Managing the Remains of Foetuses and Abandoned Infants – A Call to Urgently Review South African Law and Medico-legal Practice

This article reviews South African (SA) law and its impact on the medicolegal management of fetal remains emanating from elective and therapeutic termination of pregnancies, stillbirths and miscarriages and the remains of abandoned or exposed infants. It was found that remains are treated differently, some constituting medical waste while others have sufficient status in law to allow for burial. This approach results in some women or couples being denied a choice with regard to disposal via culturally relevant practices, and is insensitive to the fact that all remains ultimately constitute human remains. The article argues that SA law is in urgent need of reform, and turns to foreign law and forensic practice to shed light on possible alternative approaches that could assist with developing the SA position and thereby improve the practical management of fetal and infant remains in SA

Fatalities involving illicit drug use in Pretoria, South Africa, for the period 2003 - 2012

Background. Globally, illicit drugs are responsible for many fatalities annually, yet accurate data on the nature and extent of these deaths in South Africa (SA) are lacking.Objectives. To investigate the presence and profile of illicit drugs detected in deceased persons who were subjected to medicolegal autopsies and upon whom analyses were carried out in search of illicit drugs in their body fluids at the Pretoria Medico-Legal Laboratory (PMLL), SA, over a 10-year period.Methods. A retrospective descriptive case audit was conducted for the period 2003 - 2012.Results. Screening for illicit drugs was requested in 385 out of 22 566 medicolegal autopsies. Results were available for only 281 of these cases, with 154 cases showing the presence of one or more illicit drugs. The demographic profile of positive cases indicated the majority to be male (90.3%) and white (85.1%). Decedents who tested positive for illicit drugs were predominantly aged between 20 and 30 years (51.9%). The most frequently detected drug was heroin, the presence of which was confirmed in 35.2% of cases, followed by cocaine in 19.9%. Alcohol in combination with an illicit drug or drugs was detected in 56 cases (36.4%).Conclusions. Results from this study indicate that illicit drugs were implicated in a considerable number of fatalities in Pretoria. However, it is believed that the figures are a gross under-representation of the actual number of drug users who died during this period. It is therefore recommended that further research be conducted and that drug screening be requested routinely when unnatural deaths are investigated at medicolegal mortuaries, not only to ensure the administration of justice but also to obtain more accurate data for purposes of public health programmes and improve insight into the burden of illicit drug use in SA

Post-Mortem Echocardiography as a Guide to Cardiac Autopsy—A Worthwhile Concept?

Sudden and unexpected death in the young is a common and worldwide problem. Sudden, unexpected death in infancy (SUDI), clinically unexpected death in an infant between one week and one year of age, affects around 1 in 1000 infants. Autopsy will reveal a specific cause of death in only one third of cases. This has led to various ancillary examinations in an effort to increase the diagnostic yield of the autopsy

The value of medical student hepatitis B immunisation as part of clinical skills training in the Clinical Skills Unit of the University of the Free State

Background: It is compulsory for medical students of the University of the Free State to be immunised against hepatitis B before they have contact with clinical patients. Previously, the students were vaccinated on campus at the student health services. With the implementation of Curriculum 2000 (the revised MBChB programme), hepatitis B immunisation, as an example of an invasive procedure, was incorporated into the medical students’ clinical skills training programme. The aim of this study was to assess the students’ perceptions regarding immunising their peers, being immunised by their peers and the educational value of this process.Methods: Medical students in Phase II of the MBChB programme were included in this observational descriptive study and participation was voluntary. Students immunised their peers with a hepatitis B vaccine in the upper arm under the supervision of medical and nursing personnel in the laboratory of the Skills Unit. After the final immunisation, the students completed an anonymous questionnaire.Results: Sixty-six students completed the questionnaire. Of these, 80% felt that that they had improved their understanding of the theory of immunisation. Some (8%) students preferred to have the immunisation performed at a clinic or by a doctor and 6% had a problem with being vaccinated by a peer. A few (3%) students found it unacceptable to be immunised in a mixed gender group, 5% thought they had suffered complications and 5% indicated that there had been inadequate supervision. Most of the students (98%) responded positively to immunising their peers and 95% felt that it was advantageous to receive the immunisation in the skills laboratory environment. Approximately half (56%) of the students wanted to receive additional important immunisations.Conclusion: Students were positive about practising immunisation techniques on their peers.SA Fam Pract 2005;47(4): 54-5

