1,720,967 research outputs found
Understanding attrition in the South African integrated intervention for diabetes risk after gestational diabetes (IINDIAGO) study: a qualitative study of postpartum lifestyle intervention disengagement
No full textBackground and aims: lifestyle interventions can benefit women with gestational diabetes (GDM) to manage the conditionduring pregnancy and reduce future health risks including the risk of progression to Type 2 diabetes (T2DM). However, future benefits may only be realised if women engage with the intervention (coaching, educational materials, ongoing risk assessment and monitoring) after the birth of the child. The aim of this study was to explore the factors influencing women's attrition froma lifestyle intervention study (IINDIAGO—Integrated Health System Intervention aimed at reducing Type 2 Diabetes risk inwomen after Gestational diabetes) in South Africa.Methods: this cross‐sectional exploratory descriptive qualitative study was conducted with women recruited from the intervention arm of the IINDIAGO study and living in a low‐income neighbourhood (Soweto). Participants were divided into two groups: Group A (n = 11 who remained engaged with the study and received ≥ 40% of the intervention) and Group B (n = 15who had disengaged from the study and received < 30% of the intervention). Semi‐structured interviews were conducted telephonically, with interviews recorded, transcribed, and analysed using inductive and deductive methods.Results: women who remained engaged (Group A) frequently reported the perceived intervention benefits including healtheducation, reduced diabetes risk, and positive relationships with the study team. In contrast, women in Group B who had disengaged highlighted multiple challenges and competing demands related to their personal situations, including the cost of travel to the study site and the impact of the COVID‐19 pandemic, that hindered their continued participation.Conclusions: successful implementation of postpartum lifestyle interventions for women who experience GDM and are at highrisk of converting to T2DM after the pregnancy are critical. However, interventions in the postnatal period must be tailored tothe contextual realities of new mothers facing multiple demands with limited resources to facilitate continued access andengagemen
Anatomical variation of the carotid arterial system within the South African population: implications for the treatment of carotid arterial disease
Full text linkDissertation submitted to the Faculty of Health Sciences of the University of the Witwatersrand, Johannesburg in fulfilment of the requirement for the degree of Master of Science in Medicine.
Johannesburg
23 April 2015Knowledge of the anatomical variation in the carotid arterial system is important in understanding the pathogenesis and surgical treatment of atheroma. Thus, this study investigated the anatomical variation of the carotid arterial system and the frequency of atheroma within a South African population.
The carotid arterial systems were exposed bilaterally in 77 adult cadavers using standard dissection. The level of the carotid bifurcation, position and curving of the carotid arteries and frequency of common trunks and atheroma were recorded. In addition, the lengths and diameters of the carotid arteries and branches as well as the bifurcation angle were measured. Data was analyzed using descriptive and inferential statistics.
The carotid bifurcation most commonly occurred at the C3-C4 intervertebral disc. White males had longer common carotid arteries than white females. The lengths of the internal and external carotid arteries were longer in white males compared to black males. There was a higher frequency of curving of the carotid arteries in white females compared to white males. The thyro-lingual trunk was the most common trunk within the sample. The internal carotid artery was postero-lateral to the external carotid artery within most individuals. In addition, atheroma was observed at the carotid bifurcation in all individuals.
The level of the carotid bifurcation, positioning, length and diameter of the carotid arteries in the South African population are similar to descriptions in anatomical texts. The differences found within the study may be attributable to the age of the sample as well as the embryological development of the carotid arteries within the South African population. These variations may influence blood flow within the carotid arteries. Thus, knowledge of these variations may aid in understanding the aetiology and the surgical treatment of atheroma
Are cardiovascular health measures heritable across three generations of families in Soweto, South Africa? A cross-sectional analysis using the random family method
Full text linkOBJECTIVES: Cardiovascular disease is increasing in many low and middle-income countries, including those in Africa. To inform strategies for the prevention of cardiovascular disease in South Africa, we sought to determine the broad heritability of phenotypic markers of cardiovascular risk across three generations. DESIGN: A cross-sectional study conducted in a longitudinal family cohort. SETTING: Research unit within a tertiary hospital in a historically disadvantaged, large urban township of South Africa. PARTICIPANTS: 195 individuals from 65 biological families with all three generations including third-generation children aged 4–10 years were recruited from the longest running intergenerational cohort study in Africa, the Birth to Twenty Plus cohort. All adults (grandparents and parents) were female while children were male or female. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was heritability of blood pressure (BP; brachial and central pressures). Secondary outcomes were heritability of arterial stiffness (pulse wave velocity), carotid intima media thickness (cIMT) and left ventricular mass indexed to body surface area (LVMI). RESULTS: While no significant intergenerational relationships of BP or arterial stiffness were found, there were significant relationships in LVMI across all three generations (p<0.04), and in cIMT between grandparents and parents (p=0.0166). Heritability, the proportion of phenotypic trait variation attributable to genetics, was estimated from three common statistical methods and ranged from 23% to 44% for cIMT and from 21% to 39% for LVMI. CONCLUSIONS: Structural indicators of vascular health, which are strong markers of future clinical cardiovascular outcomes, transmit between generations within African families. Identification of these markers in parents may be useful to trigger assessments of preventable risk factors for cardiovascular disease in offspring
