The acceptability and intake of lipid-based pastes as a food supplement in a South African context

This descriptive study included 103 children aged 12-60 months, 39 older children and 291 adults, and was performed to assess the sensory acceptability of a lipid-based food supplement. Lipid-based pastes were found to be highly acceptable, although concern exists regarding the recommended portion sizes, especially for young children with poor appetite.Keywords: lipid-based pastes, food supplement, acceptability, intake, South Afric

UK Renal Registry 18th Annual Report: Chapter 7 Adequacy of Haemodialysis in UK Adult Patients in 2014: National and Centre-specific Analyses

Data suitable for urea reduction ratio (URR) analyses were available for 14,761 (71.9%) of the 20,539 patients receiving haemodialysis (HD) in the UK on the 30/9/2014. In 2014, 88.6% of prevalent HD patients achieved a URR .65%. The between centre range of prevalent patients achieving this target was wide (74.9-97.0%). The median URR in 2014 was 75%. URR was greater in those with longer dialysis vintage, with 91.2% of patients who had survived on renal replacement therapy (RRT) for more than two years achieving a URR .65% compared with only 73.4% of those on RRT for less than six months. Large variation between centres in the percentage of patients achieving the UK Renal Association's (RA) URR guideline persists

The exploration of service quality and its measurement for private higher education institutions

The strategic importance of service excellence for service industries places the focus on service quality leadership, service quality management systems, service quality dimensions and the measurement of service quality. Many businesses such as private higher education institutions (PHEIs) regard service quality excellence as the single most important and distinct competence for survival and sustainability. The paucity of literature on the topic does not reflect the substantial growth of PHEIs in South Africa, and this paper explores service quality in this context. This exploratory study focuses on service quality (general insights), the need for service quality management and measurement at PHEIs, and the practical value of the SERVQUAL methodologies. The research approach is exploratory in the sense that it involves a literature review and an empirical application of the SERVQUAL instrument at a PHEI. The results (with internal validity) indicate the following three factors: the increasing strategic importance of service quality at PHEIs; good service quality levels at the PHEI studied; and why and how SERVQUAL (and SERVPERF) can benefit PHEIs.Key words: service quality management, service leadership, service quality dimensions, service quality management systems, private higher education institutions (PHEIs), exploratory study, service quality measurement, SERVQUA

Moderate malnutrition in children aged five years and younger in South Africa: are wasting or stunting being treated?

Objectives: The objective of the study was to describe wasting and stunting in children aged 12-60 months, admitted to targeted supplementary feeding programmes for the treatment of moderate acute malnutrition (MAM) in South Africa.Design: A cross-sectional, descriptive study was performed.Subjects and setting: Children with MAM, managed as outpatients at primary healthcare facilities in three provinces, were included in the study conducted between September 2012 and August 2013.Outcome measures: Weight, height and mid-upper-arm circumference (MUAC) measurements were collected to classify the children as moderately or severely stunted or wasted.Results: Of the total sample (n = 225), 13% (n = 30) were diagnosed as wasted, 58% (n = 131) as stunted, and 21% (n = 47) as both wasted and stunted. MUAC was significantly associated with wasting. However, an association was not found between MUAC and stunting. Of the sample, 32% (n = 72) presented with severe stunting, and 29% (n = 65) with moderate wasting. Food insecurity was associated with wasting, but not with stunting.Conclusion: A low weight-for-age z-score resulted more from stunting than from wasting in this study. Severe stunting presented as a greater health concern than moderate wasting. Without scrutinising wasting and stunting, healthcare professionals may remain unaware of the drivers of underweight for age in children treated at South African primary healthcare facilities. Following this study’s outcomes, the sensitivity of MUAC in screening for moderate malnutrition in South African settings with a high prevalence of stunting is questionable. It is recommended that current nutritional interventions are revisited to explore the efficacy of treating children with wasting, stunting or both.Keywords: malnutrition, children, wasting, stunting, treatmen

Nutritional status of HIV-infected adults on antiretroviral therapy and the impact of nutritional supplementation in the Northern Cape Province, South Africa

Objectives: The study aimed to describe the nutritional status and determine the impact of current nutrition intervention strategies on weightchanges in adult HIV-infected patients on antiretroviral (ARV) therapy.Design: A descriptive, prospective trial was performed.Setting: The investigation was conducted at ARV roll-out centres in Kimberley, Upington, Kuruman, Prieska and Springbok in the NorthernCape Province of South Africa.Subjects: Adult HIV-infected patients receiving ARV therapy were included in the study. Outcome measures: Each participants’s body mass index (BMI) was determined before and after a four-month intervention period ofnutritional supplementation with an instant, enriched maize product.Results: Data from 98 patients (mean age 39.7 years; standard deviation 8.9 years) were assessed. Prior to intervention, the median BMI was 20 kg/m2 (range 12.6–29.7 kg/m2); the patients from Kuruman had a greater incidence of underweight compared to the other towns, with a median BMI of 17.9 kg/m2. Of the 87 patients assessed during the final week, 49.4% experienced weight gain and 40.2% lost weight. Eighteen (20.7%) patients gained more than 5% of their baseline weight, which was significant. Only eight (9.2%) patients lost more than 5% of their baseline weight. Twenty-two patients who presented with a BMI 18.5 kg/m2 presented with no change in median weight.Conclusions: Nutritional supplementation, provided according to provincial policy and combined with ARVs, nutritionally benefitted about half of the patients in the ARV programme in the Northern Cape.Keywords: nutrition supplementation; HIV-infection; ARV; adults; nutritional statu

