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Browsing by Author "et al"

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Accurate diagnosis of occlusal carious lesions - a stereo microscope evaluation of clinical diagnosis
(2002) Grossman, E. S.; Cleaton-Jones, P. E.; Côrtes, D. F.; et al
This study was undertaken to validate the caries status of 214 teeth by serial sectioning and microscopy after caries diagnosis using four methods. Two hundred and fourteen extracted human teeth with varying degrees of caries were mounted in the jaws of nine training manikins. All tooth surfaces were examined and recorded for caries by four dentists using bitewing radiographs, fibre-optic transillumination (FOTI), mirror alone and a mirror and sharp probe on two separate occasions. Thereafter the teeth were serially sectioned and assessed microscopically for depth of caries lesion on a graded score of 0-7. This report assessed the diagnostic outcome of 2,183 observations for occlusal surfaces. Sound diagnoses predominated over unsound until caries was present in the inner half of dentine. Specificity was between 90% and 95% and sensitivity 26% and 50% depending on which diagnostic method was used and where the sound/unsound threshold was set. Negative and positive predictive values were similarly influenced and varied between 53% and 80% and 73% and 90%, respectively. Probit analysis showed no significant differences (P < 0.05) between examiners and diagnostic methods. Diagnosis of occlusal caries undertaken in an in vitro simulated clinical situation is inaccurate until the caries lesion extends deep into the dentine no matter which of the four methods was used.
Advances in osteogenin and related bone morphogenetic proteins in bone induction and repair
(1992) Luyten, F. P.; Cunningham, N. S.; Vukicevic, S.; et al
Bone matrix is a repository of growth and differentiation factors as demonstrated by the induction of local cartilage and bone formation in rats. The bone inductive activity, termed osteogenin, can be dissociatively extracted, and it was isolated by heparin affinity, hydroxyapatite and molecular sieve chromatography. Osteogenin has been purified to homogeneity from bovine bone matrix and the sequences of several tryptic peptides have been determined. The sequences were similar to portions of the amino acid sequence deduced from the cDNA clone of bone morphogenetic protein-3 (BMP-3). The carboxyl-terminal quarter of osteogenin has sequence identity to the corresponding regions of two related proteins BMP-2A and BMP-2B. The bone inductive proteins are members of the TGF-beta superfamily, by virtue of the location of the highly conserved cysteines in their carboxyl-terminal region. Osteogenin and related BMPs initiate cartilage and bone formation in vivo. The study of the mechanism of action of these proteins will add considerable new information on the molecular signals controlling endochondral bone formation. In vitro data indicate that osteogenin stimulates the expression of the osteogenic and chondrogenic phenotypes. Our results demonstrate their profound influence on proteoglycan synthesis and degradation in bovine cartilage explant cultures. High affinity specific binding sites have been identified in both MC3T3 cells and articular chondrocytes. In vivo experiments demonstrate the efficacy of primate osteogenin in restoring large calvarial defects in adult baboons, establishing a primary role for osteogenin in therapeutic initiation and promotion of osteogenesis.
An analysis of fractures of the facial skeleton in three populations in the Johannesburg urban area
(1985) Beaumont, E.; Lownie, J. F.; Cleaton-Jones, P. E.; et al
Assessing the impact of mHealth interventions in low- and middle-income countries – what has been shown to work?
(2014) Hall C S; Fottrell E; Wilkilson S; et al
Background: Low-cost mobile devices, such as mobile phones, tablets, and personal digital assistants, which can access voice and data services, have revolutionised access to information and communication technology worldwide. These devices have a major impact on many aspects of people’s lives, from business and education to health. This paper reviews the current evidence on the specific impacts of mobile technologies on tangible health outcomes (mHealth) in low- and middle-income countries (LMICs), from the perspectives of various stakeholders. Design: Comprehensive literature searches were undertaken using key medical subject heading search terms on PubMed, Google Scholar, and grey literature sources. Analysis of 676 publications retrieved from the search was undertaken based on key inclusion criteria, resulting in a set of 76 papers for detailed review. The impacts of mHealth interventions reported in these papers were categorised into common mHealth applications. Results: There is a growing evidence base for the efficacy of mHealth interventions in LMICs, particularly in improving treatment adherence, appointment compliance, data gathering, and developing support networks for health workers. However, the quantity and quality of the evidence is still limited in many respects. Conclusions: Over all application areas, there remains a need to take small pilot studies to full scale, enabling more rigorous experimental and quasi-experimental studies to be undertaken in order to strengthen the evidence base.
