Introduction to Mentalization-Based Approaches for Parents, Children, Youths, and Families

Family members mentalize when they try to understand each other's behavior on the basis of intentional mental states. This article aims to introduce and briefly describe how the concept of mentalization can provide a useful framework for clinicians to understand psychopathology of children, youths, and families. The authors further outline how mentalization-based techniques and interventions can be applied to build epistemic trust and to reestablish mentalizing in families by presenting clinical vignettes of initial sessions from various clinical settings in the United Kingdom and Germany. The article concludes with a brief summary about the current evidence for mentalization-based interventions with children, adolescents, and families and provides an outlook for future clinical and research work

The peripartum management of a 32-year-old patient presenting at 34 weeks’ gestation with unrepaired cyanotic heart disease

CITATION: Rossouw, J. N., et al. 2018. The peripartum management of a 32-year-old patient presenting at 34 weeks’ gestation with unrepaired cyanotic heart disease. South African Journal of Obstetrics and Gynaecology, 24(2):36-39, doi:10.7196/sajog.1265.The original publication is available at http://www.sajog.org.zaENGLISH ABSTRACT: Unrepaired cyanotic heart disease is considered a high-risk lesion owing to the consequent increase in maternal and fetal complications. In the presence of pulmonary hypertension, maternal mortality approaching 50% has been reported, and pregnancy is therefore considered contraindicated. We present a case of a 32-year-old woman presenting at 34 weeks’ gestation in heart failure due to newly diagnosed cyanotic complex cardiac disease. The diagnosis of left atrial isomerism with a common atrium, single atrioventricular valve, and a restrictive ventricular septum defect was made. Cyanosis was due to mixing at atrial level, without features of Eisenmenger’s syndrome. Her intrapartum multidisciplinary management is described in detail. The patient was discharged home in a condition similar to her baseline, together with her healthy neonate.http://www.sajog.org.za/index.php/SAJOG/article/view/1265Publisher's versio

The effects of an L-methionine combination supplement on symptoms of upper respiratory tract infections and performance in ultramarathon runners before, during and after ultra-endurance exercise

Objective. To evaluate whether supplementation with an L-methionine combination would reduce the incidence of upper respiratory tract symptoms (URTS) and improve performance in ultramarathon runners. Design. A double-blind placebo-controlled study. Setting. Twenty-one ultramarathon runners (17 males, 4 females) preparing for participation in an 87.3 km ultramarathon. Interventions. L-methionine combination supplement (L-methionine, vitamin B6, vitamin B12, folic acid and magnesium) or placebo containing potato starch. Main outcome measures. Incidence of URTS was recorded during the runner's preparation for an ultramarathon race (75 days) and recovery from the same (75 days). CD4+, CD8+ cell counts and ratios were measured pre race, immediately post race and 75 days post race. VO2max and endurance fitness (percentage VO2max at 4 mmol-1 lactate concentration) were measured during the preparation for the race. Results. During the preparation period the incidence of URTS was 36% in the supplement group and 80% in the placebo group (p = 0.08). The incidence of URTS during the 3 weeks post race was 27% in the supplement group and 40% in the placebo group (p = 0.65). The CD4+/CD8+ cell ratios were not significantly different between groups. Endurance fitness prior to the race and race times were not significantly different. Conclusions. Although the findings of the current study show that an L-methionine combination supplement did not reduce the incidence of URTS or improve performance in ultramarathon runners, benefits may be found with a more detailed investigation using larger sample sizes and immunosuppressed athletes. South African Journal of Sports Medicine Vol.16(1) 2004: 10-1

Human brucellosis in South Africa: Public health and diagnostic pitfalls

Human brucellosis in South Africa (SA) is under-diagnosed and under-reported. This is because many clinicians have little or no experience in managing affected patients, and in part because of the nonspecific and insidious nature of the disease. A case of human brucellosis caused by Brucella melitensis in a patient from the Western Cape Province of SA is described, and the resulting exposure of staff members at two medical microbiology laboratories, as well as the public health investigation that was conducted, are discussed. The objective of this article is to highlight the need for strengthening integration between public health, medical and veterinary services and exposing deficiencies in public health, veterinary and laboratory practices

Investigating the influence of environment on the evolution of Hsp90 using comprehensive fitness maps [preprint]

Gene-environment interactions have long been theorized to influence molecular evolution. However, the environmental dependence of most mutations remains unknown. Using deep mutational scanning, we engineered budding yeast with all 44,604 single codon changes encoding 14,160 amino acid variants in Hsp90 and quantified growth effects under standard laboratory conditions and under five stress conditions (elevated temperature, nitrogen starvation, elevated salinity, high ethanol concentration, and oxidative stress caused by diamide). To our knowledge these are the largest comprehensive fitness maps of point mutant growth effects that have been determined. The growth effects of many variants differed between each of the conditions, indicating that environmental conditions can have a large impact on the evolution of Hsp90. Multiple variants provided growth advantages relative to wildtype Hsp90 under individual conditions, however these variants tended to exhibit growth defects in other environments. The diversity of Hsp90 sequences observed in extant eukaryotes preferentially contain amino acid variants that supported robust growth under all tested conditions. Thus, rather than favoring substitutions in individual conditions, the long-term selective pressure on Hsp90 may have been that of fluctuating environments, leading to robustness under a variety of conditions

