16918 research outputs found
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Carotid intima–media thickness and endothelial function in adolescents exposed to alcohol consumption and cigarette smoking in utero: a mediation analysis
No full textBackground: Previous studies have shown the effects of teratogen exposure in utero on the vascular system, but its direct and indirect effects are still questionable. Therefore, this study explored the effects of potential mediators of teratogen exposure on carotid intima–media thickness (cIMT) and flow-mediated dilation (FMD). Methods: This study was conducted between January 2022 and August 2024 in Cape Town, South Africa, and included 307 adolescents (aged 10–14) and their mothers. Anthropometry data, lipid profiles, systolic (SBP) and diastolic blood pressure (DBP), physical activity and maternal health behaviours were obtained. Vascular measurements (left and right cIMT and brachial artery FMD) were obtained via ultrasound, which included analysing the peak artery diameter separately. Statistical analyses were performed via SPSS® version 29, and mediation analyses were conducted via PROCESS Macros. Results: The cohort included a control group (n = 105), tobacco-exposed individuals (n = 115), dual-exposed individuals (tobacco and alcohol) (n = 73), and alcohol-exposed individuals (n = 14). A significant positive correlation was observed between alcohol exposure duration and LcIMT (rho = 0.531, p < 0.05), and a strong negative correlation was observed with peak diameter (rho=-0.788, p < 0.001), with a very strong correlation in males (r=-0.894, p < 0.05). The duration of alcohol exposure significantly affected LcIMT (p = 0.0468) after adjusting for body mass index (BMI), SBP and DBP. However, brachial artery (BA) peak diameter was not significantly associated with the duration of alcohol consumption during pregnancy after the adjustment for age, SBP or BA baseline diameter. Conclusion: Increased BMI and SBP may contribute to a reduced peak diameter in adolescents exposed to alcohol, potentially indicating lower FMD in adulthood. Further studies should elucidate the biological mechanisms involved through long-term prospective studies
Perceptions of physiotherapy students regarding the management of patients with underlying mental illness in clinical practice at a university in the Western Cape
No full textMental illness (MI) has become one of the leading causes of ill health and disability worldwide, as nearly half of the population will experience a MI at some stage in their life. It is therefore inevitable that most healthcare professionals, including physiotherapists, will encounter patients with MI in clinical practice. As physiotherapists occupy an essential role in the management of patients with MI, they need to be equipped with the knowledge, skill, as well as favourable attitudes and behaviours towards patients with MI. Physiotherapy students also require these competencies when managing patients with underlying mental illness they may encounter during their clinical training. Therefore, this study aimed to explore physiotherapy students’ perceptions regarding the management of patients with underlying MI in clinical practice. A qualitative approach, with an exploratory descriptive design was used. Data was collected through individual, audio-recorded face to face interviews, and video-recorded online interviews, using a semi structured interview guide. The study population included all final year undergraduate physiotherapy students registered at the University of the Western Cape (UWC), with 16 students agreeing to participate. Participants were purposively selected due to their clinical exposure and experience gained in clinical practice. Data was analysed by employing Braun and Clarke’s six phase thematic analysis, whereby codes were identified, themes were generated and results presented textually with supporting quotes. Trustworthiness of the study was ensured by employing credibility, dependability, transferability and confirmability. This study was conducted according to the ethical practices pertaining to the study of human subjects as specified by the Faculty of Community and Health Sciences’ Research Ethics Committee of UWC. Sixteen fourth year, male and female physiotherapy students with a mean age of (22.8 ±1.32 years) consented to participate in this study
Strengthening signal detection in pharmacovigilance by using international nonproprietary name (INN) stems
No full text‘Stems’, which mark pharmacological relationships between substances, form the backbone of the International Nonproprietary Name (INN) system, developed by the WHO in the 1950s. In this paper, we propose using the INN stems to enhance pharmacovigilance signal detection. After analysis of historical cases and current pharmacovigilance practices, we discuss how stem-based classification could facilitate understanding of the adverse-effects profile of each stem, to be used as a benchmark for early identification of adverse drug reactions that deviate from expected class effects, in other words signals associated with newly marketed medicines or different uses of well-known medicines. We propose a potential framework for integrating stem-based analysis into existing pharmacovigilance databases, supplemented by artificial intelligence approaches, such as machine learning. While acknowledging limitations, such as stem variability and reporting bias, we suggest that this approach offers potential advantages for regulatory authorities and healthcare professionals in post-marketing surveillance. Implementation of stem-based post-marketing surveillance could enhance signal-detection efficiency and contribute to improved patient safety through earlier identification of unexpected adverse effects and adverse reactions
Care mobilities and associated contexts of hospital-based informal caregiving in Nigeria: towards an explanatory framework
