Parental Perspectives Regarding the Return of Genomic Findings in NeuroDevelopmental Disorders – A South African Study

Introduction: There is a lack of policies and research regarding the disclosure of results in genomic research, especially in South Africa. Challenges remain regarding the disclosure of genomic research results to research participants and their families, which may partly be addressed by considering parental and participants' preferences. This study serves as a sub-study to the NeuroDev study which is performing genotyping and exome sequencing on children with NeuroDevelopmental disorders in the Western Cape; and will investigate a feedback of findings method pertaining to the needs and preferences of the patient community. Aims: To investigate parents' understanding of the genomic research study they are participating in as well as their preferences regarding the feedback process and anticipated contributions of significant genetic findings generated by the NeuroDev study. This study further hopes to inform a tailored feedback policy reflecting the needs of this South African population. Research Design: A pragmatic qualitative approach was used by conducting 12 semi-structured interviews with 17 parents of children participating in the NeuroDev study. Purposive sampling was used, selecting retrospectively from patients recruited for the NeuroDev study in which findings of de novo, significant mutations are more likely expected. Interviews were conducted in English, in a private setting at Red Cross War Memorial Children's Hospital (RCWMCH), and were audio-recorded by the researcher; observations and field notes were documented. Generated data was analyzed using thematic analysis to generate themes and transcripts were imported into NVivo 12 to assist with managing and organizing the data for analysis. Ethical approval was been obtained from the University of Cape Town (UCT) (HREC 784/2018). Results: Empiric data collection ran from May to July 2019 and preliminary data was presented at the NeuroDev AGM and on a poster at the SASHG conference, RCWMCH research open day and UCT postgraduate research day. Findings were that the parents of the participants understood the study they were participating in as well as basic concepts of genetics, however, parental understanding over the cause of their child's condition remains a source of confusion when pertaining to their understanding of genetics being ‘passed down the family lineage' and how that integrates with de novo mutations. Furthermore, there is potential for it to impact on feelings of guilt. Parents have a need for information, discovering the cause of their child's condition and to be involved in the research process with full disclosure as events unfold. Altruism seems to be a major motivator for participating in genomics research but personal and family benefit also served to be a key driver in that research results could potentially provide awareness and information regarding their child's condition, the management thereof and recurrence risk in future. Participants in this study want pertinent research results which could offer closure, acceptance and relief, however, differences over the meaning of such results were observed between those whose child already had a diagnosis versus those whose child remained undiagnosed. Furthermore, receiving non-pertinent and negative result was still perceived to be meaningful for some. Further diversity was observed in parental preferences for the explanation of preliminary results. Discussion: Given that non-pertinent results still hold value for participants, consideration should be given as to more extensive ways of communicating this if such results are not to be returned since results are generally viewed as a point of access to information or relating to their child's condition. Diverse preferences regarding when and what participants want to know for results feedback needs to be addressed in order to facilitate a guidance framework for the delivery of genomic research results and can perhaps take the form of a tiered-consent model for feedback of incidental findings. As such, genetic counsellors may have a valuable role to play in facilitating participant satisfaction and bridging the gap between researchers and public expectations. Ethical considerations: Consent was taken before commencement of the study. There were no risks with regards to participating in this study and participants had the freedom to withdraw at any time and at their own discretion

Die voorsienigheidsleer van Calvyn: Uit sy debatte

Calvyn se leer van God se voorsienigheid is ongetwyfeld een van die mees kontroversiële onderwerpe van sy teologie. Dit word duidelik in al die debatte waarin Calvyn sy leer oor die voorsienigheid moes verdedig, byvoorbeeld teen Pighius, Bolsec, Bullinger en Castellio. Vyfhonderd jaar later word Calvyn weer in die openbaar oor sy voorsienigheidsleer aangeval deur ’n Suid-Afrikaanse teoloog, Adrio König. Calvyn se antwoord op Castellio in Die verborge voorsienigheid van God is duidelik nie deur König in ag geneem nie. In Calvyn se verdediging van sy voorsienigheidsleer verwerp hy nooit die soewereiniteit van God nie, maar gee ook nie vir God die skuld vir die kwaad nie – ’n beskuldiging wat Castellio en König teen Calvyn inbring. Die troos van God se voorsienigheid lê vir Calvyn juis daarin dat God alle dinge, ook teenspoed en verdrukking, deur sy verborge voorsienigheid beskik met die doel om sy kinders nader na Hom te lei.Calvin’s teaching on providence: From his debates. Calvin’s teaching on God’s providence is without doubt one of the most controversial subjects in his theology. This is clear in all the debates in which Calvin had to defend his teaching on providence, against, for example, Pighius, Bolsec, Bullinger and Castellio. Five hundred years later Calvin has again been publicly attacked on his teaching on providence by a South African theologian, Adrio König. König, however, did not consider Calvin’s response to Castellio in The secret providence of God. In Calvin’s defence of his teaching on providence he in no circumstances denies the sovereignty of God, but also does not give God the blame for any ills that might result – an accusation that Castellio and König levied against him. For Calvin, the consolation of God’s providence rests in the fact that God ordains all things, including adversity and affliction, through his secret providence for the purpose of leading his children closer to him

