Leslie to Jim, 27 November 1962

Professional correspondenc

Leslie to Jim, 31 October 1963

Professional correspondenc

The contribution of diabetes mellitus to lower extremity amputations in four public sector hospitals in Cape Town for 2009 and 2010

Includes bibliographical references.Diabetes is the most common non-communicable disease worldwide and contributes to substantial morbidity and mortality. The prevalence of diabetes is increasing and reaching epidemic proportions, with the largest increase being seen in developing countries, including South Africa. Among the many complications of diabetes, lower extremity amputations are common, with a leg being lost to diabetes somewhere in the world every thirty seconds. The vast majority of these amputations is preventable and is a reflection of inadequate care of diabetic patients. Studies done in South Africa have shown that the care of diabetes in the public sector is suboptimal. A study in the private sector in South Africa showed that by ensuring optimal care of diabetic patients, long term glycaemic control and a decrease in complications and hospital admissions can be achieved. Lower extremity amputations can be the result of complications due to poor glycaemic control. There are, however, few studies that have been done in South Africa assessing the contribution that diabetes makes to the performance of lower extremity amputations. This study will attempt to begin to fill in this gap in South African data and the results will be compared to a previous unpublished South African study in the Cape Town Metropole from 1999

Eucalypts as a genus for short rotation forestry in Great Britain

The study focused on four research objectives: 1. To identify the species and provenances of eucalypts most suitable for biomass production in Great Britain. 2. To compare growth of eucalypts with other promising short rotation forestry genera. 3. To develop volume and biomass functions for E. gunnii. 4. To estimate yields and patterns of growth for E. gunnii. Searches on CAB abstracts and World of Science showed that there was limited research conducted on eucalypts in the UK. This research provides an original contribution to knowledge through; a long term assessment of the performance of species of cold tolerant eucalypts across a range of sites, identification of the basis for the rapid growth of eucalypts in comparison with trees from other genera, identification of the best fit function to describe stem form in E.gunnii and a characterisation of the pattern of growth in this species. The thesis provides an account of the long history of eucalypts in the UK, the first record of a eucalypt being planted in Britain probably being Eucalyptus obliqua in the late 1700s (Aiton 1789). A review is then provided of the experience and constraints to growing nine eucalypt species in the UK and their potential for short rotation forestry are described. The rapid growth of eucalypts makes them well suited to short rotation forestry, but there are considerable risks from frosts and extreme winters. Results from a trial established in Cumbria, north west England are described. Survival and growth was compared between E.gunnii, E. nitens and native or naturalised species, identified by Hardcastle (2006) as having potential for short rotation forestry. The rapid rate of growth of E. gunnii was attributed to a combination of large leaf area, a long period of growth during the year and a high specific leaf area. There was 99% mortality of E. nitens at the trial over winter, preventing comparison with other species. At the same trial and assessment was made of frost damage during the winter of 2009-2010, which proved to be the coldest for thirty years (Met Office 2010). E. gunnii was found to be more cold-tolerant than E. nitens, with 35% of the former surviving the winter and less than 1% of the latter. Larger trees were damaged more so than smaller trees reinforcing the argument for good silviculture to promote rapid, early growth. The study on stem form and growth of E. gunnii represents the first in the UK. Volume, height and dbh of a total of 636 trees, measured by felling, optical dendrometer and terrestrial laser scanner were used to test the goodness of fit of a volume function developed in France by AFOCEL and is South America by Shell Oil. The AFOCEL function was found to predict volume with less bias and be suitable for all but the smallest trees. Characterisation of growth curves using mined historic data indicated yields of 16 m3 ha-1 y-1 or approximately 8 t ha-1 y-1 at 20 years old. In contrast, growth curves derived from stem analysis of nine trees from Chiddingfold (south east England) and Glenbranter (central western Scotland) indicated lower yields at 7 m3 ha-1 y-1 at age 28 years and 4.5 m3 ha-1 y-1 at age 30 years respectively. Evidence from plantings elsewhere in the UK show that higher rates of growth are possible, but also that yields are often compromised by high mortality

Co-learning during the co-creation of a dengue early warning system for the health sector in Barbados

Over the past decade, the Caribbean region has been challenged by compound climate and health hazards, including tropical storms, extreme heat and droughts and overlapping epidemics of mosquito-borne diseases, including dengue, chikungunya and Zika. Early warning systems (EWS) are a key climate change adaptation strategy for the health sector. An EWS can integrate climate information in forecasting models to predict the risk of disease outbreaks several weeks or months in advance. In this article, we share our experiences of co-learning during the process of co-creating a dengue EWS for the health sector in Barbados, and we discuss barriers to implementation as well as key opportunities. This process has involved bringing together health and climate practitioners with transdisciplinary researchers to jointly identify needs and priorities, assess available data, co-create an early warning tool, gather feedback via national and regional consultations and conduct trainings. Implementation is ongoing and our team continues to be committed to a long-term process of collaboration. Developing strong partnerships, particularly between the climate and health sectors in Barbados, has been a critical part of the research and development. In many countries, the national climate and health sectors have not worked together in a sustained or formal manner. This collaborative process has purposefully pushed us out of our comfort zone, challenging us to venture beyond our institutional and disciplinary silos. Through the co-creation of the EWS, we anticipate that the Barbados health system will be better able to mainstream climate information into decision-making processes using tailored tools, such as epidemic forecast reports, risk maps and climate-health bulletins, ultimately increasing the resilience of the health system

The parent?infant dyad and the construction of the subjective self

Developmental psychology and psychopathology has in the past been more concerned with the quality of self-representation than with the development of the subjective agency which underpins our experience of feeling, thought and action, a key function of mentalisation. This review begins by contrasting a Cartesian view of pre-wired introspective subjectivity with a constructionist model based on the assumption of an innate contingency detector which orients the infant towards aspects of the social world that react congruently and in a specifically cued informative manner that expresses and facilitates the assimilation of cultural knowledge. Research on the neural mechanisms associated with mentalisation and social influences on its development are reviewed. It is suggested that the infant focuses on the attachment figure as a source of reliable information about the world. The construction of the sense of a subjective self is then an aspect of acquiring knowledge about the world through the caregiver's pedagogical communicative displays which in this context focuses on the child's thoughts and feelings. We argue that a number of possible mechanisms, including complementary activation of attachment and mentalisation, the disruptive effect of maltreatment on parent-child communication, the biobehavioural overlap of cues for learning and cues for attachment, may have a role in ensuring that the quality of relationship with the caregiver influences the development of the child's experience of thoughts and feelings

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo