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[Review of Poetry experience: Teaching and writing poetry in secondary schools by Stephen Tunnicliffe]
(Johannesburg College of Education, 1985-03) Faller, Francis
Aesthetics and resistance: aspects of Mongane Wally Serote's poetry.
(1990) Frielick, Frielick Stanley
The literature produced by writers who align themselves with national liberation and resistance movements presents a serious challenge to dominant standards of literary . aesthetics. Resistance writing aims to break down the assumed division between art and politics. and in this view literature becomes an arena of conflict and struggle. This dissertation examines certain aspects of the poetry of Mongane Wally Serote in order to explore the relationship between aesthetics and resistance in his writing. Over the last two decades, Serote has made a significant contribution to the development of South African literature, and his work has important implications for literary criticism in South Africa. Chapter 1 looks at some of these implications by discussing the concept of resistance literature and the main issues arising from the debates and polemics surrounding the work of Serote and other black political writers. Perhaps the most important here is the need to construct a critical approach to South African resistance literature that can come to terms with both its aesthetic qualities and political effects. This kind of approach would in some way attempt to integrate the seemingly incompatible critical practices of idealism and materialism. Accordingly, Chapter 2 is a materialist approach to aspects of Serote's early poetry. The critical model used is a simplified version of the interpretive schema set out by Fredric Jameson in The Political Unconscious. This model enables a discussion of the poetry in relation to ideology, and also suggests ways of examining the discursive strategies and symbolic processes in this particular phase of Serote's development. Serote's later work is 'characterised by the attempt to create a unifying mythology of resistance. Chapter 3 thus looks at Serote's long poems from an idealist perspective that is based on the principles of myth-criticism, As this is a complex area, this chapter merely sketches the main features of Serote' s use of myth as a form of resistance, and then suggests further avenues of exploration along these lines. The dissertation concludes by pointing towards some of the implications of recent political developments in South Africa for Serote and other resistance writers.
The problem of audience: a study of Durban worker poetry.
(1993) Kromberg, Steve
This dissertation shows how both poets and their audiences have played a central role in the emergence of Durban Worker poetry. A review of critical responses to worker poetry concludes that insufficient attention has been paid to questions of audience. Performances of worker poetry are analysed, highlighting the conventions used by the audience when participating in and evaluating the poetry, Social, political and literary factors which have influenced the audience of worker poetry are explored, as are the factors which led to the emergence of worker poetry. In discussing the influence of the Zulu izibongo (praise poetry) on worker poetry, particular attention is paid to formal and performative qualities. The waye in Which worker poetry has been utilised by both poets and audience as a powerful intellectual resource are debated. Finally, the implications of publishing worker poetry via the media of print, audio-cassettes and video-Cassettes are discussed.
New onset diabetes post renal transplantation
(2009-02-12T11:43:48Z) Harrichund, Pretissha
ABSTRACT Diabetes mellitus is a major cause of morbidity and mortality and is the leading cause of end-stage renal disease worldwide. New onset diabetes post renal transplantation is associated with reduced graft function, decreased patient survival and increased risk of graft loss. The immunosuppressive regimes used and dosage of corticosteroid therapy appear to impact on the incidence of new onset diabetes post renal transplantation. The objectives of this study were: to ascertain the prevalence of new onset diabetes post transplantation; to determine the association between new onset diabetes with immunosuppressive regimens and ethnicity; and to assess outcomes in terms of morbidity and mortality. The study design consisted of a retrospective analysis of 398 patient files transplanted between 01/07/1994 and 30/06/2004. Information retrieved from the files consisted of patient demographics ( age, race, gender ), weight, date of onset of diabetes, immunosuppressive regimens used, infections, cardiovascular and overall morbidity and mortality. The diagnosis of diabetes was based on the American Diabetes Association (ADA) criteria or the requirement for anti-diabetic agents. Results obtained showed that 15.58% (62/398) of patients became diabetic. The mean time to onset of diabetes was 22.9 months ( range 1 week to 100 months ). 20.21% Black patients (p=0.100), 9.42% White, 12.5% Coloured and 12% Indian patients became diabetic. Treatment with Cyclosporine( CyA) had an incidence of diabetes of 14.44%, Tacrolimus 20.25% p = 0.228, Rapamune 11.36% and Mycophenolate Mofetil 11.97%. Infections occurred in 96.77% of diabetic patients, p = <0.0001. Cardiovascular morbidity and mortality was 11.29%, p = 0.82. Overall mortality was 79.3% in the diabetic group p = 0.237, HR 1.45. In conclusion, the incidence of new onset diabetes is significant as it confers a higher risk of infections and overall mortality. Black patients are more affected, with an increased risk for those treated with Tacrolimus.
