bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Colorectal Anastomotic Leakage: Results of a Questionnaire amongst Members of the Dutch Society of Gastrointestinal Surgery
Authors: Daams F. , Slieker J.C. , Tedja A. , Karsten T.M. , Lange J.F.
Published: March 2013

Anastomotic leakage after colorectal surgery is correlated with considerable morbidity and mortality. Although many studies focus on risk factors and detection, studies on the treatment strategy for colorectal anastomotic leakage are scarce. A national questionnaire amongst 350 members of the Dutch Society for Gastrointestinal Surgery was undertaken on the current treatment of colorectal anastomotic leakage. The response was 40% after two anonymous rounds. 27% of the respondents state that a leaking anastomosis above the level of the promontory should be salvaged in ASA 1-2 patients <80 years of age, for ASA 3 and/or >80 years of age this percentage is 7.3%. For an anastomosis under the promontory, 50% of the respondents choose preserving the anastomosis for ASA 1-2 compared to 17% for ASA 3 and/or >80 years of age. In ASA 1-2 patients with a local abscess after a rectum resection without protective ileostomy, 31% of the respondents will create an protective ileostomy, 40% break down the anastomosis to create a definite colostomy, in ASA 3 and/or >80 years of age 14% of the respondents create a protective ileostomy and 63% a definitive colostomy. In ASA 1-2 patients with peritonitis after a rectum resection with deviating ileostomy, 31% prefer a laparotomy for lavage and repair of the anastomosis, 25% for lavage without repair and 36% of the respondents prefer to break down the anastomosis. When the patient is ASA 3 and/or >80 years of age, 13% prefer repair, 9% a lavage and 74% breaking down the anastomosis. This questionnaire shows that in contrast to older people, more surgeons make an effort to preserve the anastomosis in younger people.
Agreement between Spirometers: A Challenge in the Follow-Up of Patients and Populations?
Authors: Gerbase M.W. , Dupuis-Lozeron E. , Schindler C. , Keidel D. , Bridevaux P.O. , Kriemler S. , Probst-Hensch N.M. , Rochat T. , Künzli N.
Published: March 2013

Background: Long-term cohort studies and lung function laboratories are confronted with the need for replacement of spirometers. Lack of agreement between spirometers might affect the longitudinal comparison of data, notably when replacing conventional by portable spirometers. Objectives: To compare the handheld EasyOne (EO) with the conventional SensorMedics (SM) spirometer, and to analyze the interdevice reproducibility of EO spirometers. Methods: In total, 82 volunteers completed spirometry sessions with 1 SM and 2 of 3 EO spirometers following a Latin square design. Analyses of differences in forced vital capacity (FVC), forced expiratory flow in 1 s (FEV1), FEV1/FVC and mean forced expiratory flow calculated between 25 and 75% of the FVC between spirometers used a mixed effect model with a random intercept for each subject and the effect of the device as fixed effect adjusted for sex, age, height and order of spirometer tested. Bland-Altman plots show the 95% limits of agreement. Results: Comparisons between EO and SM showed relatively small mean differences of <3%, but systematically lower values for FVC and FEV1 in all EO devices. The 95% agreement exceeded the limits for FEV1 by 50 ml in 2 EO spirometers. The EO interdevice comparisons showed mean differences and limits of agreement within established thresholds, thus indicating fair accuracy when comparing devices. Repeats with the same spirometer did not result in statistically significant differences. Conclusions: This study suggests fair agreement between the handheld and the conventional spirometer. Differences slightly exceeding limits for FEV1 in 2 EO devices might be considered mostly irrelevant for clinical practice. However, the systematically lower FVC and FEV1 observed with EO may be significant for epidemiological studies, thus justifying inspection before replacing devices.
Laparoscopic Enucleation of Macronodules in a Patient with ACTH-Independent Macronodular Adrenal Hyperplasia 7 Years after Unilateral Adrenalectomy: Consideration of Operative Procedure
Authors: Ito Keiichi , Yoshii Takahiko , Shinmoto Hiroshi , Kanbara Taiki , Sumitomo Makoto , Kaji Tatsumi , Tanaka Yuji , Asano Tomohiko
Published: March 2013

Objectives: We evaluated the technical feasibility and efficacy of laparoscopic enucleation of adrenal macronodules in a patient with ACTH-independent macronodular adrenal hyperplasia (AIMAH). Patient and Methods: A 41-year-old female manifested Cushing's syndrome due to AIMAH in 1999 and underwent a right unilateral adrenalectomy in 2002. Although the patient's symptoms improved postoperatively, in 2005 they began to get worse as her urinary cortisol excretion increased. Computed tomography in 2008 showed four macronodules in the left adrenal gland, and we performed a laparoscopic enucleation of four adrenal nodules in hopes of avoiding the need for lifelong steroid replacement. In the operation we paid special attention to avoiding injuring major adrenal vessels. Nontumorous adrenal tissue was dissected just near the surfaces of the nodules by using a sealing system. The residual adrenal gland was at most left undissected from the surrounding tissues in order to preserve blood supply and preserve small drainage veins. Results: The operation could be performed with minimal blood loss. Plasma cortisol became measurable 22 months after the enucleation and returned to normal level 29 months after the enucleation. Conclusions: The laparoscopic enucleation of hyperplastic nodules is technically feasible and a treatment of choice for AIMAH patients who already underwent unilateral adrenalectomy.
Die Akademisierung von Naturheilkunde und Komplementärmedizin im deutschsprachigen Raum
Authors: Stange Rainer
Published: March 2013