Subendocardial Fibrosis in Left Ventricular Hypertrabeculation-Cause or Consequence?

Left ventricular noncompaction has been classified as a primary cardiomyopathy with a genetic origin. This condition is morphologically characterized by a thickened, two-layered myocardium with numerous prominent trabeculations and deep, intertrabecular recesses. Recently, it has become clear that these pathological characteristics extend across a continuum with left ventricular hypertrabeculation at one end of the spectrum

On pushing a pen and questions about academic freedoms and restrictions in a transitional setting

In a paper published online, Chaya Herman examines the relationship between political change and epistemologies and methodologies employed in research at doctorate level in the Faculty of Education at the University of Pretoria from 1985. She groups the doctoral dissertations under scrutiny together into three periods: 1985 - 1990, 1995 - 2000 and post 2000. She presents particularly negative assessments of the theses in question, characterising them among other things as research fundamentalism, patronising and pseudo-scientific knowledge, pseudo-philosophical knowledge, 'ideology masquerade [sic] as science' and disengaged knowledge lacking critical discourse and relevance. It would be understandable if the university management in general, deans of education, staff of the Faculty of Education and the PhDs who graduated during the period reviewed by Herman questioned her ex post facto analysis of their work. The paper by Herman evokes intriguing questions about issues such as fairness of comment, academic rigour and freedom, dignity and freedom of expression and how they play out in a before and after scenario of far-reaching political change and transformation. In this article we examine Herman's article (which suggests to us a certain reluctance to deal with the above questions in her analysis regarding the circumstances in which the text(s) on which she reports were written) in the light of their apparent relevance to the constitutional right to freedom of expression including academic freedom with its restrictions/limitations. Our paper introduces aspects of common law and the notion of 'who pushed the pen' into the critical consideration of the article and its possible implications for examining long-established academic and research traditions as they manifest themselves in a transformed setting. We conclude with comments on how the notion of 'pushing the pen' and knowledge of the meaning, limitation and application of the right to freedom of expression could apply to Herman's article and to all academic texts produced after the apartheid era in the democratic South Africa.National Research Foundation (NRF)http://reference.sabinet.co.za/sa_epublication/sapr1tm201

The prevalence and perception of obesity and its association with the lifestyle of women at the Mangaung University Community Partnership Project healthcare centre, Bloemfontein

Background: This investigation was prompted by the increase of obesity in developing countries with the simultaneous increased risk of preventable noncommunicable diseases. We aimed to determine the prevalence of obesity among women serving a predominantly black peri-urban community, who visited a healthcare centre in Bloemfontein. We also wanted to establish their perceived weight status, and any correlation between obesity, level of education, employment status and monthly income. Method: A cross-sectional analytical design was used. In June 2007, clinic-attending women aged 18-50 years were selected by a systematic sampling method to participate in the study. A self-administered questionnaire investigated participants’ socio-economic status, body image perception, psychological well-being, self-reported health status and physical activity. Body mass indices (BMIs) were calculated from weight and height measurements. Results: A total of 304 women completed the study, of whom 98 (32.2%) were overweight and 134 (44.1%) were obese, with a mean BMI of 30.1 kg/m2 [standard deviation (SD) 6.9 kg/m2]. More than half (53.4%) of the obese women perceived themselves as not obese. Approximately 84% of the participants were educated to secondary level, or higher. A significant difference in the employment status of the obese and non-obese participants (26.9% and 16.5% employed, respectively) was noted (p-value = 0.0013). The obese participants reported significantly less low self-esteem (29.5%) than the nonobese participants (42.4%) (p-value = 0.0250). Conclusion: The high prevalence of overweight and obesity, and the fact that 53.4% of the obese participants did not perceive themselves as such, poses a challenge for healthcare providers. Health-promotion strategies should aim to inform women about the health risks of overweight and obesity, and address misconceptions regarding perceived weight status.Keywords: overweight, obesity, women, socio-economic status, perceived weight statu