An analysis of reasons for exclusion of potential live kidney donors
(2009-03-23T07:34:50Z) Levy, Cecil Steven
Barriers to protection: gender-related persecution and asylum in South Africa
(2009-10-12T12:24:42Z) Middleton, Julie
In 1998, South Africa became the first country to explicitly state within its refugee law that gender related persecution is a binding basis for asylum, further distinguishing South Africa as a state with outstanding legal commitments to gender equality. Creating further visibility within the law, however, is only one step in the process. How the law is implemented determines its real worth and effectiveness. This study assesses the manner in which asylum decisions are made, particularly in cases of gendered harm, questioning readily accepted and essentialised notions of women and gender. It looks at how the South African asylum system defines legitimate refugees, and the interplay of fluid interpretations of gender, culture, violence and the political within these constructions. Through interviews with officials and asylum seekers, the study identifies trends in the refugee system, and interrogates the reliance on narrow understandings of the political and personal, as well as the nature of conflict and culture.
Enhancing the doctor-patient relationship: living, dying and use of the living will
(2009-10-21T10:58:09Z) Etheredge, Harriet
The research aims to establish whether processes around the consideration and execution of the living will help enhance the doctor-patient relationship. Studies have shown that the living will is not used frequently, and that the doctor-patient relationship is often deficient. The research explores the two primary topics – the living will, and the doctor-patient relationship – separately. Each primary topic is approached via a consideration of the relevant literature, and each is then analyzed from a theoretical–ethical point of view. A synthesis of these separate investigations is presented. This synthesis concludes that the living will can help enhance the doctor-patient relationship.
Analysis and interpretation of Iron studies and Vitamin C levels in paediatric patients with chronic renal failure
(2010-08-24) Lutz, Tracey Leigh
This prospective observational study analysed iron studies and vitamin C levels in patients with chronic kidney disease attending Johannesburg Hospital Paediatric Nephrology Clinic. The rationale behind this study was to determine the extent of iron deficiency among patients in chronic renal failure. Vitamin C deficiency is common among dialysis patients, it is easy to test for and easy to prevent. This study may assist in guiding future management with regards to vitamin C supplementation in patients with chronic renal insufficiency on dialysis. The study contained 45 patients of which 27 (60 %) were male and 18 (40 %) were female. The ages of the children varied from 2 years 1 month to 19 years and 7 months. The study included patients from all ethnic groups; 9 were Caucasian, 33 African, 2 Indian and 1 Coloured. Two male patients did not have Vitamin C levels analyzed. The patients were divided into 3 distinct groups; firstly those patients on haemodialysis (12 patients), those on peritoneal dialysis (22 patients) and those not yet dialysed (11 patients). In all patients who were not yet on dialysis the GFR ranged between 18.1 and 45 ml/min/1.73m2. There were no statistically significant differences between the three groups when the results of the iron studies were analysed. However, despite iron treatment 26.6 % of patients were iron deficient as indicated by their transferrin saturation which was less than 20 %. Vitamin C levels were also analysed in this study. Forty one percent of children in chronic renal failure were vitamin C deficient. There was no statistically significant variability among the three groups. Two patients (4.6%) were noted to be Vitamin C toxic. One of these patients was haemodialysed; the other was not yet on dialysis. Vitamin C deficiency in chronic renal insufficient patients on dialysis is easily correctable when identified. Vitamin C in specific well documented doses is safe to administer to this group of patients. It will also enhance the absorption of iron and thereby have an indirect effect on anaemia.