No full textHospital-based informal caregiving in Nigeria is shaped by care mobilities and contextual factors such as policy contradictions and normative care philosophies. This study explores how these factors influence caregiving practices in a Nigerian tertiary health facility. Using a qualitative approach, data were gathered through interviews and observations, involving 75 participants, including 36 in-depth interviews with caregivers and inpatients, and 39 key informant interviews with staff like nurses, doctors, security guards, and ad-hoc caregivers. Findings showed that many informal caregivers traveled long distances to assist hospitalized relatives, often “hanging around” the hospital and engaging in micro-mobilities, such as running errands. Geographical distance, policy contradictions, and the financial costs of hospitalization significantly affected caregiving dynamics. Care mobilities caregivers moving within the hospital environment emerged as a critical aspect of the caregiving process. Understanding these mobilities and how they intersect with contextual factors is essential to improving caregiving experiences. The study highlights the need for policies that support informal caregivers and enhance patient outcomes, especially in terms of reducing the burdens caregivers face due to long travel distances, hospital policies, and financial challenges
Exploring barriers to social cohesion in rural South African communities: A family-centred qualitative study
No full textIn South Africa, the need to strengthen social cohesion has become increasingly important considering various pressing challenges, particularly within family and community structures. Addressing these issues is crucial for promoting solidarity and inclusion among all South Africans. This study explores the barriers to social cohesion in two rural South African communities using a family-centred approach. It adopts a family centred perspective to develop targeted interventions that support communities, government officials, and policymakers in tackling critical social challenges, including trust deficits, feelings of non-belonging, family instability, and economic disparities across municipalities. The study utilized a qualitative, exploratory design, drawing on data collected from two rural communities in South Africa: Lambert's Bay in the Western Cape and Philippolis in the Free State Province. A total of 19 participants were engaged, comprising 11 parents and 8 community stakeholders. Data collection was conducted through in-depth, face-to-face interviews in participants’ preferred languages to ensure accuracy and comfort. Data analysis followed Braun and Clarke's reflexive thematic analysis approach, supported by Atlas.ti software, to systematically interpret the findings. The results identified seven key themes: family instability and domestic violence, inequality and economic disparity, lack of trust in relationships, racial discrimination, limited access to education and skills development, feelings of non-belonging and substance abuse and violence. These findings underscore the significance of family instability as a central factor in broader social cohesion. It is recommended that interventions adopt a family-centred approach. The study concludes with high-level policy and community intervention recommendations to support these efforts
The juxtaposition of invalidation and “inviting in”: a qualitative study of bisexual identity in South Africa
No full textUnderstanding one’s sexual orientation plays a significant role in contributing to one’s sexual identity and developing a coherent sense of self. Misconceptions and prevailing prejudices make it difficult for bisexual individuals to navigate their sexual identities in many societies. Disclosure of one’s identity is accompanied by certain risks depending on how the information is received. However, disclosing one’s identity can also be positive, especially as it assists in fostering relationships. This article derives from a descriptive study involving 14 semi-structured interviews with young adults aged 18–24 who identified as bisexual. Data were subjected to a reflexive thematic analysis. Themes of invalidation, belongingness and reclaiming through ‘inviting in’ were identified. By processing the feelings of invalidation regarding their bisexual identities which were placed upon them by their respective cultural groups, and society in general, participants were able to develop a sense of agency and reclaim their power. Findings highlight the need for further research on bisexuality, particularly in South Africa, and the need to understand how bisexual identity development occurs in interaction with other sexual and gender identities
Exploring the potential of deep brain stimulation in managing cluster headache: a systematic review
No full textBackground: The debilitating nature of cluster headache (CH) is typified by intense, repeated cephalgia that are often referred to as “suicide headaches” owing to their severity. Individuals may not respond appropriately to therapeutic interventions despite various alternatives being readily available. This warrants an investigation into further management options. One of the promising solutions for CH has been identified as deep brain stimulation (DBS), which specifically targets the posterior hypothalamus. Aim: This systematic review aims to summarize the current literature on the safety and efficacy of DBS in the management of CH. Method and materials: A comprehensive literature search identified 15 relevant studies comprising clinical trials, case reports, and observational studies from Embase, Web of Science, PubMed/MEDLINE, Scopus, and the Cochrane Library using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 standards. Results: The systematic review elucidated that DBS, with a focus on the posterior hypothalamus, facilitated significant reductions in the frequency, severity, and duration of cephalgic ‘attacks’ associated with CH observed. While individual responses varied, DBS was generally well-tolerated, with transient and reversible adverse effects involving focal neurological deficits (i.e., diplopia) being the most common. Importantly, long-term benefits were observed in vast populations, improving their overall quality of life. Furthermore, DBS demonstrated effects beyond localized hypothalamic stimulation, with evidence suggesting modulation of the pain processing network. Additionally, DBS was found to alleviate nocturnal CH attacks without disrupting circadian rhythms. These findings suggest that DBS holds promise as a therapeutic option for CH, particularly in individuals refractory to other treatments. Conclusion: Existing research suggests that DBS, particularly when targeting the posterior hypothalamus, can significantly reduce CH ‘attack’ frequency, severity, and duration. Further research should focus on patient selection criteria and a deeper understanding of the mechanisms underpinning DBS to optimize its effectiveness in managing such a disabling cephalgia