Aus heutiger Perspektive erscheint es selbstverständlich, dass Naturheilkunde und Komplementärmedizin in den medizinischen Fakultäten vertreten sind. Das war nicht immer der Fall. Insbesondere im deutschsprachigen Raum waren dafür über 100 Jahre Entwicklungsgeschichte notwendig. Anhand der Beschreibung von Personen und Institutionen, die daran beteiligt waren, wird im vorliegenden Essay eine kurze Geschichte der akademischen Entwicklungen nachgezeichnet, die ausdrücklich zu den gegenwärtigen Forschungsaktivitäten im Bereich der Naturheilkunde und Komplementärmedizin geführt hat. Im deutschen Sprachraum gibt es derzeit 8 Professuren, die den Bereich der Naturheilkunde oder Komplementärmedizin abdecken und somit Medizin auf akademischer Ebene auf höchstem Niveau repräsentieren. Naturheilkunde und Komplementärmedizin werden in der universitätsmedizinischen Landschaft mittlerweile stark rezipiert. Dennoch wird eine große Mehrheit der heutigen Forschungsaktivitäten von gemeinnützigen Organisationen finanziert und ist somit von deren ökonomischer Entwicklung abhängig.
The Evolution of Complementary and Alternative Medicine (CAM) in the USA over the Last 20 Years
Authors: Jonas Wayne B. , Eisenberg David , Hufford David , Crawford Cindy
Published: March 2013

Medical practices that reside outside the mainstream medical structures have existed for centuries, often waxing and waning in prominence and use for various reasons. Recently, there has been a resurgence in interest and use of such practices in the USA generally referred to under the label of ‘complementary and alternative medicine' (CAM). In this article we summarize some of the highlight events that punctuated this resurgence over the last 20 years. As in the past, social forces affecting these trends circulate around power, resources, and scope of practice. However, a prominent feature of this dynamic is a discussion about the role of science and ‘evidence-based medicine' in addressing pluralistic healthcare-related practices. In the early years of this period, attempts to formulate the place of CAM practices as they relate to epistemology, nonconventional assumptions about health and healing, and the complexity of understanding ‘whole systems' were discussed and often examined. Less attention is being paid to those core assumptions in more recent times. The focus now seems to be on how CAM practices can be judiciously and effectively ‘integrated' into mainstream medicine. Examples of how this dynamic is evolving are described.
Severity of Urinary Incontinence of Nursing Home Residents Correlates with Malnutrition, Dementia and Loss of Mobility
Authors: Rose Achim , Thimme Anne , Halfar Carolin , Nehen Hans Georg , Rübben Herbert
Published: March 2013

Introduction: The prevalence of urinary incontinence increases with age. Especially in nursing homes people often do not only suffer from incontinence, in addition they present comorbidities, i.e. dementia or loss of mobility. In this study we assessed the severity of urinary incontinence and comorbidities of nursing home residents. Methods: We included 81 residents of nursing homes who underwent recordings of medical history, physical examination and ultrasound diagnostic of the urinary tract. Grading of urinary incontinence was assessed by the amount of pads used daily. Severity of immobility, dementia and malnutrition was assessed. Further examinations were urinalysis by dip stick and microbiological testing, geriatric depression scale, and QLQ-C30. Results: We found incontinence at different degrees present at 67/81 (83%) of nursing home residents. We could show, that more severe incontinence correlated with worse nutritional status (r = 0.53, p < 0.0001), increase in demential symptoms (r = 0.37, p = 0.0012) and worse mobility r = 0.71, p < 0.0001). There was no correlation for the severity of urinary incontinence with the prevalence of diabetes, intake of diuretics or the presence of urinary tract infections. Conclusions: Worsening of nutritional status, cognitive function and mobility not only correlate with the prevalence but also with the severity of urinary incontinence.
Age-Related Association between Apolipoprotein E ε4 and Cognitive Function in Japanese Patients with Alzheimer's Disease
Authors: Nagata Tomoyuki , Shinagawa Shunichiro , Kuerban Bolati , Shibata Nobuto , Ohnuma Tohru , Arai Heii , Nakayama Kazuhiko , Yamada Hisashi
Published: March 2013