Understanding intimate femicide in South Africa
(2010-09-22) Mathews, Shanaaz
When a woman is killed she is most likely to be murdered by an intimate partner. This form of homicide known as intimate femicide is conceptualised to be the most extreme consequence of intimate partner violence. Not much is known about such killings in South Africa or in other developing settings. This thesis studied intimate femicide using two complimentary studies from two methodological perspectives. The first study was quantitative with the aim of describing the incidence and pattern of intimate femicide in South Africa. The second study used qualitative methods and explored the social construction of the early formation of violent masculinities. Five papers written from these two studies are presented in this thesis. Study one was a retrospective national mortuary-based study and collected data on all female homicides, 14 years and older, who died in 1999 from a stratified, multi-stage sample of 25 mortuaries. Data was collected from the mortuary file, autopsy report, and a police interview. The second study used a cluster of qualitative in-depth interviews with 20 incarcerated men in prison who have been convicted for the murder of an intimate partner, as well as interviews with family and friends of both the perpetrator and the victim. Overall it was found that 50.3% of women murdered in South Africa are killed by an intimate partner, with an intimate femicide rate of 8.8/100 000 and an intimate-femicide suicide rate of 1.7/100 000 females 14 years and older. Blunt force injuries were shown to be associated with intimate killings, while gun ownership was associated with intimate femicide-suicides. vi elevated Blood Alcohol Concentration (BAC) combined with unemployed status was also found to be associated with intimate killings. The qualitative study showed that traumatic childhood experiences such as violent and neglectful parenting practises particularly by mothers made these men feel unloved, inferior and powerless with this found to be a pathway to violent models of masculinity used as a means to attain power and respect. This study shows that such traumatic experiences can lead to a suppression of emotions. It is argued that cognitive dissonance act as a protective mechanism which allows these men to perpetrate acts of violence without consideration of its impact. These findings suggests that intimate femicide is a complex phenomenon with a “web” of associated and mediating factors which all contribute to it excessive levels in South Africa. It shows that intimate femicide is an extension of intimate partner violence and as such has to take into account the unequal gender relations in society. Building gender equity and shifting patterns of femininity and masculinity is a key strategy in reducing this form of violence.
Levels and factors associated with homicide-related deaths in a rural South African population
(2011-03-25) Otieno, George Omondi
Background: World Health Organization (WHO) estimates that more than 1.6 million people die every year because of violence and out of these deaths, homicide accounts for almost one third. Ninety percent (90%) of homicide are thought to occur in low and middle income countries. South Africa has one of the most disturbing rates of homicide in the world. These high homicide rates besides resulting in reduced life expectancy also have serious health, social and economic consequences. Aim: The study aimed at quantifying the burden as well as and identifying factors associated with homicide deaths in rural KwaZulu-Natal in South Africa during the period of 2000 to 2008. Objectives: To estimate a 9 year period (2000-2008) homicide incidence rates as well as identify factors associated with homicide-related deaths. Further, the analysis described spatial distribution of homicide-related deaths in a rural South African population. Design: Analytical longitudinal study. Methods: Using data drawn from the Verbal Autopsies (VAs) conducted on all deaths recorded during annual demographic and health surveillance over a 9-year period (2000-2008), Kaplan-Meier (K-M) survival estimates of incidence rates were used to estimate the cumulative probability of death until the end of the period. Estimates were reported by sex and residency. Weibull regression methods were used to investigate factor associated with homicide deaths. Kulldorff spatial scan statistics was used to describe homicide clustering. Results: With 536 homicide-related deaths, and 814, 715 total Person Years of contribution, the study found an overall incidence rate of 66 (95% CI= (60, 72) per 100, 000 Person Years of v Observation (PYOs) for the period studied. Death due to firearm was reported the leading cause of mortality (65%). Most deaths occurred over the weekends (43%), followed by Friday (16.2%).The highest homicide incidence rates were recorded in 2001 (90; 95% CI= (71, 111) per 100,000 person years at risk and 2004 (86; 95% CI= (68, 108) per 100,000 person years at risk. Males had a rate that was about six times more than females 115 (95% CI=105,127) per 100,000 PYOs. Age-specific homicide rate were highest among males aged 25-29 years (209.90 per 100,000 PYOs) and females aged 50-54 years (78 per 100,000 PYOs). Resident, age, sex, education, socioeconomic status, and employment independently predicted homicide risk. The study identified two geographical clusters with significantly elevated homicide risk. Conclusion: A significant six fold difference in homicide rate existed between males and females. Sex differential increases with age, with males aged 15-54 years the most likely to be killed, and females aged 55 years and above having the highest homicide rate. Increase in wealth status and level of education increases one‘s risk of homicide. Employment per se was protective from homicide risk. Firearm was the leading cause of mortality. Most deaths occur over the weekend. Two geographical areas with elevated homicide risk were observed. These findings underscore the need to have timely information and strategies for effective violence prevention program to subgroups and areas at risk.
Exposure to violent crime, fear of crime, and traumatic stress symptomatology.
