New meanings of “home” in South Africa

The search for a place we can call “home” and where we feel we can truly belong is a common human experience. This article explores the different meanings attached to the concept of home and how these influence our experience of belonging. These will be discussed in the context of individual as well as family and cultural experiences, with special emphasis on the contributions of family therapy towards this understanding. The article will also explore how finding a “home” is particularly relevant in present-day post-apartheid South African society. In conclusion it will be argued that “home” may be a fluid concept which requires mobility and flexibility in order to accommodate the complexities of a postmodern world

Multimorbidity and socioeconomic deprivation in primary care consultations

Purpose: The influence of multimorbidity on the clinical encounter is poorly understood, especially in areas of high socioeconomic deprivation where burdensome multimorbidity is concentrated. The aim of the current study was to examine the effect of multimorbidity on general practice consultations, in areas of high and low deprivation. Methods: We conducted secondary analyses of 659 video-recorded routine consultations involving 25 general practitioners (GPs) in deprived areas and 22 in affluent areas of Scotland. Patients rated the GP’s empathy using the Consultation and Relational Empathy (CARE) measure immediately after the consultation. Videos were analyzed using the Measure of Patient-Centered Communication. Multilevel, multi-regression analysis identified differences between the groups. Results: In affluent areas, patients with multimorbidity received longer consultations than patients without multimorbidity (mean 12.8 minutes vs 9.3, respectively; P = .015), but this was not so in deprived areas (mean 9.9 minutes vs 10.0 respectively; P = .774). In affluent areas, patients with multimorbidity perceived their GP as more empathic (P = .009) than patients without multimorbidity; this difference was not found in deprived areas (P = .344). Video analysis showed that GPs in affluent areas were more attentive to the disease and illness experience in patients with multimorbidity (P < .031) compared with patients without multimorbidity. This was not the case in deprived areas (P = .727). Conclusions: In deprived areas, the greater need of patients with multimorbidity is not reflected in the longer consultation length, higher GP patient centeredness, and higher perceived GP empathy found in affluent areas. Action is required to redress this mismatch of need and service provision for patients with multimorbidity if health inequalities are to be narrowed rather than widened by primary care

Epidermal growth factor (EGF) withdrawal masks gene expression differences in the study of pituitary adenylate cyclase-activating polypeptide (PACAP) activation of primary neural stem cell proliferation

BACKGROUND: The recently discovered adult neural stem cells, which maintain continuous generation of new neuronal and glial cells throughout adulthood, are a promising and expandable source of cells for use in cell replacement therapies within the central nervous system. These cells could either be induced to proliferate and differentiate endogenously, or expanded and differentiated in culture before being transplanted into the damaged site of the brain. In order to achieve these goals effective strategies to isolate, expand and differentiate neural stem cells into the desired specific phenotypes must be developed. However, little is known as yet about the factors and mechanisms influencing these processes. It has recently been reported that pituitary adenylate cyclase-activating polypeptide (PACAP) promotes neural stem cell proliferation both in vivo and in vitro. RESULTS: We used cDNA microarrays with the aim of analysing the transcriptional changes underlying PACAP induced proliferation of neural stem cells. The primary neural stem/progenitor cells used were neurospheres, generated from the lateral ventricle wall of the adult mouse brain. The results were compared to both differentiation and proliferation controls, which revealed an unexpected and significant differential expression relating to withdrawal of epidermal growth factor (EGF) from the neurosphere growth medium. The effect of EGF removal was so pronounced that it masked the changes in gene expression patterns produced by the addition of PACAP. CONCLUSION: Experimental models aiming at transcriptional analysis of induced proliferation in primary neural stem cells need to take into consideration the significant effect on transcription caused by removal of EGF. Alternatively, EGF-free culture conditions need to be developed

Estudo da parceria entre empresas e escolas para ensino à distância com alunos da educação de jovens e adultos na cidade de Curitiba-PR

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Engenharia de ProduçãoO presente trabalho apresenta uma pesquisa que identifica as possibilidades de parcerias entre empresas e escola e sugere a implantação de Lei de Incentivo Fiscal para a Educação de Jovens e Adultos. A referida lei é uma adaptação da Lei de Incentivo Fiscal para o Esporte Amador no Município de Curitiba, lei esta já aprovada e em vigência. A Lei de Incentivo para a Educação tem como objetivo atingir a classe operária de baixa renda que trabalha em empresas que adotarem a Educação de Jovens e Adultos. Para que esta Lei passe a vigorar a Prefeitura Municipal de Curitiba teria que direcionar um percentual de 1 a 10% do valor pago para o IPTU - Imposto Predial Territorial Único e desenvolver parcerias com Instituições Educacionais que ofertem a Educação de Jovens e Adultos a distância. Como sugestão da classe empresarial, para uma Associação ou Fundação onde o funcionário possa ter livre acesso sem vínculo empregatício e sem taxa de adesão, com laboratório de informática para que seja oportunizando o estudo a estes funcionários, que terão somente que agendar dia e hora que irá utilizar o laboratório para o desenvolvimento das aulas

Is it just about the crime? A psychological perspective on South African emigration

Various economic and socio-political reasons are usually given to explain people’s decisions to emigrate from South Africa, and violent crime is often cited as the most compelling factor. By contrast, little attention has been paid to the psychological context within which the decision to emigrate is made. In this article, the experiences of ten South Africans prior to their emigration from South Africa are discussed. This qualitative study formed part of a larger research project exploring the impact of emigration on South African family life. The results suggest that the socio-psychological context within which the decision to emigrate is made is highly complex and involves a number of interlinked factors. Although emigrants are aware of the impact of their departure on the people and systems surrounding them, they need to cut themselves off psychologically from significant others in order to leave and socially disengage from the home country. Consequently, it is argued that emigration affects not only the people leaving, but also those left behind (and who, according to the findings of this study, do not generally benefit from the move). Therefore adequate psychological and practical preparation is recommended and the needs of elderly people left behind are highlighted.The National Research Foundation (NRF)http://www.journals.co.za/ej/ejour_sapsyc.htmlgv201