Modelling vertical uniform contact stress of heavy vehicle tyres

The field of tyre dynamics is a relatively new, but highly complex field of engineering. The testing and modelling of various tyres in order to determine stress distributions of tyres on the road surface, under varying conditions, remains a relevant and important field of study. The information from these studies are essential to understanding vehicle dynamics as the small contact patches between the vehicle tyres and road surface is the only area of interaction between the entire vehicle and the road surface. The contact stress data is also essential in the calculation of road wear characteristics of tyres and vehicles. Different models exist to estimate the contact stress between the tyre and road surface, but most contain assumptions that limit their applicability to a small set of tyres under very specific load cases. This paper considers the development of mathematical models that are used to estimate the vertical uniform contact stress for three types of heavy vehicle tyres. The three tyres studied are 315/80 R22.5, 385/65 R22.5 and 425/65 R22.5 tyres. The models have been developed through the use of tyre testing data obtained from the Stress-In-Motion (SIM) system. It was found that 4th order polynomials provided the most accurate stress results over the selected operating range of 25 kN to 45 kN which is the typical load range for heavy vehicle tyres due to legal axle load limits. The polynomial formulas require only the tyre inflation pressure and vertical tyre load as inputs, in order to estimate the vertical uniform contact stress. The models developed correlate well with the test data and showing an average absolute error of less than 2 %.Paper presented at the 35th Annual Southern African Transport Conference 4-7 July 2016 "Transport ? a catalyst for socio-economic growth and development opportunities to improve quality of life", CSIR International Convention Centre, Pretoria, South Africa.The Minister of Transport, South AfricaTransportation Research Board of the US

Mid-upper arm circumference (MUAC) as a feasible tool in detecting adult malnutrition

Objectives: This study aimed to expand on the limited South African malnutrition prevalence data and investigate the feasibility of mid-upper-arm circumference (MUAC) as a malnutrition screening tool. Design: A cross-sectional, multi-centre, descriptive design was adopted. Setting: The study was undertaken in three tertiary public hospitals in the same urban area within the Eastern Cape of South Africa. Subjects: Adult hospitalised patients volunteered to participate (n = 266). Methods: Data were collected using interviewer-administered questionnaires; obtaining anthropometric measurements; and consulting medical files. For maximum accuracy of various MUAC cut-off points, receiver operating characteristic curves were generated and area under the curve determined. Results: Both body mass index (BMI) and MUAC identified 21% of participants as underweight or malnourished, and 39% as overweight or obese. The Malnutrition Universal Screening Tool (MUST) found 23% at increased malnutrition risk. Nurses or doctors detected and referred only 19% of underweight patients (BMI < 18.5 kg/m2), to dietetics services. Direct measurements of BMI and MUST were unobtainable in 38% and 43% of patients respectively, whilst MUAC was obtainable in 100%. A statistically significant relationship (p < 0.001) exists between MUAC, BMI and MUST to detect malnutrition or malnutrition risk. MUAC cut-offs for undernutrition were determined at < 23 cm (BMI < 16 kg/m2) and < 24 cm (BMI < 18.5 kg/m2), respectively, for the study’s population groups. Conclusion: Malnutrition prevalence was high in this study, but often unidentified, with only a fifth referred to dietetic services. MUAC is a feasible method to identify adult malnutrition and should be considered as a malnutrition screening tool and key nutritional status indicator in South African public hospitals

Measurement of antiacetylcholine receptor auto-antibodies in myasthenia gravis

Two different acetylcholine receptor (AChR) preparations derived from amputated human muscle (AChRAMP) and from the human rhabdomyosarcoma cell line TE671 (AChRTE67,) were compared in radio-immunoprecipitation assays for the detection of AChR auto-antibodies in serum specimens from 20 patients with proven myasthenia gravis. Tests performed with the AChRTE67, and AChRAMP antigen preparations were positive in all the patients and in 19/20 respectively. A high degree of correlation (r = 0,94) was evident between the two auto-antigen preparations. Assays based on the use of TE671-derived antigen represent a useful alternative to the conventional assay using AChRAMP  for the detection of AChR autoantibodies