Neurological soft signs as an endophenotype in an African schizophrenia population – a pilot study

Objective: The use of endophenotypes, such as neurological soft signs (NSS), is advocated as one possible method to elucidate the heterogeneity of schizophrenia. Exploring the associations between NSS and specific illness symptoms has revealed some trends, although results have been conflicting. To date, such studies have been conducted largely on Caucasian populations and our pilot study represents the first attempt to gather such data in a homogenous African population. Method: Fifty-one patients, all of Xhosa ethnicity and participating in a larger schizophrenia genetic study were recruited. NSS were evaluated using a modified Neurological Evaluation Scale. Data were analysed using SPSS with the strength of the overall relationships between NES groups and SANS and SAPS components analyzed by means of canonical correlation analysis. Results: The canonical correlation of SANS domains (excluding asociality) with the NES conceptual groups was 0.53 (SE=0.11, p=0.024) and of the SAPS domains 0.38 (SE=0.13, p=0.943). Conclusion: Our results suggest a correlation between negative symptoms of schizophrenia and the presence of NSS, supporting the recruitment of a larger sample to more comprehensively evaluate a possible role for NSS as an endophenotype in the Xhosa schizophrenia population. Taking into account that NSS evaluations allow for inexpensive, relatively easy-to-do objective evaluations, this method presents us with a valuable research tool that can be used effectively within our under-resourced environment to help inform on the neurobiological substrate of schizophrenia.Keywords: Schizophrenia; Endophenotype; Neurological Soft Sign

Compressive Behaviour of Confined Polycrystalline Ice

NRC publication: Ye

Knowledge and perceptions of nursing staff on the new Road to Health Booklet growth charts in primary healthcare clinics in the Tygerberg subdistrict of the Cape Town metropole district

Objectives: The objectives of the study were to assess the perceptions of nursing staff on the Road to Health Booklet (RTHB), to assess their knowledge of the RTHB growth charts, and to determine whether the level of knowledge was acceptable for successful utilisation of the RTHB growth charts.Design: A cross-sectional descriptive survey.Setting: Twelve primary healthcare clinics in the Tygerberg subdistrict.Subjects: Nursing staff who were going to work with the RTHB on a daily basis.Outcomes measures: The knowledge and perceptions of the nursing staff on the new RTHB were measured using a self-administered questionnaire.Results: The study highlighted that the majority of the nursing staff did not possess sufficient knowledge to successfully utilise the RTHB. The mean score percentage for the total 12 knowledge questions was 55%. Less than a third (n = 13) of participants could correctly interpret the cut-off value for mid-upper-arm circumference. Only 38% and 52% correctly knew that -2 standard deviation for weight-for-age and weight-for-length represents underweight and wasting, respectively. Fifty-five per cent could correctly interpret the growth faltering graph. Forty-three per cent of participants felt the change to the RTHB was unnecessary, and 55% thought that mothers or caregivers would not easily understand the RTHB. More than half (n = 22) of the participants said that they had adequate knowledge to work with the RTHB, while the rest reported that they did not.Conclusion: The RTHB has the potential to decrease the prevalence of malnutrition in children. However, to achieve this, effective usage and understanding of the RTHB is critical.Keywords: Road to Health booklet, growth monitoring, primary healthcare clinics, knowledg

Underrecognition and undertreatment of asthma in Cape Town primary school children

Background. In view of the high local prevalence of asthma, the extent of recognition and appropriate managementof childhood asthma was studied in a large suburban area of Cape Town.Design. Cross-sectional study based on random community sample of schools.Method. 1955 parents of sub B pupils from 16 schools completed a questionnaire, followed by: (f) an interview of parents of 348 symptomatic children; and (if) bronchial responsiveness testing on 254 children. the final case group consisted of 242 children with reported asthma or multiple asthma symptoms on both questionnaires. Children in whom asthma was acknowledged were compared with those in whom it was not.Results. Overall, any past or current ('ever') asthma was acknowledged by respondents in only 53% of the children, and current asthma in only 37.1%. While most children had received treatment in the previous 12 months, 66.1% of therecognised group were on current treatment (23.2% on daily treatment), compared with 37% of the unrecognised group (3% daily). Salbutamol and theophylline syrups were the most common types of medication, while inhalers and antiinflammatory medications were underused. Only a minority of parents reported the child ever having used a peak flow meter, or volunteered knowledge of preventive measures. Current treatment, and to a lesser degree recognition of asthma by parents, were more common among children on medical aid and of higher socio-eonomic status.Conclusions. These findings suggest that ways need to be found: (i) to increase the use of current asthma treatment guidelines by practitioners; (ii) to provide access to comprehensive care by children not on medical aid; and (iii) to improve education of parents in home management measures such as severity assessment and avoidance of smoking, allergen and dietary triggers

Evaluation of two nano-silane-modified emulsion stabilised pavements using accelerated pavement testing

Upgrading, maintenance and rehabilitation of road infrastructure is expensive, especially in view of the growing scarcity and cost of suitable road building materials. In areas with high mica content and secondary minerals such as smectite in the natural materials, stabilisation with cement is not viable. The Council for Scientific and Industrial Research of South Africa has embarked on a research programme to evaluate the performance of substandard materials improved with anionic nano-silane modified bitumen emulsions for use in base and subbase layers. This work comprises laboratory testing as well as Accelerated Pavement Testing using the Heavy Vehicle Simulator (HVS). The results of a full-scale HVS test on a light pavement as well as initial analysis on a medium traffic road are discussed. It has been shown that stabilisation of available substandard materials using an anionic nano-silane modified bitumen emulsion compared with the standard approach of importing high quality crushed aggregate can lead to savings as high as 40%–50% for equivalent performance. In addition, there was also a significant reduction in construction effort and time.The Gauteng Department of Roads and Transport.https://www.tandfonline.com/loi/gpav20hj2023Civil Engineerin