Aims: In the present study, we investigated whether apolipoprotein E (APOE) polymorphisms influenced the cognitive function of Japanese patients with Alzheimer's disease (AD) at certain ages. Methods: Among 200 outpatients with dementia and amnestic mild cognitive impairment, 133 Japanese patients with AD were recruited and divided into two genotypic groups: APOE ε4 carriers and noncarriers. Then, we compared several neuropsychological test scores between the two genotypic groups for two different generations: 70s (70-79 years) and 80s (80-89 years). Results: The total Mini-Mental State Examination score (p < 0.05) and one of its subtest scores, the 3-stage command score (p < 0.01), were significantly lower for the ε4 carriers than for the noncarriers among patients in their 80s, but not among those in their 70s. The duration of illness differed significantly between the ε4 carriers and the noncarriers among subjects in their 80s but was not correlated with cognitive function. Conclusion: The present results suggest that APOE may significantly influence comparatively simple memory processing in certain generations of Japanese patients with AD.
Basal Cell Carcinoma Arising from Xeroderma Pigmentosum: A Case Report and an Immunohistochemical Study
Authors: Furudate Sadanori , Fujimura Taku , Tojo Gen-ichi , Haga Takahiro , Aiba Setsuya
Published: March 2013

We describe a 26-year-old Japanese patient with basal cell carcinoma arising from xeroderma pigmentosum (XP). Immunohistochemical staining revealed dense infiltration of CD163+ M2 macrophages, together with Foxp3+ regulatory T cells. Interestingly, MMP9, which was reported as one of the functional markers for immunosuppressive macrophages, was al-so detected in the CD163+ M2 macrophage-infiltrated areas. Our case suggests the immunological background of tumor development in a patient with XP.
Endogenous Tissue Plasminogen Activator Enhances Fibrinolysis and Limits Thrombus Formation in a Clinical Model of Thrombosis
Authors: Lucking Andrew J. , Gibson Kyle R. , Paterson Elspeth E. , Faratian Dana , Ludlam Christopher A. , Boon Nicholas A. , Fox Keith A.A. , Newby David E.
Published: March 2013

Objective—

Using a clinical model of deep arterial injury, we assessed the ability of exogenous and endogenous tissue plasminogen activator (t-PA) to limit acute in situ thrombus formation.

Approach and Results—

Ex vivo thrombus formation was assessed in the Badimon chamber at low and high shear rates in 2 double-blind randomized cross-over studies of 20 healthy volunteers during extracorporeal administration of recombinant t-PA (0, 40, 200, and 1000 ng/mL) or during endogenous t-PA release stimulated by intra-arterial bradykinin infusion in the presence or absence of oral enalapril. Recombinant t-PA caused a dose-dependent reduction in thrombus area under low and high shear conditions (
P
<0.001 for all). Intra-arterial bradykinin increased plasma t-PA concentrations in the chamber effluent (
P
<0.01 for all versus saline) that was quadrupled in the presence of enalapril (
P
<0.0001 versus placebo). These increases were accompanied by an increase in plasma D-dimer concentration (
P
<0.005 for all versus saline) and, in the presence of enalapril, a reduction in thrombus area in the low shear (16±5;
P
=0.03) and a trend toward a reduction in the high shear chamber (13±7%;
P
=0.07).

Conclusions—

Using a well-characterized clinical model of coronary arterial injury, we demonstrate that endogenous t-PA released from the vascular endothelium enhances fibrinolysis and limits in situ thrombus propagation. These data support a crucial role for the endogenous fibrinolytic system in vivo and suggest that continued exploration and manipulation of its therapeutic potential are warranted.
Adventitial Perfusion and Intraplaque Hemorrhage
Authors: Sun Jie , Song Yan , Chen Huijun , Kerwin William S. , Hippe Daniel S. , Dong Li , Chen Min , Zhou Cheng , Hatsukami Thomas S. , Yuan Chun
Published: March 2013

Background and Purpose—

Autopsy studies have suggested a relationship between intraplaque hemorrhage (IPH) and vasa vasorum, which arise primarily from the adventitia. Adventitial vasa vasorum can be characterized in the carotid arteries by estimating perfusion parameters via dynamic contrast-enhanced MRI. The purpose of this investigation was to use dynamic contrast-enhanced MRI to test in vivo in a clinical population whether adventitial perfusion, indicative of vasa vasorum microstructure, is associated with IPH.

Methods—

Symptomatic patients with carotid plaque ipsilateral to the ischemic event underwent bilateral carotid artery MRI examination, which included multicontrast sequences for detecting IPH and a dynamic contrast-enhanced MRI sequence for characterizing adventitial perfusion. Kinetic modeling of the dynamic contrast-enhanced MRI time series was performed to estimate adventitial

v
p

(fractional plasma volume, reflecting local blood supply) and
K

trans

(transfer constant, reflecting vessel surface area, and permeability).

Results—

From the 27 patients (22 men; 69±10 years of age) recruited, adventitial perfusion parameters were obtained in 50 arteries. The presence of IPH was associated with a significantly higher value in adventitial
K

trans

(0.142±0.042 vs 0.112±0.029 min
−1
;
P
<0.001) but not in

v
p

(0.163±0.064 vs 0.149±0.062;
P
=0.338). This relationship remained after adjusting for symptomatic status, degree of stenosis, and other confounding factors.

