The assessment of intravascular volume

No Abstrac

Noodlottige kindermishandeling: ‘n literatuuroorsig en die profiel in die Suid-Vrystaat (1995-2003) Fatal child abuse: a literature review and the profile in the Southern Free State (1995-2003)

Agtergrond Kindermishandeling is \'n sosiale probleem met verreikende gevolge. Ernstige onderrapportering van gevalle vind plaas, en geen studies kon opgespoor word wat die Suid-Afrikaanse konteks van die probleem ondersoek nie. In hierdie studie is gepoog om die profiel van die slagoffers van noodlottige kindermishandeling in die Suid-Vrystaat te ondersoek. Metodes Alle kindersterftes van kinders van tien jaar en jonger is uit die register van sterftes by die SAPD- (Suid-Afrikaanse Polisiediens-) lykshuis, Bloemfontein, geïdentifiseer. Hierdie sterftes se verslae is vir gevalle van noodlottige kindermishandeling geëvalueer. Irrelevante verslae is geëlimineer totdat \'n groep moontlike gevalle van noodlottige kindermishandeling verkry is. In gevalle waar daar twyfel oor die oorsaak van dood was, is \'n kliniese assistent in Geregtelike Geneeskunde geraadpleeg. In sommige gevalle het die assistent aanbeveel dat \'n geskiedenis uit polisieverslae verkry moes word. Indien gevalle nie op so \'n wyse bevestig kon word nie, is dit in die sogenaamde ‘grys area\' ingesluit. Negentien gevalle is geïdentifiseer en vier is in die grys area geplaas. Resultate Uit die 19 gevalle was die meerderheid vroulik (14). Die mediaanouderdom van slagoffers was twee jaar. Die slag-offers toon \'n eweredige verspreiding t.o.v. ras. Geen patroon kon geïdentifiseer word in die jaarlikse en maandelikse verspreiding van sterftes nie. Die meeste van die slagoffers, 73.7% (14 van 19 gevalle), was van normale massa, en geen slagoffers het aan \'n wanvoedingsiekte gely nie. Hoofbese-rings was die algemeenste oorsaak van sterftes (63.2%), gevolg deur veelvuldige beserings (21.2%). Gevolgtrekking Indien dokters bedag is op die tekens van kindermishandeling, kan gevalle vroeg geïdentifiseer word. Sodoende kan \'n beduidende verlaging in mortaliteit en morbiditeit bewerkstellig Introduction Child abuse is a social problem with far-reaching consequences. Serious underreporting of cases occurs, and no studies could be found which investigates the South African context of the problem. In this study we aimed to determine the profile of victims of fatal child abuse in the Southern Free State. Methods All child deaths of children 10 years and younger in the period 1 January 1995 to 31 December 2003 were identified in the register of deaths at the SA Police Mortuary, Bloemfontein. The reports of these deaths were evaluated to identify possible cases of fatal child abuse. Irrelevant reports were eliminated until a group of possible cases of fatal child abuse were identified. In cases where there was uncertainty about the cause of death, a registrar in Forensic Medicine was consulted. In some cases she advised that a history be obtained from police reports. Cases which could not be confirmed in this way were included in a so-called grey area. Nineteen cases were identified, and a further 4 placed in the grey area. Results Of the 19 cases, the majority were female (14). The median age of cases was 2 years. Cases showed an even distribution regarding race. No patterns regarding annual or monthly distribution were found. Most victims, 73.7% (14 of 19 cases), were of normal weight and no victims suffered from malnutrition. Head injuries were the most common cause of death (63.2%) followed by multiple injuries (21.2%). Conclusion If doctors are aware of the signs of child abuse cases can be identified early. In this way a significant decrease in mortality and morbidity can occur. word.South African Family Practice Vol. 49 (9) 2007: pp. 1

Critical care triage during the COVID-19 pandemic in South Africa: A constitutional imperative!

Triage and rationing of scarce intensive care unit (ICU) resources are an unavoidable necessity. In routine circumstances, ICU triage is premised on the best interests of an individual patient; however, when increased demand exceeds capacity, as during an infectious disease outbreak, healthcare providers need to make difficult decisions to benefit the broader community while still respecting individual interests. We are currently living through an unprecedented period, with South Africa (SA) facing the challenges of the global COVID-19 pandemic. The Critical Care Society of Southern Africa (CCSSA) expedited the development of a triage guidance document to inform the appropriate and fair use of scarce ICU resources during this pandemic. Triage decision-making is based on the clinical odds of a positive ICU outcome, balanced against the risk of mortality and longer-term morbidity affecting quality of life. Factors such as age and comorbid conditions are considered for their potential impact on clinical outcome, but are never the sole criteria for denying ICU-level care. Arbitrary, unfair discrimination is never condoned. The CCSSA COVID-19 triage guideline is aligned with SA law and international ethical standards, and upholds respect for all persons. The Bill of Rights, however, does not mandate the level of care enshrined in the constitutional right to healthcare. ICU admission is not always appropriate, available or feasible for every person suffering critical illness or injury; however, everyone has the right to receive appropriate healthcare at another level. If ICU resources are used for people who do not stand to benefit, this effectively denies others access to potentially life-saving healthcare. Appropriate triaging can therefore be considered a constitutional imperative

Developing open source materials for foundation phase: Diverse spaces for collaboration

Determining a space for collaborative activities involves the creation of a unique space which encourages reciprocal learning and the creation of products that can benefit all participants. The aim of this article was to explore the experiences of group members in this collaborative space. The group consisted of lecturers from different Higher Education Institutions (HEIs) tasked to create quality open-source materials for teaching and learning Literacy in Foundation Phase at HEIs (coming together and work in one space) in the endeavour to connect and share collaboratively. Selected components of the theories of space suggested by Lefebvre and Soja were employed to explain the data which were gleaned through interviews with all participants in the group. This paper makes two important contributions: firstly, it substantively presents a deeper understanding of the experiences of the group in collaborative work and secondly, through the use of a theoretical framework on space, offers insights into the nature of collaboration within diverse spaces

MADIBA: A web server toolkit for biological interpretation of Plasmodium and plant gene clusters

<p>Abstract</p> <p>Background</p> <p>Microarray technology makes it possible to identify changes in gene expression of an organism, under various conditions. Data mining is thus essential for deducing significant biological information such as the identification of new biological mechanisms or putative drug targets. While many algorithms and software have been developed for analysing gene expression, the extraction of relevant information from experimental data is still a substantial challenge, requiring significant time and skill.</p> <p>Description</p> <p>MADIBA (MicroArray Data Interface for Biological Annotation) facilitates the assignment of biological meaning to gene expression clusters by automating the post-processing stage. A relational database has been designed to store the data from gene to pathway for <it>Plasmodium</it>, rice and <it>Arabidopsis</it>. Tools within the web interface allow rapid analyses for the identification of the Gene Ontology terms relevant to each cluster; visualising the metabolic pathways where the genes are implicated, their genomic localisations, putative common transcriptional regulatory elements in the upstream sequences, and an analysis specific to the organism being studied.</p> <p>Conclusion</p> <p>MADIBA is an integrated, online tool that will assist researchers in interpreting their results and understand the meaning of the co-expression of a cluster of genes. Functionality of MADIBA was validated by analysing a number of gene clusters from several published experiments – expression profiling of the <it>Plasmodium </it>life cycle, and salt stress treatments of <it>Arabidopsis </it>and rice. In most of the cases, the same conclusions found by the authors were quickly and easily obtained after analysing the gene clusters with MADIBA. </p