Sudden and unexpected childhood deaths investigated at the Pretoria Medico-Legal Laboratory, South Africa, 2007 - 2011

Background. Sudden and unexpected death is well known to occur in infants, and although sudden deaths are less frequent after the first birthday, they still account for a significant proportion of childhood deaths. In 2009, 1.9% of the total deaths in the USA were childhood deaths. In South Africa (SA) this proportion was much higher at 11.85%. According to the law, sudden and unexpected deaths are generally investigated as unnatural deaths. Establishing an exact underlying anatomical cause of death will depend on available resources and can be difficult in a substantial proportion of cases.Methods. A retrospective descriptive case audit was conducted at the Pretoria Medico-Legal Laboratory (PMLL), SA, from 1 January 2007 through to 31 December 2011. All children aged 1 - 18 years who died suddenly and unexpectedly were included.Results. Ninety-eight cases were identified, which constituted nearly 1% of total admissions to the PMLL. The majority of the deaths were of children aged 1 - 5 years, and the male/female ratio was 1.04:1. In the largest proportion of cases (n=28, 28.6%), the medicolegal investigation, including autopsy and ancillary investigations, did not establish an underlying anatomical cause of death. In the cases where a cause of death was established, pneumonia was the most common diagnosis (n=22, 22.4%).Conclusions. The fact that the cause of the largest proportion of deaths could not be ascertained emphasises the need for consideration of additional investigative techniques, such as molecular/genetic screening, which have provided an underlying cause of death in a significant number of cases in other countries. There is a lack of published research on the causes and incidence of sudden unexpected deaths in children in SA, and further research in this area is needed

Workgroup Report: Base Stations and Wireless Networks—Radiofrequency (RF) Exposures and Health Consequences

Radiofrequency (RF) waves have long been used for different types of information exchange via the airwaves—wireless Morse code, radio, television, and wireless telephony (i.e., construction and operation of telephones or telephonic systems). Increasingly larger numbers of people rely on mobile telephone technology, and health concerns about the associated RF exposure have been raised, particularly because the mobile phone handset operates in close proximity to the human body, and also because large numbers of base station antennas are required to provide widespread availability of service to large populations. The World Health Organization convened an expert workshop to discuss the current state of cellular-telephone health issues, and this article brings together several of the key points that were addressed. The possibility of RF health effects has been investigated in epidemiology studies of cellular telephone users and workers in RF occupations, in experiments with animals exposed to cell-phone RF, and via biophysical consideration of cell-phone RF electric-field intensity and the effect of RF modulation schemes. As summarized here, these separate avenues of scientific investigation provide little support for adverse health effects arising from RF exposure at levels below current international standards. Moreover, radio and television broadcast waves have exposed populations to RF for > 50 years with little evidence of deleterious health consequences. Despite unavoidable uncertainty, current scientific data are consistent with the conclusion that public exposures to permissible RF levels from mobile telephony and base stations are not likely to adversely affect human health

Seksuele teistering in die werkplek: ’n Suid-Afrikaanse perspektief

Sexual harassment in the workplace is a grave problem and it significantly impedes on a person’s entrance into many sectors of the wage labour market. The number of sexual harassment complaints increases dramatically every year, although researchers estimate that 80 to 90% of sexual harassment cases go unreported. Despite the high figures, few South African court cases and legal literature deal with sexual harassment. The reason for this is that few persons who are harassed report a case for fear that they will lose their jobs or that they will become sources of ridicule.Sexual harassment is an infringement upon a person’s personality and thus an iniurandi. The South African Constitution determines that there shall not be discriminated against any person and that includes a person’s right to work without harassment and discrimination. It is therefore necessary that all employers ensure a safe environment without discrimination for all employees. Employers must adopt a policy on sexual harassment, communicate it to all employees and ensure that the policy be adhered to. If harassment does take place, the procedure and disciplinary process prescribed in the policy must be enforced

Evaluation of views and perceptions of junior doctors on urology training and exposure during internship in South Africa: are we losing future urologists?