(2011-04-13) Engelbrecht, Sarah-Kate
The central aim of the study was to investigate the relationships between exposure to violent crime, traumatic stress symptomatology, and fear of crime. Secondary areas of interest included the effect of the frequency of exposure to violent crime on traumatic stress symptomatology and fear of crime, as well as sex differences in the three main variables of study. In order to explore these aims, a quantitative cross-sectional research design was used. Measures included a self-developed exposure measure, the Impact of Event Scale-Revised, and a fear of crime measure used in a previous South African study. The sample was comprised of 216 first-year university students at the University of the Witwatersrand in Johannesburg. Statistical analyses included descriptive statistics, Pearson’s correlations, t-tests, and analysis of variance (one-way and two-way) and post-hoc t-tests. The results of the research indicated high levels of exposure to violent crime (including direct and indirect exposure). Almost half the sample (47%) reported exposure to violent crime in the preceding 12 months. Furthermore, over half the sample (58%) reported direct exposure to non-crime trauma in the preceding 12 months, with only about one-quarter of the sample (20%) reporting no exposure to any kind of trauma in the preceding 12 months. It was thus unsurprising that levels of traumatic stress symptomatology were generally in the moderate range and at least 20% of the total sample reported traumatic stress symptomatology of clinical concern. Fear of crime was found to be rather pervasive in the sample. Findings showed support for the relationships between exposure to violent crime and traumatic stress symptomatology, exposure to violent crime and fear of crime, and fear of crime and traumatic stress symptomatology. Significant differences were found between groups based on level and type of exposure and significant correlations were found between the perceived severity of exposure to violent crime on the one hand, and traumatic stress symptomatology and fear of crime on the other hand. Frequency of exposure to violent crime was found to be significantly related to fear of crime but not to traumatic stress symptomatology. Female subjects reported significantly higher perceived severity of exposure to violent crime, hyperarousal related symptoms and fear of crime. The implications of the findings are explored.
The demographic profile, substance use, competence to stand trial and criminal responsibility among “ Observation Patients” admitted for forensic psychiatric evaluation at Sterkfontein Hospital, Gauteng, South Africa.
(2011-10-19) Pillay, Anben
A review of the literature indicates that young males, who are unemployed with low levels of education, predominate in populations of pre-trial criminal offenders suspected of having a psychiatric illness, also known as “Observation Patients” according to the Criminal Procedures Act of 1977 in South Africa. Other contributory factors include a history of mental illness and non-compliance on psychiatric medication, a previous forensic history, co-morbid substance abuse and being intoxicated at the time of the offence. Dual diagnosis is considered a key contributor to criminal behaviour in this group of patients. The review of the literature also shows a significant proportion of co-morbid intellectual disability among offenders found to be psychiatrically ill at the time of the criminal event. A previous study conducted 20 years earlier, in 1986 at the Sterkfontein Forensic Psychiatric Unit by Vorster (1986) showed that the typical profile was a single, unemployed, poorly educated male in his twenties, usually with a history of psychiatric treatment. This typical profile confirmed the evidence in the literatures at the time of the study.
Media representations of gratuitous violence in South Africa.
(2012-01-17) Green, Mailie
No abstract present on CD or dissertation.
A review of patterns of renal disease at Chris Hani Baragwanath Academic Hospital from1982 to 2011
(2014) Vermeulen, Alda
This study reports a review of biopsy-confirmed renal pathology from Soweto Gauteng. A retrospective analysis was conducted of 1848 adult native renal biopsy reports from Chris Hani Baragwanath Academic Hospital from 1 January 1982 to 31 December 2011. The mean age of all patients biopsied was 33.5 ± 12.6 years and the majority of patients (96.4%) were black. The most frequent histological findings were secondary glomerular diseases (SGNs) (49.3%) and primary glomerular diseases (PGNs) (39.7%). SGNs increased, while PGNs decreased over time (p<0.001). The main contributors to SGN were lupus nephritis (31.0%) and HIV associated nephropathy (HIVAN) (13.3%) while for PGN it was focal segmental glomerulosclerosis (FSGS) (29.6%). HIV positive biopsies constituted 19.7% of all biopsies with a dominant diagnosis of HIVAN (32.7%). Changing patterns of renal disease are evident in the data. The increased SGNs likely reflect the influence of renal pathology secondary to HIV and lupus nephritis.
