The crisis in church leadership and the Bible : addressing issues in the practical theology of church leadership through the exegesis of selected portions of the Epistle to Titus

The 21st century is marked by the widespread influence of post-modernism and the relativisation of truth. As such, confidence in the truth of Scripture is flagging, and nowhere is this felt more, ironically, than in the appointment and the working of pastors of the Word of God. Movements such as the historical Jesus research abroad, and the so-called “New Reformation” in South Africa, are calling into question long-held tenets of the Christian faith, as well as the inerrant nature of the Bible. The failing trust in the Scripture has also led to a diminished reliance on exposition of the Bible. This again relates to the training of pastors, as theological training today is marked by greater disdain for biblical subjects and a threatening rift between practical theology and biblical exposition. The aim of this study is to demonstrate how the trend might be countered, by applying an exposition of portions of the book of Titus relevant to the selection, appoint, and task of the pastor, to the current situation as it exists today. The exposition focused on the following excerpts from the epistle: 1:1–2:8, 3:12–15. The pastor was discussed as the exemplification of the Church elder, but it was also noted that all that applies to the pastor, equally applies to all elders of the Church. Emphasis was laid on the character of the pastor, the biblical requirements for the ministry, the appointment of pastors, the biblically mandated task of the pastor, the role of the pastor in defending and teaching sound doctrine, and how the teaching of the pastor is to filter down through the congregation, through the older men to the younger men, the older women to the younger women, and how a general ethos of relational ministry is to pervade the mindset of the whole Church (pastor and congregants) in all that they do. Through the exposition, it is seen that biblical exposition is still relevant, and has a role to play in all spheres of life and theology, including practical theological concerns such as the appointment and task of pastors.Dissertation (MA(Theol))--University of Pretoria, 2010.Practical Theologyunrestricte

Nutritional status, glycaemic control and barriers to treatment compliance among patients with type 2 diabetes attending public primary health clinics in Maseru, Lesotho

Objectives: To evaluate the nutritional status, glycaemic control and barriers to treatment compliance of outpatients with type 2 diabetes mellitus (T2DM) attending two public primary health clinics in Maseru, Lesotho.Design: Cross-sectional analytical study.Setting: Lesotho Defence Force Clinic and Domiciliary Clinic.Subjects: 124 participants with T2DM, 30–69 years.Outcome measures: Sociodemography, medical history, diet, lifestyle, metabolic risk-related anthropometry, glycaemic and metabolic control, and barriers that may impact on treatment compliance.Results: Participants (53.9; SD 9.4 years; 79.5% females; 53.3% diagnosed for > 5 years) were knowledgeable about basic lifestyle recommendations for diabetes, and reported being active (98.3%). However, 88.5% were overweight or obese; 93.4%, 78.1%; 66.1% did not meet the recommended intakes of dairy, vegetables and fruit; 10.7% used tobacco; and 52% of men drank excessively. None performed blood glucose self-monitoring, and 90.2% were ignorant of normal blood glucose ranges, while 94.3% had uncontrolled hypertension despite being on anti-hypertensive medication. Participants were rarely screened for long-term glycaemic control or comorbidities, or referred to dietitians, but 98.4% were satisfied with the services.Conclusions: In this setting, patients were not meeting treatment goals for T2DM, and were not being screened or referred, rendering clinic visits a revolving door that poses the risk of costly complications

Comparison of lung ultrasound with transpulmonary thermodilution in assessing extra-vascular lung water

Background: Increased extra-vascular lung water (EVLW) is common in critical care and correlates with the severity of acute lung injury, length of intensive care unit stay and mortality. Lung ultrasound (LUS) can assess EVLW by determining the amount of ‘B-lines’: artefacts signifying alveolar-interstitial oedema. This study’s aim was to determine whether EVLW estimation with the help of LUS correlates with the more accurate PiCCO2® cardiac output system utilising transpulmonary thermodilution.Methods: This prospective observational study was undertaken at Universitas Academic Hospital, Bloemfontein. Patients were scanned according to a fixed protocol, followed by transpulmonary thermodilution. The cumulative B-line count was compared with the EVLW index generated by the PiCCO2® system.Results: Four males and six females were enrolled. The mean EVLW index was 9.1 ml/kg/m2 (standard deviation 1.45), and the median cumulative B-line count was 14 (interquartile range 6–25). A positive, but not statistically significant, correlation was found (r = 0.40, p = 0.25) between the B-line count and EVLW index.Conclusion: This study investigated a possible correlation between LUS interpretation and transpulmonary thermodilution in assessing EVLW. Results seem promising, but the small sample could indicate only that LUS might be of use for the assessment of EVLW. Further studies are needed.Keywords: B-lines,critical care, extra-vascular lung water, lung ultrasound, thermodilutio