The economic cost of air pollution in Mangaung metro municipality: A case study in South Africa

Economic and domestic activities have been causing a profound deterioration of air quality in developed and developing countries. The health problems arising from air pollution have become apparent which result in welfare losses in society such as increased workdays lost and high health cost. This study shows the mitigating cost and workdays lost as a result air pollution related illness and the factors influencing these economic parameters (mitigating cost and workdays lost). Our results demonstrate the economic impact of air pollution which will provide information that could be used to know the significance of air quality, to value the benefits of air pollution control programs, social benefits (in terms of government subsidising clean energy source), policies or strategies to ensure a safe and acceptable air standard to minimise health effects

Clinical and pathological features of acral melanoma in a South African population: A retrospective study

Background. Acral melanoma (AM) is a rare subtype of cutaneous melanoma (CM) that disproportionately affects skin of colour and carries a poorer prognosis than other melanoma subtypes. The poor prognosis is attributed to late diagnosis and subsequent relatively high Breslow thickness, but also to an intrinsic biological aggressiveness. Scientific data on AM from the developing world are limited and a need exists to characterise the disease further in the South African (SA) population.Objectives. To describe the clinical and pathological features of AM in an SA population.Methodology. A retrospective chart review characterised the demographics, clinical features and histological data of 66 patients diagnosed with AM between January 2010 and June 2016 at Tygerberg Academic Hospital, Cape Town, SA.Results. Sixty-six patients with AM were identified from 335 patients diagnosed with CM during the set time frame. The mean age (standard deviation (SD)) was 61.5 (12.5) years. Forty-two (63.6%) of the patients were female (male/female ratio 1:1.75). The majority of patients diagnosed with AM were black (48.5%), and the proportion of AM in black patients with CM was 80.0%. Fifty-six AMs (84.8%) were located on the foot and 10 (15.2%) on the hand. The median duration of the lesion before diagnosis was 10 months (range 2 - 84) and the mean (SD) tumour size was 3.8 (2.2) cm at diagnosis. The mean Breslow thickness of all AMs at diagnosis was 5.2 mm (median 4.2  mm, range 0 - 22). Stage of disease was known in 41 patients, 23 (56.1%) of whom had at least stage III disease at diagnosis. Mean Breslow thickness for foot and hand melanomas was 4.9 mm (range 0 - 22) and 6.9 mm (range 0 - 13.3), respectively (p=0.2552). The mean Breslow thickness in the black population was 6.3 mm compared with 4.2 mm and 4.3 mm, respectively, in the white and coloured populations (p=0.178). Patients from outside the Western Cape Province (WC) presented with a mean Breslow thickness of 6.6 mm (range 0 - 14.5) and patients from the WC with a mean Breslow thickness of 4.9 mm (range 0 - 22) (p=0.3602).Conclusions. AMs accounted for a significant proportion of all CMs diagnosed. Patients presented with an advanced stage of disease at diagnosis, and further studies are needed to further investigate the reasons for delayed diagnosis.

An analysis of biopsies for suspected skin cancer at a tertiary care dermatology clinic in the Western Cape province of South Africa

CITATION: De Wet, J. et al. 2020. An analysis of biopsies for suspected skin cancer at a tertiary care dermatology clinic in the Western Cape province of South Africa. Journal of Skin Cancer, 2020:9061532, doi:10.1155/2020/9061532.The original publication is available at https://www.hindawi.comBackground. Skin cancer is a growing health concern worldwide. It is the most common malignancy in South Africa and places a large burden on the public healthcare sector. There is a paucity of published scientific data on skin cancer in South Africa. Objectives. To report the findings of biopsies performed in patients with suspected skin cancer attending the Tygerberg Academic Hospital (TAH) Dermatology outpatient department (OPD) in the Western Cape Province of South Africa. Methodology: A retrospective chart review identified all patients who underwent a biopsy for a suspected skin cancer diagnosis between September 2015 and August 2016 at the TAH dermatology OPD. Results. A total number of 696 biopsies from 390 participants were identified, of which 460 were histologically confirmed as malignant lesions. The proportion of clinically suspected skin cancers that were histologically confirmed as cancer was 68%. The most commonly occurring malignancies were basal cell carcinoma (BCC) (54.8%), squamous cell carcinoma (SCC) (18.9%), squamous cell carcinoma in-situ (SCCI) (8.0%), Kaposi’s sarcoma (KS) (6.7%), malignant melanoma (MM) (6.1%), and keratoacanthoma (KA) (4.6%). The number needed to treat (NTT) for all cancers diagnosed and for MM was 1.5 and 4 respectively. BCC (89.3%) and KS (67.7%) was the most common skin cancer in the white and black population respectively. The ratio of BCC to SCC was 2.03. Conclusion. This study provides valuable scientific data on the accuracy of skin cancer diagnosis, distribution and patient demographics in the Western Cape Province of South Africa, on which further research can be based. The study highlights the burden of skin cancer on this specific population group and calls for standardised reporting methods and increased surveillance of skin cancers.https://www.hindawi.com/journals/jsc/2020/9061532/Publisher's versio

Fall from Grace: South Africa and the Changing International Order

Special Issue for Perspectives on the Changing Global Balance of Power</p