bluuebunny/crossref_metadata_2025 huggingface dataset:
Le fressellianisme face au dilemme de l’accointance
Authors: Murez Michael
Published: September 2019

Selon le russellianisme , nous avons des pensées singulières faisant directement référence aux objets, fondées sur des relations d’accointance (1 re partie). Selon le frégéanisme , toute pensée est médiatisée par un concept (2 e partie). Le fressellianisme anti-descriptiviste cherche à réconcilier ces thèses apparemment opposées, et à éviter les objections auxquelles chacune s’expose, en postulant des concepts singuliers , individués par des relations d’accointance (3 e partie). Mais le fressellianisme rencontre un dilemme : s’il conçoit l’accointance en termes causaux, il rencontre les mêmes objections que le russellianisme ; mais s’il conçoit l’accointance en termes épistémiques, il rencontre les mêmes objections que le frégéanisme (4 e partie). Le but principal de cet article est ainsi essentiellement négatif : il s’agit de montrer que le fressellianisme anti-descriptif, qui prétend constituer une avancée significative par rapport au russellianisme et au frégéanisme, hérite en fait des faiblesses des deux approches.
Trois ans plus tard
Authors: Bertho-Lavenir Catherine
Published: September 2019

Entre travail du deuil et bureaucratie, rites et formalités, le vif saisit le mort, corps et âme, corps et biens : les obligations requises par la transmission ajoutent à l’épreuve du chagrin.
Paradis pour les athées
Authors: Sicard Monique
Published: September 2019

À défaut de dieux, peut-on néanmoins accéder à l’immortalité, sous quelle forme et dans quel paradis ? Paradoxalement, l’athéisme multiplie les occasions de survivre.
Héros, martyrs, victimes
Authors: Huyghe François-Bernard
Published: September 2019

Droit de tuer, sacrifice de soi, vie sauvée, vie donnée : la mort violente obéit désormais à des économies stratégiques et symboliques qui redessinent la figure de la victime, du héros et du martyr.
Mort à Palerme
Authors: Dumas Robert
Published: September 2019

Il faut que tout change pour que rien ne change, selon le mot de Lampedusa. Il faut que tout meure pour que rien ne meure, traduit, en images, Visconti au cinéma.
La bouche d’ombre audiovisuelle
Authors: Perraud Antoine
Published: September 2019

Encore plus de traces, écrites et désormais audiovisuelles, plus d’émotion devant ces spectres qui semblent toujours plus vivants. Sur nos écrans.
À quoi rêvent les cadavres ?
Authors: Grillet Thierry
Published: September 2019

Survivre, certes, mais qui survit ? Réduit à quoi ? Réponses d’hier et de demain, de la mythologie à la science-fiction.
Prendre la suite
Authors: Debray Régis
Published: September 2019

Il n’y a qu’une question sérieuse, pour un fugitif de passage sur cette planète, comme pour une idée neuve, un amour, un cénacle, une grande cause : qu’est-ce qui continue ou ne continue pas ? Qu’est-ce qu’il peut en rester, et dans quel état ?
Une poignée de sel sur les braises de la lutte pour la libération de l’avortement et de la contraception
Authors: Mathieu Marie
Published: September 2019

Prenant appui sur le documentaire paru en 2018 Quand je veux, si je veux qui donne la parole à des femmes ayant avorté récemment en France, et dans un contexte où le droit à l’IVG est remis en cause par des gouvernements conservateurs dans de nombreux pays, Marie Mathieu rappelle quelques éléments essentiels sur un combat d’actualité. Alors qu’il est un événement fréquent et ordinaire de la vie des femmes, l’avortement constitue toujours une pratique stigmatisée et un tabou. Derrière les stéréotypes et les méconnaissances existent des vécus et des parcours diversifiés de femmes confrontées à la prise en charge solitaire du travail contraceptif et à des résistances lorsqu’elles souhaitent exercer « un droit, leur droit : celui de mettre un terme à une grossesse et de décider ainsi de leur propre vie ».
Par des femmes, pour les femmes. Rééditer Notre corps, nous-mêmes quarante ans après l’original
Authors: Membres du collectif Notre corps no  , Delage Pauline
Published: September 2019

En 1969, alors que le mouvement féministe se développe aux États-Unis, des militantes féministes de Boston se réunissent lors d’ateliers autour de la santé des femmes et de leur corps : le cadre de ces groupes de parole, la non-mixité entre femmes, sont propices à des échanges émancipateurs sur des enjeux intimes, considérés comme des tabous, tels que la sexualité, la contraception ou l’avortement, mais aussi le rapport aux médecins et au pouvoir médical. La parole des femmes constitue alors le socle de la production de savoirs originaux, qui prend d’abord la forme d’une brochure publiée en 1970 puis d’un ouvrage, Our Bodies Ourselves , édité pour la première fois en 1971. Le titre souligne bien la visée politique du livre : l’appropriation par les femmes de leur corps. Traduit ou adapté dans une trentaine de langues, notamment en français en 1977, sous le titre Notre corps, nous-mêmes , le livre devient un classique féministe portant sur la santé et le corps. Si le livre a été édité neuf fois aux États-Unis 2 , la version française n’a jamais été actualisée jusqu’à présent. Le processus de réécriture mis en route il y a trois ans par le collectif Notre corps nous-mêmes souligne certains des enjeux liés à la transmission de savoirs féministes sur les corps des femmes et à leur actualisation, quarante ans après l’édition originale.
Après #MeToo : Réappropriation de la sororité et résistances pratiques d’étudiantes françaises
Authors: Albenga Viviane , Dagorn Johanna
Published: September 2019

