The clinical utility and cost effectiveness of routine thyroid screening in adult psychiatric patients presenting at Stikland Hospital, Cape Town, South Africa

Objective: The use of thyroid tests to assess psychiatric patients remains debatable. Therefore, this study was conducted to examine the utility and cost effectiveness of the current protocol used in thyroid testing in adult psychiatric patients presenting at Stikland Hospital, Cape Town, South Africa. Method: This was a retrospective chart review conducted at Stikland Hospital between 1 January 2000 and 31 December 2005. The following data was recorded: demographic variables, clinical diagnoses at admission and discharge, number of days from admission to a thyroid test request, the reason for thyroid screening, number of thyroid tests, their yield and costs involved, as well as the action taken following an abnormal thyroid test result. Results: The mean age of patients (n = 1080: n = 364 male, n = 716 female) was 42.8 years (SD ±16.6). Pre-existing thyroid disease was documented in 70 (6%) of patients. Normal Thyroid Stimulating Hormone (TSH) test results significantly (p = 0.0001) increased, whilst abnormal TSH test results significantly (p = 0.0001) decreased from baseline to follow-up. Except for gender, the outcome of TSH screening was independent of demographic and clinical diagnoses. Only 16% of TSH tests yielded clinically significant results. Conclusion: The findings of this study do not support the early, routine screening for thyroid dysfunction in psychiatric patients at this facility. It is possible that thyroid screening may present with transient abnormalities of no particular clinical significance, and would therefore not be a cost effective practice.Keywords: Psychiatry; Screening; Thyroid abnormality; Thyroid stimulating hormon

Exchange biased anomalous Hall effect driven by frustration in a magnetic kagome lattice.

Co[Formula: see text]Sn[Formula: see text]S[Formula: see text] is a ferromagnetic Weyl semimetal that has been the subject of intense scientific interest due to its large anomalous Hall effect. We show that the coupling of this material's topological properties to its magnetic texture leads to a strongly exchange biased anomalous Hall effect. We argue that this is likely caused by the coexistence of ferromagnetism and geometric frustration intrinsic to the kagome network of magnetic ions, giving rise to spin-glass behavior and an exchange bias

The Intertwined Successional Development of the Lamb Gut Microbiota And Immune System (Poster)

Gastrointestinal tract (GIT) microbes play critical roles in host nutrition, health and immunological development. For adult ruminants, GIT-dwelling microbes provide ~70% of daily energy requirements. The GIT also houses 70 % of the animal’s immune system in the form of the Gut-associated Lymphatic Tissue (GALT), which houses 80% of all plasma cells and depends on microbial stimulation for maturation. Because nutrition and disease are two major factors in the economic sustainability of livestock production, our group set out to characterize the successional development of GIT microbiota and immune activity. Blood and GIT samples were collected from lambs immediately at birth through one-year of age, and from the dam’s vagina, mouth, and rectum at parturition. Blood samples were profiled for serum titers of IgM, IgA and IgG, while microbiota were profiled in GIT samples by 16S rRNA gene sequencing. Lamb GIT microbiota initially resembled the dam’s vaginal microbiota but following exposure to the dam, became rapidly more similar to the dam’s teat. GIT samples eventually formed stable climax communities similar to the dams around 180 days of age. This corresponded to the peak serum titers for each immunoglobin, which, aside from a peak in IgG at birth (likely colostral transfer), had gradually increased prior to this time. Immunoglobins peaked and then return to a sub peak level between 180 and 365 days. These results indicate dam vaginal microbiota have a short-lived impact on the neonatal microbiota, with the GIT microbiota going through a dynamic successional development to 180 d when immune function appears to peak

The Paranormal is (Still) Normal: The Sociological Implications of a Survey of Paranormal Experiences in Great Britain