'Visions of land in the poetry of Chenjerai Hove and Musaemura Zimunya"
(2014-01-20) Mapanzure, Rangarirayi
Land occupies a special position in the history of Zimbabwe and the African continent in general. The research aims to critically examine the seemingly contradictory visions of land in Zimbabwean poetry. In their poetry, Musaemura Zimunya and Chenjerai Hove concoct startling images of the land or landscape in Zimbabwe. This forces one to not only gaze at the land or landscape but also engage with other broad issues related to literature and history. The research attempts to answer a number of questions. It discusses how history has shaped the Zimbabwean terrain and how this has been captured by the imaginative processes. The focus is on how land is depicted in Zimbabwean poetry and literature in general showing the overall significance of colonialism in this respect. It then examines in detail the poetry of the selected poets showing how each particular poet envisions the land. The poets seem to betray conflicting “structures of feeling”. The research explores the contentious issue of “demarcations” or “boundaries” of “country” and “city” focusing on the perceived conflicted relationship between the “two”. An attempt is then made to make alternative reading of the selected poets’ reading of the land. It is argued that the poets’ visions of landscape are in fact a rejection of the present and future, which may be seen as amounting to, in broad terms, an indictment of the postcolonial condition. The poetry evokes feelings and fantasies of escape from the land but ironically to the land which seems to fail to live up to the expectations.
Establishment of a flow cytometric assay in the setting of renal transplant for T and B cell crossmatching
(2014-02-17) Ramparsad, Narisha
Donor specific crossmatching is performed prior to renal transplantation in order to determine the presence of pre-existing antibodies against donor HLA antigens which can result in hyperacute rejection. Flow cytometric crossmatching is reported in the literature to be a more sensitive and objective method of testing than the complement dependent cytotoxicity (CDC) method that is currently used in the Gauteng Province. A prospective analysis of the flow cytomeric crossmatch (FCXM) assay using the Luminex technology as the reference method was conducted. Forty-three samples were analysed. The T cell crossmatch (using a cutoff value of 2) revealed a sensitivity of 66.7%, a specificity of 83.8%, a positive predictive value (PPV) of 40% and negative predictive value (NPV) of 93.9%. The B cell crossmatch (using a cutoff value of 5) gave a sensitivity of 100%, specificity of 92.7%, and a PPV and NPV of 40 and100%, respectively. In addition, a retrospective analysis of clinical data for all patients transplanted during the period January 2008 to May 2009 was performed. Of a total of 50 patients assessed post transplant, none of the patients showed signs of hyperacute rejection, while twelve percent (12%) of patients revealed signs and symptoms suggestive of acute rejection. The validation of the flow cytometric crossmatch analysis was complex as there is no gold standard reference method. The assay was validated based on the clinical relevance of its high negative predictive value and the absence of hyperacute rejections in the clinical follow up. The rate of acute rejection found in this study is similar to that reported in literature.
Outcome in kidney transplant recipients receiving kidneys from renal donors screened using 51CR-EDTA to determine glomerular filtration rate
(2014-04-10) Malan, Nico
There is a global preponderance of renal disease and many of these conditions are associated with renal failure. A significant proportion of these patients will develop advanced kidney disease with ultimately end stage renal failure. Kidney transplantation is the most successful treatment of patients in end stage renal failure. Currently, the majority of transplantations in the University of the Witwatersrand (WITS) Academic complex (which comprises Charlotte Maxeke Academic, Helen Joseph and Chris Hani Baragwanath Academic Hospitals) are performed with cadaveric donor kidneys. With the worldwide shortage of kidneys required for patients in renal failure, living kidney donation has increased the availability of donor kidneys. Potential renal donors (PRD) are subjected to a battery of investigations prior to being considered for donation, amongst other, glomerular filtration rate (GFR). Potential renal donors at