Using Twitter Post Data to Ascertain the Sentiment of Alcohol-related Blackouts in the United States

Research shows variability in how alcohol-related blackouts (periods of memory loss during/after drinking) are subjectively evaluated. We accessed 3.5 million original Tweets written in the U.S. between July 2009 and February 2020 that referenced blackouts, and coded the sentiment (positive or negative) of those Tweets, using the machine learning function of a Twitter-sponsored commercial platform. The sentiment of Tweets was examined by day of week and compared to the sentiment of blackout Tweets on certain holidays to non-celebration matched days. Tweets were more likely to have a positive (73%) than negative sentiment, and positive Tweets were more common during weekends. Relative to typical non-celebratory weekends, a greater proportion of blackout Tweets were positive around Thanksgiving and New Year’s Eve, though differences were not observed relative to several other celebratory periods (e.g., Superbowl). Results have implications for online interventions, which can use social networking sites to target alcohol during high-risk periods

Diabetes-related knowledge, attitude and practices (KAP) of adult patients with type 2 diabetes mellitus in the Free State province, South Africa

Introduction: Type 2 diabetes mellitus (T2DM) is a global health problem with high morbidity and mortality in patients who are mostly still economically active. The growing incidence and health implications for those affected make T2DM a major public health issue. Objectives: To compile a demographic, anthropometric and knowledge, attitude and practices (KAP) profile of adult patients with T2DM in the public health sector of the Free State province, South Africa. Design: A descriptive observational study was conducted. Setting: A total of 255 participants attending public health facilities in the Free State were interviewed. Outcome Measures: Questionnaires were completed in an interview to determine demographics and KAP. Anthropometric measurements were obtained by standard techniques. Results: The majority of the participants (n = 222; 87.1%) were black women from urban areas, who were overweight and obese. The median age at diagnosis was 48 years (range 15–80 years), and 25 participants (9.8%) lacked formal schooling. In 212 participants (83.1%), a waist circumference above cut-off points was observed. Only half of the participants knew the normal range for blood glucose. Approximately 80% felt that they would be a different person if they did not have diabetes. Although 96.1% of participants were knowledgeable about the benefits of physical exercise, only 31.0% reported exercising on a daily basis. A statistically significant association was found between knowledge and attitudes, indicating that better knowledge about diabetes could be associated with a more positive attitude towards diabetes. Conclusion: Poor knowledge, a negative attitude and poor practices related to diabetes were observed in a very high percentage of participants, which may contribute to morbidity and mortality. The fact that knowledge was associated with attitude indicates that interventions aimed at improving knowledge could benefit patients in more than one way. Interventions to equip patients to successfully manage their condition are urgently required

Does forgiveness mediate the impact of school bullying on adolescent mental health?

OBJECTIVE : The link between both bullying and victimisation and psychopathology has been well established. Forgiveness has been associated with better mental health. However, few studies have examined the relationship between adolescent forgiveness, psychopathology and bullying/ victimisation. This study investigated forgiveness as a mediator of the adverse mental health problems experienced by bullies and victims of bullying. METHOD : Participants were 355 Year 10 or Year 11 pupils (age = 14.9 years) from two British secondary schools in 2007, who completed self-administered measures on bullying and victimisation, mental health, forgiveness of self and others, and forgivingness. The mediating influence of forgiveness on the impact of bullying/victimisation on mental health was tested with a structural equation model. RESULTS : Data from 55.6% of the 639 eligible pupils were analysed. Results confirmed an association between bullying/victimisation, forgiveness and psychopathology. Forgiveness scores were found to play a mediating role between bullying/victimisation and psychopathology. CONCLUSIONS : Victimised adolescents who were better able to forgive themselves were more likely to report lower levels of psychopathology, while bullying adolescents who were unable to forgive others were more likely to report higher levels of psychopathology. This suggests a greater role for forgiveness within future research, intervention and policy on bullying. Forgiveness can form a valuable part of preventative and educational anti-bullying programmes.http://www.tandfonline.com/loi/rcmh202015-12-22hb201

Iron-focussed nutritional status of mothers with children (6–59 months) in rural northern Ghana

