Browsing by Author "Nel, Daan G."
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- ItemPlasma glutamine levels in relation to intensive care unit patient outcome(MDPI, 2020) Blaauw, Renee; Nel, Daan G.; Schleicher, Gunter K.Low and high plasma glutamine levels are associated with increased mortality. This study aimed to measure glutamine levels in critically ill patients admitted to the intensive care unit (ICU), correlate the glutamine values with clinical outcomes, and identify proxy indicators of abnormal glutamine levels. Patients were enrolled from three ICUs in South Africa, provided they met the inclusion criteria. Clinical and biochemical data were collected. Plasma glutamine was categorized as low (<420 µmol/L), normal (420–700 µmol/L), or high (>700 µmol/L). Three hundred and thirty patients (median age 46.8 years, 56.4% male) were enrolled (median APACHE II score) 18.0 and SOFA) score 7.0). On admission, 58.5% had low (median 299.5 µmol/L) and 14.2% high (median 898.9 µmol/L) plasma glutamine levels. Patients with a diagnosis of polytrauma and sepsis on ICU admission presented with the lowest, and those with liver failure had the highest glutamine levels. Admission low plasma glutamine was associated with higher APACHE II scores (p = 0.003), SOFA scores (p = 0.003), C-reactive protein (CRP) values (p < 0.001), serum urea (p = 0.008), and serum creatinine (p = 0.023) and lower serum albumin (p < 0.001). Low plasma glutamine was also associated with requiring mechanical ventilation and receiving nutritional support. However, it was not significantly associated with length of stay or mortality. ROC curve analysis revealed a CRP threshold value of 87.9 mg/L to be indicative of low plasma glutamine levels (area under the curve (AUC) 0.7, p < 0.001). Fifty-nine percent of ICU patients had low plasma glutamine on admission, with significant differences found between diagnostic groupings. Markers of infection and disease severity were significant indicators of low plasma glutamine.
- ItemStaff and student health and wellness at the Faculty of Medicine and Health Sciences, Stellenbosch University : current status and needs assessment(MedPharm Publications, 2017) Koen, Nelene; Philips, Lauren; Potgieter, Sunita; Smit, Yolande; Van Niekerk, Evette; Nel, Daan G.; Visser, JanickeBackground: Emphasis is currently placed on the importance of employee and student wellness initiatives. The aim was to assess staff and student health status at the Faculty of Medicine and Health Sciences (FMHS), Stellenbosch University (SU), and to conduct a wellness needs assessment. Methods: Online, self-administered questionnaires were used to collect data concerning staff and students. Additionally, students’ anthropometric and biochemical parameters were assessed. Summary statistics, correlation coefficients and appropriate analysis of variance were used for data analyses. Results: Data were obtained from staff (survey: n = 300) and students (screening: n = 536; survey: n = 330). Some 58% (n = 174) of staff had a self-reported BMI of ≥ 25 kg/m2 whilst mean screening values for all variables fell within normal reference ranges for students. In all, 78% (n = 232) of staff reported to exercise < 150 min/week and 28% (n = 91) of students were sedentary for > 8 h/day; 63% (n = 188) of staff expressed the need to make better food choices, 17% (n = 55) of students were aware of the need to change but experienced reluctance, and both staff and students felt dietary assistance would be beneficial (43% vs. 46%). In addition, 79% of staff (n = 208) and 42% of students (n = 138) reported being under constant pressure. Conclusion: Much can be done to improve the health and well-being of both staff and students at the FMHS, SU. Wellness is a multifactorial concept; as such, health-promotional strategies for classrooms and workplaces should consider all factors in order to provide a holistic approach and potentially identify those who are at risk of a sub-optimal wellness status. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2018; DOI: 10.1080/20786190.2017.1396788
- ItemTranslation and validation of the EORTC QLQ-CX24 questionnaire into the indigenous African languages of isiXhosa and Afrikaans(Medpharm Publications, 2012) Du Toit, George C.; Nel, Daan G.Objectives: Quality of life (QOL) assessment plays an important role in oncological clinical practice and research settings when evaluating treatment outcome. Cervical cancer remains a prevalent disease in South African women. The current study translated the European Organisation for Research and Treatment of Cancer (EORTC) cervical cancer module, QLQ-CX24, into isiXhosa and Afrikaans and validated the questionnaires. Setting and subjects: The QLQ-CX24 was translated forwards into isiXhosa and Afrikaans and backwards into English, and then reconciled by four independent language practitioners. The translated version was completed by 15 isiXhosa- and 15 Afrikaans-speaking patients with cervical cancer. Cronbach’s alpha coefficient, a measure of internal consistency of response, was calculated. The conversion validity was evaluated by assessing the correlation between each item and its scale. Discriminant validity was examined by comparing the correlation values of each item with other scales using Pearson’s and Spearman’s correlation coefficients. Results: The translated isiXhosa and Afrikaans questionnaires demonstrated good conversion validity in the multi-item scales, with values of Cronbach’s alpha coefficient ≥ 7. Discriminant validity was demonstrated in the single-item questions. Patients completed the questionnaires in less than 20 minutes. Conclusion: The translated isiXhosa and Afrikaans versions of QLQ-CX24 were successfully translated and validated and is available for research and clinical use.