The Atacama Cosmology Telescope Cosmology from Crosscorrelations of unWISE Galaxies and ACT DR6 CMB Lensing
(IOP PUBLISHING LTD) Garrit S. Farren; Alex Krolewski; Niall MacCrann; Simone Ferraro; Matthew Hilton; et al
The Atacama Cosmology Telescope Mitigating the Impact of Extragalactic Foregrounds for the DR6 Cosmic Microwave Background Lensing Analysis
(IOP PUBLISHING LTD) Niall MacCrann; Blake D. Sherwin; Frank J. Qu; Toshiya Namikawa; Matthew Hilton; et al
The bacteriology of sheep periodontitis with special reference to Actinobacillus actinomycetemcomitans
(1986) Dreyer, W. P.; Parker, J. R.; Ebersole, J. L.; et al
Barriers to accessing health care in Nigeria: implications for child survival
(2014) Adedini, S A; Odimegwu, C; Bamiwuye, S A; et al
Background: Existing studies indicate that about one in every six children dies before age five in Nigeria. While evidence suggests that improved access to adequate health care holds great potential for improved child survival, previous studies indicate that there are substantial barriers to accessing health care in Nigeria. There has not been a systematic attempt to examine the effects of barriers to health care on under-five mortality in Nigeria. This study is designed to address this knowledge gap. Data and method: Data came from a nationally representative sample of 18,028 women (aged 15 49) who had a total of 28,647 live births within the 5 years preceding the 2008 Nigeria Demographic and Health Survey. The risk of death in children below age five was estimated using Cox proportional hazard models and results are presented as hazards ratios (HR) with 95% confidence intervals (CI). Results: Results indicate higher under-five mortality risks for children whose mothers had cultural barriers and children whose mothers had resource-related barriers to health care (HR: 1.44, CI: 1.32 1.57, pB0.001), and those whose mothers had physical barriers (HR: 1.13, CI: 1.04 1.24, pB0.001), relative to children whose mothers reported no barriers. Barriers to health care remained an important predictor of child survival even after adjusting for the effects of possible confounders. Conclusion: Findings of this study stressed the need for improved access to adequate health care in Nigeria through the elimination of barriers to access. This would enable the country to achieve a significant reduction in childhood mortality.
Clinical access to Bedaquiline Programme for the treatment of drug-resistant tuberculosis
(2014-03) Conradie, F; Meintjies, G; Hughes, J; et al
While clinical disease caused by drug-sensitive Mycobacterium tuberculosis (MTB) can usually be treated successfully, clinical disease caused by drug-insensitive MTB is associated with a poorer prognosis. In December 2012, a new drug, bedaquiline, was approved by the US Food and Drug Administration. This article documents the process whereby the National Department of Health, Right to Care and Médecins Sans Frontières obtained access to this medication for South Africans who might benefit from subsequent implementation of the Clinical Access to Bedaquiline Programme.
Clinical, histological and microbiological study of hand-excavated carious dentine in extracted permanent teeth
(2003) Bönecker, M.; Grossman, E.; Cleaton-Jones, P. E.; et al
Changes in cultivable flora in dentine samples collected before and after hand excavation were examined in association with clinical status of the cavity surface, light microscopy and scanning electron microscopy (SEM). Thirty-five extracted permanent molar teeth with an occlusal caries lesion were excavated with hand instruments according to the atraumatic restorative treatment (ART) approach. Excavation pressure, dentine colour and consistency were recorded at the dentine-enamel junction (DEJ) prior to carious dentine removal and at the cavity floor after the final excavation; a microbiological sample of dentine was taken at both stages. Twelve restored teeth; six with positive and six with negative bacterial growth on the second sample, were selected for light microscopy and SEM. The hand-excavation removed tooth structure was soft, irreversibly damaged, dark and highly infected. Hand excavation reached dentine of increased hardness with a more normal colour to provide a sound structural base for restoration. Light and SEM examination of the cavity floor showed infected dentinal tubules in all 12 teeth examined. Linear logistic analysis showed a statistical association between light-yellow dentine on the cavity floor and an absence of bacterial growth (P = 0.006). This short-term in vitro study showed that caries-producing bacteria remained in dentine close to the cavity floor in 26/35 teeth despite clinical observations that indicated a suitably prepared cavity floor.
