Bone density and depression in premenopausal South African women: a pilot study

Objective: It is posited that the effect of depression on BMD is dependent on the severity of depression. Conflicting evidence exists regarding this possible association. This study investigated the association between depression and low bone mineral density (BMD). Methods: The hypothesis was investigated in a random sample of volunteers (n=40) and in premenopausal female psychiatric patients (n=5) diagnosed with recurrent severe major depression. The outcome measures were BMD (DEXA); depression (Beck Depression Inventory and Psychological General Well-being Scale) and 24-hour saliva cortisol levels (ELISA). In a comparison of women (4 of the 40 i.e. “control” subjects) with negligible symptoms of depression and the five patients with severe recurrent major depression- BMD, depression, saliva cortisol and bone turnover markers were measured and compared. Pro-inflammatory status (IL-1 and TNF-alpha) was investigated in the psychiatric patients only. Results: In the random – non clinical - sample of women (n=40), 26 exhibited normal BMD and 14 exhibited low BMD. Depressive symptoms and cortisol levelswere not significantly different between these two groups. Women with severe recurrent major depression(n=5) exhibited lower median BMD T-scores, higher overall bone turnover and higher 24-hour cortisol levels compared to “control” subjects (n=4). The psychiatric patients also exhibited elevated IL-1 levels. Conclusion: The effect of depression on BMD may be dependent on the depression severity. IL-1 and cortisol are possible mediators in depression-induced BMD loss.Key words: Bone mineral density; Cortisol; Depression; Pro-inflammatory cytokine

Education and training experiences of early childhood care and education practitioners in rural and urban settings of Durban, South Africa

BACKGROUND : The education and training experiences of Early Childhood Care and Education (ECCE) practitioners reflect gaps and inequalities in South Africa's educational system. Most South African ECCE centre practitioners do not have the appropriate qualifications to provide quality education to young learners AIM : The study aimed to explore how the education and training experiences of ECCE practitioners impact their professional identity in urban and rural settings in KwaZulu-Natal province and to develop a model that would enhance the education and training of ECCE practitioners SETTING : Ten participants were selected for this study: one centre head and four practitioners from a rural setting, and one centre head and four practitioners from an urban area METHODS : Wenger's social theory of learning was used to obtain an in-depth understanding of ECCE practitioners' education and training experiences and how they function as professional workers. An interpretative, qualitative case study was adopted. Data was collected through focus group semi-structured interviews and non-participants' observation and then analysed thematically RESULTS : The findings revealed that practitioners in rural settings had to contend with unfair working conditions daily, working all day in challenging circumstances whilst earning low incomes. Urban practitioners worked reasonable hours and received living wages, although they also experienced challenges such as a lack of parental involvement, lack of transport for children and high rates of absenteeism CONCLUSION : Inequalities between rural and urban practitioners existed concerning resources, salaries, working conditions and further study and professional growth opportunities. Ensuring that practitioners attain proper Early Childhood Care (ECC) qualifications will raise the profession's esteem amongst wider communities.This article is based on the master’s thesis of Pam Zulu.http://www.sajce.co.zaam2023Early Childhood EducationEducation Management and Policy Studie

Levels of procalcitonin, C-reactive protein and neopterin in patients with advanced HIV-1 infection

Objectives. To compare the value of procalcitonin, C-reactive protein (CRP) and neopterin as indicators of immune deficiency, co-infection, efficacy of treatment, and disease progression, in patients with advanced HIV-1 infection. Design. Cross-sectional, investigating baseline blood measurements and clinical observations in 82 HIV-positive patients divided into an antiretroviral treatment (ART) group and an ART-naïve group. Setting. Secondary general hospital in Pretoria. Results. Procalcitonin and CRP levels showed no significant differences between the ART and ART-naïve groups, and no correlations with CD4 counts or viral loads. CRP levels were significantly higher with TB co-infection (

Neopterin and Soluble CD14 Levels as Indicators of Immune Activation in Cases with Indeterminate Pattern and True Positive HIV-1 Infection

<div><p>Background</p><p>We aimed to evaluate the roles of the plasma immune activation biomarkers neopterin and soluble CD14 (sCD14) in the indirect assessment of the immune activation status of patients with the indeterminate HIV-1 (IHIV-1) pattern and a true HIV-1-positive infection (PCG).</p><p>Methods</p><p>This cross-sectional and descriptive study included eighty-eight patients with the IHIV-1 pattern, 100 patients in the PCG, and 100 people in a healthy control group (HCG). Neopterin and sCD14 levels were determined by competitive and sandwich ELISA methods, respectively.</p><p>Results</p><p>Mean neopterin and sCD14 levels among those with the IHIV-1 pattern were significantly lower than among the PCG (<i>p</i> < 0.001 and <i>p</i> = 0.001, respectively), but they were similiar to those in the HCG (<i>p</i> = 0.57 and <i>p</i> = 0.66, respectively. Mean neopterin and sCD14 levels among the PCG were found to be significantly higher than among those with the IHIV-1 pattern (<i>p</i> < 0.001 and <i>p</i> = 0.001, respectively) and among those in the HCG (<i>p</i> = 0.001, <i>p</i> < 0.001, respectively). Neopterin did not have adequate predictive value for identifying those in the PCG (area under the curve [AUC] = 0.534; 95% CI, 0.463–0.605; <i>p</i> = 0.4256); sCD14 also had poor predictive value but high specificity (100%) for identifying those in the PCG (AUC = 0.627; 95% CI, 0.556–0.694; <i>p</i> = 0.0036).</p><p>Conclusions</p><p>While low levels of these two biomarkers were detected among those with the IHIV-1 pattern, they were found in high levels among those in the PCG. These two markers obviously cannot be used as a sceening test because they have low sensitivies. Taken together, we suggest that neopterin and sCD14 may be helpful because they both have high specificity (92%-100%) as indirect non-specific markers for predicting the immune activation status of individuals, whether or not they have true positive HIV-1.</p></div