (66%) and detection (42%) bias. Compared to usual care, alternative models of care may make little or no difference to the proportion of residents with at least one emergency department visit (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.84 to 1.20; 7 trials, 1276 participants; low-certainty evidence), but may reduce the proportion of residents with at least one unplanned hospital admission (RR 0.74, 95% CI 0.56 to 0.99, I 2 = 53%; 8 trials, 1263 participants; low-certainty evidence). We are uncertain of the effect of alternative models of care on adverse events (proportion of residents with a fall: RR 1.15, 95% CI 0.83 to 1.60, I² = 74%; 3 trials, 1061 participants; very low-certainty evidence) and adherence to guideline-recommended care (proportion of residents receiving adequate antidepressant medication: RR 5.29, 95% CI 1.08 to 26.00; 1 study, 65 participants) as the certainty of the evidence is very low. Compared to usual care, alternative models of care may have little or no effect on the health-related quality of life of ACF residents (MD -0.016, 95% CI -0.036 to 0.004; I² = 23%; 12 studies, 4016 participants; low-certainty evidence) and probably make little or no difference to the number of deaths in residents of ACFs (RR 1.03, 95% CI 0.92 to 1.16, 24 trials, 3881 participants, moderate-certainty evidence). We did not pool the cost-effectiveness or cost data as the specific costs associated with the various alternative models of care were incomparable, both across models of care as well as across settings. Based on the findings of five economic evaluations (all interventions focused on co-ordination of care), we are uncertain of the cost-effectiveness of alternative models of care compared to usual care as the certainty of the evidence is very low. AUTHORS' CONCLUSIONS: Compared to usual care, alternative models of care may make little or no difference to the number of emergency department visits but may reduce unplanned hospital admissions. We are uncertain of the effect of alternative care models on adverse events (i.e. falls, pressure ulcers, infections) and adherence to guidelines compared to usual care, as the certainty of the evidence is very low. Alternative models of care may have little or no effect on health-related quality of life and probably have no effect on mortality of ACF residents compared to usual care. Importantly, we are uncertain of the cost-effectiveness of alternative models of care due to the limited, disparate data available.</p
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