Conclusions—

This study demonstrated an independent pathophysiological link between the adventitia and IPH and related it to the microstructure of adventitial vasa vasorum. Adventitial perfusion imaging may be useful in studying plaque pathogenesis, but further examination through prospective studies is needed.
National Institutes of Health Stroke Scale Score and Vessel Occlusion in 2152 Patients With Acute Ischemic Stroke
Authors: Heldner Mirjam R. , Zubler Christoph , Mattle Heinrich P. , Schroth Gerhard , Weck Anja , Mono Marie-Luise , Gralla Jan , Jung Simon , El-Koussy Marwan , Lüdi Rudolf , Yan Xin , Arnold Marcel , Ozdoba Christoph , Mordasini Pasquale , Fischer Urs
Published: March 2013

Background and Purpose—

There is some controversy on the association of the National Institutes of Health Stroke Scale (NIHSS) score to predict arterial occlusion on MR arteriography and CT arteriography in acute stroke.

Methods—

We analyzed NIHSS scores and arteriographic findings in 2152 patients (35.4% women, mean age 66±14 years) with acute anterior or posterior circulation strokes.

Results—

The study included 1603 patients examined with MR arteriography and 549 with CT arteriography. Of those, 1043 patients (48.5%; median NIHSS score 5, median time to clinical assessment 179 minutes) showed an occlusion, 887 in the anterior (median NIHSS score 7/0–31), and 156 in the posterior circulation (median NIHSS score 3/0–32). Eight hundred sixty visualized occlusions (82.5%) were located centrally (ie, in the basilar, intracranial vertebral, internal carotid artery, or M1/M2 segment of the middle cerebral artery). NIHSS scores turned out to be predictive for any vessel occlusions in the anterior circulation. Best cut-off values within 3 hours after symptom onset were NIHSS scores ≥9 (positive predictive value 86.4%) and NIHSS scores ≥7 within >3 to 6 hours (positive predictive value 84.4%). Patients with central occlusions presenting within 3 hours had NIHSS scores <4 in only 5%. In the posterior circulation and in patients presenting after 6 hours, the predictive value of the NIHSS score for vessel occlusion was poor.

Conclusions—

There is a significant association of NIHSS scores and vessel occlusions in patients with anterior circulation strokes. This association is best within the first hours after symptom onset. Thereafter and in the posterior circulation the association is poor.
Effect of Aerobic Exercise (Walking) Training on Functional Status and Health-related Quality of Life in Chronic Stroke Survivors
Authors: Gordon Carron D. , Wilks Rainford , McCaw-Binns Affette
Published: March 2013

Background and Purpose—

Little is known about the effects of community-based walking programs in persons with chronic stroke. The purpose of this study was to determine the effects of aerobic (walking) training on functional status and health-related quality of life in stroke survivors.

Methods—

A single-blind randomized controlled trial was conducted. The intervention group (n=64) walked overground for 30 minutes, 3 times per week for 12 weeks. The control group (n=64) received massage to the affected side. Medical Outcomes Short Form, 36-Item Short Form Health Survey (SF-36), was used to assess health-related quality of life; Barthel Index and Older Americans Resource and Services scale for functional status; 6-minute walk test for endurance; and Motricity Index for lower extremity strength.

Results—

There was a trend toward greater improvement over time for the Physical Health Component of the SF-36 (
P
=0.077) and significantly greater improvement over time for distance walked in 6 minutes in favor of the walking group (
P
<0.001).

Conclusions—

Aerobic walking improves the physical health component of quality of life and endurance in persons with chronic stroke. It should form part of a comprehensive health promotion strategy.

Clinical Trial Registration—

Trial was not registered as enrollment commenced before 2005.
The Relationship between Islam and Judaism: A Neglected Aspect
Authors: Mazuz Haggai
Published: March 2013

Abstract

The Islamic tradition of differentiating Muslim practices from those of other monotheists has been relatively neglected by scholars. In this article, I discuss this relatively neglected aspect of the relationship between Islam and Judaism.
Deconstruction, Psychopathology and Dialectics
Authors: Hook Derek , Parker Ian
Published: March 2013

This paper endeavours to ask how one might rethink essentialized and reified concepts of psychology and psychopathology as they are represented and experienced in the domain of ‘psychological culture’. Deconstruction, a critical mode of reading systems of meaning, and of unravelling the ways these systems work as texts, is the theoretical and methodological tool of choice for this task. The objective here is to critically engage with privileged notions of psychology on the reciprocal levels of both the personal and the political, the subjective and the social. An additional tool that becomes important here, in linking the internal and external deconstructions of psychology, is dialectics. Dialectics is a means of comprehending the relation between different forms of critique and the relation between different domains in which the psychological is worked through. Connecting the spheres of social relationships with individual activity, and the realms of political and personal in this way, enables a critical linking of the individual and the social without reducing one to the other. Engaged, albeit schematically, in this way, psychopathology may be approached as a construct that has been storied into being in psychiatric texts, that has been sedimented in practices which make it look and feel substantial and real. Essentialized in these ways, the abstract notion of psychopathology operates as if it were concrete, whilst the concrete practices surrounding it operate as if they were abstract. To sufficiently critically engage with constructs of psychopathology then, it is necessary to simultaneously grapple with the objective and subjective aspects of the problem, to engage with how ‘normality’ and ‘pathology’ function both in reality and within the subjective grasp they have on us as we read our own experience at each moment as normal or pathological.
The Relationship between Intention to Emigrate and Organisational Commitment
Authors: Miller Karen , Haskell Charmaine , Thatcher Andrew
Published: March 2013