À l’automne 2017, les hashtags #MeToo et #BalanceTonPorc ont participé à un mouvement féministe d’ampleur mondiale de dénonciation du harcèlement et des violences sexuelles. En raison de leur âge et de leur style de vie, les étudiantes sont particulièrement touchées et concernées par les violences dans l’espace public. Elles sont également les réceptrices et les relais d’idées et de pratiques féministes via les réseaux sociaux. Cet article revient sur les appropriations de #MeToo et du féminisme par des étudiantes françaises qui mettent en pratique des formes de résistances individuelles et collectives proches de la sororité, pour lutter contre les violences sexistes et sexuelles.
Sexualité juvénile et rapports de pouvoir : réflexions sur les conditions d’une éducation à la sexualité
Authors: Amsellem-Mainguy Yaëlle , Vuattoux Arthur
Published: September 2019

Les séances d’éducation à la sexualité – lorsqu’elles ont lieu – sont appréhendées dans une perspective de risques, la sexualité des jeunes se trouvant alors décontextualisée et euphémisée, comme si elle n’était pas traversée par les mêmes rapports de pouvoir que celle des adultes, comme si la violence subie par les jeunes dans la sexualité n’était pas de même nature. En revenant sur plusieurs enquêtes menées auprès de jeunes dans ou hors institutions, Yaëlle Amsellem-Manguy et Arthur Vuattoux soulignent que ce biais particularisant revient à homogénéiser et naturaliser les comportements sexuels des jeunes, au risque de marginaliser encore plus les minorités sexuelles et minorités de genre.
Femmes handicapées et violences sexuelles : entre difficultés de prise en charge et empuissancement
Authors: Aulombard-Arnaud Noémie
Published: September 2019

Malgré #MeToo, certaines femmes, certains corps féminins sont toujours invisibilisés et leurs expériences de la violence sexuelle et sexiste niées. Noémie Aulombard revient ici sur les conséquences du regard valido-centré sur ces violences et sur les enjeux spécifiques de la lutte des femmes handicapées.
La canopée cosmopolite
Authors: Anderson Elijah , Bidet Alexandra , Boisson Hélène
Published: September 2019

La diversité raciale, ethnique et sociale des espaces publics urbains n’a jamais été aussi grande. Distance et tension sociales se traduisent par la méfiance à l’égard des inconnus. Dans ce contexte, la « canopée cosmopolite » offre un répit aux personnes les plus diverses, en leur permettant de mener ensemble leurs activités, tout en se livrant à une « ethnographie ordinaire » ( folk ethnography ), qui leur sert de base, cognitive et culturelle, pour élaborer leurs façons d’agir en public.
Rigidités nominales et réelles des salaires en France : quel rôle des accords collectifs ?
Authors: Gautier Erwan , Roux Sébastien , Suarez-Castillo Milena
Published: September 2019

Cet article propose de décrire le degré de rigidité à la baisse des salaires en France sur la période récente et d’examiner dans quelle mesure les accords collectifs de salaire y contribuent. Le degré de rigidité à la baisse est plus fort sur les salaires de base que sur l’ensemble des salaires, y compris les primes et heures supplémentaires. Toutefois, l’effet des accords collectifs est assez similaire sur la dynamique des salaires de base et de l’ensemble de la rémunération : une hausse de 1 % des salaires de branche accroît d’un peu plus de 0,1 pp les salaires. L’effet des accords d’entreprise est un peu plus fort : observer un accord d’entreprise est associé à des salaires plus élevés de l’ordre de 0,3 pp. L’effet des accords de branche est faiblement décroissant le long de la distribution des salaires, et très hétérogène selon les secteurs.
Déjouer les pronostics scolaires et les destins sociaux. Sur quelques représentations et usages de la filière Staps
Authors: Bodin Romuald , Orange Sophie
Published: September 2019

L’enjeu de cet article est de mettre en évidence les principes qui sont au fondement de l’orientation en Staps et qui expliquent en partie les raisons de son succès, mais aussi de son investissement par des bacheliers aux profils scolaire et social variés. Au-delà du portrait statistique de ces candidats, l’étude de leur trajectoire scolaire et sociale renseigne sur le sens conféré à cette filière dans les parcours scolaires. Il apparaît ainsi à l’analyse que la filière Staps, par les singularités de ses contenus disciplinaires comme de son type de recrutement, se présente comme une voie de reclassement pour des élèves faisant l’expérience des limites de la démocratisation scolaire. Elle parvient ainsi à maintenir les illusions d’ascension sociale pour les uns et à tenir à distance, pendant un temps au moins, les risques d’un déclassement pour les autres.
Innovation organisationnelle et technologique dans les sports de montagne : une histoire du laboratoire d’Essai des matériels de l’École nationale de ski et d’alpinisme
Authors: Lefèvre Brice , Boutroy Eric
Published: September 2019

L’École nationale de ski et d’alpinisme, école d’État française dédiée à la formation des professionnels de la montagne (guides et moniteurs de ski) se caractérise par un laboratoire d’essai des matériels de montagne à l’histoire singulière, élément phare de son image et de sa notoriété internationale. La description des grandes phases de l’histoire de ce service, depuis l’après-guerre jusqu’à nos jours, permet de démêler l’écheveau des facteurs et des acteurs qui a rendu possible son émergence via la constitution progressive d’un réseau social et technique adéquat. Remarquable révélateur des mutations professionnelles et des évolutions des pratiques sportives en montagne autant que celles de la société, cette structure peut être considérée in fine à la fois comme une innovation matérielle, organisationnelle et de service.
Elle ne sera pas celle-là…
Authors: Denat Patricia
Published: September 2019

