The National Food Consumption Survey (NFCS): South Africa, 1999

Objective: The aim of the National Food Consumption Survey (NFCS) in South Africa was to determine the nutrient intakes and anthropometric status of children (1-9 years old), as well as factors that influence their dietary intake. Design: This was a cross-sectional survey of a nationally representative sample of all children aged 1-9 years in South Africa. A nationally representative sample with provincial representation was selected using 1996 Census information. Subjects: Of the 3120 children who were originally sampled data were obtained from 2894, a response rate of 93%. Methods: The sociodemographic status of each household was assessed by a questionnaire. Dietary intake was assessed by means of a 24-hour recall and a food-frequency questionnaire from the caregivers of the children. Food purchasing practices were determined by means of a food procurement questionnaire. Hunger was assessed by a modified hunger scale questionnaire. Nutritional status was determined by means of anthropometric measurements: height, weight, head circumference and arm circumference. Results: At the national level, stunting (height-for-age below minus two standard deviations (< -2SD) from the reference median) was by far the most common nutritional disorder, affecting nearly one in five children. The children least affected (17%) were those living in urban areas. Even with regard to the latter, however, children living in informal urban areas were more severely affected (20%) compared with those living in formal urban areas (16%). A similar pattern emerged for the prevalence of underweight (weight-for-age < -2SD), with one in 10 children being affected at the national level. Furthermore, one in 10 (13%) and one in four (26%) children aged 1-3 years had an energy intake less than half and less than two-thirds of their daily energy needs, respectively. For South African children as a whole, the intakes of energy, calcium, iron, zinc, selenium, vitamins A, D, C and E, riboflavin, niacin, vitamin B6 and folic acid were below two-thirds of the Recommended Dietary Allowances. At the national level, data from the 24-hour recalls indicated that the most commonly consumed food items were maize, sugar, tea, whole milk and brown bread. For South African children overall, one in two households (52%) experienced hunger, one in four (23%) were at risk of hunger and only one in four households (25%) appeared food-secure. Conclusion: The NFCS indicated that a large majority of households were food-insecure and that energy deficit and micronutrient deficiencies were common, resulting in a high prevalence of stunting. These results were used as motivation for the introduction of mandatory fortification in South Africa. © The Authors 2005.Conference Pape

Just hearing about it makes me feel so humiliated: Emotional and motivational responses to vicarious group-based humiliation

Witnessing a fellow ingroup member being humiliated might be the most common situation in which intergroup humiliation is experienced. Humiliation on a group level is as complex as humiliation on an interpersonal level because of shared appraisals with other emotions. We propose that witnessing a fellow ingroup member being negatively stereotyped by an outgroup member elicits anger and/or shame insofar as it is appraised as vicariously humiliating leading to anger-related approach and shame-related avoidance. Evidence for this proposition was experimentally assessed in three studies using two intergroup contexts: nationality (Study 1: n = 291) and gender (Study 2: n = 429 females and Study 3: n = 353 males). Across these intergroup contexts, the group-devaluing event emphasizing a negative ingroup stereotype evoked anger-related approach and shame-related avoidance indirectly through vicarious humiliation. We conclude that the accompanying emotions and thus resulting motivations determine whether vicarious humiliation results in intergroup conflict.info:eu-repo/semantics/publishedVersio

The public’s attitude towards strike action by healthcare workers and health services in South Africa

Objectives. To evaluate a representative group of South Africans for their views about healthcare worker strikes and related matters.Methods. A descriptive, cross-sectional, self-administered  questionnaire-based study of 600 participants over the age of 18 years and able to read English, from two representative shopping malls (300 from each mall) in Greater Johannesburg. Data were analysed using SAS software version 9.1.3 for Windows. Tests for significant relationships were carried out using Pearson’s χ2 test at the 0.05 confidence level. The strength of the associations was determined by Cramer’s V.Results. Results revealed strong opinions among the population regarding strikes, numerous misapprehensions when it comes to striking and rights, a poor awareness of other healthcare-related rights and the perception of poor treatment at public hospitals.Conclusions. A majority of South Africans are aware of the healthcare worker strikes and are dissatisfied with the manner in which these take place, with strong objections to the perceived neglect of the critically ill during strikes, compounded by poor treatment at public hospitals. Many South Africans lack awareness of human rights issues, a situation which requires urgent remedy