Background: Anaemia, especially iron deficiency anemia, is an important cause of morbidity and mortality in African women and children. Aim: To assess the intake of nutrients related to iron and anaemia status among mothers in smallholder agrarian communities in Northern Ghana where anaemia is known to be endemic. Setting: Tolon Kumbumgu district and Tamale Metropolis in Ghana. Methods: A cross-sectional study was conducted among 161 mothers with children 6–59 months. Questionnaires on socio-demographics, household food security and production and food frequencies, and three 24-hour recalls were administered during structured interviews, and BMI was assessed. Dietary intakes were analysed with the Ghana Nutrient Database® (version 6.02). Nutrient intake was evaluated using the estimated average requirements and iron intakes using the probability method. Results: Most mothers (91.9%) had low literacy and were subsistence farmers. The staple diet was homemade unrefined, unfortified maize meal, homemade unfortified oil (shea butter), and seasonal green leafy vegetables (mostly amaranth), butternut, tomatoes, onions and legumes. Inadequate intakes of vitamin A (in 9.9%), folate (in 46.6%) and vitamin B12 (in 98.8%) were observed, in combination with high fibre (47.8 ± 19.0 g/day) intakes and high tea consumption. If 10% iron bio-availability was assumed, 33.1% were estimated to have inadequate iron intake; if 5% iron bio-availability was assumed, 80.8% were estimated to have inadequate iron intakes. Conclusion: In these low socio-economic agrarian communities, mothers of infants are living on home produce and rarely consumed foods (fortified salt, cooking oil and wheat flour) from the national food fortification programmes intended to address anaemia and other micronutrient deficiencies

A comparison of the ability of three common contact lens solutions with different constituents to inhibit growth of <i>Staphylococcus aureus</i>

Background: Staphylococcus aureus is a common commensal on skin and mucosal surfaces; its contact with the eye may cause a variety of ocular inflammations and infections such as blepharitis, conjunctivitis and keratitis, amongst others. Soft contact lenses provide perfect conditions for the breeding of certain pathogens, and disinfecting solutions for contact lenses are therefore of utmost importance. These solutions should be effective in inhibiting the growth of a variety of pathogens to protect the user from ocular infections. Aim: To highlight the need for clinicians to be aware of the effects of various recommended disinfecting contact lens solutions. Method: Three popular disinfecting contact lens solutions readily available in South Africa were chosen. These and a control solution (saline) were prepared and inoculated with S. aureus to evaluate the antimicrobial efficacy of each solution. The primary stand-alone test was used to evaluate the solutions according to the ISO standard specifically for this purpose. Results: The test results indicated that two of the solutions met the ISO standards; the third failed. Of the two that passed the test, only one showed the required 3-log reduction after 30 minutes, as per the ISO standard, although this solution is marketed as a ’10 minute system’. Conclusion: It is important for clinicians to be aware of the complications that may be caused by contaminated solutions, and patients should be warned about the effects thereof. To ensure healthy eyes for our patients, sufficient knowledge regarding the efficacy of recommended multipurpose solutions is necessary. Solutions that meet ISO standards promote good ocular health and ensure sufficient cleaning and disinfecting of contact lenses

Preoperative education in hip and knee arthroplasty patients in Bloemfontein

Background: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are frequently performed surgeries worldwide. Preoperative education enhances patient physiotherapy management and satisfaction and should be tailored to patients’ educational needs. Limited research is available regarding the preoperative educational needs for these patients. Objectives: To determine the extent of preoperative education received and the preoperative educational needs of patients undergoing THA and TKA. Method: A structured interview utilising a self-developed questionnaire was used and included questions exploring preoperative education, educational needs, method of education and health care professional providing education. A total of 14 THA and 36 TKA patients, 2–4 days post-operatively at private hospitals in Bloemfontein, were conveniently sampled. Results: All participants had arthroplasties because of osteoarthritis. All participants with THA and 35 (98%) participants with TKA received preoperative education from orthopaedic surgeons, and 8 (57%) participants with THA and 9 (25%) participants with TKA received preoperative education from physiotherapists. Education was mostly given as pamphlets months before the surgery. Participants received the least amount of information regarding exercises, especially preoperative exercise, pain relief and activities of daily living. Conclusion: This study highlights the need for improvement in patient engagement and education, together with enhanced health care practitioner communication and collaboration. Patient centeredness and individualised THA and TKA preoperative education programmes are recognised as a necessary attribute of quality health care and can lead to improved THA and TKA outcomes. The importance of exercise as part of preoperative interprofessional education in the management of THA and TKA should be emphasised as exercise is the cornerstone for rehabilitation of THA and TKA. Clinical implications: This study aimed to emphasise the importance of tailored preoperative education for THA and TKA patients to improve patient outcomes

In memoriam Branko Cividini

Branko Cividini (Samobor, 13. lipnja 1953. - Zagreb, 5. svibnja 2017.