Testes de aprovação conjuntival na avaliação de hiperreatividade ocular específica e inespecífica

Resumo: Hiperreatividade ocular, manifestada por prurido, hiperemia conjuntival, quemose e lacrimejamento, pode ser especifica quando desencadeada por aeroalergenos (HRCe) ou inespecifica, quando desencadeada por fatores ambientais inespecificos (HRCi). Este trabalho teve como objetivo investigar a presenca de hiper-reatividade ocular especifica pelo teste de provocacao conjuntival com alergenos (TPCA) e inespecifica pelo teste de provocacao conjuntival hiperosmolar (TPCH) em individuos com queixas oculares. Oitenta e cinco individuos foram testados com alergenos de acaros da poeira (Dp e Bt) e polen de graminea (Lp) por teste cutaneo alergico (TCA), dosagem serica de IgE total e especifica aos alergenos (S-IgE). Cinquenta e seis individuos foram classificados como alergicos por apresentar TCA e S-IgE positivos a pelo menos um alergeno. TCA foi positivo para acaros em 23 individuos alergicos, para polen em 13 e para ambos os alergenos em 20. TPCA com doses crescentes de alergenos foi considerado positivo quando atingiu escore cumulativo para sinais e sintomas .5, apresentando escore medio total 6,6 em 77 TPCA positivos. Dos 82 TPCA realizados (Dp=26; Bt=26; Lp=30), 77 (94%) foram positivos ao mesmo alergeno da reatividade cutanea (p<0.0001); sensibilidade foi 94% e especificidade foi 85%. Nao houve TPCA positivo nos controles. Prurido se correlacionou com 96% dos TPCA positivos e ocorreu antes de hiperemia em 66% (51/77) destes testes. Dose limiar de alergeno para resposta positiva na pele foi menor do que a do olho para todos os alergenos testados (p<0.0001), com 76% dos TPCA reagindo nas diluicoes 1:8 a 1:2 e 86% dos TCAT nas diluicoes 1:1024 a 1:16. IgE total elevada ocorreu em 63% dos TPCA positivos em individuos sensiveis a acaros, mas nao aos sensiveis a polen. Houve um caso de sibilancia e um de edema periocular intenso com TPCA positivos. TPCA foi reproduzido apos 1 semana com a mesma dose de alergeno que desencadeou o 1o teste em 78% dos alergicos. Teste de provocacao conjuntival hiperosmolar com concentracoes seriadas de glicose foi realizado em sessenta tres individuos (38 alergicos; 25 nao alergicos) ate o aparecimento de hiperemia conjuntival, quando o teste foi considerado positivo. Fotografias digitais foram analisadas por 2 observadores que marcaram a hiperemia nas provocacoes positivas (GIMP 2.6.5) em vermelho. O numero de pontos vermelhos do olho afetado foi comparado com o numero de pontos azuis do olho controle. TPCH foi positivo em 87% dos alergicos (33/38), sendo 6/7 sensiveis ao polen de graminea, 17/20 aos acaros e 10/11 a ambos os alergenos; sensibilidade foi 87% e especificidade foi 84%. TPCH foi positivo em 16% (4/25) dos controles. Houve correlacao significativa entre os numeros de pontos vermelhos em 23 imagens digitais marcadas pelos observadores. TPCA identificou HRCe em individuos alergicos a acaros e ao polen de graminea com conjuntivite alergica. TPCA mostrou ser um teste sensivel, especifico e reprodutivel. TPCH identificou HRCi em individuos alergicos e nao alergicos. HRCi foi mais frequente nos alergicos, mesmo quando estavam assintomaticos. Fotografias digitais podem ser uteis na avaliacao objetiva de hiperemia ocular em TPCH

The development and optimisation of a primary care-based whole system complex intervention (CARE Plus) for patients with multimorbidity living in areas of high socioeconomic deprivation

&lt;B&gt;OBJECTIVES&lt;/B&gt; To develop and optimise a primary care-based complex intervention (CARE Plus) to enhance the quality of life of patients with multimorbidity in the deprived areas. &lt;B&gt;METHODS&lt;/B&gt; Six co-design discussion groups involving 32 participants were held separately with multimorbid patients from the deprived areas, voluntary organisations, general practitioners and practice nurses working in the deprived areas. This was followed by piloting in two practices and further optimisation based on interviews with 11 general practitioners, 2 practice nurses and 6 participating multimorbid patients. &lt;B&gt;RESULTS&lt;/B&gt; Participants endorsed the need for longer consultations, relational continuity and a holistic approach. All felt that training and support of the health care staff was important. Most participants welcomed the idea of additional self-management support, though some practitioners were dubious about whether patients would use it. The pilot study led to changes including a revised care plan, the inclusion of mindfulness-based stress reduction techniques in the support of practitioners and patients, and the stream-lining of the written self-management support material for patients. &lt;B&gt;DISCUSSION&lt;/B&gt; We have co-designed and optimised an augmented primary care intervention involving a whole-system approach to enhance quality of life in multimorbid patients living in the deprived areas. CARE Plus will next be tested in a phase 2 cluster randomised controlled trial

Teacher perspectives on addressing environmental issues in ELT

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