South Africa is currently experiencing one of the highest periods of emigration in its history. However, this phenomenon has received little research attention. This study examined the issue of emigration from an organisational psychology perspective by exploring the relationship between intention to emigrate and organisational commitment. To achieve this an Intention to Emigrate scale was developed in order to assess individuals' behavioural intentions with regard to leaving the country. Thereafter, the relationship between intention to emigrate and organisational commitment was examined. The sample consisted of 105 employees from a single organisation. The Intention to Emigrate was found to be reliable and some evidence for the validity of the scale was also established. A significant relationship between intention to emigrate and organisational commitment, measured by the Organisational Commitment Questionnaire, was established. In addition, the results indicated that people are more likely to emigrate if they have a university qualification and/or friends that have settled abroad.
Social Identity Theory and the Authoritarian Personality Theory in South Africa
Authors: Niens Ulrike , Cairns Ed , Finchilescu Gillian , Foster Don , Tredoux Colin
Published: March 2013

Social identity theory assumes that individuals and collectives apply identity management strategies in order to cope with threatened social identities. It is argued here that an integration of social identity theory and the authoritarian personality theory may help to investigate identity management strategies for minority and majority groups. It was intended to investigate predictors of identity management strategies applied by students at the University of Cape Town. Analyses are based on a questionnaire survey of 457 university students. Results only partially confirmed assumptions derived from social identity theory. Group identification and perceptions of legitimacy were related to the individual identity management strategy, “individualisation”, while the collective strategy “social competition” was associated with collective efficacy and authoritarianism. Perceptions of instability and authoritarianism predicted preferences for “temporal comparisons”. ‘Superordinate recategorisation’ was only very weakly predicted by group identification. The study indicated that social identity theory and the authoritarian personality theory might play different roles in preferences for identity management strategies. While social identity theory appears better in explaining individual identity management strategies, the authoritarian personality theory might be better in explaining collective strategies.
HIV/AIDS/STD Knowledge, Attitudes, Beliefs and Behaviours in a Rural South African Adult Population
Authors: Peltzer Karl
Published: March 2013

The aim of the study was to evaluate data on behavioural indicators in relation to HIV/AIDS/STD prevention and occurrence in a rural adult population in South Africa. A representative community sample of adults (n=398) using a three-stage cluster sampling method was chosen for a household survey, and qualitative data were obtained from adults using ten focus group discussions. The survey sample included 398 adults: 155 (38.9%) male and 243 (61.1%) female, whose ages ranged from 25 to 49 years ( M=37.1 years, SD=12.6). The questionnaire included 71 items on HIV-related knowledge, attitudes, beliefs and behaviours. The results indicated a mean HIV/AIDS knowledge score of 6.77 (range: 0 to 9), indicating a moderately adequate knowledge. HIV/AIDS knowledge was identified as a predictor for HIV-risk behaviour. Forty-six percent of the men and 21.4% of the women indicated that they had had a non-regular sexual partner in the last 12 months, and 53.4% of the women and 45.6% men said that they had never used a condom with their non-regular, non-commercial partner during the preceding 12 months. Among female adult women, 15.4% reported having been victims of enforced sex during the last 12 months. There was a high incidence of self-reported genital discharge/ulcers/sores within the preceding 12 months among the participants (19.7% in men and 11% in women). The study's findings are discussed in relation to implications for health education.
Perceived Career Barriers among South African High School Learners
Authors: Stead Graham B. , Els Catherine , Fouad Nadya A.
Published: March 2013

The perception of career barriers has the potential to influence individuals' career choice processes and facilitate or detract from their realising their career goals. Grade 12 black ( n = 90) and Grades 11 ( n = 140) and 12 ( n = 118) white high school learners completed a semi-structured questionnaire asking whether gender discrimination, racial or ethnic discrimination, personal characteristics or other factors were perceived as barriers to progressing in the career they would like to enter. The majority of learners did not perceive gender discrimination or personal characteristics as possible career barriers. Racial or ethnic discrimination as perceived career barriers were most problematic for Grade 11 white learners (56%), but also of concern to the other two samples (40% to 44%).
Exploring Parents' Stories of Coping with Their Child's Cancer: A Qualitative Study
Authors: Papaikonomou Maria , Nieuwoudt Johan
Published: March 2013