Variable contribution identification and visualization in multivariate statistical process monitoring

CITATION: Rossouw, R. F.; Coetzer, R. L. J. & Le Roux, N. J. 2020. Variable contribution identification and visualization in multivariate statistical process monitoring. Chemometrics and Intelligent Laboratory Systems, 198. doi:10.1016/j.chemolab.2019.103894The original publication is available at https://www.sciencedirect.com/journal/chemometrics-and-intelligent-laboratory-systemsMultivariate statistical process monitoring (MSPM) has received book-length treatments and wide spread application in industry. In MSPM, multivariate data analysis techniques such as principal component analysis (PCA) are commonly employed to project the (possibly many) process variables onto a lower dimensional space where they are jointly monitored given a historical or specified reference set that is within statistical control. In this paper, PCA and biplots are employed together in an innovative way to develop an efficient multivariate process monitoring methodology for variable contribution identification and visualization. The methodology is applied to a commercial coal gasification production facility with multiple parallel production processes. More specifically, it is shown how the methodology is used to specify the optimal principal component combinations and biplot axes for visualization and interpretation of process performance, and for the identification of the critical variables responsible for performance deviations, which yielded direct benefits for the commercial production facility.https://www.sciencedirect.com/science/article/pii/S0169743919305088?via%3DihubPublishers versio

The development of water quality methods within ecological Reserve assessments, and links to environmental flows

In the South African National Water Act (NWA, No 36 of 1998), the eco-logical Reserve is defined as the quality and quantity of water required to ensure appropriate protection of water resources, so as to secure ecologically sustainable development and use. Aquatic ecosystems are recognised as the core location of water resources, and although con-siderable progress has been made in developing methods for quantify-ing environmental flow requirements, this paper describes and discuss-es the first agreed method for quantifying environmental water quality requirements in an ecological Reserve assessment. Integration of flow and water quality is emphasised, and is based on the philosophy that environmental flows should be motivated to provide ecologically im-portant flow-related habitat, or geomorphological function, but should not be motivated to solve water quality problems by dilution. Water qual-ity is multivariate, and not all variables can be considered in an ecologi-cal Reserve assessment, but core water quality variables include: sys-tem variables (salts, dissolved oxygen, turbidity, temperature), nutrients (phosphate, nitrite, nitrate) and toxic substances (those listed in the South African Water Quality Guidelines for Aquatic Ecosystems, includ-ing toxic metal ions, toxic organic substances, and/or substances from a chemical inventory of an effluent or discharge). In addition, biological indicator data (eg SASS data), chlorophyll-a (eg phytoplankton and pe-riphyton data) and toxicity test data may be used. For each variable, a concentration range or response is linked to a class within a water re-source classification system, where classes range from minimally to severely modified

Probable tacrolimus toxicity from tibolone co-administration in a woman: a case report

Introduction: Tibolone is a synthetic steroid, used with increasing frequency to treat symptoms of menopause, including patients with solid-organ transplants who are taking concurrent immune suppression. To the best of our knowledge, there are no reported drug interactions between tibolone and tacrolimus, one of the principal immune suppressants used in kidney transplantation. Case presentation: We report the case of a 49-year-old Caucasian woman who had received a kidney transplant and who developed acute kidney injury secondary to tacrolimus toxicity 10 days after starting tibolone therapy. No alternative causes were found. Tibolone is known to be a weak competitive inhibitor of CYP3A4, which is involved in tacrolimus metabolism. Conclusions: Despite a careful evaluation, no alternative reason was found for the acute kidney injury, and her kidney function returned to the previous baseline within several days of cessation of the medication, and with no other specific treatment. Using the Drug Interaction Probability Scale we conclude that she experienced a probable drug interaction. We believe that transplant clinicians should utilise frequent therapeutic drug monitoring of tacrolimus in patients starting or stopping tibolone therapy

Discipline in Education

This book addresses a perennial challenge to the success of the South African education system, namely, discipline. This volume steers the interrogation of discipline in a new direction, reflecting on ways in which recent research can benefit South African schools. This includes the need for alternative discipline that will enhance education. The scholarly contribution lies in its in-depth exploration of the relevance of research findings to South African schools and to the twenty-first-century socio-political environment. For the first time, scholarly interrogation of the issue of learner discipline in South African schools draws on indigenous knowledge systems. Its post-colonial and decolonial perspectives offer an ethical and moral compass for behaviour that could contribute to the well-being of South African society (and other societies similarly afflicted by anti-social behaviour). The book offers a range of perspectives on the debates on discipline and associated issues, and should stimulate future discussions on discipline and indiscipline at a time when South Africa and many other societies engage with the effects of social and political transformation. This scholarly book is aimed at academics and researchers. The contributors include philosophers, moralists, corporativists, education law specialists, curriculum specialists, specialists in education and culture, advocates of ubuntu, and people using meta-syntheses of approaches and practices and religious practices such as a Christian ethical/moral approach to parental and school discipline. They draw on their insights into postcolonialism, the impact of indigenous knowledge, theories of agency, dysfunctionality and school underperformance. The book offers an intriguing depiction of opposing views on discipline