In medias res: the diminishing of historical continuity in modern thought

Innovation and future predictions are discussed as the main goals of modern technology. Living in this empirical, modern world set on the future has the possibility of diminishing the value of historical continuity as observation and outcome-based theory take precedence over contemplation and tradition. It is proposed that the forgetfulness of modernity creates a stilted perception of time and thought which results in a dissonance between the perceiving subject and their surroundings. This is exacerbated by digital media as it mostly frames information as an attractive or trending source of amusement rather than as a possibility for edification. The result of this dissonance between the subject and their surroundings and the influence of digital media can be seen in the thoughtless or repetitive action and the abdication of action altogether in favour of escape from reality. This is problematised in as far constructive action for the well-being of the individual cannot be sustained in terms of the current engagement with digital technology.   Drawing on thinkers such as Connerton (1989, 2009), Davidson (2004), Habermas (1987, 1989), a discussion follows regarding how the diminishing historical continuity in thought can lead to the manipulation and a lack of rationality discussed in Horkheimer’s and Adorno’s culture industry thesis. To adopt the approach of continuity as embodied in the phrase in medias res(in the midst of things) in interpretation, rather than an observation assuming novel activity, may bring an alternative consideration for how modern technology (specifically the digital) can be used to assist the individual in taking contextual action rather than trying to escape action altogether while reframing the potential of digital technology towards a constructive, achievable standing rather than resigning it to a problematic system of distraction and degradation of thought. &nbsp

In medias res: the diminishing of historical continuity in modern thought

Innovation and future predictions are discussed as the main goals of modern technology. Living in this empirical, modern world set on the future has the possibility of diminishing the value of historical continuity as observation and outcome-based theory take precedence over contemplation and tradition. It is proposed that the forgetfulness of modernity creates a stilted perception of time and thought which results in a dissonance between the perceiving subject and their surroundings. This is exacerbated by digital media as it mostly frames information as an attractive or trending source of amusement rather than as a possibility for edification. The result of this dissonance between the subject and their surroundings and the influence of digital media can be seen in the thoughtless or repetitive action and the abdication of action altogether in favour of escape from reality. This is problematised in as far constructive action for the well-being of the individual cannot be sustained in terms of the current engagement with digital technology.   Drawing on thinkers such as Connerton (1989, 2009), Davidson (2004), Habermas (1987, 1989), a discussion follows regarding how the diminishing historical continuity in thought can lead to the manipulation and a lack of rationality discussed in Horkheimer’s and Adorno’s culture industry thesis. To adopt the approach of continuity as embodied in the phrase in medias res(in the midst of things) in interpretation, rather than an observation assuming novel activity, may bring an alternative consideration for how modern technology (specifically the digital) can be used to assist the individual in taking contextual action rather than trying to escape action altogether while reframing the potential of digital technology towards a constructive, achievable standing rather than resigning it to a problematic system of distraction and degradation of thought.

Adherence in twice weekly therapy for childhood tuberculosis

AIM: This thesis examines the adherence to therapy as part of a clinical trial to determine the effectiveness of fully intermittent therapy for childhood tuberculosis. OBJECTIVES: These were to determine 1) the effectiveness of fully twice weekly therapy in childhood pulmonary tuberculosis, 2) whether adherence rates would be affected by twice weekly dosing and 3) whether certain socio-demographic factors influenced adherence

The 'DOP' system around Stellenbosch - results of a farm survey

No Abstrac

Planning for emergency services using GIS-based geographic accessibility analysis

Municipalities and metropolitan structures are required by law to provide sufficient response to emergency situations. In order to respond efficiently to disasters such as fire and flooding, it is necessary to place facilities optimally. This case study presents and applies a methodology to determine the locations of additional fire stations, using accessibility analysis rather than incident data which is often incomplete or unavailable. The required response time is based on the SANS 10090:2003 standard for various risks. The case study recommends that in the longer term seven additional fire stations are needed in conjunction with the existing 19 fire stations in the eThekwini Metro in South Africa to offer a response to fire incidents as required by the standard.&nbsp

Outcomes of ventriculoperitoneal shunt insertion in the management of idiopathic intracranial hypertension in children

