Mass hysteria among South African primary school

During August 2002, at a primary school in Kwa-Dukuza, KwaZulu-Natal, 27 children who had been well when they left their homes collapsed at school, displaying tremors and shivers throughout their bodies. Many of the children also presented with abdominal cramps and nausea. Almost all the children experienced a feeling of tightness in their chests as well as hyperventilation, which was then followed by fainting. This hysteria spread by line of sight (that is, other children seeing this also collapsed). Mass hysteria had presented similarly, with only a mild variation in the hallucinations, in secondary schools in Mangaung, Bloemfontein, during 2000 and in Gauteng during 2009. Radio stations, such as Radio 702, presented these incidents for discussion and for concerned parents’ questions to be answered. In all three episodes, the majority of the affected children were girls. Witchcraft, poisoning, insect bites – in the case of Mangaung – and gas leaks were proposed as causes of this strange behaviour by the previously well children. Experts who investigated these possibilities, however, excluded any identifiable cause. Nearly all the children were well again the next day. The assessment after the incidents was an outbreak of mass hysteria. The parents and the lay media, however, refused to accept this diagnosis, which added to the stress and the anxiety that the children faced when they returned to school. Mass hysteria can be taxomised into two broad categories: the explosive type, which typically appears in small, institutionalised social networks; and the large, diffused type, during which false rumours and beliefs overwhelm a community. This discussion focuses on the second category – that which affects people in one institution. The discussion includes the rare outbreak in Kwa-Dukuza, together with the common presentations and symptoms of mass hysteria. Also discussed are the consequences of not managing this condition well immediately on presentation. These consequences entail a perpetuation of the condition, spreading to a greater number of children, to the parents and to the teachers. This may then lead to a disruption in learning at the schools affected and, possibly, later on, to anxiety disorders.Keywords: withcraft; line of sight; pseudoseizure

Nurses’ monitoring of the Road to Health Chart at primary healthcare level in Makhado, Limpopo province

Background: The Road to Health Chart (RTHC) is a record chart carried by the caregiver that combines essential information on the growth monitoring of a child, immunisation, vitamin A supplementation, deworming medicine and other illnesses. It provides useful information to the parent and healthcare professional. This study sought to determine the challenges faced by professional nurses in monitoring the RTHC during consultation, the degree of implementation of the RTHC programme, and the most utilised aspect of the RTHC at Louis Trichardt Memorial Hospital and surrounding primary healthcare (PHC) clinics.Method: A cross-sectional study was conducted among 128 registered professional nurses. A self-administered questionnaire was used.Results: Ninety-six questionnaires were completed. Most of the respondents were female and aged 40-49 years. The majority of the PHC professional nurses stated that the challenges faced in monitoring the RTHC were staff shortages, lack of equipment, a work overload and unequal distribution of professional nurses on duty per shift. There was poor knowledge on how to identify malnutrition. The majority of PHC professional nurses had not completed their basic courses.Conclusion: PHC professional nurses voiced their concern that challenges encountered during consultations were direct reasons for their poor monitoring of the RTHC. The degree of implementation of the RTHC programme fell short of the norms and standards of the Department of Health and Social Development concerning child health care in South Africa. The most utilised aspect of the RTHC was the expanded programme on immunisation, vitamin A supplementation and deworming medicine.Keywords: immunisation, malnutrition, anthropometric indices, child mortality, child healt

Trade mark parody in South Africa — The last laugh!

This article endeavours to find the balance (if any) in South African law between the rights of trade mark owners from infringement of their trade marks, and the constitutional right to free expression (with particular reference to parody) in a society that advocates the values of democracy and freedom. As intellectual property, registered trade marks deserve the protection of the law, a careful balancing act between property rights and fundamental freedoms must be performed to determine if one outweighs the other. In this regard Laugh It Off Promotions CC v South African Breweries International will be discussed. The position of parody in South African trade mark law desperately needs to have a last laught, once and for all

Industry engagement in work-integrated learning - exploring the benefits, challenges and realities