The focus of this investigation was to explore stories about coping with childhood cancer in a support group for parents. Using the principles of ethnographic epistemology, this study considered the stories of eight parents whose children were diagnosed with cancer and who decided to join a support group. Themes were identified which led to a delineation of how each parent coped with this trauma in their lives. In addition, the researchers' perspective as to what was helpful to the group members is discussed. An overview of the existing body of knowledge on childhood cancer and the family is presented and the value of a social support group in parenting a child with cancer is considered. It is argued that there is a need for a conceptual shift in order to understand the problem of parenting such a child.
African Families' Perceptions of Traumatic Brain Injury
Authors: Mokhosi M. T. , Grieve K. W.
Published: March 2013

Using semi-structured interviews, this study explored the perceptions of traumatic brain injury (TBI) held by a group of 22 brain-injured individuals and their caregivers living in rural African communities. While there are similarities between these findings and those in other parts of the world regarding the cognitive, emotional, personality and behavioural changes experienced by brain-injured individuals, the perceived aetiology of brain injury differed according to the individuals' worldview. Most of the participants believed that the accidents considered in this study as well as the injuries they gave rise to were the result of witchcraft, ancestral anger, God's will or thwasa. The reactions of family members to caring for, and living with, a brain-injured person appeared to be influenced by specific social practices and local cultural beliefs. It is important to incorporate these beliefs into the rehabilitation process. Suggestions for rehabilitation are discussed.
Sex, Sexuality and Sickness: Discourses of Gender and HIV/AIDS among Kwazulu-Natal Women
Authors: Hoosen Sarah , Collins Anthony
Published: March 2013

Current HIV-prevention work indicates that simply providing HIV-related information plays a limited role in changing sexual practices, and instead stresses the need to address the social and cultural forces shaping individual behaviour. The aim of this study was thus to explore the social influences that shape women's sexual behaviour with specific attention given to discourses of gender and HIV/AIDS. Material was generated through seven focus group discussions with black women living in a peri-urban area in Durban, and was interpreted using discourse analysis. The study clarified the ways in which women are not necessarily in a position to make purely rational, individual decisions about safe sex, since these decisions are intimately linked to social constructions of sexuality and the power relations that operate in cultures. It identified specific cultural practices linked to the organisation of gender roles and how these influence safe sex practices. The analysis then examined the implications of these findings for future HIV/AIDS education interventions.
Reviewing Clinical Psychology Training in the Post-Apartheid Period: Have We Made Any Progress?
Authors: Ahmed Rashid , Pillay Anthony L.
Published: March 2013

The recruitment and training of clinical psychologists remain important challenges for South African psychology in the post-apartheid period. Specifically, the challenges are to address issues of equity and redress, develop relevant policy, curricula and practices, and to produce graduates who are able and willing to work in the context of diversity and disadvantage. In this article we selectively review the progress made in responding to these challenges. Our conclusion is one of concern, since clinical psychology's track record in terms of training leaves much to be desired. While there is a greater degree of engagement with issues of equity and access, training still remains racially skewed and redress is largely confined to simply providing institutional access. Furthermore, the ‘silences' and paucity of attempts at transforming recruitment and selection processes, policy, curricula and training practices are of even greater concern. We argue that while there are constraints to transforming training in terms of the tensions and contradictions between mainstream professional training requirements, social conditions and ‘relevant’ discourses and practices, a far more substantive engagement with, and commitment to the fundamental issues are required. This review concludes with the assertion that clinical psychology is rapidly running out of time to remedy its deficiencies and maintain its respectability as a helping profession for the entire nation. Some tentative suggestions are offered for the way forward.
Suicide Ideation in the South African Police Service
Authors: Pienaar Jacobus , Rothmann Sebastiaan
Published: March 2013

Little information exists regarding the suicide ideation of uniformed members of the South African Police Service (SAPS). The objectives of this study were to determine the level of suicide ideation of police members and to determine the differences between the suicide ideation of various demographic groups. Across-sectional survey design was used. Stratified random samples ( N = 1781) were taken of police members of eight provinces in South Africa. The Adult Suicide Ideation Questionnaire and a biographical questionnaire were administered. The results indicated that 8.30% of the sample showed a high level of suicide ideation. Multiway frequency analyses showed that the observed frequencies of high suicide ideation (compared with low suicide ideation), statistically, were significantly higher than the expected frequencies in groups based on race, rank, gender, province, alcohol consumption, educational qualifications, medical problems and previous suicide attempts.
Psychology and the Art of Programme Evaluation
Authors: Potter Charles
Published: March 2013

This article suggests that psychologists may find value in the literature on programme evaluation, both theoretically and methodologically. Programme evaluation is an eclectic and diverse field and its literature reflects the contributions of persons trained within a variety of disciplines. It draws on a number of fields, which include management and organisational theory, policy analysis, education, sociology, social anthropology and the literature on social change. As such, the literature on programme evaluation may have value for psychologists planning evaluations of social programmes, in providing access to evaluation approaches and models developed within these different traditions. In terms of the breadth of perspectives and research traditions on which the evaluation literature draws, different forms of evaluation research can contribute to a psychology in South Africa which deals with multiple values and issues. On a theoretical level, this article suggests that the issues and debates reflected in the evaluation literature (e.g., those on empowerment) mirror debates that have occurred within the mainstream of psychology over the past 20 years. For this reason, the issues raised in the evaluation literature are relevant to the development of psychology as a discipline. The approaches and models proposed for the evaluation of social programmes are also potentially useful on a methodological level, particularly to those psychologists who work in community settings.
Where is the Evidence in South African Clinical Psychology?
Authors: Kagee Ashraf
Published: March 2013