Purpose The ventriculoperitoneal (VP) shunt has become the procedure of choice for treatment of idiopathic intracranial hypertension (IIH). We aimed to assess the efficacy of frameless stereotactic placement of VP shunts for the management of medically resistant IIH in children and to assess the role of gender and obesity in the aetiology of the condition. Methods This is a retrospective analysis of the case notes of 10 patients treated surgically at the University Hospital of Wales in Cardiff, from May 2006 to September 2012. Results VP shunts were successful in relieving headache, papilloedema and stabilising vision. No sex predilection was identified, and increased BMI was a feature throughout the population, regardless of age. Conclusions Neuronavigated VP shunt insertion is an effective mode of treatment for medically resistant IIH in children. The aetiological picture in children does not seem to be dominated by obesity, as in adults. Literature on childhood IIH is sparse, and larger scale, comparative studies would be of benefit to treating clinicians

Smoking cessation for improving mental health

Background: There is a common perception that smoking generally helps people to manage stress, and may be a form of 'self‐medication' in people with mental health conditions. However, there are biologically plausible reasons why smoking may worsen mental health through neuroadaptations arising from chronic smoking, leading to frequent nicotine withdrawal symptoms (e.g. anxiety, depression, irritability), in which case smoking cessation may help to improve rather than worsen mental health. Objectives: To examine the association between tobacco smoking cessation and change in mental health. Search Methods: We searched the Cochrane Tobacco Addiction Group's Specialised Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, and the trial registries clinicaltrials.gov and the International Clinical Trials Registry Platform, from 14 April 2012 to 07 January 2020. These were updated searches of a previously‐conducted non‐Cochrane review where searches were conducted from database inception to 13 April 2012. Selection Criteria: We included controlled before‐after studies, including randomised controlled trials (RCTs) analysed by smoking status at follow‐up, and longitudinal cohort studies. In order to be eligible for inclusion studies had to recruit adults who smoked tobacco, and assess whether they quit or continued smoking during the study. They also had to measure a mental health outcome at baseline and at least six weeks later. Data Collection and Analysis: We followed standard Cochrane methods for screening and data extraction. Our primary outcomes were change in depression symptoms, anxiety symptoms or mixed anxiety and depression symptoms between baseline and follow‐up. Secondary outcomes included change in symptoms of stress, psychological quality of life, positive affect, and social impact or social quality of life, as well as new incidence of depression, anxiety, or mixed anxiety and depression disorders. We assessed the risk of bias for the primary outcomes using a modified ROBINS‐I tool. For change in mental health outcomes, we calculated the pooled standardised mean difference (SMD) and 95% confidence interval (95% CI) for the difference in change in mental health from baseline to follow‐up between those who had quit smoking and those who had continued to smoke. For the incidence of psychological disorders, we calculated odds ratios (ORs) and 95% CIs. For all meta‐analyses we used a generic inverse variance random‐effects model and quantified statistical heterogeneity using I2. We conducted subgroup analyses to investigate any differences in associations between sub‐populations, i.e. unselected people with mental illness, people with physical chronic diseases. We assessed the certainty of evidence for our primary outcomes (depression, anxiety, and mixed depression and anxiety) and our secondary social impact outcome using the eight GRADE considerations relevant to non‐randomised studies (risk of bias, inconsistency, imprecision, indirectness, publication bias, magnitude of the effect, the influence of all plausible residual confounding, the presence of a dose‐response gradient). Main Results: We included 102 studies representing over 169,500 participants. Sixty‐two of these were identified in the updated search for this review and 40 were included in the original version of the review. Sixty‐three studies provided data on change in mental health, 10 were included in meta‐analyses of incidence of mental health disorders, and 31 were synthesised narratively. For all primary outcomes, smoking cessation was associated with an improvement in mental health symptoms compared with continuing to smoke: anxiety symptoms (SMD −0.28, 95% CI −0.43 to −0.13; 15 studies, 3141 participants; I2 = 69%; low‐certainty evidence); depression symptoms: (SMD −0.30, 95% CI −0.39 to −0.21; 34 studies, 7156 participants; I2 = 69%' very low‐certainty evidence); mixed anxiety and depression symptoms (SMD −0.31, 95% CI −0.40 to −0.22; 8 studies, 2829 participants; I2 = 0%; moderate certainty evidence). These findings were robust to preplanned sensitivity analyses, and subgroup analysis generally did not produce evidence of differences in the effect size among subpopulations or based on methodological characteristics. All studies were deemed to be at serious risk of bias due to possible time‐varying confounding, and three studies measuring depression symptoms were judged to be at critical risk of bias overall. There was also some evidence of funnel plot asymmetry. For these reasons, we rated our certainty in the estimates for anxiety as low, for depression as very low, and for mixed anxiety and depression as moderate. For the secondary outcomes, smoking cessation was associated with an improvement in symptoms of stress (SMD −0.19, 95% CI −0.34 to −0.04; 4 studies, 1792 participants; I2 = 50%), positive affect (SMD 0.22, 95% CI 0.11 to 0.33; 13 studies, 4880 participants; I2 = 75%), and psychological quality of life (SMD 0.11, 95% CI 0.06 to 0.16; 19 studies, 18,034 participants; I2 = 42%). There was also evidence that smoking cessation was not associated with a reduction in social quality of life, with the confidence interval incorporating the possibility of a small improvement (SMD 0.03, 95% CI 0.00 to 0.06; 9 studies, 14,673 participants; I2 = 0%). The incidence of new mixed anxiety and depression was lower in people who stopped smoking compared with those who continued (OR 0.76, 95% CI 0.66 to 0.86; 3 studies, 8685 participants; I2 = 57%), as was the incidence of anxiety disorder (OR 0.61, 95% CI 0.34 to 1.12; 2 studies, 2293 participants; I2 = 46%). We deemed it inappropriate to present a pooled estimate for the incidence of new cases of clinical depression, as there was high statistical heterogeneity (I2 = 87%). Authors' Conclusions: Taken together, these data provide evidence that mental health does not worsen as a result of quitting smoking, and very low‐ to moderate‐certainty evidence that smoking cessation is associated with small to moderate improvements in mental health. These improvements are seen in both unselected samples and in subpopulations, including people diagnosed with mental health conditions. Additional studies that use more advanced methods to overcome time‐varying confounding would strengthen the evidence in this area.</p