High-significance detection of correlation between the unresolved gamma-ray background and the large-scale cosmic structure
No full textOur understanding of the γ-ray sky has improved dramatically in the past decade, however, the unresolved γ-ray background (UGRB) still has a potential wealth of information about the faintest γ-ray sources pervading the Universe. Statistical cross-correlations with tracers of cosmic structure can indirectly identify the populations that most characterize the γ-ray background. In this study, we analyze the angular correlation between the γ-ray background and the matter distribution in the Universe as traced by gravitational lensing, leveraging more than a decade of observations from the Fermi-Large Area Telescope (LAT) and 3 years of data from the Dark Energy Survey (DES). We detect a correlation at signal-to-noise ratio of 8.9. Most of the statistical significance comes from large scales, demonstrating, for the first time, that a substantial portion of the UGRB aligns with the mass clustering of the Universe as traced by weak lensing. Blazars provide a plausible explanation for this signal, especially if those contributing to the correlation reside in halos of large mass (∼ 1014 M ⊙) and account for approximately 30-40% of the UGRB above 10 GeV. Additionally, we observe a preference for a curved γ-ray energy spectrum, with a log-parabolic shape being favored over a power-law. We also discuss the possibility of modifications to the blazar model and the inclusion of additional γ-ray sources, such as star-forming galaxies, misalinged active galactic nuclei, or particle dark matter
Stellar processes driven by the rise of nuclear collectivity
No full textThe sudden rise of nuclear collectivity above the pairing gap is revealed in this work as the primary source for the relative increase of the symmetry energy with respect to the ground state, as originally suggested by Donati and collaborators. This finding is uncovered by available data on giant dipole resonances built on excited states and 1h¯ω shell-model calculations of the myriads of products of electric dipole matrix elements that compose the nuclear dipole polarizability of the ground and first-excited states. At the temperatures involved in stellar environments, a larger symmetry energy impacts stellar collapse, the nucleosynthesis of heavy elements and the nuclear equation of state of hot neutron stars. According to the Pauli exclusion principle, the symmetry energy reduces the binding energy of nuclei with a larger number of neutrons N than protons Z. It is commonly given by the term −asym (A)(N − Z)2/A in the Bethe–Weizsäcker semi-empirical mass formula [1,2], where asym (A) is the symmetry energy parameter and A = N +Z the atomic mass number. Analog parametrizations of the symmetry energy can be found in the literature [3–6]. In a seminal work, Donati and collaborators [7] calculated a relative increase of the symmetry energy of approximately 2.5 MeV or 8% for mediummass nuclei in the temperature interval T = 0 − 1 MeV
Assessment of SDG 3 research priorities and COVID-19 recovery pathways: a case study from University of the Western Cape, South Africa
No full textThe COVID-19 pandemic has disrupted the progress toward Sustainable Development Goal 3, particularly in developing countries, exacerbating existing health disparities and creating new challenges for health systems worldwide. This study explores the role of university research in advancing SDG 3 targets in a post-pandemic context using the University of the Western Cape as a case study. Through qualitative data analysis of research titles and abstracts registered between 2020 and 2022, we applied the WHERETO model of McTighe and Bloom’s Taxonomy to categorize research according to the SDG 3 targets and indicators. This approach provides insight into which health priorities were addressed through scholarly research at UWC in alignment with the UN 2030 Agenda, particularly during pandemic recovery. Our findings indicate that research priorities largely corresponded with South Africa’s health challenges, with the highest concentration of studies addressing non-communicable diseases and mental health (Target 3.4), infectious diseases (Target 3.3), and medicine development (Target 3.b). These priorities align with the National Health Research Committee’s identified health priorities for disadvantaged communities in the Western Cape. Notably, research on mental health and emergency preparedness (Target 3.d) increased significantly during the pandemic period, reflecting shifting priorities in response to COVID-19. This study offers critical insights into how university research shifted priorities adapted during the pandemic and identifies areas requiring focused attention to support post-pandemic recovery. By highlighting research gaps and opportunities, our findings provide a foundation for developing more comprehensive approaches to health research that address the disparities exacerbated by COVID-19 while advancing the 2030 agenda. This model could inform research prioritization at other institutions facing similar challenges in both local and global context