Elucidation of the complex Baylis-Hillman reaction of 3-methoxy-2-nitrobenzaldehyde with methyl vinyl ketone

DABCO-catalyzed reaction of 3-methoxy-2-nitrobenzaldehyde with methyl vinyl ketone (MVK) affords a mixture of products, comprising the ‘normal’ Baylis-Hillman adduct, theMVKdimer and a pair of diastereomeric bis-(MVK)Baylis-Hillman adducts. 1HNMRspectroscopy-based kinetic studies have provided clear insights into the competing pathways and product distribution in this complex reaction

Life expectancy of patients with diabetic foot sepsis post-lower extremity amputation at a regional hospital in a South African setting. A retrospective cohort study

BACKGROUND : Diabetes foot sepsis (DFS) is the leading cause of amputation of lower extremities. Over 50 % of patients who have had major lower extremity amputation due to DFS are dead within 4 years following the procedure. AIM : To determine the life expectancy of patients following amputation for DFS at a regional hospital in South Africa. METHODS : We conducted an audit of patients who had DFS and were admitted over a 5-year period. The duration from admission to time of death was recorded in days. Occurrence of death was confirmed from family members of the deceased using structured telephonic interview questionnaires. Categorical findings were summarized using actual counts and percentages and compared using either the Chi-square or Fisher's exact test. We used the mean with standard deviation or median and range to compare parametric and non-parametric continuous data, respectively. The Shapiro-Wilk test was used to test normality of data. Multivariate logistic regression was done to establish factors that were strongly associated with the mortalities. Adjusted survival curves were added to compare the rate of occurrence of mortality between males and females with age as a confounder. Statistical significance was set at a p-value below 0.05. RESULTS : 197 were found of which 100 % of participants had Type 2 diabetes mellitus and 63.5 % were males. Associated comorbidities included hypertension in 73.6 %, obesity in 66 %, alcohol use in 64.5 % and smoking in 58.4 %. 190 participants had an amputation and 19.3 % died. CONCLUSION : DFS was more common in males and 96 % of the patients had an amputation. Mortality rate within 4 years following amputation was 19.3 % and was higher in females and individuals with multiple comorbidities.http://www.thesurgeon.nethj2024SurgerySDG-03:Good heatlh and well-bein

Basic characteristics of atmospheric particles, trace gases and meteorology in a relatively clean Southern African Savannah environment

We have analyzed one year (July 2006–July 2007) of measurement data from a relatively clean background site located in dry savannah in South Africa. The annual-median trace gas concentrations were equal to 0.7 ppb for SO<sub>2</sub>, 1.4 ppb for NO<sub>x</sub>, 36 ppb for O<sub>3</sub> and 105 ppb for CO. The corresponding PM<sub>1</sub>, PM<sub>2.5</sub> and PM<sub>10</sub> concentrations were 9.0, 10.5 and 18.8 μg m<sup>−3</sup>, and the annual median total particle number concentration in the size range 10–840 nm was 2340 cm<sup>−3</sup>. During Easterly winds, influence of industrial sources approximately 150 km away from the measurement site was clearly visible, especially in SO<sub>2</sub> and NO<sub>x</sub> concentrations. Of gases, NO<sub>x</sub> and CO had a clear annual, and SO<sub>2</sub>, NO<sub>x</sub> and O<sub>3</sub> clear diurnal cycle. Atmospheric new-particle formation was observed to take place in more than 90% of the analyzed days. The days with no new particle formation were cloudy or rainy days. The formation rate of 10 nm particles varied in the range of 0.1–28 cm<sup>−3</sup> s<sup>−1</sup> (median 1.9 cm<sup>−3</sup> s<sup>−1</sup>) and nucleation mode particle growth rates were in the range 3–21 nm h<sup>−1</sup> (median 8.5 nm h<sup>−1</sup>). Due to high formation and growth rates, observed new particle formation gives a significant contribute to the number of cloud condensation nuclei budget, having a potential to affect the regional climate forcing patterns

Piloting a mental health training programme for community health workers in South Africa: an exploration of changes in knowledge, confidence and attitudes

Background There is a shortage of trained mental health workers in spite of the significant contribution of psychiatric disorders to the global disease burden. Task shifting, through the delegation of health care tasks to less specialised health workers such as community health workers (CHWs), is a promising approach to address the human resource shortage. CHWs in the Western Cape province of South Africa provide comprehensive chronic support which includes that for mental illness, but have thus far not received standardized mental health training. It is unknown whether a structured mental health training programme would be acceptable and feasible, and result improved knowledge, confidence and attitudes amongst CHWs. Methods We developed and piloted a mental health training programme for CHWs, in line with the UNESCO guidelines; the WHO Mental Health Gap Action Programme and the South African National framework for CHW training. In our quasi-experimental (before-after) cohort intervention study we measured outcomes at the start and end of training included: 1) Mental health knowledge, measured through the use of case vignettes and the Mental Health Knowledge Schedule; 2) confidence, measured with the Mental Health Nurse Clinical Confidence Scale; and 3) attitudes, measured with the Community Attitudes towards the Mentally Ill Scale. Knowledge measures were repeated 3 months later. Acceptability data were obtained from daily evaluation questionnaires and a training evaluation questionnaire, while feasibility was measured by participant attendance at training sessions. Results Fifty-eight CHWs received the training, with most (n = 56, 97.0%) attending at least 7 of the 8 sessions. Most participants (n = 29, 63.04%) demonstrated significant improvement in knowledge, which was sustained at 3-months. There was significant improvement in confidence, along with changes in attitude, indicating improved benevolence, reduced social restrictiveness, and increased tolerance to rehabilitation of the mentally ill in the community but there was no change in authoritarian attitudes. The training was acceptable and feasible. Conclusions Mental health training was successful in improving knowledge, confidence and attitudes amongst trained CHWs. The training was acceptable and feasible. Further controlled studies are required to evaluate the impact of such training on patient health outcomes. Trial registration PACTR PACTR201610001834198 , Registered 26 October 2016

Must Land Reform Benefit the Victims of Colonialism?

Appealing to African values associated with ubuntu such as communion and reconciliation, elsewhere I have argued that they require compensating those who have been wronged in ways that are likely to improve their lives. In the context of land reform, I further contended that this principle probably entails not transferring unjustly acquired land en masse and immediately to dispossessed populations since doing so would foreseeably lead to such things as capital flight and food shortages, which would harm them and the broader society. Oritsegbubemi Anthony Oyowe has recently argued against my claim that land reform should be enacted in a way expected to benefit victims of colonialism while not greatly burdening innocent third parties, instead supporting the return of land to its rightful owners regardless of how the manner in which it were done would affect people’s quality of life. Here I expound Oyowe’s argumentation and respond to it in defence of my initial position, appealing to examples from southern Africa to illustrate

African Communitarianism and Difference

There has been the recurrent suspicion that community, harmony, cohesion, and similar relational goods as understood in the African ethical tradition threaten to occlude difference. Often, it has been Western defenders of liberty who have raised the concern that these characteristically sub-Saharan values fail to account adequately for individuality, although some contemporary African thinkers have expressed the same concern. In this chapter, I provide a certain understanding of the sub-Saharan value of communal relationship and demonstrate that it entails a substantial allowance for difference. I aim to show that African thinkers need not appeal to, say, characteristically Euro-American values of authenticity or autonomy to make sense of why individuals should not be pressured to conform to a group’s norms regarding sex and gender. A key illustration involves homosexuality