Fatalities involving illicit drug use in Pretoria, South Africa, for the period 2003 - 2012

Background. Globally, illicit drugs are responsible for many fatalities annually, yet accurate data on the nature and extent of these deaths in South Africa (SA) are lacking.Objectives. To investigate the presence and profile of illicit drugs detected in deceased persons who were subjected to medicolegal autopsies and upon whom analyses were carried out in search of illicit drugs in their body fluids at the Pretoria Medico-Legal Laboratory (PMLL), SA, over a 10-year period.Methods. A retrospective descriptive case audit was conducted for the period 2003 - 2012.Results. Screening for illicit drugs was requested in 385 out of 22 566 medicolegal autopsies. Results were available for only 281 of these cases, with 154 cases showing the presence of one or more illicit drugs. The demographic profile of positive cases indicated the majority to be male (90.3%) and white (85.1%). Decedents who tested positive for illicit drugs were predominantly aged between 20 and 30 years (51.9%). The most frequently detected drug was heroin, the presence of which was confirmed in 35.2% of cases, followed by cocaine in 19.9%. Alcohol in combination with an illicit drug or drugs was detected in 56 cases (36.4%).Conclusions. Results from this study indicate that illicit drugs were implicated in a considerable number of fatalities in Pretoria. However, it is believed that the figures are a gross under-representation of the actual number of drug users who died during this period. It is therefore recommended that further research be conducted and that drug screening be requested routinely when unnatural deaths are investigated at medicolegal mortuaries, not only to ensure the administration of justice but also to obtain more accurate data for purposes of public health programmes and improve insight into the burden of illicit drug use in SA

Integrable Spin Chains with U(1)^3 symmetry and generalized Lunin-Maldacena backgrounds

We consider the most general three-state spin chain with U(1)^3 symmetry and nearest neighbour interaction. Our model contains as a special case the spin chain describing the holomorphic three scalar sector of the three parameter complex deformation of N=4 SYM, dual to type IIB string theory in the generalized Lunin-Maldacena backgrounds discovered by Frolov. We formulate the coordinate space Bethe ansatz, calculate the S-matrix and determine for which choices of parameters the S-matrix fulfills the Yang-Baxter equations. For these choices of parameters we furthermore write down the R-matrix. We find in total four classes of integrable models. In particular, each already known model of the above type is nothing but one in a family of such models.Comment: 16 pages, 3 figures, references correcte

Green-Schwarz Strings in TsT-transformed backgrounds

We consider classical strings propagating in a background generated by a sequence of TsT transformations. We describe a general procedure to derive the Green-Schwarz action for strings. We show that the U(1) isometry variables of the TsT-transformed background are related to the isometry variables of the initial background in a universal way independent of the details of the background. This allows us to prove that strings in the TsT-transformed background are described by the Green-Schwarz action for strings in the initial background subject to twisted boundary conditions. Our construction implies that a TsT transformation preserves integrability properties of the string sigma model. We discuss in detail type IIB strings propagating in the \g_i-deformed AdS_5 x S^5 space-time, find the twisted boundary conditions for bosons and fermions, and use them to write down an explicit expression for the monodromy matrix. We also discuss string zero modes whose dynamics is governed by a fermionicgeneralization of the integrable Neumann model.Comment: 33 pages, latex, v2: typos correcte