Accueillir un enfant, quelles qu’en soient les modalités, suscite notre imaginaire, des désirs, et le sentiment plus ou moins flou mais bien réel qu’il nous incombe de l’emmener vers cet idéal que nous concevons pour lui. Et dans cette « mission » qui est la nôtre, nous oublions bien souvent que cet enfant a sa propre réalité, ses propres désirs. Alors, parent ou parent de substitution, « ignorants » et compétents, nous nous engageons avec ferveur sur un chemin incertain, ne sachant pas encore qu’il nous faudra changer de voie maintes fois pour nous reposer, nous interroger et nous adapter finalement, car par amour pour lui, pour ce tout-petit, nous garderons le cap d’une parentalité aussi ajustée que possible, jusqu’à ce qu’il puisse choisir sa route.
« Je veux le meilleur »
Authors: Louin Corinne
Published: September 2019

Vouloir le meilleur pour nos enfants ne cacherait-il pas des intentions paradoxales ? Mais au fait, qu’est-ce que le meilleur ? Un enfant dénué de toute pulsionnalité ? Cet article se propose d’explorer, d’interroger pourquoi les manifestations de la sexualité infantile relevant du développement normal d’un enfant sont interprétées comme des manifestations perverses. Y aurait-il une confusion entre la sexualité infantile et la sexualité génitalisée adulte ? Le discours ambiant aurait-il des effets sur la manière dont les parents accompagnent leur enfant vers le travail de culture, vers le travail de civilisation de la pulsion ? Le discours ambiant tendrait-il à vouloir rendre nos enfants a-pulsionnels ?
Histoire singulière
Authors: Humbert-Foichat Kathy
Published: September 2019

Vignette clinique : histoire singulière d’une mère qui ne peut rêver sa fille et chemine en quête d’appuis pour la rencontrer.
Des attentes, des espoirs... et désespoir
Authors: Bachler Laurent
Published: September 2019

Les rêves que nous avons pour nos enfants traduisent l’amour que nous leur portons. Plus que tout, nous voulons que nos enfants soient heureux. Mais cet amour lié aux rêves que nous avons pour eux génère plus de souffrance et de douleur qu’autre chose. Notre désir de les voir réussir leur vie se transforme en attentes qui sont souvent déçues. Nous cherchons alors à surmonter cette déception en ayant de grands espoirs pour eux. Mais ces espoirs s’accompagnent de la crainte qu’ils ne soient pas réalisés. C’est alors que notre amour blessé, déçu et soucieux court le risque de se transformer en haine. Pour éviter la déception, la crainte et la haine, il faudra apprendre à aimer nos enfants autrement.
Psychotropic Medications for Bipolar Disorder in Pregnancy
Authors: Favini Andrea , Homitsky Sarah
Published: September 2019

Women with bipolar disorder are at high risk for relapse throughout pregnancy and in the postpartum period, especially when mood stabilizer medication is discontinued. Postpartum disruption of circadian rhythms, immune dysregulation, and abrupt fluctuation of reproductive hormones can precipitate postpartum psychosis, a psychiatric emergency with an increased risk of suicide and a 4% risk of infanticide. Fortunately, effective treatments exist for managing bipolar disorder in pregnancy, with the aim of preventing episode recurrence and maintaining function. Risks associated with psychotropic medication in pregnancy must be balanced against risks of untreated bipolar illness. In this review, we present risk profiles of existing treatments for bipolar disorder in pregnancy and breast-feeding, concluding with key evidence-based resources for clinicians and patients.

[
Psychiatr Ann.
2019;49(9):392–398.]
Suicide During Transition of Care: A Narrative Review of the Literature
Authors: Dar Kamil Rehmani , Bhullar Darmant Kaur , Dar Sabrina Kamil , Memon Raheel Imtiaz , Naveed Sadiq
Published: September 2019

Suicide is a major public health concern, having caused approximately 800,000 deaths worldwide in 2014 according to the World Health Organization. The aim of this article is to provide a deeper understanding of the risk factors for suicidal behaviors after hospital discharge. In April 2018, we systematically searched two electronic databases (PubMed and Scopus) for relevant publications using the following search terms: “suicide” AND “hospital” OR “emergency department” AND “discharge.” Risk factors that were associated with a higher risk of suicide during the transition of care were demographic factors, social factors, factors related to the clinical setting and care, clinical factors, and service delivery. Suicidal behavior during transition of care was significantly prevalent among older age groups, men, unemployed patients, unmarried patients, and patients with a shorter duration of stay at the hospital and having a history of multiple hospitalizations, frequent visits to emergency departments, and reporting suicidal ideation prior admission. A number of these risk factors are modifiable; hence, the identification of these risk factors can help in formulating an effective discharge plan.

[
Psychiatr Ann.
2019;49(9):409–414.]
Individually Customized IOL Versus Standard Spherical Aberration-Correcting IOL
Authors: Schrecker Jens , Schröder Simon , Langenbucher Achim , Seitz Berthold , Eppig Timo
Published: September 2019

PURPOSE:

To compare the visual performance of an individually customized intraocular lens (IOL) versus a standard spherical aberration-correcting IOL.