New trends in the management of postpartum haemorrhage

If the World Health Organization (WHO) global maternal mortality by cause is examined for the period 1997-2007, haemorrhage constitutes 35% of deaths. Published data from the triennium 2008-2010 in South Africa indicate that if non-pregnancy-related sepsis is excluded, haemorrhage still ranks with hypertension as the most common cause of maternal deaths (24%). So how can anaesthetists improve this situation and save lives? Sadly, the main reason for the appalling figures in respect of maternal deaths in sub-Saharan Africa is poor access to basic obstetric care, blood products and basic commodities, such as electricity, for the refrigeration of blood and drugs such as oxytocin.1 Nevertheless, there are many areas where management, and hence outcomes, could be improved. This article addresses the crucial issues of predicting haemorrhage, assessing blood loss, point-of-care monitoring and transfusion protocols. Surgical techniques and oxytocic therapy are equally important, and are the subject of many other reviews.Keywords: postpartum haemorrhage; management; new trend

A clinical and molecular investigation of two South African families with Simpson-Golabi-Behmel syndrome

Background. Simpson-Golabi-Behmel syndrome (SGBS) is an X-linked recessive overgrowth syndrome manifesting primarily in boys and characterised by macrosomia, distinctive facial features and multiple congenital abnormalities. Although this rare condition is thought to be underdiagnosed, making a diagnosis is important as affected boys have a 7.5% risk of developing visceral tumours and surveillance is warranted. Mutations in GPC3 are found in up to 70% of boys affected with SGBS.Objectives. A clinical and molecular investigation of two boys with SGBS, probands B and S, and their mothers. Documentation of the clinical phenotype could assist with diagnosis in affected boys and will lead to early initiation of tumour surveillance.Methods. Hospital folders were reviewed and clinical consultations arranged for both probands and their mothers. Molecular investigations initially searched for whole-exon deletions in GPC3 followed by gene sequencing.Results. The clinical phenotype of both probands was consistent with that previously reported in the literature. The main features pointing towards the diagnosis were macrosomia, coarse facial features and macroglossia with a midline groove in the tongue. Proband B developed a Wilms tumour. He was found to have a novel mutation causing a premature stop codon.Conclusions. This research represents the first published report of SGBS in South Africa. Early recognition and confirmation of this condition is important in order to institute tumour surveillance and assist families with accurate recurrence risks

Die Geldigheidsvereistes van 'n Trust opnuut Ondersoek: Khabola v Ralithabo [2011] ZAFSHC 62

The trust is universally recognised and used. It is generally accepted that trust deeds meet the basic requirements. However, it is not always that simple and the courts are repeatedly forced to take deeds of trust under scrutiny. In such cases the court has to rule on the validity of the trust, the locus standi of the parties, trust administration, the intent of the parties or what the implications of an invalid trust are for previous and current agreements. Similar problems arose in Khabola v Ralithabo. The authors discuss this verdict and show that there is still much uncertainty on how certain trust aspects have to be dealt with, and emphasise the importance of testing every trust deed according to the essential requirements of a valid trust.   &nbsp

Professionalism and the intimate examination – are chaperones the answer?

Complaints of sexual impropriety against health care practitioners are escalating. Professionalism in the practitioner-patient relationship and the role-based trust in health care do not allow crossing of sexual boundaries. Communication with patients is key to prevent erroneous allegations of sexual misconduct. The intimate examination is difficult to define. A chaperone present during an intimate examination protects the patient and practitioner and should be considered a risk reduction strategy in practice.S Afr Med J 2011;110:814-816

The effect of sepsis and short-term exposure to nitrous oxide on the bone marrow and the metabolism of vitamin B 12 and folate

It is recognised that prolonged anaesthesia with nitrous oxide (N20) induces megaloblastic anaemia by oxidising vitamin B12 To determine whether sepsis aggravates the effect of H20 on haemopoiesis 5 patients with severe sepsis, who required surgery and were exposed to short-term (45 - 105 minutes) N20 anaesthesia, were studied. Hone had evidence of pre-operative vitamin B12 or folate deficiency. The effect of the combination of N20 anaesthesia and sepsis on DNA synthesis in bone marrow cells was assessed morphologically, and by the deoxyuridine suppression test. In 3 patients exposed to the longest duration (75 - 105 minutes) of N20, addition of folinic acid and vitamin B12 partially improved the utilisation of deoxyuridine in vitro. No patient had evidence of megaloblastic haemopoiesis as judged by bone marrow morphology. It is concluded that prolonged N20 anaesthesia in patients with severe sepsis may adversely affect DNA synthesis. Although this effect did not manifest as overt megaloblastic erythropoiesis, it may be prudent to avoid N20 in such patients