In the stars

This is a book about the nature of reality and the illusions we embrace to smooth our paths through the vagaries of life in an uncertain world. It is about the dichotomies which exist in life and how our perceptions of life define our realities. It uses the stars, moon and sky as a tool to explore these differences by counterpoising the two main characters as having different views of the same subject. Thus Gabriel is an astronomer with a rational scientific approach to the universe while Lena, though brought up in a scientific tradition, has, through her experiences and personality, learnt to question this approach and developed a more aesthetic and mythological approach to the universe. While this is explored in the tensions between her and Gabriel, her own reality is questioned through her interaction with Kingston Ingovazana Mabilu. Although she is drawn to his philosophical views on life, in the end she has misgivings about the extremes to which these beliefs will eventually take her and is unable to commit to cultural beliefs which are so different from her own. The different perceptions are also explored in relation to ideas about health, medicine, causes of illness and their treatments. This brings into opposition the two prevalent paradigms in Southern Africa of the Western medical view and the alternative traditional view. The book tries to demonstrate how these are both valid with the characters showing justifications for their own points of view. Finally, the relationship between Lena and Gabriel focuses on the delicate fragility of relationships between people, in their attempts to understand each other, to communicate, to trust and to truly know each other. In the end, these challenges may be insurmountable. The themes of the book were inspired by the everyday dichotomies of life in Southern Africa; the different languages, religions and world views. It seemed important to explore issues of life and death, health and illness, particularly in a country where, less than a decade ago, the president of the country declared that HIV was not caused by a virus. The constructs of madness also warranted elucidation, as different cultures view these behaviours very differently. The second theme of astronomy versus mythology of the universe was inspired in part by Ben Okri in Starbook and The Famished Road, where magical realism opens up new ideas about the nature of reality in an African context. I also noted the tension between these ideas and the advanced technology of the Square Kilometre Array to be developed in South Africa. The book merely hints at the political past of South Africa but concentrates on the present paradigm of differing beliefs

Cardiac Depression Scale: Mokken scaling in heart failure patients

Background: There is a high prevalence of depression in patients with heart failure (HF) that is associated with worsening prognosis. The value of using a reliable and valid instrument to measure depression in this population is therefore essential. We validated the Cardiac Depression Scale (CDS) in heart failure patients using a model of ordinal unidimensional measurement known as Mokken scaling. Findings: We administered in face-to-face interviews the CDS to 603 patients with HF. Data were analysed using Mokken scale analysis. Items of the CDS formed a statistically significant unidimensional Mokken scale of low strength (H<0.40) and high reliability (Rho>0.8). Conclusions: The CDS has a hierarchy of items which can be interpreted in terms of the increasingly serious effects of depression occurring as a result of HF. Identifying an appropriate instrument to measure depression in patients with HF allows for early identification and better medical management. Keywords: Cardiac Depression Scale, Heart failure, Depression, Mokken scalin

Recommendations for amniocentesis in HIV-positive women

There is limited literature on the known risk of HIV transmission during amniocentesis. Before the introduction of highly active antiretroviral therapy (HAART), amniocentesis was avoided owing to the increased risk of HIV transmission. Recent literature suggests that it is safe to perform amniocentesis in women on HAART with undetectable viral loads. In South Africa (SA), many women access antenatal care late in pregnancy and there is often insufficient time to attain undetectable viral loads within a pre-viability period. Guidelines and recommendations for invasive testing in HIV-positive women in the SA setting are lacking. This article provides recommendations to healthcare practitioners who are faced with an HIV-positive patient requiring amniocentesis

Validation of the reasons for gambling questionnaire (RGQ) in a British population survey

Introduction. The aim of the study is to validate the five-dimensional structure of the Reasons for Gambling Questionnaire (RGQ) and to test the differences between different types of gamblers (i.e., offline gamblers who gambled in-person only vs.mixed-mode gamblers who gambled both online and offline) on the five dimensions of the RGQ. Methods. Data from the 2010 British Gambling Prevalence Survey (BGPS) were used. The analysed data comprised 5,677 individuals (52.7% female; mean age=47.64 years; SD=17.82). Confirmatory factor analysis and independent-samples t-tests were applied. Results. The five-dimensional structure of the RGQ wasconfirmed in the general sample and among gender and age subgroups. Furthermore, mixed-mode gamblers (MMGs) who gambled both online and offline had higher scores for enhancement, recreation and money motives than offline gamblers that gambled in-person only (IPGs). In addition among males, there was a significant difference in the scores for enhancement and recreation motives across MMGs and IPGs. Among past-year gamblers aged 16-34 years, MMGs had higher scores for enhancement, recreational and monetary motives than IPGs whilst among past-year gamblers aged 35-55years, MMGs had higher scores for enhancement and recreational motives than IPGs. Conclusions. The results are consistent with a previous test of the RGQ and the findings indicate that the RGQis a valid instrument to assess gambling motives among the general population

