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The effect of a post‑anaesthesia high‑care unit (PAHCU) admission on mobilization, length of stay and in‑hospital mortality post‑surgery in low energy neck of femur fracture patients
(Springer Link, 2024-01-09) Essa, S.; Venter, S.; Jordaan, J. D.
Purpose/aim: With an ageing population and an increase in fragility fractures of the hip (FFH), the role of an anaesthetist is evolving to include more peri-operative care. A post-anaesthesia high-care unit (PAHCU) should enhance care in postoperative patients. To our knowledge, there are no studies that have investigated the effect of a PAHCU admission on postoperative outcomes after FFH. This study aimed to compare post-operative outcomes of FFH patients admitted to PAHCU versus a standard post-operative orthopaedic ward (POOW).
Methodology: A retrospective cohort study was conducted on adult patients with FFH who underwent surgery between January 2019 and December 2020 at our institution. Data were sourced from electronic medical records. SPSS version 28 was used to analyse data.
Results: A total of 231 patients were included. The PAHCU group (n = 35) displayed a higher burden of chronic illness and higher peri-operative risk scores as compared to the POOW group (n = 196). Median time to mobilize (TTM) in PAHCU was 84 h vs. 45 h in POOW group (p = 0.013). Median length of stay (LOS) in PAHCU was 133 h vs. 94 h in POOW (p = 0.001). The in-hospital mortality was 2.9% (n = 1) for PAHCU and 3.6% (n = 7) for POOW (p = 1). The 30-day mortality was 11.8% (n = 4) for PAHCU and 10.1% (n = 19) in POOW.
Conclusion: PAHCU admission resulted in delayed time to surgery and TTM, together with prolonged LOS, compared to those managed in POOW. However, these mortality rates remained comparable in both groups. This study contributes valuable insights into post-operative care of FFH patients in a resource-poor setting.
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Dialogue, horizon and chronotope : using Bakhtin’s and Gadamer’s ideas to frame online teaching and learning
(Springer Nature, 2024-04-05) Rule, Peter
The information explosion and digital modes of learning often combine to inform the quest for the best ways of transforming information in digital form for pedagogical purposes. This quest has become more urgent and pervasive with the ‘turn’ to online learning in the context of COVID-19. This can result in linear, asynchronous, transmission-based modes of teaching and learning which commodify, package and deliver knowledge for individual ‘customers’. The primary concerns in such models are often technical and economic – technology as a cost-effective ‘solution’ to educational challenges. In this paper I argue for the importance of dialogic learning space in teaching and learning by means of Information and Communication Technologies, whether in the form of fully online learning, blended learning or face-to-face encounters using ICT affordances. Although the 20th Century theorists Mikhail Bakhtin (1895–1975) and Hans-Georg Gadamer (1900–2002) produced their seminal works before the advent of ICTs, they were both concerned with the quality and authenticity of human engagement with texts and with other persons and contexts. Besides a shared interest in dialogue as an ontological feature of human life and being, they both used spatiotemporal concepts for understanding and interpreting texts. The article draws on Gadamer’s notions of dialogue and horizon, and Bakhtin’s notions of dialogue and chronotope, to conceptualize dialogic possibilities for online education. Its purpose is to provide a framework, grounded in Bakhtin’s and Gadamer’s ideas, for a dialogic approach to online teaching and learning in higher education.
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Bovine tuberculosis in African buffalo (Syncerus caffer): Progression of pathology during infection
(PLOS, 2022-11-11) Lakin, Hilary Ann; Tavalire, Hannah; Sakamoto, Kaori; Buss, Peter; Miller, Michele; Budischak, Sarah A.; Raum, Kristina; Ezenwa, Vanessa O.; Beechler, Brianna; Jolles, Anna
Background
Bovine tuberculosis (BTB) is a zoonotic disease of global importance endemic in African buffalo (Syncerus caffer) in sub-Saharan Africa. Zoonotic tuberculosis is a disease of global importance, accounting for over 12,000 deaths annually. Cattle affected with BTB have been proposed as a model for the study of human tuberculosis, more closely resembling the localization and progression of lesions in controlled studies than murine models. If disease in African buffalo progresses similarly to experimentally infected cattle, they may serve as a model, both for human tuberculosis and cattle BTB, in a natural environment.
Methodology/Principal findings
We utilized a herd of African buffalo that were captured, fitted with radio collars, and tested for BTB twice annually during a 4-year-cohort study. At the end of the project, BTB positive buffalo were culled, and necropsies performed. Here we describe the pathologic progression of BTB over time in African buffalo, utilizing gross and histological methods. We found that BTB in buffalo follows a pattern of infection like that seen in experimental studies of cattle. BTB localizes to the lymph nodes of the respiratory tract first, beginning with the retropharyngeal and tracheobronchial lymph nodes, gradually increasing in lymph nodes affected over time. At 36 months, rate of spread to additional lymph nodes sharply increases. The lung lesions follow a similar pattern, progressing slowly, then accelerating their progression at 36 months post infection. Lastly, a genetic marker that correlated to risk of M. bovis infection in previous studies was marginally associated with BTB progression. Buffalo with at least one risk allele at this locus tended to progress faster, with more lung necrosis.
Conclusions/Significance
The progression of disease in the African buffalo mirrors the progression found in experimental cattle models, offering insight into BTB and the interaction with its host in the context of naturally varying environments, host, and pathogen populations.
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Scientific selection: a century of increasing crop varietal diversity in US wheat
(National Academy of Science, 2022-12-13) Chaia, Yuan; Pardey, Philip G.; Silverstein, Kevin A. T.
A prevalent and persistent biodiversity concern is that modern cropping systems lead to an erosion in crop genetic diversity. Although certain trait uniformity provides advantages in crop management and marketing, farmers facing risks from change in climate, pests, and markets are also incentivized to adopt new varieties to address complex and spatially variable genetics, environment, and crop management interactions to optimize crop performance. In this study, we applied phylogenetically blind and phylogenetically informed diversity metrics to reveal significant increases in both the spatial and temporal diversity of the US wheat crop over the past century. Contrary to commonly held perceptions on the negative impact of modern cropping systems on crop genetic diversity, our results demonstrated a win-win outcome where the widespread uptake of scientifically selected varieties increased both crop production and crop diversity.
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Exploring the Experiences of Zimbabwean Migrant educators teaching in the Western Cape, South Africa
(2024-03-08) Chiware, Doreen; Chiware, Doreen; Walters, Handri; Walters, Handri