Comparison of the health related quality of life, CD4 count and viral load of AIDS patients with HIV who have been on treatment for 12 months in rural South Africa
(2013-03) Ingumbor J; Steward A; Holzemer W; et al
This study compared the level of CD4 count, viral load and health-related quality of life (HRQOL) between treatment-naive AIDS patients and a cohort of people living with HIV who have been on treatment for 12 months. This study is based on a secondary data analysis of the records of 642 people with HIV consisting of 311 treatment-naive AIDS patients and 331 people with HIV who have been on treatment for 12 months. The study findings are mostly presented in tables and analysed using the f-test to compare HRQOL scores, CD4 count and viral load in the two groups. The study generally noted poor financial capacity and low activity tolerance among the participants. Significant changes were noted in all the domains of HRQOL compared between the treatment-naive patients and the 12 months treatment cohort. In the same manner, the median CD4 cell count and viral load differed significantly between both groups. The treatment-naive and the 12 months treatment cohorts consistently reported much lower quality of life scores in the level of dependence domain which includes the measures of mobility, activity of daily living, dependence on medication and work capacity. There were little or no associations between the biomedical markers (CD4 count and viral load) and HRQOL indicators. However, the quality of life tended to increase with increase in the CD4 cell count. The poor to no association between the biomedical markers and HRQOL indicators show that these cannot be direct proxies of each other and that the CD4 cell count and viral load alone may be inadequate eligibility criteria for social support.
Comparison of three anaesthetic scavenging devices using cuffed and non-cuffed nasal endotracheal tubes during dental anaesthesia
(1981) Moyes, D.; Cleaton-Jones, P.; Shaw, R.; et al
Cooccurrence and abundance of pollinators and pests in horticultural systems in Africa using an integrated Earth observationbased approach
Grace R Aduvukha; Elfatih M Abdel-Rahman; Bester Mudereri; Arthur W Sichangi; Godfrey O Makokha; et al
Cost and impact of scaling up interventions to save lives of mothers and children: taking South Africa closer to MDGs 4 and 5
(2015) Chola, M; Pillay, Y; Barron, P; et al
BACKGROUND:South Africa has made substantial progress on child and maternal mortality, yet many avoidable deaths of mothers and children still occur. This analysis identifies priority interventions to be scaled up nationally and projects the potential maternal and child lives saved. DESIGN: We modelled the impact of maternal, newborn and child interventions using the Lives Saved Tools Projections to 2015 and used realistic coverage increases based on expert opinion considering recent policy change, financial and resource inputs, and observed coverage change. A scenario analysis was undertaken to test the impact of increasing intervention coverage to 95%. RESULTS:By 2015, with realistic coverage, the maternal mortality ratio (MMR) can reduce to 153 deaths per 100,000 and child mortality to 34 deaths per 1,000 live births. Fifteen interventions, including labour and delivery management, early HIV treatment in pregnancy, prevention of mother-to-child transmission and handwashing with soap, will save an additional 9,000 newborns and children and 1,000 mothers annually. An additional US$370 million (US$7 per capita) will be required annually to scale up these interventions. When intervention coverage is increased to 95%, breastfeeding promotion becomes the top intervention, the MMR reduces to 116 and the child mortality ratio to 23.
Desegregating health statistics and health research in South Africa
(1997) Walker, A. R. P.; Sitas, F.; Cleaton-Jones, P. E.; et al
Does moonlighting influence South African nurses' intention to leave their primary jobs?