METHODS:

In this prospective comparative study, 74 eyes of 60 patients scheduled for cataract surgery were randomized in a 2:1 ratio to receive either an individually customized IOL (; HumanOptics AG, Erlangen, Germany; customized group) or an aspheric IOL with a standard correction of spherical aberration (SA) (Tecnis ZCB00; Johnson & Johnson Vision Surgical, Inc., Santa Ana, CA; standardized group). In the customized group, IOL calculation was based on a minimum of a merit function that contained terms representing residual refraction, residual SA, and modulation transfer function. In the standardized group, the IOL was calculated with a routine procedure using the Holladay formula and had a standard SA correction of −0.27 µm. Refraction, visual acuity (far, intermediate, near), photopic and mesopic contrast sensitivity, defocus curve, corneal and ocular spherical aberration, and pupil size were measured 4 weeks and 3 months postoperatively.

RESULTS:

The customized group comprised 48 eyes of 37 patients and the standardized group 26 eyes of 23 patients. At 3 months, mean total ocular SA (5 mm) was 0.04 ± 0.06 µm in the customized group and −0.01 ± 0.05 µm in the standardized group. Uncorrected distance visual acuity and distance-corrected near visual acuity were statistically significantly better in the customized group. Contrast sensitivity testing yielded significantly better results in the customized group under photopic and mesopic conditions for almost all spatial frequencies. Compared to the standardized group, the defocus curve of the customized group showed a wider plateau surrounding the distance focal point.

CONCLUSIONS:

With the implantation of an individually optimized aspheric IOL visual performance, especially contrast sensitivity, can be significantly improved compared to a standard aberration-correcting IOL.

[
J Refract Surg.
2019;35(9):565–574.]
A Randomized Comparative Study of Topography-Guided Versus Wavefront-Optimized FS-LASIK for Correcting Myopia and Myopic Astigmatism
Authors: Zhang Yu , Chen Yueguo
Published: September 2019

PURPOSE:

To compare clinical outcomes between topography-guided customized ablation treatment (TCAT) and wavefront-optimized (WFO) laser in situ keratomileusis (LASIK) in fellow eyes of myopic patients.

METHODS:

This prospective randomized contralateral study included 432 eyes of 216 myopic patients who underwent LASIK. TCAT was randomly performed in one eye (TCAT group) and WFO LASIK in the fellow eye (WFO group). The WaveLight FS200 femtosecond laser (Alcon Laboratories, Inc., Fort Worth, TX) was used to create the flap and the EX500 excimer laser was used for photoablation. The Sirius combined corneal topographer and tomographer system (CSO, Florence, Italy) was used to measure the corneal aberrations. Refractive and visual outcomes and corneal aberrations were compared between the two groups.

RESULTS:

At 1 month postoperatively, the uncorrected distance visual acuity (UDVA) was 20/20 or better in 89.4% of eyes in the TCAT group and 93.5% of eyes in the WFO group (
P
< .05). The UDVA became similar at postoperative 6 months (
P
> .05). Postoperative corrected distance visual acuity and residual manifest refractive spherical equivalent were similar between the groups (
P
> .05). The postoperative residual refractive astigmatism in the TCAT group was greater than that in the WFO group (
P
< .05). The optical path difference and root mean square of higher order aberrations and coma were significantly lower in eyes in the TCAT group at postoperative 1 and 6 months (
P
< .05).

CONCLUSIONS:

TCAT in virgin eyes induced less corneal optical path difference, fewer higher order aberrations, and less coma than WFO LASIK. However, TCAT was not as accurate as WFO, especially in astigmatism correction. A better compensation method for TCAT is warranted.

[
J Refract Surg.
2019;35(9):575–582.]
Advantages and challenges of using mobile ethnography in a hospital case study: WhatsApp as a method to identify perceptions and practices
Authors: Bjørner Thomas , Schrøder Morten
Published: September 2019

The focus of this article is to provide the reader with reflexivity and a framework for using mobile ethnography. Based on a case study with an ethnographic approach (including mobile ethnography using WhatsApp), we identified perceptions and practices for improved workflows and procedures related to nurses’ introduction and implementation of self-catheterization at the National Spinal Injuries Centre in Great Britain. We offer detailed procedures, advantages, and challenges in using mobile ethnography. The ethnographic approach consisted of four phases, including initial workshops, go-along observations, interviews, and a mobile ethnographic approach using WhatsApp as a mobile diary for six nurses. Within the case study, three major themes were revealed by the ethnographic approach, with the conclusion that nurses have positive attitudes towards self-catheterization, but these nurses are becoming less influential and the practices around this technique are consequently disappearing. The main result is that use of WhatsApp as a self-tracking tool can extend the methodological toolbox, but reflexivity and preliminary work are required to make the practice beneficial.
The microbiological impact of pulsed xenon ultraviolet disinfection on resistant bacteria, bacterial spore and fungi and viruses
Authors: Stibich Mark , Stachowiak Julie
Published: September 2019

Pathogens can persist in the patient care environment and cause the risk of transmission to patients. Pulsed xenon ultraviolet (PX-UV) is increasingly being used to disinfect patient rooms, operating rooms and other areas. Data on the impact of PX-UV on resistant bacteria, bacterial spores, fungi, viruses and the Ebola virus are lacking in the literature. Laboratory data are presented in this paper on the log reductions observed after the exposure of PX-UV to a variety of organisms in a laboratory setting.
Seroprevalence of polio antibodies in adult laboratory staff in South Africa, 2009 to 2013
Authors: Moonsamy Shelina , Suchard Melinda
Published: September 2019

