Effect of pH on the Mechanical Properties of Single-Biopolymer Mucilage (Opuntia ficus-indica), Pectin and Alginate Films: Development and Mechanical Characterisation.

Pectin and alginate are well-established biopolymers used in natural film development. Single-polymer mucilage films were developed from freeze-dried native mucilage powder of two cultivars, 'Algerian' and 'Morado', and the films' mechanical properties were compared to single-polymer pectin and alginate films developed from commercially available pectin and alginate powders. The casting method prepared films forming solutions at 2.5%, 5%, and 7.5% (w/w) for each polymer. Considerable variations were observed in the films' strength and elasticity between the various films at different polymer concentrations. Although mucilage films could be produced at 5% (w/w), both cultivars could not produce films with a tensile strength (TS) greater than 1 MPa. Mucilage films, however, displayed > 20% elongation at break (%E) values, being noticeably more elastic than the pectin and alginate films. The mechanical properties of the various films were further modified by varying the pH of the film-forming solution. The various films showed increased TS and puncture force (PF) values, although these increases were more noticeable for pectin and alginate than mucilage films. Although single-polymer mucilage films exhibit the potential to be used in developing natural packaging, pectin and alginate films possess more suitable mechanical attributes.

Microstructural and Mechanical Properties of Calcium-Treated Cactus Pear Mucilage (Opuntia spp.), Pectin and Alginate Single-Biopolymer Films.

Pectin and alginate satisfy multiple functional requirements in the food industry, especially relating to natural packaging formulation. The continuous need for economic and environmental benefits has promoted sourcing and investigating alternative biomaterials, such as cactus pear mucilage from the cladodes of Opuntia spp., as natural packaging alternatives. The structural and mechanical properties of mucilage, pectin and alginate films developed at a 5% (w/w) concentration were modified by treating the films with calcium (Ca) in the calcium chloride (CaCl2) form. Scanning electron microscopy (SEM) showed the 5% (w/w) 'Algerian' and 'Morado' films to display considerable microstructure variation compared to the 5% (w/w) pectin and alginate films, with calcium treatment of the films influencing homogeneity and film orientation. Treating the alginate films with a 10% (w/w) stock CaCl2 solution significantly increased (p < 0.05) the alginate films' tensile strength (TS) and puncture force (PF) values. Consequently, the alginate films reported significantly higher (p < 0.05) film strength (TS and PF) than the pectin + Ca and mucilage + Ca films. The mucilage film's elasticity was negatively influenced by CaCl2, while the pectin and alginate films' elasticity was positively influenced by calcium treatment. These results suggest that the overall decreased calcium sensitivity and poor mechanical strength displayed by 'the Algerian' and 'Morado' films would not make them viable replacements for the commercial pectin and alginate films unless alternative applications were found.

Operational Characteristics of Women Street Food Vendors in Rural South Africa.

Objective: To characterize the operations of the street food enterprise in the Vhembe district, focusing on business profile, sold foods, inputs, pricing, record-keeping practices and total running cost. Methods: A descriptive cross-sectional face-to-face study of 511 vendors was done using a structured researcher-administered questionnaire comprising demographic and operational characteristics. Convenience sampling was used to choose the vending sites. Chi-square tests were conducted between four categorical variables (gender, age, marital status and citizenship) and operational characteristics. P-values were considered significant at p < 0.05. However, a Bonferroni adjustment decreased the significant value to p < 0.013. Results: The findings highlight the dominance of single middle-aged (35-44) women (63.1%) with some high school education. About 14% migrated from Zimbabwe. Most vendors were owners (86.1%), with 70.0% in business for at least 1-10 years. Food sold included mielie pap (stiff porridge) served with beef or chicken, sometimes with vegetables. Plate prices were R40.00 (2.6 USD) for a full plate and R30.00 (2 USD) for half a plate. The typical street food consumers were government officials, middlemen, and schoolchildren. Social media such as Whatsapp were used to communicate between the street food vendors and customers. The results highlight poor managerial skills as only 15.5% kept records, most of which were sales records (59.5%). On average, street vendors made a monthly profit of R3200.00 (213 USD) while spending R1800.00 (120 USD) on daily running expenses. There were statistically significant variations in some operational characteristics of vendor variables and gender, age, marital status, and citizenship. Conclusions: There is a need for capital and management for small businesses and food training for rural street food vendors. Therefore, government officials, policymakers, and NGOs could target street vendors to offer training and microfinance to improve their business skills while promoting food safety and consumption of nutritious foods.