the WITS Academic Complex undergo GFR assessment using 51Cr-ethylene-diamine-tetra-acetic acid (EDTA). Some PRD, potentially those on a vegetarian diet, have a “low” GFR (≤80ml/min/1.73m2) and do not meet criteria for renal donation. These potential renal donors are requested to follow a novel protocol, following a diet high in animal protein (beef and fish) for one week after which time the GFR is determined again. Potential renal donors where the GFR increases (thus showing good renal reserve), subsequently donate a kidney. We do not know the outcome of recipients receiving kidneys in which the GFR “normalized” following a protein load. To the best of our knowledge, the outcome of such recipients is also not described in the current available body of literature. The aim is to determine the outcome in recipients receiving kidneys from protein loaded donors versus recipients of non-protein loaded (“normal” GFR) kidneys. Methods The study follows a retrospective record analysis of patient demographics and work-up results (cross-matching, GFR, infectious diseases, renal anatomy etc.) and outcomes in: i. All potential renal donors (PRDs) from 1997 to July 2012 who had GFR determined by clearance of 51Cr-EDTA ii. The subset of those who donated a kidney iii. Donors with “low” (≤80ml/min/1.73m2) baseline GFR and subsequent protein-loaded GFR iv. Donors with a “normal” (>80ml/min/1.73m2) GFR v. The recipients receiving the grafts – outcome, complications, creatinine over time and survival Results In this study it was shown that 51Cr-EDTA clearance correlates with calculated creatinine clearance (r2=0.44) within the range of 51Cr-EDTA clearance between 40 and 180ml/min (uncorrected for BSA). It was also shown that reproducibility of 51Cr-EDTA clearance in 7 donor patients was excellent (r2=0.86), suggesting a robust method. Two hundred and forty nine patients were screened using 51Cr-EDTA clearance. Two hundred and twelve potential donors had good GFR and were not protein loaded. Of these potential renal donors, one hundred and twenty four were well matched and donated to recipients, with complete follow up in 85 cases. A total of 88 potential donors were excluded for various reasons. In this non-protein loaded group that donated kidneys, overall graft and recipient survival over 16 years was 64%. Thirty seven potential renal donors were protein loaded since their initial GFR was ≤80ml/min/1.73m2. Of these 37 potential donors, 15 were excluded. Twenty two potential donors donated kidneys in this group, with outcomes available in 13 recipients. Overall graft and recipient survival over 14 years was 58.3% for this group. This was not significantly different from the recipients receiving grafts from non-protein loaded donors (p=0.14; log rank test). For potential donors, upon protein loading, GFR increased significantly to 89.3±18.4 ml/min/1.73m2 (p<0.0001), with a mean percentage increase of 26.0±24.4% (median 22.2%; range: -12.9% to +103.4%). Furthermore, when comparing only patient survival between recipients of grafts from donors that were protein loaded and donors that were not protein loaded, there is still no significant difference between the two groups. The pre-protein loaded GFR correlated with the post-protein loaded GFR measurement. There was a negative correlation between pre-protein load (baseline) GFR and percentage increase in GFR following protein loading. In all donors, GFR declined from pre-transplant determination of 97.7±18.1ml/ min/1.73m2 to 75.2±16.4ml/min/1.73m2 (p<0.005). Discussion and conclusion 51Cr-EDTA is a reliable, reproducible technique to assess the GFR of potential renal donors. The novel protein loading technique developed in our institution is a convenient way to assess the functional renal reserve of potential renal donors that have a suboptimal estimated GFR of ≤80ml/min/1.73m2. Although the patient numbers in this study are small, there is no significant difference between the outcome of recipients of renal grafts from non-protein loaded and protein loaded donors. The inclusion of potential donors that show a normal GFR post protein load may increase the pool of available kidney grafts and assist greatly in the treatment of many patients with end stage renal disease. Further research in this area is encouraged, and multicenter studies may yield results that with larger number of patients that may ratify the results of this study.
Cardiovascular risk profile of kidney transplant recipients at the Charlotte Maxeke Johannesburg Academic Hospital.