While a rich body of research exists to inform the practice of clinical psychology, South African mental health professionals have failed to incorporate empirical findings in their clinical work. This article argues that South African psychology has become increasingly devoid of an empirical base, to the detriment of the clients it purports to serve. A fundamental epistemological problem that faces clinical psychology is the credibility it bestows on non-falsifiable theories. As such, practitioners have been led to rely to an inordinate degree on so-called clinical intuition and experience. Yet, the application of both of these practices yields demonstrably inferior treatment outcomes when compared with actuarial methods of judgement and prediction, and empirically supported interventions. While the notion of empirically supported treatments and its emphasis on randomised controlled trials are not unproblematic, far worse is the practice of giving credibility to clinical practices based on folklore and theoretical dogma in the absence of evidence. The argument presented in this article is that if South African clinical psychology is to make itself relevant to the needs of contemporary society, it needs to abandon non-falsifiable theoretical tenets and adhere more vigorously to the criteria of evidence when dispensing clinical services.
The Complexity of Evidence Notwithstanding: A Reply to Swartz
Authors: Kagee Ashraf
Published: March 2013

This article is a response to the caveats raised by Swartz (this issue) regarding the complexities of emphasising evidence-based interventions in psychology. It is acknowledged that the process of amassing evidence to support psychological interventions requires overcoming considerable logistical and contextual difficulties. Yet, the dangers of not taking into account the vast body of data on the effectiveness of psychotherapy are likely to have serious consequences for consumers of psychological service and for the profession of psychology itself. The challenge for South African psychology is to address the complexities raised by Swartz in ways that minimise leaps of faith regarding the effectiveness of interventions so that therapeutic decisions are based on sound data rather than unsubstantiated theoretical conjecture.
Factors That Influence Adult Recidivism: An Exploratory Study in Pollsmoor Prison
Authors: Gaum Goudine , Hoffman Sandy , Venter J. H.
Published: March 2013

Available statistics on recidivism in South Africa are severely limited, but estimates indicate that it is unacceptably high. This study uses data from the case files of two psychologists working in the Department of Correctional Services at Pollsmoor Prison, Cape Town, to describe the incidence, possible reasons for, and treatment of, recidivism. In addition, qualitative data in the form of transcripts of focus group interviews and semi-structured interviews are used to analyse the experiences and perceptions of inmates who have returned to prison on more than one occasion. The analysis suggests that prison behaviour is not an indicator of successful rehabilitation; rehabilitation interventions are often provided too late; learning to trust is important for rehabilitation, as is a shift from external to internal locus of control and learning to control emotions; drug abuse is a bad indicator for rehabilitation; and many rehabilitation programmes still focus on process rather than results. On the basis of these findings, it is recommended that half-way houses should be established; that there should be greater focus on inmate empowerment; that constancy of services and increased human resources should be provided; and that further research should be conducted into recidivism in South Africa.
Mind the Gap: Have the Registered Counsellors Fallen Through?
Authors: Elkonin Diane S. , Sandison Alida
Published: March 2013

The professional category of Bachelor of Psychology (B.Psych.) Registered Counsellor was created in order to deliver psychological services at a primary health care level to previously disadvantaged communities. Between 2002 and 2004 the Nelson Mandela Metropolitan University, in the Eastern Cape, produced 84 graduates in this category. In an attempt to follow the career paths of these graduates, a survey was undertaken to determine how many graduates had progressed to the stage of professional registration and were working as Registered Counsellors, and to explore their present status and employment experiences. It was found that very few had registered with the Professional Board for Psychology and that most were continuing postgraduate studies or had moved into alternate career fields. Themes that emerged from the survey concern difficulty with registration, difficulty with employment, and lack of public and professional knowledge of the scope of practice of the Registered Counsellor. There were also some positive perceptions regarding the value of the Registered Counsellor category and the quality of training.
Study Orientation and Causal Attribution in Mathematics Achievement
Authors: Moodaley Reveni R. , Grobler Adelene A. , Lens Willy
Published: March 2013

