Rising rates of Caesarean sections: an audit of Caesarean sections in a specialist private practice

Background: Caesarean section (CS) rates are increasing worldwide; rates in the private sector in South Africa are reported to be particularly high.To the best of our knowledge there has been no recent audit of Caesarean sections performed by the private health sector in KwaZulu-Natal. The aimof this study was to carry out an audit of CS in a private practice.Methods: An audit of the patient records over a period of one year was done. No personal identifiers were noted or reported on. All relevant clinicaldata were pooled and used to analyse the clinical information.Results: There were 364 deliveries in the study period and 209 of these were CS, giving a rate of 60.4%. Most of the caesarean sections were carriedout because of a previous CS; maternal request and HIV status also contributed to the high rate.Conclusion: The high CS rate in private practice is probably a window to the increased rates of Caesarean section being performed worldwide.This high rate is in keeping with trends in countries such as South America, and is considerably higher than the ideal rate of 10 to 15% in low-riskobstetric populations suggested by the WHO

Learners engaging with transformation geometry

This article reports on a qualitative, interpretivist study that focused on the use of visualisation and analytic strategies by Grade 12 learners when working with problems based on transformation geometry. The research was conducted with 40 learners from a Grade 12 class at one high school in the north Durban area of Kwazulu-Natal. Participants completed a written task and a smaller sample of the participants engaged in investigative semi-structured interviews with the researchers. The framework for the study was based on transformations of semiotic representations as well as the visualiser/analyser model. The findings revealed that most learners performed treatments in the analytic mode when responding to the tasks, and showed limited movement across the two modes which are essential for a deepening of understanding. The study identified one learner, however, who was able to move flexibly between the modes and who displayed a deep understanding of the concepts. The article concludes by recommending that opportunities need to be created for learners to engage in transformation geometry activities which emphasise conversion.Keywords: analysis; conversions; transformation geometry; transformations; treatments; visualisatio

Unanticipated treatment complication and legal recourse

A middle - aged, partially edentulous Caucasian female patient presented to a general dentist for extraction of a mandibular tooth. The tooth was removed by the dentist, but following incomplete resolution of pain the patient returned three months later for a consultation. The dentist diagnosed an abscess following radiographic investigation and referred the patient to a specialist who diagnosed a fracture of the mandible. The fracture had occurred unbeknown to the dentist and was consequently treated by a reduction procedure. The patient has since pursued legal action against the dentist.DHE

Melting of two‐dimensional colloidal crystals: A simulation study of the Yukawa system

The two‐dimensional melting transition of charged polystyrene spheres in aqueous colloidal suspension has been studied by molecular dynamics simulation of a screened Coulomb system. Some central predictions of the Kosterlitz–Thouless–Halperin–Nelson–Young theory of defect‐mediated melting are confirmed, such as an apparent divergence of the correlation lengths for translational and bond‐orientational order at different thermodynamic state points, but there are also predictions of the theory that are violated. The defect topology is very complex, with oscillation periods of the defect density of many million time steps duration. The need for extensive sampling and, to a lesser degree, the choice of potential function continue to be the crucial issues for any attempt to generate a hexatic structure by means of computer simulation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71272/2/JCPSA6-100-4-3114-1.pd

Glycosyltransferase gene expression profiles classify cancer types and propose prognostic subtypes

Aberrant glycosylation in tumours stem from altered glycosyltransferase (GT) gene expression but can the expression profiles of these signature genes be used to classify cancer types and lead to cancer subtype discovery? The differential structural changes to cellular glycan structures are predominantly regulated by the expression patterns of GT genes and are a hallmark of neoplastic cell metamorphoses. We found that the expression of 210 GT genes taken from 1893 cancer patient samples in The Cancer Genome Atlas (TCGA) microarray data are able to classify six cancers; breast, ovarian, glioblastoma, kidney, colon and lung. The GT gene expression profiles are used to develop cancer classifiers and propose subtypes. The subclassification of breast cancer solid tumour samples illustrates the discovery of subgroups from GT genes that match well against basal-like and HER2-enriched subtypes and correlates to clinical, mutation and survival data. This cancer type glycosyltransferase gene signature finding provides foundational evidence for the centrality of glycosylation in cancer