(2014) Rispel, L; Chirwa, T; Blaauw, D; et al
BACKGROUND: Staff retention and turnover have risen in prominence in the global discourse on the health workforce. Moonlighting, having a second job in addition to a primary job, has not featured in debates on turnover. OBJECTIVE: This paper examines whether moonlighting is a determinant of South African nurses' intention to leave their primary jobs. DESIGN: During 2010, a one-stage cluster random sample of 80 hospitals was selected in four South African provinces. On the survey day, all nurses working in critical care, theatre, emergency, maternity, and general medical and surgical wards completed a self-administered questionnaire after giving informed consent. In addition to demographic information and information on moonlighting, the questionnaire obtained information on the participants' intention to leave their primary jobs in the 12 months following the survey. A weighted analysis of the survey data was done using STATA(®) 13. RESULTS: Survey participants (n=3,784) were predominantly middle-aged with a mean age of 41.5 (SD±10.4) years. Almost one-third of survey participants (30.9%) indicated that they planned to leave their jobs within 12 months. Intention to leave was higher among the moonlighters (39.5%) compared to non-moonlighters (27.9%; p<0.001). Predictors of intention to leave in a multiple logistic regression were moonlighting in the preceding year, nursing category, sector of primary employment, period working at the primary job, and number of children. The odds of intention to leave was 1.40 (95% CI: 1.16-1.69) times higher for moonlighters than for non-moonlighters. The odds ratio of intention to leave was 0.53 (95% CI: 0.42-0.66) for nursing assistants compared to professional nurses and 2.09 (95% CI: 1.49-2.94) for nurses working for a commercial nursing agency compared to those working in the public sector.
Elimination of mother- to - child transmission of HIV in South Africa : Rapid scale- up using quality improvement
(2014-03) Bardwaj, S.; Barron, P.; Treger-Slavin, P.; et al
Background: South Africa (SA) is committed to achieving the goal of eliminating mother-to-child transmission (MTCT) of HIV by 2015. To achieve this, universal coverage of quality antenatal, labour, delivery and postnatal services for all women has to be attained. Over the past decade, the prevention of mother-to-child transmission (PMTCT) programme has been scaled up to reach all healthcare facilities in the country. However, challenges persist in achieving 100% coverage and access to the programme. Objectives: We describe the process undertaken by the National Department of Health (NDoH), in collaboration with partners, to develop, implement and monitor a data-driven intervention to improve facility, district, provincial and national PMTCT-related performance. Methods: Between 2011 and 2013, the NDoH developed and implemented an intervention using data-driven participatory processes to understand facility-level bottlenecks to optimise PMTCT implementation and to scale up priority PMTCT actions nationally. Results: There was remarkable improvement across all key indicators in the PMTCT cascade over the 3 years 2011 - 2013. Simple monitoring tools such as a visual dashboard and data for action reports were successfully used to improve the performance of the PMTCT programme across SA. MTCT has shown a significant downward trend. Conclusions: It is feasible to implement district-level, data-driven quality improvement processes at a national scale to improve the performance of the PMTCT programme at the local level.
Equity and justice should underpin the discourse on tipping points
(COPERNICUS GESELLSCHAFT MBH) Laura Pereira; Ignacio Gianelli; Therezah Achieng; Diva Amon; Sally Archibald; Suchinta Arif; Tracy-Lynn Field; Nicola Stevens; et al
Essential evidence for guiding health system priorities and policies: anticipating epidemiological transition in Africa
(2014) Byass, P; De Savigny, D; Lopez, A.D; et al
BACKGROUND: Despite indications that infection-related mortality in sub-Saharan Africa may be decreasing and the burden of non-communicable diseases increasing, the overwhelming reality is that health information systems across most of sub-Saharan Africa remain too weak to track epidemiological transition in a meaningful and effective way. PROPOSALS: We propose a minimum dataset as the basis of a functional health information system in countries where health information is lacking. This would involve continuous monitoring of cause-specific mortality through routine civil registration, regular documentation of exposure to leading risk factors, and monitoring effective coverage of key preventive and curative interventions in the health sector. Consideration must be given as to how these minimum data requirements can be effectively integrated within national health information systems, what methods and tools are needed, and ensuring that ethical and political issues are addressed. A more strategic approach to health information systems in sub-Saharan African countries, along these lines, is essential if epidemiological changes are to be tracked effectively for the benefit of local health planners and policy makers. CONCLUSION: African countries have a unique opportunity to capitalize on modern information and communications technology in order to achieve this. Methodological standards need to be established and political momentum fostered so that the African continent's health status can be reliably tracked. This will greatly strengthen the evidence base for health policies and facilitate the effective delivery of services.
An evaluation of an in vivo enamel acid etch biopsy technique for fluoride determination
(1974) van der Merwe, E H M; Retief, D H; Barbakow, F H; et al

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