Abstract: The purpose of the paper is to identify benefits and challenges for businesses serving as hosts for business students involved in work integrated learning (WIL) initiatives. A student and educator perspective on WIL targeting businesses is also identified. A literature review is applied for analyzing work integrated learning in a business perspective. This perspective is supplied with statistical data from a survey of business students and business educators revealing the extent and relevance of connectedness to businesses within curriculum and learning process. Four gaps between business schools and businesses are identified, which should be closed for a successful WIL. These are related to institutional support systems, the student mentor at the business school versus the host firm mentor, the student versus the host firm mentor/business peers, and gaps between curriculum and business cases/tasks. The findings have primarily implications for the business school both on institutional level and on mentor level. It is assumed that WIL has a marginal focus within businesses unless students are directly contributing in solving real business problems. Literature employing a business perspective on WIL is limited, and calls for further empirical research in order to design realistic and relevant WIL assignment in a business context

Coupled DEM-CFD Model to Predict the Tumbling Mill Dynamics

The charge motion in a tumbling mill has been mostly described by empirical, mechanistic and computational models. The computational model presented in this work is a three phase approach for the tumbling mill that combines a particle description for the solids modelled by the Discrete Element Method, and the continuum description for the fluid by CFD approach. In the present work a phase coupled approach is developed using C++ subroutines to model the charge and slurry dynamics inside a tumbling mill by mapping the particles on the CFD mesh and resolving the particle volume and velocities on per cell basis. The coupled DEM-CFD approach is implemented and the effect of drag force on the slurry by the particle motion. The set of coupled simulation were run varying the slurry rheology and results were validated with equivalent PEPT experiment of lab scale mills and a very good agreement is found in some cases. The Beeststra drag correlation was used to calculate the drag force between the fluid and the particles. The free surface profile of the charge as well as the slurry is calculated as well as the axial center of mass profile of the mil

Auditing stillbirths at Lower Umfolozi War Memorial Regional Hospital: A 12-month review.

BACKGROUND: Although the total number of stillbirths worldwide was estimated at 2.6 million in 2009, there is currently a dearth of literature on stillbirths in developing countries and rural settings, where the majority of such births occur. The 'Hands Up' Mortality and Morbidity Extraction Tool (HUMMET), developed at Lower Umfolozi War Memorial Regional Hospital (LUWMRH) in 2010, outlines a systematic approach to summarising individual cases of adverse perinatal outcomes. OBJECTIVES: To depict the HUMMET form by describing the detailed demographic and obstetric profile of patients who delivered a stillborn infant at LUWMRH, as well as risk factors associated with these stillbirths between 1 April 2014 and 31 March 2015. The findings add to a global initiative advanced by the Lancet series on stillbirths, aimed at raising awareness of stillbirth statistics in low- and middle-income countries. METHODS: A total of 310 detailed stillbirth case summaries of 305 patients were collected during the study period, representing 90% of the total number of stillborn infants delivered at LUWMRH. A retrospective audit of the HUMMET forms was conducted and the cases were further summarised in a Microsoft Excel spreadsheet that allowed for a univariate analysis of the variables. RESULTS: The stillbirth rate at LUWMRH is much higher than that at other regional hospitals owing to the number of at-risk referrals and emergency cases from surrounding clinics and district hospitals. Referrals were from local clinics (49%) and district hospitals (45%), 35% of stillbirths were due to abruptio placentae and a large proportion were associated with gestational hypertension, pre-eclampsia and/or eclampsia. Avoidable factors were predominantly a late patient response to reduced fetal movements and delays in transfer to hospital. Twenty percent of stillbirths were associated with inappropriate monitoring or management of the obstetric condition at the district hospital. CONCLUSION: The HUMMET form provides a systematic approach to analysing cases of perinatal morbidity and mortality in line with the requirements of the Perinatal Problem Identification Programme database, but provides more details on the circumstances and contributing factors. A repeat audit is recommended to determine whether interventions have been effective

Use of the partogram by doctors and midwives at Odi District Hospital, Gauteng, South Africa