A test of the Interpersonal-psychological theory of suicidal behaviour in a sample of mental health outpatients

Abstract : Tests of two key hypotheses of the Interpersonal-Psychological Theory of Suicidal Behaviour (IPTS) were conducted in a cross-sectional sample of 239 psychiatric outpatients. Results of regression analyses indicated that thwarted belongingness (TB) and perceived burdensomeness (PB) were independently associated with death ideation, with some degree of death ideation being reported by all participants who obtained higher than mean scores on measures of PB and TB. After controlling for demographic covariates and depressive symptoms, the main effects of TB, PB, hopelessness, and all two-way interactions, suicide ideation was significantly predicted by the interactive effects of high levels of: TB, PB, and hopelessness. The findings are discussed in terms of their implications for future research on the theory and the clinical context

Deconstructing career myths and cultural stereotypes in a context of low resourced township communities

The current research presents the voices of black adolescents struggling to emerge from the shadow of the Apartheid legacy, focusing on the career beliefs that are perpetuated in low socio-economic communities and negatively influence career opportunities. Inaccurate information can result in career myths, which can have a negative impact on career development. The present study uses the Systems Theory Framework (STF) as a means of engaging with clients from marginalised groups. It also offers a mechanism to explore the impact of overlooked career influences such as culture, religion, community and socio-economic conditions. The qualitative career measure, My System of Career Influences (MSCI), was used to explore the factors that contribute to career decision-making. Specifically, widely shared irrational beliefs that had prevented participants from applying to tertiary institutions were examined. Career misconceptions were grouped according to Stead and Watson’s (1993) career myths, namely: 1) test myths; 2) misconceptions of exactitude; 3) self-esteem myths; and 4) career anxiety myths. The meaning-making that adolescents from disadvantaged contexts undergo, based on their unique constellation of contextual career influences and their resultant story-telling, is intrinsic to understanding local South African career identities embedded in township communities.Keywords: career beliefs; career decision-making; career development; career myths; My System of Career Influences; South African township; Systems Theory Framewor

Vulnerability and resilience of female farmers in Oku, Cameroon, to climate change

Abstract: The experience of climate change is filtered through ones existing cultural, social and economic vulnerabilities. The rural poor in natural resource dependent communities in various African countries are likely to be negatively affected by climate change. In many cultures female farmers are considerably worse off than their male counterparts. This study makes use of a life history methodology in order to examine the particular nature of the vulnerability experienced by rural women in Oku in the Bamenda Highlands region of Cameroon. Gender is linked to vulnerability through a number of factors. These include access to and control over land, division of labour, marriage relationships, access to education and responsibility for dependents. Participants’ life histories show how vulnerability in the region develops over time and is both complex and non‐linear. Nevertheless, the participants expressed how they used their agency, both individual and collective, in coping with vulnerability. They narrate different adaptation strategies employed including livelihood diversification, and changing farming practices. Understanding the role of gender in shaping women’s vulnerability is useful in informing the design and implementation of adaptation policies. This article makes an empirical contribution to the discussions on the need to engender climate change research, policy and actions

COGNITIVE BEHAVIOURAL THERAPY IN SOUTH AFRICA: COUNSELLORS' EXPERIECES FOLLOWING A TRAINING PROGRAMME

Many South African communities experience high level of violence and other phenomena that potentially provoke symptoms of traumatic stress among residents. Cognitive behaviour therapy (CBT) has been demonstrated to be an effective psychological intervention to ameliorate symptom of trauma, but is seldom practised in South African community mental health settings. In order to determine the barriers to implementing CBT. 12 credentialed community counsellors participated in a two-day training workshop focused on CBT.  Counsellor were asked to implement CBT with their clients who presented with ymptom of PTSD. The counsellors were then asked to complete a questionnaire six-months after the training workshop in order to identify the barriers they experienced in implementing the treatment model. The chief barriers that counsellors identified included high workload and limited time, unsuitable clients, client drop out, and an inappropriate match between the counsellor's theoretical paradigm and the CBT model. These result are considered in the context of community mental health care in post-apartheid South Africa