The global eradication of polio has been a World Health Organization goal since May 1988 with the current target for global eradication set at 2018. A keystone of the eradication initiative is achieving and maintaining high immunisation coverage, producing high population immunity. Assessing infant vaccination coverage does not give a reliable indication of adult immunity levels as antibody titres decline with age. A requirement of the occupational health programme at the National Institute for Communicable Diseases is to test newly appointed personnel for immunity to polio. During the period 2009 to 2013, 352 sera were collected and tested by means of antibody neutralisation assays to determine immunity to all three polio serotypes. The objective of this study was to assess immunity to polio in personnel employed at the National Institute for Communicable Diseases as a proxy for the general adult South African population. The seroprevalence to polio serotypes 1, 2 and 3 were 85.5, 90.0 and 74.0%, respectively. Of the 352 samples tested, 2.3% were sero-negative for all three serotypes and 36.0% were sero-negative to at least one of the serotypes. The seroprevalence to polio serotype 3 falls below the target of 80.0%, and could pose a potential risk following importation or development of vaccine derived poliovirus type 3.
Group B streptococcus colonisation in pregnant women at Dr. George Mukhari Hospital, South Africa
Authors: Monyama M. C. , Bolukaoto J. Y. , Chukwu M. O. , Maloba M. R.B. , Moyo S. R. , Mavenyengwa R. T. , Nchabeleng M. , Lebelo S. L.
Published: September 2019

The aim of the study was to estimate group B streptococcus (GBS) colonisation in pregnant mothers using selective enrichment broth and solid media for culturing GBS. Vaginal and rectal swabs were collected from 413 pregnant women for GBS culture at recruitment stage. Direct plating and enrichment broth culture methods were compared by using the same swab samples. The swabs were cultured on colistin nalidixic agar (CNA) plate and incubated at 37°C and examined after 18-24 h. The samples which were culture negative on a CNA agar plate were then inoculated into a Todd-Hewitt enrichment broth to recover any GBS present that was not recovered on the solid agar. With the CNA agar plate, the samples were cultured separately to enable identification of colonised sites such as vaginal sites or rectal sites. Rectal and vaginal swabs were inoculated into Todd-Hewitt enrichment broth at the same time in the same tube. The GBS colonisation rate in pregnant women was 30.9% (128/413). The CNA agar plate recovered 45.3% (58/128) of the GBS isolates, whereas 54.7% (70/128) isolates were recovered from Todd-Hewitt broth. Pregnant women of various ages were found to be at risk of GBS colonisation. The colonisation rate was however highest among women of 25–29 age groups as compared with other age groups. Detection of group B streptococcus improved when both rectal and vaginal swabs were collected for laboratory analysis. The simultaneous use of Todd-Hewitt broth and CNA plate also improved the yield of group B streptococcus.
Assessment of knowledge, attitude and practice of post-exposure prophylaxis against blood-borne viral infection among dental surgeons in a teaching hospital
Authors: Okoh Mercy , Saheeb Birch D.
Published: September 2019

Background: This study was aimed at assessing the level of knowledge, attitude and practice of dental surgeons on human immunodeficiency virus (HIV) and hepatitis B virus (HBV) post-exposure prophylaxis (PEP).Methods: A descriptive, cross-sectional study was conducted among all the consenting dental surgeons at the University of Benin Teaching Hospital, Benin City, Nigeria, between May and July, 2015. The survey was carried out using a self-administered, anonymous, twenty-five item, and structured questionnaire.Results: A total of 40 (74.1%) males and 14 (25.9%) females responded in the study. The majority, 37 (68.5%), of the dental surgeons had inadequate knowledge about PEP. Majority of the dental surgeons, 44 (81.5%), had a good attitude towards PEP for HIV/HBV. From the study participants, 52 (96.3%) agreed on the importance of PEP for HIV/HBV in the work place. A high proportion of the respondents, 47 (87.0%), had been vaccinated against HBV. Among all of the respondents, 25 (46.3%) were exposed to HIV/HBV risky conditions. Sixteen of the 25 exposed dental surgeons, 16/25 (64.0%), did not take PEP. Among the respondents who did not take PEP, 15 of those 16 (93.6%) stated that their reason for not taking PEP was due to fear of stigma and discrimination.Conclusion: This study shows that knowledge and practice of dental surgeons towards PEP for HIV/HBV is inadequate. A formal PEP training centre with proper guidelines is recommended for dental surgeons.
Relationship between HIV serostatus, CD4 count and rehospitalisation: Potential implications for health systems strengthening in South Africa
Authors: Moodley Yoshan , Tomita Andrew
Published: September 2019

Background: Despite three decades of scientific response to HIV/AIDS, the generalised HIV epidemic continues to persist in South Africa. There is growing acknowledgement that health system strengthening will be critical in tackling HIV/AIDS. Patient rehospitalisation is an important quality benchmark of health service delivery, but there is currently limited data on rehospitalisation of patients with HIV/AIDS in South Africa, a setting with a high burden of HIV disease.Objectives: To determine the relationship between combined HIV serostatus and CD4 count, and rehospitalisation in South Africa.Methods: This study was a retrospective analysis of data from 11,362 non-surgical adult patients who attended the Hlabisa Hospital in South Africa. Data related to patient age, gender, HIV serostatus, CD4 count (for HIV-positive patients) and comorbidity were analysed through univariate (Fisher’s Exact or χ2 tests) and multivariate (Cox regression) statistical methods to determine associations with rehospitalisation within 1 month (acute rehospitalisation) or 12 months (long term rehospitalisation).Results: An HIV-positive serostatus with CD4 count 350 cells/mm3 or an HIV-positive serostatus with an unknown CD4 count were independently associated with a higher risk of acute (p = 0.010 and p = 0.003) and long term rehospitalisation (p 0.001 for both categories) when compared with an HIV-negative serostatus group.Conclusions: HIV-positive individuals with immune deficiency, or lacking a CD4 count measurement are at risk of rehospitalisation. Strengthening primary healthcare service delivery of these key affected inpatient populations should be a priority.
First report of neonatal bacteraemia caused by blaNDM-1 Raoultella ornithinolytica
Authors: Mahabeer Yesholata , Singh-Moodley Ashika , Mackanjee Harshavadan , Perovic Olga , Mlisana Koleka P.
Published: September 2019