The Idea of a “For-Profit” Private Christian University in South Africa

The one-sided focus of Christian higher education in South Africa on the field of theology and the lack of integrating faith and learning in other subjects emphasizes the need for a Christian university in South Africa. The question addressed in this article is whether a Christian university can also be for-profit, considering the fact that all Christian private higher education institutions in South Africa are non-profit. There are numerous criticisms against for-profit higher education institutions. The greatest of these are that for-profit private higher education institutions miss the purpose of what it means to be a university and that profitable higher education institutions exploit students. The church also has numerous criticisms of the profit motive, but from the Bible it is clear that there are two lines of thought regarding profit. The one is that profit is dangerous and that it easily becomes an idol; the other is that people are called to be profitable. This article concludes that there is room for a for-profit Christian higher education institution in South Africa. This for-profit Christian higher education institution should be imagined in terms of its understanding of profit regarding its mission, students, faculty and governance.   https://doi.org/10.19108/KOERS.84.1.244

Microbial oxidation of dodecane and tridecane into a,w-dicarboxylic acids using recombinant Yarrowia lipolytica

Includes bibliographical references (leaves 137-150).a,w-Dicarboxylic acids are reactive intermediates, widely used as raw materials to synthesise products such as perfumes, hot-melting adhesives, engineering plastics and high quality lubricants. These acids can be obtained via chemical or biological routes by using various feedstocks such as linear alkanes. Linear alkanes are chemically inert; hence, the production of reactive products requires complex and sophisticated reactions catalysed by either catalysts or enzymes. However, simultaneous by-product formation on chemical synthesis increases production cost and limits commercial availability, preventing their widespread application. Biological routes alternatively, selectively transform linear alkanes into fatty and a,w-dicarboxylic acids. Linear alkanes, due to their relative abundance and increased availability, following the expansion of gas-to-liquid fuels technology, are viewed as prospective feedstocks for the microbial production of a,w-dicarboxylic acids. The commercialisation of the biological conversion of linear alkanes is constrained by the low turnover frequency of the cytochrome P450 hydroxylase complex responsible for catalysing the first and rate limiting step of the monoterminal and diterminal pathways. Low product yields may be caused by the further catabolism of a,w-dicarboxylic acids, through the ~-oxidation pathway into energy, carbon dioxide and water. To prevent this, metabolic engineering techniques can be applied to prevent ~-oxidation by disrupting the genes encoding the enzyme catalysing the first step in the~-oxidation pathway. The specific productivity of bioconversion can then be increased further by over-expressing the genes encoding the cytochrome P450 hydroxylase complex. Recombinant Yarrowia lipolytica strains TVN 497, TVN 499, TVN 501 and TVN 502 were developed in such a manner by the collaborating research group at the University of the Free State and made available for this research

Paediatric organophosphate poisoning - a rural hospital experience

Objectives. To document the presentation and course of organophosphate poisoning (OPP) in children  and to record the frequency of atropine toxicity during treatment.Design. A retrospective observational study was conducted of all recorded paediatric cases of OPP  admitted to a regional hospital over a 5-year period from 1 June 1996 to 31 May 2001.Setting. The study was conducted at Eben Donges Hospital, a regional hospital in the Boland/Overberg area of the Western Cape, where pesticide-intensive fruit farming remains the largest revenue generator.Subjects. The study included all children aged 12 years or less (as per health services classification) with confirmed OPP.Results. There were 23 patients. Most of the cases came from the De Dooms area (35%), with poisoning by ingestion accounting for 61% of cases. A distinct seasonal predominance was found that coincided with the summer harvest. Mode of presentation was variable and was not related to the initial  pseudocholinesterase level. Evidence of atropine toxicity occurred in 8 of the 18 cases treated with atropine. No statistically significant risk factor was found for atropine toxicity. The average duration of hospitalisation was 5,05 days, with 2 children requiring transfer to tertiary .facilities.Conclusions. The high number of referrals from a specific geographical area, combined with a 61%  accidental ingestion rate, illustrates an area where legislation has failed to limit unnecessary exposure. Awareness of the seasonal predominance could prove pivotal to the success of future preventive strategies. Initial presentation and serum pseudocholinesterase levels did not correlate with duration ofstay. The decision to transfer to a tertiary facility should only be explored once the patient has been stabilised with atropine. Atropine treatment is effective but carries a risk of toxicity. Glycopyrrolate may constitute an alternative treatment option

Talent management: An empirical study of selected South African hotel groups

This article sheds light on the use of talent-management practices insome of the major hotel groups in South Africa. Growing numbersof organisations globally as well as in South Africa are embracingthe concept of talent management, as it has a major impact on thecompany’s competitive advantage. Results reported in the 2008Travel & Tourism Competitive Report issued by the World EconomicForum (WEF 2008) indicate that as far as the Human Resourcesdimension of companies in this industry in South Africa is concerned,they fare fairly poorly. As this industry is people intensive, a closer investigation of this aspect was necessary. The research was undertaken in a subcomponent of the tourist accommodation industry, namely hotels. A cluster of 14 hotel groups, representing 33 995 hotel rooms (approximately 77% of all the hotel rooms in South Africa) participated in the survey. Despite the negative finding of the WEF, the results indicate that the hotel groups to a large extent apply the principles underlying talent management within their companies. However, some problem areas do exist, and recommendations are made in this regard

Resistance to change, work engagement and psychological capital of academics in an open distance learning work environment.