(2014-04-25) Muhammad, Aminu Sakajiki
INTRODUCTION Cardiovascular diseases (CVD) are more common in kidney transplant recipients (KTRs) than in the general population. The high incidence of CVD in the KTRs can be attributed to traditional risk factors, additional risk factors associated with graft dysfunction and those specifically related to transplantation. Carotid intima-media thickness (cIMT) is a proven surrogate of atherosclerosis; it correlates with vessel pathology and is precisely imaged using ultrasound technology. This study was aimed at determining the prevalence and predictors of cardiovascular risk among KTRs at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and to examine the relationship between cardiovascular risk factors and carotid intima media thickness. METHODS Patients aged 18 years and above who received a kidney transplant at the CMJAH between January 2005 and December 2009 were recruited. A questionnaire that captured cardiovascular risk factors was administered. Patients records were assessed for information on their post transplant follow up. All patients had echocardiography and carotid doppler done for measurement of intima-media thickness. The Framingham Risk Score was used to categorize patients into low, moderate, high risk and very high risk groups. Results were analyzed using statistical package for social sciences (SPSS) version 17, p value of 0.05 was considered significant. RESULTS One hundred (KTRs) 63 male (63%) and 37 female (37%) were recruited ranging in age from 19 to 70 years, with a mean age of 42.2 ± 12.42. Thirty six patients (36%) were found to have high cardiovascular risk. Multiple regression showed proteinuria (p = 0.022), higher cumulative steroid dosage (p = 0.028), elevated serum triglycerides (p = 0.04) and the presence of plaques in the carotid artery (p = 0.012) as predictors of higher cardiovascular risk.Carotid intima-media thickness correlates with higher CVD risk. Fourteen patients (14%) had a carotid artery plaque. Twenty five patients (25%) had cIMT of >0.7 mm. CONCLUSION Kidney transplant recipients in CMJAH were found to have high cardiovascular risk (36%) and carotid intima-media thickness correlates with this high CVD risk. Routine follow up of KTRs should include measurement of cIMT as it provides a simple non-invasive assessment of subclinical atherosclerosis.
Combined paediatric liver-kidney transplantation: analysis of our experience
(2014-08-27) Strobele, Bernd
Background. Renal insufficiency is increasingly common in end-stage liver disease and allocation of livers to this category of patient has escalated. The frequency of combined liver-kidney transplantation (CLKT) has consequently increased. Indications for CLKT in children differ from those for adults and typically include rare congenital conditions; subsequently limited numbers of this procedure have been performed in paediatric patients worldwide. Scant literature exists on the subject. Methods. Subsequent to institutional approval, a retrospective chart analysis of all paediatric CLKTs performed at the Transplant Unit, Wits Donald Gordon Medical Centre, University of the Witwatersrand, Johannesburg, South Africa between January 2005 and July 2013 was conducted. Results. Defining children as younger than 18 years of age, 43 patients had received a liver transplant since 2005, of whom 8 received a CLKT. Indications included autosomal recessive polycystic kidney disease (n=3), primary hyperoxaluria type 1 (n=4) and heterozygous factor H deficiency with atypical haemolytic uraemic syndrome (n=1). Graft combinations included whole liver and one kidney (n=5), whole liver and two kidneys (n=1) and left lateral liver segment and one kidney (n=2), all from deceased donors. Patient age ranged from 4 to 17 years (median 9) and included 4 females and 4 males. Weight ranged from 13 to 42 kg (median 22.5). We describe one in-hospital mortality. The remaining 7 patients were long-term survivors with a survival range from 6 to 65 months. Conclusions. Although rarely indicated in children, CLKT is an effective treatment option, appropriately utilising a scarce resource and significantly improving quality of life in the recipient.
An analysis of coverage of gender-based violence, sourcing patterns and representation of victims in Sowetan, January-March 2008
(2014-10-22) Ndlovu, Sikhonzile
Despite its pervasiveness, gender-based violence is one of the least talked about violations of women’s rights as most of it takes place within the private domain and is never reported (Gender Links 2002). Gender-based violence is mostly common at family and community level and mostly affects women (Omarjee, 2006). Family attitudes and pressures ensure that this remains hidden from the outside world (IPS, 2009). People Opposing Women Abuse (POWA South Africa) estimates that only one in nine gender-based violence incidences are reported. Violence against women continues partly because women do not seem to acknowledge violence perpetrated against them and are unlikely to seek help when it occurs (Rasool, 2002). The Noord taxi rank ‘miniskirt’ incident, as it came to be known, exposed the sad realities of gender-based violence in contemporary South Africa. In February 2008, a 25 year old woman was sexually harassed for wearing a miniskirt at the Noord Taxi Rank. This incident, described by Nyar (2008) as degrading and shocking, is part of the fabric of South African life. The way that media represents gender-based violence has a significant role to play in curbing this social ill. Sadly, media often emphasise the need for women to be extra vigilant when moving around at night. This in essence is saying that women should take responsibility for the fact that they may be attacked at any time (Gqola, 1997). This scrutiny is also reflected in the way that media have also questioned the morals of victims of gender-based violence especially rape (Carter and Weaver, 2003). This study analysed Sowetan’s daily media output for the months of January to March 2008 to establish patterns in coverage of gender-based violence, sourcing and representation of victims. Key words Gender, gender-based violence, victims, feminist theory, patriarchy, power, media, representation, sourcing

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