Raoultella ornitholytica, an environmental organism, has only recently been reported as a cause of infections in humans, and is associated mainly with bacteraemia in elderly patients. Carbapenem resistance is unusual in Raoultella spp. We describe the first paediatric case of blaNDM-1 Raoultella ornitholytica bacteraemia in a preterm neonate that developed three days after hospitalisation. This case report discusses a rare organism that had an unexpected susceptibility profile and caused bacteraemia in a neonate. Treatment options are explored.
An investigation of maternal mortality at a tertiary hospital of the Limpopo province of South Africa
Authors: Ntuli Sam T. , Mogale Mabina , Hyera Francis L.M. , Naidoo Shan
Published: September 2019

Objective: To understand the elements influencing the maternal deaths in the Limpopo province, South Africa.Methods: A retrospective review of all maternal deaths which occurred at the Pietersburg Hospital, Limpopo province was done over a five-year period (January 2011 to December 2015). The hospital death register was used to collate a list of maternal deaths occurring during the study period. The medical records of maternal deaths were reviewed. The total deliveries and live births for each year were obtained from the delivery registers. The data collected included maternal age, parity, referring facility, date of admission, date and time of death, ward where death occurred, and cause of death.Results: There were 14 685 live births and 232 maternal deaths between 2011 and 2015, resulting in an institutional Maternal Mortality Ratio (iMMR) of 1579/100 000 live births. The mean age of the patients was 29 years. Forty-three per cent of deaths occurred within 24 hours of admission, 35% died in ICU and 89% were referred from regional and district hospitals and community health centres. Of the referred patients, 83% were from district hospitals. Obstetric haemorrhage and pre-eclampsia, or eclampsia, were the main causes of death.Conclusion: The iMMR at Pietersburg Hospital remains unacceptably high. Most of the maternal deaths are due to obstetric haemorrhage, pre-eclampsia or eclampsia, medical and surgical disorder and non-pregnancy related infections.
Evaluation of the Copan eSwab®, a liquid-based microbiology transport system, for the preservation of Neisseria gonorrhoeae at different temperatures
Authors: Gumede Lindy , Radebe Frans , Nhlapo Duduzile , Maseko Venessa , Kufa-Chakezha Tendesayi
Published: September 2019

Aims and objectives: To evaluate the survival duration of Neisseria gonorrhoeae from male urethral discharge specimens collected using the Copan eSwab® liquid-based microbiology transport system, at both ambient and refrigerator temperatures.Methods: Three urethral swabs (one Dacron, two Copan eSwabs®) were collected from each male patient presenting with purulent urethral discharge to a community-based primary healthcare centre in Johannesburg. The Dacron swab was directly inoculated onto New York city agar medium, and the Copan eSwabs® transported and held at room and refrigerator temperature, for daily sub-culture onto New York city agar over a total period of seven days (168 h). The utility of Copan eSwabs® for the transport and survival of N. gonorrhoeae at different temperatures was determined by comparison to culture obtained by ‘gold standard’ direct plate inoculation.Results: N. gonorrhoeae isolation rates from Copan eSwabs® at fridge temperature and ambient temperature were as follows: 87.9% vs 79.3% at 48 h; 67.2% vs 60.3% at 72 h; 60.3% vs 22.4% at 96 h; and, 53.4% vs 3.4% at 120 h, respectively. The viability of subculture decreased significantly from eSwabs® maintained at room temperature from 96 h onwards of specimen collection.Conclusion: To ensure the preservation and an acceptable isolation rate of N. gonorrhoeae from urethral discharge specimens, Copan eSwabs® should be transported and maintained at refrigerator temperatures, and must reach the processing laboratory by at least 120 h (5 days) after collection.
Mechanisms of antibiotic resistance in Haemophilus parainfluenzae
Authors: Abotsi Regina E. , Govinden Usha , Essack Sabiha Y.
Published: September 2019

Haemophilus parainfluenzae is part of the HACEK group of fastidious bacteria commonly implicated in endocarditis and bacteremia. Previously considered as a normal respiratory, oral and sometimes genitourinary commensal, it has been recognised as a pathogen that can cause life-threatening infections in both immunocompromised and healthy individuals. It has also been reported as a bacterium that can harbor transferable antibiotic resistance genes. This paper presents a literature review on the molecular mechanisms of resistance of H. parainfluenzae to commonly prescribed antibiotics and discusses areas for further research.
Infectious Diseases Threat and Africa’s Health Security
Authors: Nkengasong John , Kamwi Richard
Published: September 2019

No abstract available.
Anaemia in pregnancy in a setting of high HIV prevalence rates
Authors: Tunkyi Kay , Moodley Jagidesa
Published: September 2019