Lazarus Syndrome - Challenges created by pediatric autoresuscitation

Pediatric autoresuscitation is extremely rare, with only 4 documented cases in the literature. The longest recorded time between stopping cardio pulmonary resuscitation (CPR) and return of spontaneous circulation is 2 minutes. We report a previously well 18-month-old who attended the emergency department after an unexplained cardiac arrest. After 10 cycles of CPR, resuscitation was stopped; 6 minutes later, the patient had a return of spontaneous circulation and was transferred to the pediatric intensive care unit. The patient remains alive but with significant neurological impairment. There are a variety of theories regarding the pathology of pediatric autoresuscitation. The most commonly accepted model is that there is a degree of autopositive end-expiratory pressure impending venous return as a consequence of vigorous ventilation during CPR. This case challenges clinicians to reassess our current definition of death and reaffirms the need for clearer guidelines surrounding the certification of death

Surgical management of raised intracranial pressure secondary to otogenic infection and venous sinus thrombosis

Purpose This study reviews paediatric patients with raised intracranial pressure as a result of venous sinus thrombosis secondary to otogenic mastoiditis, requiring admission to the paediatric neuroscience centre at the University Hospital Wales, Cardiff. The consensus regarding the management of otogenic hydrocephalus in the published literature is inconsistent, with a trend towards conservative over surgical management. We reviewed our management of this condition over a 9-year period especially with regard to ventriculo-peritoneal (VP) shunting. Methods Analysis of a prospectively collected database of paediatric surgical patients was analysed and patients diagnosed with otogenic hydrocephalus from November 2010 to August 2018 were identified. Our data was compared with the published literature on this condition. Results Eleven children, 7 males and 4 females, were diagnosed with otogenic hydrocephalus over the 9-year period. Five (45.5%) required VP shunt insertion to manage their intracranial pressure and protect their vision. The remaining six patients (54.5%) were managed medically. Conclusions When children with mastoiditis and venous sinus thrombosis progress to having symptoms or signs of raised intracranial pressure, they should ideally be managed within a neuroscience centre. Of those children, almost half will need permanent cerebrospinal fluid diversion to protect their sight