Recommendations for amniocentesis in HIV-positive women

There is limited literature on the known risk of HIV transmission during amniocentesis. Before the introduction of highly active antiretroviral therapy (HAART), amniocentesis was avoided owing to the increased risk of HIV transmission. Recent literature suggests that it is safe to perform amniocentesis in women on HAART with undetectable viral loads. In South Africa (SA), many women access antenatal care late in pregnancy and there is often insufficient time to attain undetectable viral loads within a pre-viability period. Guidelines and recommendations for invasive testing in HIV-positive women in the SA setting are lacking. This article provides recommendations to healthcare practitioners who are faced with an HIV-positive patient requiring amniocentesis

Geologic and Structural Evolution of the NE Lau Basin, Tonga: Morphotectonic Analysis and Classification of Structures Using Shallow Seismicity

The transition from subduction to transform motion along horizontal terminations of trenches is associated with tearing of the subducting slab and strike-slip tectonics in the overriding plate. One prominent example is the northern Tonga subduction zone, where abundant strike-slip faulting in the NE Lau back-arc basin is associated with transform motion along the northern plate boundary and asymmetric slab rollback. Here, we address the fundamental question: how does this subduction-transform motion influence the structural and magmatic evolution of the back-arc region? To answer this, we undertake the first comprehensive study of the geology and geodynamics of this region through analyses of morphotectonics (remote-predictive geologic mapping) and fault kinematics interpreted from ship-based multibeam bathymetry and Centroid-Moment Tensor data. Our results highlight two unique features of the NE Lau Basin: (1) the occurrence of widely distributed off-axis volcanism, in contrast to typical ridge-centered back-arc volcanism, and (2) fault kinematics dominated by shallow-crustal strike slip-faulting (rather than normal faulting) extending over ~120 km from the transform boundary. The orientations of these strike-slip faults are consistent with reactivation of earlier-formed normal faults in a sinistral megashear zone. Notably, two distinct sets of Riedel megashears are identified, indicating a recent counter-clockwise rotation of part of the stress field in the back-arc region closest to the arc. Importantly, these structures directly control the development of complex volcanic-compositional provinces, which are characterized by variably-oriented spreading centers, off-axis volcanic ridges, extensive lava flows, and point-source rear-arc volcanoes that sample a heterogenous mantle wedge, with sharp gradients and contrasts in composition and magmatic affinity. This study adds to our understanding of the geologic and structural evolution of modern backarc systems, including the association between subduction-transform motions and the siting and style of seafloor volcanism

Identifying children who are struggling in school

Abstract : Introduction : School-age children with motor coordination challenges typically require formal referral for occupational therapy services and often experience lengthy wait times for one-to-one intervention. In a new service delivery model called Partnering for Change, therapists work collaboratively with educators in classrooms to observe, identify, and support children. This study describes children identified through a traditional referral process and compares them with children identified by occupational therapists through classroom observation and dynamic performance analysis. Methods : Participants included 246 children enrolled in a 2-year evaluative study of the Partnering for Change service delivery. Parents completed a demographic questionnaire, the Developmental Coordination Disorder Questionnaire, and the Strengths and Difficulties Questionnaire. Children’s educators completed the Strengths and Difficulties Questionnaire and the School Function Assessment. Children completed the Movement Assessment Battery for Children. Results : Children identified were significantly younger and more likely to be girls than those referred under the traditional model. Using observation and dynamic performance analysis, occupational therapists identified children who had equally marked difficulties as those who came from the waitlist. In the Partnering for Change model, waitlists for service were eliminated for all children. Conclusions : Occupational therapists can identify children who are experiencing significant challenges participating at school without the need for standardized assessment, formal referrals, and waitlists