Background: Although there is much literature on anaemia in pregnancy, there are limited data on anaemia specific to HIV in pregnancy. The aim of this study was to determine the prevalence of anaemia among HIV-infected antenatal attendees at their first visit.Methods: This was a secondary analysis of 2 000 antenatal attendees enrolled into a study on anaemia in pregnancy and was carried out at a regional hospital from 2012–2014. Demographic and clinical data including anaemia, perinatal and maternal outcomes of HIV infected women were analysed.Results: Of the 2 000 recruited, 854 (42.7%) were anaemic, 943 (47.2%) were infected with HIV, and 609 (64.6%) HIV-infected women had anaemia. There was a significant difference in the prevalence of anaemia in HIV-infected patients on antiretroviral (ARV) treatment compared to untreated patients (41.4% vs 92.1%; p 0.0001). Mild grades of anaemia were common in HIV-infected patients on ARVs, while moderate to severe grades were most common in patients who were not on ARVs. Besides birthweight and hypertensive disorders of pregnancy, there was no significant difference in neonatal and maternal outcomes irrespective of duration of ARV treatment.Conclusions: There was a high prevalence of anaemia among HIV-infected, untreated pregnant women. Assessment of anaemia at the first antenatal visit is, therefore, essential.
Diagnostic and mortality outcomes in a cohort of adult meningitis suspects in KwaZulu-Natal
Authors: Nonkala Onke , Aldous Colleen , Wilson Douglas
Published: September 2019

Background: The clinical value of lumbar puncture (LP) in settings with a high human immunodeficiency virus (HIV) prevalence has not been well defined.Methods: We performed a retrospective chart review in 394 adults undergoing LP at a single regional level public-sector hospital in KwaZulu-Natal, South Africa.Results: The median age of all the participants was 32.8 years (interquartile range 26.7; 41.2). Two hundred and fifty-five participants (64.7%) had an abnormal cerebrospinal fluid (CSF) analysis; 202 (79.5%) of whom were HIV seropositive. Sixty-four (25.1%) were diagnosed with tuberculosis meningitis and 62 (24.3%) tested positive for cryptococcal antigen. Thirty-three specimens grew Cryptococcus neoformans (32 tested antigen positive) and Streptococcus pneumonia was isolated in three specimens (0.8%). An abnormal CSF result was associated with increased risk of inpatient death (OR 3.8 [95% CI 1.7; 9.6]; p-value = 0.0004)Conclusions: CSF abnormalities were common in this cohort of adults with suspected meningitis in KwaZulu-Natal, and were associated with increased odds of mortality in hospitalised participants.
Invasive and non-invasive group A β-haemolytic streptococcal infections in patients attending public sector facilities in South Africa: 2003–2015
Authors: Barth Dylan , Mayosi Bongani M. , Badri Motasim , Whitelaw Andrew , Engel Mark E.
Published: September 2019

Background: The burden of disease caused by group A streptococcus (GAS) in Africa is largely unknown. The aim of this study was to determine the incidence of invasive (iGAS) and non-invasive GAS (non-iGAS) infections in patients attending the public health sector of South Africa.Methods: iGAS and non-iGAS infection was defined as GAS isolated in culture from sterile and non-sterile sites respectively. Using annual census data, we calculated incidence rates (IR) of iGAS and non-iGAS infection by reviewing cases from the National Health Laboratory Service (NHLS) database derived from the 9 provinces of South Africa between 2003 and 2015.Results: About 50% of the samples were collected in the Eastern Cape province which had data for all the years under observation; missing data from the other eight provinces precluded analysis of annual incidence. A multi-modal distribution of 5 256 GAS cases was observed in the Eastern Cape province. iGAS cases (n = 428) showed an annual mean IR of 0.48 (Range: 0.15–1.12) cases per 105 per year (py) with a marginal decrease from 2003 to 2015 (Rate Difference (RD), 0.23/105 py; 95% CI: 0.02–0.44/105 py). The mean annual IR for non-iGAS infection (n = 4828) was 5.48 (Range: 0.19–11.55) cases/105py; IR showed a decrease (RD, 11.36/105 py; 95% CI: 10.53–12.19/105 py). The Mann-Kendall test and the Theil-Sen estimator showed a decreasing trend in the incidence of non-iGAS infection (p = 0.002) over the study period.Conclusions: The incidence of non-iGAS infection in the Eastern Cape province of South Africa declined from 2003 to 2015. The trends from the Eastern Cape and incomplete data from other provinces indicate the need for a detailed prospective evaluation of GAS infection in South Africa to verify this trend and provide information for planning appropriate interventions.
Where have all the flowers gone? – Changing climate, seasons and weather and the challenges and opportunities for public health research
Authors: Sweijd Neville , Wright Caradee Y.
Published: September 2019

No abstract available.
Risk factors associated with MRSA
Authors: Gupta Sonal , Mishra Bibhabati , Thankur Archana , Dogra Vinita , Loomba Poonam S. , Jain Manisha , Bhargava Aradhana
Published: September 2019

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infection is associated with increased morbidity and mortality compared with infections caused by methicillin-sensitive Staphylococcus aureus (MSSA). Treatment of MRSA infection is complicated by the fact that these organisms are resistant to multiple antimicrobial agents, so treatment options are limited. The aim of the present study is determine risk factors association with MRSA as compared with MSSA and to compare the minimum inhibitory concentrations (MICs) of vancomycin, teicoplanin, linezolid and erythromycin to MRSA and MSSA.Methods: A nine-month prospective study was carried out. Staphylococcus aureus strains with clinical correlation, isolated from hospitalised patients, were included in the study. MIC of vancomycin, teicoplanin, linezolid and erythromycin was determined by E-test (HIMEDIA). Risk factors such as immunosuppression, previous hospitalisation, surgical procedure done, invasive devices and antibiotic therapy were determined by a pre-set protocol.Results: A total of 62 S. aureus strains were included in the study. Some 40% of S. aureus strains were methicillin resistant. The risk factors, invasive devices, previous hospitalisation and comorbid illness were found to be significantly associated with MRSA. Borderline significant association was observed with immunosuppression and antibiotic therapy. Erythromycin resistance was observed in 56% of MRSA, while no resistance was observed in MSSA. Teicoplanin MIC50 values and mean MIC were found to be lowest in vitro among vancomycin and linezolid against both MRSA and MSSA. The efficacy of teicoplanin, in terms of clinical and microbiological cure, has not been proven to be superior to vancomycin, but it has a better toxicity profile and has demonstrated a reduced risk of adverse events. Conclusions: Minimising risk factors and attention to alternative antibiotics and infection control practices may ease the problem of management of infections with MRSA.
Antimicrobial resistance surveillance in the South African private sector report for 2016
Authors: Perovic Olga , Ismail Husna , Van Schalkwyk Erika , Lowman Warren , Prentice Elizabeth , Senekal Marthinus , Govind Chetna N.
Published: September 2019