The empirical relationship between study orientation as measured by the Study Orientation in Mathematics Questionnaire (SOM) and achievement in mathematics was investigated for Grade 9 learners from five racially integrated, secondary schools in the Northern Cape province in South Africa. A series of hierarchical regression analyses was performed to determine the percentage of the criterion (mathematics achievement) variance that could be explained by study orientation in mathematics. This investigation was augmented by the further exploration of learners' attributions regarding the causes of their achievement in mathematics. The results emphasised the importance of the set of study orientation variables as predictors of achievement in mathematics for both genders and all three race groups (i.e., black, white and coloured students). Study milieu and problem-solving behaviour appeared to be the most significant individual predictors of mathematics achievement for both genders, and both black and white Grade 9 learners. The causal attribution of achievement scales jointly contributed significantly to the explanation of the variance in mathematics achievement for the following groups: male, white and coloured learners with positive perceptions of their achievement; and male, white and black learners with negative perceptions of their achievement in mathematics
Violence, Re-Membering, and Healing: A Textual Reading of Drawings for Projection by William Kentridge
Authors: Thompson Vanessa , Laubscher Leswin
Published: March 2013

This article examines the extent to which insights about the processes and dynamics of psychological health might be located at the intersection between trauma and creativity. To that end, we focus on the animated art series, Drawings for Projection (1989–1999), by the noted South African artist, William Kentridge. Spanning a decade that overlaps the transition from apartheid to the post-apartheid era, Kentridge's art directly addresses themes of violence, reparation, hurt, restoration, and healing. Our intention is not to propose an art therapy but a derivative psychology from the artwork situated in cultural discourse and meaning systems. We provide a hermeneutic reading of Drawings for Projection, and our results suggest that Kentridge's art contains a restorative narrative and function. We identify four narrative aggregations ( Violence as erasure; Re-membering; The breath of the other; and The face of the other) from the data, which we then organise interpretively. This interpretive reading is influenced and informed by the writings of the philosopher Emmanuel Levinas. As such, we speculate that healing violent traumata involves an ethical reorientation towards the other in re-membrance, care, and action, or else we run the risk of violence returning in reconstituted form. Movement towards an ethical psychology of the other, rather than an egocentric psychology of the self, is suggested.
Sport Participation, Psychological Well-Being, and Psychosocial Development in a Group of Young Black Adults
Authors: Malebo Andrew , van Eeden Chrizanne , Wissing Maríe P.
Published: March 2013

The purpose of this study was to determine whether young black adults who participate in sport differ in psychological well-being and psychosocial development from those who do not participate actively in sport. An availability sample of 293 students between 20 and 35 years old from three tertiary institutions in South Africa completed self-report measures of psychological well-being and psychosocial development. The reliability and validity of the instruments were acceptable for use in this particular group. Students who participate actively in sport had significantly lower levels of negative affect, somatic symptoms, symptoms of depression, and pessimistic life orientation, and significantly higher levels of positive affect, sense of coherence, and self-efficacy beliefs. They also manifested higher levels of purpose and autonomy. Educational and policy implications of the findings are indicated.
Factors Related to and the Consequences of the Termination of Pregnancy at the Umtata General Hospital, Eastern Cape
Authors: Mdleleni-Bookholane Tembeka
Published: March 2013

The purpose of this study was to examine the factors related to and the consequences of the termination of pregnancy (TOP) among women who underwent the termination of pregnancy procedure at Umtata General Hospital, using Miller's (1992) abortion decision model. A convenience sampling technique was used to select the participants. Only those women who had undergone TOP at the gynaecological clinic of the hospital during November and December 2000 and were willing to talk about their experience were included. Ninety-eight women expressed a willingness to participate. Data were collected using semi-structured interviews. Responses were recorded using a pen-and-paper method. Data were analysed using SPSS and thematic analysis. The findings were interpreted using Miller's (1992) abortion decision model. The women who participated came from different age groups, marital status, and educational levels. The findings revealed that the women's decision to go for TOP was related to a lack of preparedness for childbearing, age, marital status, relationship problems, and lack of financial resources and support. Anticipated parental support and perceived support from friends were associated with more favourable reactions to undertaking TOP.
Mothers, Fathers, or Parents: Same-Gendered Families in South Africa
Authors: Lubbe Carien
Published: March 2013

Advances and changes in globalised culture compel psychologists to take cognisance of the wide variety of ways in which families are formed and in which children grow up. Although members of the gay community have in the past usually been associated with a childless lifestyle, gay people are increasingly opting for motherhood and fatherhood by creating families of their own or by continuing to live with their children from former heterosexual relationships. This article addresses the concept of same-gendered families as an example of the changing face of families, relating it to the heteronormativity that is embedded in Westernised societies. The dichotomies of sexuality are confronted and used to illuminate the cultural assumptions embedded in the concept ‘family’ from a postmodern perspective. An overview is given of available research from a South African perspective. Trends evident in local research are related to international perspectives to provide a brief synopsis of available knowledge on same-gendered families. Special attention is given to a postmodern and social constructionist perspective on the concept of family, by examining the gendered and sexualised perceptions that underlie same-gendered families. The interfaces between parenting, gender, sexuality, and reproduction are examined and critically scrutinised. Implications of this for the profession of psychology are briefly discussed. The same-gendered couple as a family challenges the normative conceptions of the traditional model of the two-parent (hetero-gender) family because the latter is socially and legally constructed from a biological model of reproduction. The article concludes that structural variables, such as the gender composition of families and the division of parental performances, are less important than process variables such as the quality of relationships and the quality of care given to the children.