Historically, there has been limited sociological interest in the paranormal and no systematic study of reported paranormal experiences. There are also few medium-to-large-scale survey results with nationally representative populations focusing on paranormal experiences. This paper provides details of an exploratory survey conducted in 2009 with a nationally representative sample of 4,096 adults aged 16 years and over across Great Britain. Our findings show that 37% of British adults report at least one paranormal experience and that women, those who are middle-aged or individuals resident in the South West are more likely to report such experiences. These results establish incidence levels of reported paranormal experiences in contemporary Britain. We argue also that they merit a more sustained sociological consideration of the paranormal. In this respect we renew and update the robust justification and call for serious research positioning the paranormal as a social phenomenon, originally proposed well over thirty years ago by Greeley (1975)

The Shared Pleasure Paradigm: A study in an observational birth cohort in South Africa

Mother–infant dyads in low- and middle-income countries (LMICs) may be exposed to a range of factors associated with suboptimal development. Optimal infant development is likely supported by synchronicity in the early mother–infant relationship, but limited corroborative research is available in LMICs. The Drakenstein Child Health Study (DCHS) provided an opportunity to study this synchronicity and its associations in South Africa. A South African birth cohort study investigating early-life determinants of child health in a LMIC context provided participants. The Shared Pleasure (SP) paradigm helped assess early mother–infant synchronicity in videos of a sub-set of 291 mother–infant dyads at their 14-week well baby visit. General linear regression models investigated the relationship between selected maternal and infant characteristics and the presence of Shared Pleasure moments. Out of a possible 291 dyads, 82% (n=239) yielded Shared Pleasure moments. The mean age of mothers was 27 years, while infant sex distribution comprised 54% females and 46% males. The shortest single Shared Pleasure moment lasted at least 0.5 s and the longest 28 s. Shared Pleasure moments were associated with higher gestation age at delivery (p=0.008) and higher infant birth weight (p=0.006), but were not related to mother's mental health and infant health outcomes at 14 weeks. The high frequency of positive Shared Pleasure moments in reciprocal dyadic interactions in this sample suggests that signifcant disruption in shared pleasure may be present only in extreme cases (e.g. mothers with severe mental disorders). Further work is needed to investigate the mechanisms underlying the associations between early mother–infant synchronicity and better

Missed opportunities for measles immunisation in selected western Cape hosl?itals

Measles is still a major cause of childhood mortality and morbidity in South Africa. The World Health Organisation (WHO) has recently recommended that greater a"ention be paid to opportunities for immunisation in the curative sector. This study quantified the extent of missed opportunities for measles immunisation in children a"ending primary, secondary and tertiary level curative hospitals in the western Cape. Exit interviews of 1 068 carers of children aged between 6 and 59 months inclusive showed that 2,4 - 40,7% of carers had been requested to produce a Road-to-Health card, and that 4,8 - 43,1% of carers had a card available. The proportion of children with documented evidence of measles immunisation available ranged from 4,8% to 40,0% between facilities. The study demonstrated that a considerable number of potential opportunities to immunise children against measles are currently being missed in children a"ending hospitals and day hospitals in the western Cape. The study documents the effect of a fragmented approach to health care, and'indicates a need for rapid integration of preventive and curative components of health care into a metropolitan-based primary health care service

Increasing Short-Stay Unplanned Hospital Admissions among Children in England; Time Trends Analysis '97-'06

BACKGROUND: Timely care by general practitioners in the community keeps children out of hospital and provides better continuity of care. Yet in the UK, access to primary care has diminished since 2004 when changes in general practitioners' contracts enabled them to 'opt out' of providing out-of-hours care and since then unplanned pediatric hospital admission rates have escalated, particularly through emergency departments. We hypothesised that any increase in isolated short stay admissions for childhood illness might reflect failure to manage these cases in the community over a 10 year period spanning these changes. METHODS AND FINDINGS: We conducted a population based time trends study of major causes of hospital admission in children 2 days. By 2006, 67.3% of all unplanned admissions were isolated short stays <2 days. The increases in admission rates were greater for common non-infectious than infectious causes of admissions. CONCLUSIONS: Short stay unplanned hospital admission rates in young children in England have increased substantially in recent years and are not accounted for by reductions in length of in-hospital stay. The majority are isolated short stay admissions for minor illness episodes that could be better managed by primary care in the community and may be evidence of a failure of primary care services