Background: There is scientific evidence that using the partogram reduces maternal and foetal morbidity and mortality. The use of partograms by doctors and midwives at Odi District Hospital has been reported as inadequate by external audits. The level of knowledge of and use of partograms amongst doctors and midwives at Odi District Hospital was investigated.Methods: A cross-sectional survey of doctors and midwives was undertaken using a self-administered questionnaire. A mixedmethods research approach was used to elicit information on the knowledge and use of the partogram.Results: Despite 57 (83.8%) participants having had some form of training on the partogram, only 54 (79.4%) routinely used it. All but one participant had heard of the partogram. Reasons for not using the partogram included being unsure how to use it (13%), partogram charts not available (8.7%), partogram takes too long (21.7%), being too busy (26.1%), and a feeling that the partogram was not the doctor’s responsibility (26.1%). Overall knowledge of partograms was insufficient, resulting in inadequate use of partograms. In-service training is required to improve the skills of doctors and midwives in the correct knowledge and use of partograms.Conclusion: Partograms are not used as required by doctors and midwives, and further training is needed.Keywords: district hospital, doctors and midwives, in-service training, knowledge and use of partograms, partogra

The shape and behaviour of a granular bed in a rotating drum using Eulerian flow fields obtained from PEPT

Non-invasive single-particle tracking techniques, such as positron emission particle tracking (PEPT), provide useful information about the behaviour of a representative particle moving in a bulk of similar particles in a rotating drum. The Lagrangian trajectories that they yield can be used to study, for example, particulate diff usion or granular interaction. However, often the Eulerian flow fi elds of the entire granular bed are more useful-- they can be used to study segregation, for instance, or the evolution of the free surface of the bed. In this work, we present a technique for converting Lagrangian trajectories to Eulerian flow fields via a time-weighted residence time distribution (RTD) of the tracked particle. We then perform PEPT experiments on a mono-disperse bed of spherical particles in a cylindrical drum, rotated at various rates, and use the RTD procedure to obtain flow fi elds of the bed. We use these flow fi elds to investigate the e ffect of drum rotational speed on the shape and behaviour of a granular bed in a rotating drum, and the insights gained thereby to defi ne a comprehensive set of surfaces{ such as the bulk free surface{ to divide the bed into regions of distinct granular behaviour. We further defi ne scalar bed features-- such as the centre of circulation of the bed-- that can be used to quantitatively compare the behaviour of granular beds in rotating drums operated under various conditions

Evaluation of a two-question screening tool in the detection of intimate partner violence in a primary healthcare setting in South Africa

Introduction: Intimate partner violence has been recognised globally as a human rights violation. It is universally underdiagnosed and the institution of timeous multi-faceted interventions has been noted to benefit intimate partner violence victims. Currently the concept of using a screening tool to detect intimate partner violence has not been widely explored in a primary healthcare setting in South Africa, and for this reason the current study was undertaken. The objectives of this study were: (1) to determine the operating characteristics of a two-question screening tool for intimate partner violence (Women Abuse Screening Tool–short); and (2) to estimate the prevalence of intimate partner violence among women attending an outpatient department, using a validated questionnaire (Women Abuse Screening Tool).Methods: A cross-sectional study was conducted prospectively at the outpatient department of a primary care hospital, with systematic sampling of one in eight women over a period of three months. Participants were asked about their experience of intimate partner violence during the past 12 months. The Women Abuse Screening Tool–short was used to screen patients for intimate partner violence. To verify the result of the screening, women were also asked the remaining questions from the full Women Abuse Screening Tool.Results: Data were collected from 400 participants, with a response rate of 99.3%. Based on the results for the Women Abuse Screening Tool, the prevalence of intimate partner violence in the sample was 32%. The Women Abuse Screening Tool–short was shown to have a sensitivity of 45.2% and specificity of 98%.Conclusion: With its high prevalence, intimate partner violence is a health problem at this facility. The Women Abuse Screening Tool–short lacks sufficient sensitivity and therefore is not an ideal screening tool for this primary care ambulatory setting. The low sensitivity can be attributed to the participants’ understanding of the screening questions, which utilise Eurocentric definitions of intimate partner violence. Improvement in the sensitivity of the Women Abuse Screening Tool–short in this setting may be achieved by lowering the threshold for a positive result.Keywords: intimate partner violence, primary healthcare facility, screening too