Aim: The relevance of surveillance for antimicrobial resistance is increasingly recognised in the light of a global action plan to combat resistance. This report presents antimicrobial susceptibility testing on ESKAPE pathogens from private sector laboratories in South Africa for 2016.Methods: Antimicrobial susceptibility testing (AST) performed on ESKAPE organisms (Enterococcus faecium, Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter cloacae and Escherichia coli) isolated from blood cultures at four private pathology laboratories in 2016 were analysed. Analysis and reporting of data were done via a uniform platform created by the NICD for national AST data.Results: AST were reported on 9 029 ESKAPE organisms including 58% Enterobacteriaceae, 28% Gram-positive bacteria and 14% Gram-negative bacteria and drug-bug combination was performed following the Global Antimicrobial Surveillance System (GLASS) guidelines by the World Health Organization.Conclusions: The most important resistance to address is a high level of ESBL in Enterobacteriaceae, which necessitates the use of carbapenems for treatment. Resistance to carbapenems is recorded in this report but not confirmation of genes by genotypic methods. During this period, no increase in vancomycin-resistant Enterococci was observed.
Bacterial infections in hospitalised severely malnourished children in Durban, South Africa
Authors: Nyamurenje Lionel , Archary Moherndran
Published: September 2019

Background: Severe acute malnutrition (SAM) results in alterations of host defence mechanisms, which leads to increased susceptibility to infections. This study describes culture-confirmed bacterial infections in a cohort of HIV-negative severely malnourished children and compares it with a previously described cohort of HIV-positive children.Methods: A retrospective chart review was conducted of all HIV-negative children with SAM admitted to King Edward Hospital, Durban between January 1, 2015 and December 31, 2015. All positive bacterial cultures obtained within 2 days of admission (admission infections) and during 2 to 30 days of admissions (hospital acquired infections) were documented. A cohort of HIV-positive children with SAM was prospectively recruited between July 2012 and February 2015 at the same facility for the MATCH study.Results: A total of 101 patients were eligible for the study, 53% were HIV unexposed; 73% of the total 250 cultures obtained were during admission. Escherichia coli (E. coli) contributed 26% of all positive cultures on admission. Significant differences were noted in laboratory variables between HIV-negative vs. HIV-positive children admitted with SAM. Extended-spectrum betalactamase (ESBL) producers in HIV-positive patients constituted 40% of all Gram-negative isolates vs. 24% in HIV-negative patients.Conclusion: Gram-negative organisms remain an area of concern in both HIV-positive and HIV-negative patients with SAM with resistant organisms more prevalent in HIV-positive patients. Prevention of mother-to-child transmission of HIV reduces prevalence and incidence of HIV, which has been shown to contribute to the burden of bacterial infections in malnourished children.
Herpes simplex virus-2 infections in pregnant women from Durban, South Africa: prevalence, risk factors and co-infection with HIV-1
Authors: Abbai Nathlee S. , Govender Shanthie , Nyirenda Makandwe
Published: September 2019

Currently there is a lack of data on herpes simplex virus-2 (HSV-2) and human immunodeficiency virus-1 (HIV-1) co-infections as well as risk factors for infection in antenatal women from South Africa. The present study attempts to fill this gap. This cross-sectional study was conducted from April to August 2017 at the antenatal clinic of the King Edward VIII hospital in Durban, South Africa. In total 248 pregnant women participated in the study. Data on the women’s demographics, sexual behaviour and clinical information were collected. HIV testing was conducted using a rapid test and the HerpeSelect 2 ELISA was used to test for HSV-2. The prevalence of HSV-2 and HIV-1 was 71% and 50% and coinfection rate was 60%. In adjusted analyses, women who were aged ≥ 35 years (adjusted odds ratio [AOR]: 4.95, p = 0.01), experienced recent symptoms of genital itching/sores/warts (AOR 2.48, p = 0.05) and were HIV-positive (AOR 3.64, p0.01), were more likely to be infected with HSV-2.Older age (30–34 years old) (AOR 6.53, p 0.01) and having ≥ 4 lifetime sex partners (AOR 4.59, p = 0.03) were strongly associated with HSV-2/HIV-1 co-infections. The findings of this study call for continuous risk reduction counselling in this population.
CCT: a coordinate conversion tool for hepatitis B virus
Authors: Bell Trevor Graham , Yousif Mukhlid , Kramvis Anna
Published: September 2019

The hepatitis B virus (HBV) genome has ∼3 200 nucleotides, coding for seven proteins in four overlapping open reading frames (ORFs). Comparison of genomic coordinates between different samples and/or published literature requires manual conversion. An online tool is presented to convert nucleotide or amino acid positions between ORFs, regions and domains of the HBV genome. The user enters a position into an interactive web page, which then shows this position in all other applicable ORFs, regions or domains and plots it on a diagrammatic representation of the HBV genome. This tool assists researchers to convert coordinates, thereby facilitating comparisons between samples.