The axillary approach to raising the latissimus dorsi free flap for facial re-animation: a descriptive surgical technique

The latissimus dorsi flap is popular due to the versatile nature of its applications. When used as a pedicled flap it provides a robust solution when soft tissue coverage is required following breast, thoracic and head and neck surgery. Its utilization as a free flap is extensive due to the muscle's size, constant anatomy, large caliber of the pedicle and the fact it can be used for functional muscle transfers. In facial palsy it provides the surgeon with a long neurovascular pedicle that is invaluable in situations where commonly used facial vessels are not available, in congenital cases or where previous free functional muscle transfers have been attempted, or patients where a one-stage procedure is indicated and a long nerve is required to reach the contra-lateral side. Although some facial palsy surgeons use the trans-axillary approach, an operative guide of raising the flap by this method has not been provided. A clear guide of raising the flap with the patient in the supine position is described in detail and offers the benefits of reducing the risk of potential brachial plexus injury and allows two surgical teams to work synchronously to reduce operative time

Stereo facial image matching to aid in Fetal Alcohol Syndrome screening

Includes abstract. Includes bibliographical references

School management teams’ perception of the strategy of screening, identification, assessment and support in a mainstream school

Abstract: Background: The Department of Education introduced Education the White Paper 6 in 2001 as a plan to implement inclusive education to address inequalities in the education system, allowing all learners to access the curriculum. Emanating from the paper, the policy on Screening, Identification, Assessment and Support (SIAS) was promulgated to manage learners with disabilities and special needs. In schools, the stakeholders’ perceptions impact on their feelings, thoughts, understanding, processing, reactions and behaviours. Consequently, School Management Teams’ perceptions affect the implementation of the SIAS policy. These teams are leaders and catalysts in the process of resource allocation and implementing adequate infrastructure in order to effectively manage the policy. Although providing an admirable vision, teachers report challenges in the implementation of inclusive education and the SIAS policy as stressful, paper-laden and time consuming, particularly in under-resourced schools.M.Ed. (Educational Psychology

Rising Powers in International Development: the State of the Debate in South Africa

South Africa occupies an interesting position in the international development debate. On the one hand, as Africa’s most developed, diversified and, until recently, largest economy representing close to one-third of sub-Saharan Africa’s gross domestic product (GDP), it is an active player in numerous global governance and development fora, it maintains an extensive development partnership with the rest of Africa and is a member of the group of emerging countries, the Brazil-Russia-India-China-South Africa (BRICS) Forum. Yet, on the other hand, it positions itself within the developing world, insisting that South Africa is itself a developing state despite its wealth relative to the rest of the continent and other developing countries.UK Department for International Developmen

Asymptotic stability and blow up for a semilinear damped wave equation with dynamic boundary conditions

In this paper we consider a multi-dimensional wave equation with dynamic boundary conditions, related to the Kelvin-Voigt damping. Global existence and asymptotic stability of solutions starting in a stable set are proved. Blow up for solutions of the problem with linear dynamic boundary conditions with initial data in the unstable set is also obtained

Deconstructing sex: an in-depth, qualitative exploration of women’s sexual experiences and difficulties

Epidemiological research on sexual difficulties in women has reported high rates of sexual problems and dissatisfaction across the lifespan. Nevertheless, feminist scholars and social science researchers argue that an absence of research exploring women’s subjective interpretations of their sexuality and sexual difficulties exists, since prevalence studies do not address how the range of diverse socio-cultural, relational, biological and psychological processes interact to influence women’s sexuality across the lifespan. The current study aimed to narrow this research dearth by presenting an in-depth, qualitative exploration of heterosexual women’s accounts of their sexual experiences and their perceived sexuality. A phenomenological approach was utilised against the socially constructed notion of sex to understand women’s sexuality. Five core themes emerged from qualitative interviews with 18 women that were considered paramount to women’s subjective interpretations and experience of their sexuality and sexual difficulties. There were socio-cultural factors; inter-relationship factors; social roles and expectations; practices and preferences; and views on change. The current study highlights the multifaceted double standard within socio-cultural expectations of what it means to be a heterosexual woman, exemplified in the relationship between women’s sexual difficulties and idealistic sexual expectations, male-centred sexual socialisation, over-burdened social roles, unequal relationships, and inadequate sexual practices. Despite experiencing sexual difficulties with associated distress throughout the lifespan, participants did not identify with prevailing medicalised notions of sexual problems. Participants differentiated between sex as important and sex as a priority. Relationships between sexual maturity, confidence and sexual satisfaction as well as sexual knowledge and sexual agency emerged in the narratives. Clinical implications incorporating women-centred classification frameworks such as a New View of women’s sexual problems are discussed. Directions for future research are presented

Haemolytic anaemia in disseminated lupus erythematosus

Report of a cas

Psychosocial rehabilitation for people with mental illness in the South African context : an evaluation from a service-users perspective

Includes bibliographical references (leaves 83-93).The aim of this study was to explore perceived significant changes in the quality of life of people with mental illness accessing psychosocial rehabilitation programmes. Furthermore a comparison was drawn between the outcomes experienced by these service-users and the vision and aims of Cape Mental Health Society's programmes. These included the Fountain House clubhouse model, community-based support groups, supported housing and a self-advocacy body. The aim of psychosocial rehabilitation as an empowerment model is that service-users gain improved functioning, an increase in social functioning and an enhancement of their subjective quality of life. Embedded in these programmes is the provision of safe spaces, where meaningful interactions with others in shared activities occur. This contributes to skills development, social competence and the building of a positive sense of self, which is in line with principles of the recovery paradigm. Few such services exist in Cape Town, South Africa and no relevant studies have been documented. A qualitative participatory approach was used utilising focus groups on two levels: first in mapping the territory and defining outcomes according to service-users; and secondly, for data collection of lived experiences of participants. The 'most significant change technique', a process which involves the collection of stories of subjective change, was used to focus the group processes. All groups were digitally recorded and transcribed. Data was examined according to a basic method of thematic analysis and participants' stories were classified according to broad domains of social, personal, learning, work, and living. A total of 44 service- 4 users from the four Cape Mental Health Society programmes, all diagnosed with severe mental illness, from varied demographic backgrounds and levels of functioning participated in nine focus groups. Participants felt that in attending the programmes they had experienced improved interpersonal connection, interaction and activity. This then seems to indicate some process of reclamation and recovery in the face of the loss of meaningful relationships when becoming ill with a mental illness. The positive benefits experienced by participants in the supportive community offered by the programmes, seem to be in line with programme objectives. The findings support the importance of opportunities for participation in valued meaningful activities, within a social context. Participants felt that by attending the programmes they benefitted on a personal level, building a positive sense of self, which included increased confidence and self-esteem, gaining hope, improved positive attitude, self-knowledge and acceptance, increase in motivation, increased vitality, increased motivation, increased awareness and interest in life, and gaining a sense of purpose and meaning. Subjective quality of life improvements for most participants in this study included an improved positive sense of self as well as valued socialization experiences, confirming the importance of these factors in recovery. The Cape Mental Health Society psychosocial rehabilitation programmes are accordingly robust in nature. In line with the philosophy of psychosocial rehabilitation and recovery principles, the programmes seem to be providing safe spaces for people with mental illness, creating opportunities for meaningful interactions with others, 5 thereby enhancing the confidence and self-esteem of participants while, at the same time building social skills

Cold Haemagglutination in primary atypical pneumonia

No Abstrac