Viral Prevalence in Wild Serval Population is Driven by Season and Sex.

One of the key factors influencing the population dynamics of threatened species such as felids is disease, but long-term studies of the factors influencing seroprevalence of wild felids are extremely rare, hindering conservation efforts. We set out to determine seroprevalence of six viral diseases (feline panleukopenia virus, feline leukemia virus, feline coronavirus, feline calicivirus, feline herpes virus, and feline immunodeficiency virus) among a population of serval (Leptailurus serval) with an extremely high density in South Africa. We captured 55 individuals over four years and screened blood samples for antibodies to each virus. We found that seroprevalence were high (ranging from 30.0% positive for a single virus to 1.8% positive for up to five viruses) and that seroprevalence was influenced by season and sex, but not body condition. We suggest further monitoring of this population and recommend that long-term studies are conducted for serval and other felids to determine whether these trends are representative on a broader scale.

Supporting Self-Management of Cardiovascular Diseases Through Remote Monitoring Technologies: Metaethnography Review of Frameworks, Models, and Theories Used in Research and Development.

BACKGROUND: Electronic health (eHealth) is a rapidly evolving field informed by multiple scientific disciplines. Because of this, the use of different terms and concepts to explain the same phenomena and lack of standardization in reporting interventions often leaves a gap that hinders knowledge accumulation. Interventions focused on self-management support of cardiovascular diseases through the use of remote monitoring technologies are a cross-disciplinary area potentially affected by this gap. A review of the underlying frameworks, models, and theories that have informed projects at this crossroad could advance future research and development efforts. OBJECTIVE: This research aimed to identify and compare underlying approaches that have informed interventions focused on self-management support of cardiovascular diseases through the use of remote monitoring technologies. The objective was to achieve an understanding of the distinct approaches by highlighting common or conflicting principles, guidelines, and methods. METHODS: The metaethnography approach was used to review and synthesize researchers' reports on how they applied frameworks, models, and theories in their projects. Literature was systematically searched in 7 databases: Scopus, Web of Science, EMBASE, CINAHL, PsycINFO, Association for Computing Machinery Digital Library, and Cochrane Library. Included studies were thoroughly read and coded to extract data for the synthesis. Studies were mainly related by the key ingredients of the underlying approaches they applied. The key ingredients were finally translated across studies and synthesized into thematic clusters. RESULTS: Of 1224 initial results, 17 articles were included. The articles described research and development of 10 different projects. Frameworks, models, and theories (n=43) applied by the projects were identified. Key ingredients (n=293) of the included articles were mapped to the following themes of eHealth development: (1) it is a participatory process; (2) it creates new infrastructures for improving health care, health, and well-being; (3) it is intertwined with implementation; (4) it integrates theory, evidence, and participatory approaches for persuasive design; (5) it requires continuous evaluation cycles; (6) it targets behavior change; (7) it targets technology adoption; and (8) it targets health-related outcomes. CONCLUSIONS: The findings of this review support and exemplify the numerous possibilities in the use of frameworks, models, and theories to guide research and development of eHealth. Participatory, user-centered design, and integration with empirical evidence and theoretical modeling were widely identified principles in the literature. On the contrary, less attention has been given to the integration of implementation in the development process and supporting novel eHealth-based health care infrastructures. To better integrate theory and evidence, holistic approaches can combine patient-centered studies with consolidated knowledge from expert-based approaches. TRIAL REGISTRATION: PROSPERO CRD42018104397; https://tinyurl.com/y8ajyajt. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/13334.

Amitriptyline prescribing in public sector healthcare facilities in the Western Cape, South Africa.

BACKGROUND: Inappropriate medication use is a major patient safety concern, especially for the elderly population. Amitriptyline is widely used in primary care in South Africa and a cross-sectional study found that amitriptyline was prescribed potentially inappropriately in 6.5% of elderly patients. An analysis of prescriptions from the Chronic Dispensing Unit in the Western Cape revealed that amitriptyline was one of the most common medicines prescribed without a suitable diagnosis listed on the prescription. OBJECTIVE: The main objective of the medicine use evaluation (MUE) was to determine whether amitriptyline was prescribed in accordance with recommendations from standard treatment guidelines (STG) and essential medicines lists (EML) endorsed by the National Department of Health, South Africa. METHODS: A retrospective, cross-sectional, multicentre review of patients' clinical notes was conducted. The study population was selected by systematic random sampling from adult outpatients who were prescribed amitriptyline for longer than three months. Criteria for evaluation included amitriptyline indication and total daily dose prescribed. RESULTS: Of the sample of 2237 patient medical records reviewed, 1732 (77.4%) included amitriptyline prescriptions that were according to the approved STG indications. For the approved STG indications, amitriptyline was prescribed mainly for osteoarthritis (25.8%), neuropathies (18.5%) and chronic non-cancer pain (17.9%). Major depressive disorders constituted only 8.6% of the patient records reviewed; however, doses were atypically low. The main inappropriate indication for amitriptyline was sleep disorders (16%). CONCLUSION: This MUE has highlighted the need to improve the use of amitriptyline in specific patient populations, e.g. the elderly and patients with sleeping disorders.

Frameworks, Models, and Theories Used in Electronic Health Research and Development to Support Self-Management of Cardiovascular Diseases Through Remote Monitoring Technologies: Protocol for a Metaethnography Review.

BACKGROUND: Electronic health (eHealth) is a multidisciplinary and rapidly evolving field, and thus requires research focused on knowledge accumulation, curation, and translation. Cardiovascular diseases constitute a global health care crisis in which eHealth can provide novel solutions to improve the efficiency and reach of self-management support for patients where they most need it: their homes and communities. A holistic understanding of eHealth projects focused on such case is required to bridge the multidisciplinary gap formed by the wide range of aims and approaches taken by the various disciplines involved. OBJECTIVE: The primary objective of this review is to facilitate a holistic interpretation of eHealth projects aimed at providing self-management support of cardiovascular diseases in the natural setting of patients, thus priming the use of remote monitoring technologies. The review aims to synthesize the operationalization of frameworks, models, and theories applied to the research and development process of eHealth. METHODS: We will use Noblit and Hare's metaethnography approach to review and synthesize researchers' and practitioners' reports on how they applied frameworks, models, and theories in their projects. We will systematically search the literature in 7 databases: Scopus, Web of Science, EMBASE, CINAHL, PsycINFO, ACM Digital Library, and the Cochrane Library. We will thoroughly read and code selected studies to extract both raw and contextual data for the synthesis. The relation of the studies will be determined according to the elements of the frameworks, models, or theories the studies applied. We will translate these elements between each other and intend to synthesize holistic principles for eHealth development for the case at hand. RESULTS: The search strategy has been completed, data extraction is almost finalized, and the first synthesis approaches are underway. The search yielded 1224 citations and, after we applied the selection criteria, 17 articles remained. We expect to submit the final results for publication in 2019. CONCLUSIONS: This review is important because it aims to create a holistic understanding of a multidisciplinary topic at the crossroads of eHealth, cardiovascular diseases, and self-management. The value of metaethnography in contrast to other systematic review methods is that its synthesis approach seeks to generate a new understanding of a topic, while preserving the social and theoretical contexts in which findings emerge. Our results will show how useful this method can be in bridging the multidisciplinary gap of eHealth research and development, to inform and advance the importance of holistic approaches, while showcasing this approach for the case of self-management in cardiovascular diseases. TRIAL REGISTRATION: PROSPERO CRD42018104397; https://www.crd.york.ac.uk/PROSPERO/display_record.php? RecordID=104397 (Archived by WebCite at http://www.webcitation.org/75H1kP1Mm). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13334.