Obesity, hypertension, and tobacco use associated with left ventricular remodeling and hypertrophy in South African women: Birth to Twenty Plus Cohort
Full text linkBACKGROUND: Left ventricular hypertrophy (LVH) is a marker of increased risk in developing future life-threatening cardiovascular disease (CVD), however, it is unclear how CVD risk factors, such as obesity, blood pressure (BP), and tobacco use, are associated with left ventricular (LV) remodeling and LVH in urban African populations. Therefore, we aimed to identify the prevalence of LVH as well as the health factors associated with LV remodeling and LVH, within black South African adult women and their pre-pubescent children. METHODS: Black female adults (n = 123; age: 29–68 years) and their children (n = 64; age: 4–10; 55% female) were recruited from the Birth to Twenty Plus Cohort in Soweto, South Africa. Tobacco and alcohol use, physical activity, presence of diabetes mellitus, heart disease, and medication were self-reported. Height, weight, and blood pressure were measured in triplicate to determine the prevalence of obesity and hypertension respectively. Echocardiography was used to assess LV mass at end-diastole, based on linear measurements, and indexed to body surface area to determine LVH. RESULTS: Hypertension and obesity prevalences were 35.8% and 59.3% for adults and 45.3% and 6.3% for children. Self-reported tobacco use in adults was 22.8%. LVH prevalence was 35.8% in adults (75% eccentric: 25% concentric), and 6.3% in children. Concentric remodeling was observed in 15.4% of adults, however, concentric remodeling was only found in one child. In adults, obesity [OR: 2.54 (1.07–6.02; p = 0.02)] and hypertension [3.39 (1.08–10.62; p = 0.04)] significantly increased the odds of LVH, specifically eccentric LVH, while concentric LVH was associated with self-reported tobacco use [OR: 4.58 (1.18–17.73; p = 0.03)]. Although no logistic regression was run within children, of the four children LVH, three had elevated blood pressure and the child with normal blood pressure was overweight. CONCLUSIONS: The association between obesity, hypertension, tobacco use, and LVH in adults, and the 6% prevalence of LVH in children, calls for stronger public health efforts to control risk factors and monitor children who are at risk
The Healthy Aging Adult South Africa report card: a systematic review of the evidence between 2013 and 2020 for middle-aged South African men and women
No full textDue to the increasing non-communicable disease burden in Africa, several strategies that target the major lifestyle and physiological risk factors have been implemented to combat such diseases. The Healthy Aging Adult South Africa report card systematically reviews national and regional prevalence data of middle-aged South African adults (45–65 years) published between 2013 and 2020 on diet, physical activity, tobacco use and alcohol consumption, obesity, hypertension, dyslipidaemia and diabetes mellitus. Each indicator was assigned two grades, (1) based on the availability of prevalence data, and (2) based on whether policies have been proposed and implemented for the respective indicators. Alcohol consumption, obesity, hypertension and diabetes received an A grade for the availability of prevalence data. Tobacco use and diet received an A grade for policy and implementation. Gaps have been identified that need to be filled by future research focusing on continued surveillance of all indicators in order to inform and implement effective policies
Paediatric Hypertension in Africa: A Systematic Review and Meta-Analysis
Full text linkBackground: The burden of cardiovascular disease (CVD) and hypertension is rapidly increasing in low- and middle-income countries. This is evident not only in adults, but also in children, but recent estimates of prevalence in children are lacking particularly in Africa. As such, we conducted a systematic review and meta-analysis to provide updated estimates of paediatric hypertension in Africa. Methods: We searched PubMed and EBSCO to identify articles published from January 2017-November 2020. Studies were assessed for quality. We combined results for meta-analyses using a random effects model (Freeman-Tukey arcsine transformation). Heterogeneity was quantified using the I2 statistic. Findings: In the narrative synthesis of 53 studies, publication bias was low for 28, moderate for 24, and high for one study. Hypertension prevalence ranged substantially (0·2%-38·9%). Meta-analysis included 41 studies resulting in data on 52918 participants aged 3-19 from 10 countries. The pooled prevalence for hypertension (systolic/diastolic BP≥95th percentile) was 7·45% (95%CI 5·30-9·92, I2=98.96%), elevated BP (systolic/diastolic BP≥90th percentile and <95th percentile) 11·38% (95%CI 7·94-15·33, I2=98.97%) and combined hypertension/elevated BP 21·74% (95%CI 15·5-28·69, I2=99.48%). Participants categorized as overweight/obese had a higher prevalence of hypertension (18·5% [95%CI 10·2-28·5]) than those categorized as underweight/normal (1·0% [95%CI 0·1-2·6], 4·8% [95%CI 2·9-7·1], p<0·001). There were significant differences in hypertension prevalence when comparing BP measurement methods and classification guidelines. Interpretation: Compared to a previous systematic review conducted in 2017, this study suggests a continued increase in prevalence of paediatric hypertension in Africa, as well as highlighting the potential role of to increasing overweight/obesity. Funding: This research was funded in part by the Wellcome Trust [Grant number:214082/Z/18/Z]. For the purpose of Open Access, we applied a CC-BY public copyright licence to any Author Accepted Manuscript version arising from this submission. LJW and SAN are supported by the DSI-NRF Centre of Human Development at the University of the Witwatersrand.<br/
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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