CITATION: Silolo, S. Van Deventer, H. Van Der Merwe, A. 2020. Evaluation of views and perceptions of junior doctors on urology training and exposure during internship in South Africa: are we losing future urologists?. South African Journal of Surgery. Volume 58 (4): 219-219, doi:10.17159/2078-5151/2020/v58n4a3221The original publication is available at:http://www.scielo.org.zaBACKGROUND: In South Africa, urological and other subspecialty training and exposure vary across each university at undergraduate and internship level. Many students and junior doctors complete their degrees and medical internship with little or no exposure and training to enable them to manage common urological conditions at primary healthcare level with the adequate competency, proficiency and confidence. We aimed to evaluate the exposure and urological training ofjunior doctors during internship and to determine whether it had any impact on their attitudes toward urology as a speciality in which to pursue a career. METHODS: We used a descriptive cross-sectional survey design. We emailed a questionnaire to 200 community service doctors who completed internship during 2016-2018, working across Western Cape hospitals. The questionnaire aimed to assess their clinical exposure to urology, confidence in basic urological knowledge and clinical skills, and their attitudes toward urology as a postgraduate career choice. RESULTS: The response rate was 104/200 (52%), 75% (n = 78) of the respondents had completed their internship without rotating through the urology department, 53.8% (n = 56) felt that their knowledge of essential urology topics was 'average' and still required further teaching and guidance, and 43.3% (n = 45) were not confident of performing a circumcision. 11.5% (n = 12) respondents were interested in pursuing a career in urology. The duration of the rotation through urology during internship and pursuing a career in urology were significantly associated (p = 0.005). CONCLUSION: The study showed that urological exposure and training at internship level is below the standard it needs to be in order to produce proficient and competent doctors able to practise efficiently during community service. The study also highlighted that limited exposure has a negative impact on potential future urologists wanting to pursue a career in the field. Incorporation of necessary urology skills short courses into the internship programme might help mitigate some ofPublisher's versio

The role of phosphatidylinositide-3-kinase in basal mitogen-activated protein kinase activity and cell survival

AbstractPhosphatidylinositide-3-OH-kinase (PI 3-kinase) is an upstream activator of p42/p44 mitogen-activated protein kinase (MAPK), but the role of PI 3-kinase-dependent MAPK remains obscure. Here we demonstrate that in a variety of different cell types, PI 3-kinase inhibition results in an inhibition of MAPK in unstimulated cells but does not interfere with growth factor-, or TPA-induced MAPK activity. Furthermore, inhibition of either PI 3-kinase or MEK/MAPK results in cell death in serum-starved cells. We concluded that basal, but not induced MAPK activity is mediated by PI 3-kinase and that this PI 3-kinase-mediated MEK/MAPK activity is essential for cell survival in quiescent cells

Evaluation of the SUNHEART Cardiology Outreach Programme

Introduction: The demand for advanced cardiac care and specialised interventions is on the increase and this results in bottlenecks and increased waiting times for patients who require advanced cardiac care. By decentralising cardiac care, and using a hub-and-spoke model, the SUNHEART Outreach Programme of cardiovascular care aims to improve access to advanced cardiac care in the Western Cape. Tygerberg Hospital is the central hub, with the fi rst spoke being Paarl Hospital. Objective: To determine the value of the SUNHEART Outreach Programme to the public health care system. Methods: An audit of patients accessing the OutreachProgramme was performed for the period May 2013 - May 2014 and consequently compared to a historical cohort of patients accessing the health care system during the preceding 6 months, from October 2012 -April 2013. Access to advanced cardiac care was measured in time to initial evaluation, time to defi nitive diagnosis or intervention and patient compliance with appointments. The value to the health care system was also assessed by performing a cost analysis of transport of patients and health care workers, as well as compliance with appointments. We documented the spectrum of disease requiring advanced cardiac care toguide future interventions. Results: Data of 185 patients were included in the audit. Sixty four patients were referred to tertiary care from October 2012 - April 2013 and 121 patients were referred to the outreach facility from May 2013 - May 2014. There was a signifi cant reduction in waiting times with the median days to appointment of the historical cohort being 85 days compared to 18 days in the Outreach Programme cohort (p<0.01). Patient compliance with appointments was signifi cantly superior in the Outreach Programme cohort (90% vs. 56%: p<0.01). Valvular (36.5%) and ischaemic heart disease (35.5%) were the major pathologies requiring access to cardiac care services. Transport costs per patient treated was signifi cantly reduced in the outreach programme cohort (R118,09 vs. R308,77). Conclusion: Decentralisation of services in the form of an Outreach Programme, with a central hub, improves access to advanced cardiac care by decreasing waiting time, improving compliance with appointments and decreasing travel costs

Bruikbaarheid van non-destructieve detectietechnologieën voor routinematige inspecties

Routinematige inspecties binnen het fytosanitaire domein vinden doorgaans plaats door middel van steekproefsgewijze visuele inspecties van de producten. Hierbij wordt gelet op de symptomen en/of aanwezigheid van schadelijke organismen. De vraag is, of er geen sneller, goedkoop èn betrouwbaar alternatief is. De onderzochte technologieën zijn onderverdeeld in: detectie van beeld; detectie van geur; detectie van geluid. Een tweede fase heeft het doel gehad de potentie, haalbaarheid en beperkingen van een deze detectietechnieken voor routinematige inspecties in beeld te brengen, ondersteund door experimentele gegevens en hands-on ervaringen