Orientation: In the present knowledge economy, the external environment is rapidly evolving and organisations are increasingly demanding much more from their employees. Psychological capital (PsyCap) and work engagement (WE), seen as positive human resource strengths and psychological capacities, can be developed and effectively managed for enhanced work performance. Employees’ resistance to change (RTC) is a key barrier to organisational change. Research purpose: To investigate the interrelationships between PsyCap, WE and RTC of open distance learning (ODL) academics. Motivation for the study: Little empirical research has investigated the application of positive work and organisational psychological functioning of ODL academics. Universities can use the study results to develop strategies which may enable institutions and individuals to flourish through positive well-being despite change. Research approach/design and method: A quantitative survey including a probability sample of 208 (N = 208) academics was utilised. Structural equation modelling was used to analyse the data. Main findings: The results reveal a meaningful positive relationship between the positive psychological constructs of PsyCap and WE, and a meaningful negative relationship between the psychodynamic construct RTC, and the positive psychological constructs of PsyCap and WE. Structural equation modelling indicated an adequate fit of conceptual structural model. Practical/managerial implications: Results suggest that reduced RTC and increased positive psychological behaviour could contribute to a positive organisation and individual well-being in a changing work environment. Contribution/value-add: This study adds to the body of knowledge and insights into positive work and organisational functioning of academics in a changing ODL work environment.Human Resource Managemen

The Employment Status of Magistrates in South Africa and the Concept of Judicial Independence

Protection in terms of labour law is primarily only available to persons with status as employees. In South Africa the courts have over the years developed different tests to establish who is an employee and therefore entitled to protection afforded by labour law. These tests have been incorporated into legislation. The Labour Relations Act 66 of 1995 provides for a definition and presumption of who is an employee. The Act further excludes certain categories of persons from its application and ambit. Although magistrates have not expressly been excluded from the application of the Act, it has been held that they are not employees, because such a categorisation would infringe upon the principle of judicial independence as guaranteed by the Constitution of the Repubblic of South Africa, 1996. The purpose of this paper is to evaluate whether magistrates could be categorised as employees in terms of the traditional tests of employment and still be able to maintain judicial independence as required by the South African Constitution.    &nbsp

Training and experience of doctors administering obstetric anaesthesia in the Free State Level 1 and 2 Hospitals

Background All the published Saving Mothers Reports generated by the National Committee of the Confidential Enquiries into MaternalDeaths in South Africa have associated anaesthesia-related maternal deaths with the lack of skills of the doctors administering the anaesthesia. The Reports have shown the Free State to be one of the provinces in South Africa with the highest rate of obstetric anaesthesia deaths. Therefore, the current study was performed to determine whether a deficiency exists in the training and experience of doctors administering obstetric anaesthesia. The identifying of such a deficiency would call for the implementation of remedial measures.Methods The study was performed in 2005 using questionnaires designed by the first two authors of this paper. All Level 1 and 2hospitals in the Free State performing Caesarean sections (CSs) were visited. The doctors administering obstetric anaesthesia were each asked to respond to a questionnaire. The questionnaires enquired about previous training and experience in anaesthesia and, more specifically, obstetric anaesthesia, as well as anaesthesia and nonanaesthesia qualifications. In addition, questions were asked regarding supervision, and whether other duties were performed while administering anaesthesia. Results The response rate was 69% (105/148 doctors). Of the respondents, 9.5% were interns, 24.7% community service doctors, 47.6% medical officers, 15.2% general practitioners (GPs) and 2.9% specialists. Twenty-three per cent of respondents had been in their present post for five years or more. Most doctors had received 4 weeks or less training in anaesthesia as an Intern, not including obstetric anaesthesia in 13 cases. Six doctors (GPs or medical officers) had been appointed in posts in which obstetric anaesthesia was required, without previously having administered obstetric anaesthesia. At the time of the survey, two doctors had never performed spinal anaesthesia and five had never administered general anaesthesia for CS, although all were regularly administering obstetric anaesthesia. Apart from the specialists, the Diploma in Anaesthesia was held by only one doctor, a medical officer. Half of the interns were not directly supervised while administering obstetric anaesthesia, while more than half the community service doctors were employed in hospitals where no senior support wasavailable. The doctors frequently had both to administer the anaesthetic and to perform neonatal resuscitation. Twelve ofthe doctors concerned had often also to perform the surgery itself. Most of the doctors requested further training in obstetricanaesthesia and improved senior anaesthetic assistance.Conclusions There is a lack of experience, training and supervision amongst doctors administering obstetric anaesthesia in the Free State.Doctors regularly have to perform other duties, whilst administering obstetric anaesthesia, which may put the mother atrisk from inadequate observation. These may be contributory factors to the high rate of maternal deaths from anaesthesia