Partner bereavement when parenting dependent children: What factors influence adjustment?

Little is known about those who are widowed while raising dependent children. This study aimed to explore the factors which influence adjustment to partner death. Seven fathers and five mothers were interviewed, and constructivist grounded theory was used. Three interrelated themes were identified: Interpersonal influences, Intrapersonal influences, and Contextual influences. Dependent children meant sole responsibility and increased demands, yet ultimately provided widowed parents a purpose. Participants highlighted the need for increased awareness of young widowhood at a systemic and cultural level, to improve communication around death and young widowhood. Implications included social, financial and therapeutic interventions.

Stigma, Acceptance and Belonging for People with IDD Across Cultures.

PURPOSE OF REVIEW: This review explores recent literature (from 2017 onwards) to identify current developments related to reducing stigma and increasing acceptance for people with Intellectual and Developmental Disabilities (IDD) in their communities across diverse cultures. RECENT FINDINGS: We identified literature related to experiences of stigma for people with IDD and their families across diverse cultures, as well as current and potential interventions and approaches for promoting acceptance. SUMMARY: Although the literature confirms that stigma is still a major barrier to acceptance and inclusion for people with IDD regardless of culture, there appears to be progress in terms of using diverse approaches to support acceptance and belonging. Researchers are also increasingly acknowledging the importance of culture and context in the experience and mitigation of stigma. There remains a need for researchers and practitioners to include people with IDD in identifying and prioritising interventions that promote belonging within their communities.

Relationship between magnesium and lipids in patients with diabetes mellitus

Introduction: Non-communicable diseases, especially cardiovascular diseases (CVD), have become more prevalent across the world, more so in developing countries. Novel methods in the management of CVD risks in patients with diabetes mellitus, type 2 (DM2) requires constant attention and an ever-evolving approach. The role of magnesium supplementation in the management of CVD has been described, but the relationship between serum magnesium (Mg) and the lipid subsets have had conflicting results in different population groups. Methods: A cross-sectional study was performed by collecting data on patients with DM2 from a specialised diabetes clinic at Edendale Hospital, Pietermaritzburg, KwaZulu-Natal, South Africa, between July 1, 2015 and June 30, 2016. Lipid subsets (total cholesterol [TC], high-density lipoprotein cholesterol [HDL], low-density lipoprotein cholesterol [LDL] and triglycerides [TG]), age, sex and Mg were recorded for analysis. Results: A total of 495 clinical data sheets were analysed. The majority of participants were female (73.45%) with a mean age of 56.97 years. A statistically significant, positive, linear relationship was found between Mg and TC (R= 0.11;p= 0.01) as well as Mg and LDL R= 0.14;p= 0.001), but not between Mg and HDL (R= 0.02;p= 0.66) and Mg and TG (R= 0.01;p= 0.82). Discussion: The results of this study are similar to findings by a group of researchers in China and differ when compared with studies observing Caucasian patients. It is plausible that intrinsic ethnic differences in lipid metabolism and the various ways in which magnesium requiring enzymatic processes are utilised may be responsible for the results found in the present study population versus those found in Caucasian study participants in other countries. More research is required to determine the effect of magnesium supplementation and CVD outcomes in the present study population

Major depressive disorder in patients with diabetes mellitus in Pietermaritzburg, South Africa.

BACKGROUND: Diabetes mellitus (DM) and major depressive disorder (MDD) constitute a major burden of disease. A study found that type 2 DM (DM2) is associated with a two-fold increase in risk of developing MDD worldwide - except in Africa. The present study challenges this statement. OBJECTIVES: To determine the prevalence of MDD in a cohort of patients with DM and its effect on glycaemic control. METHODS: A cross-sectional study was performed at a diabetes clinic at Edendale Hospital, Pietermaritzburg, South Africa (1 March - 31 May 2017). A total of 176 participants were enrolled. Participants completed the Patient Health Questionnaire-9 (PHQ-9), with a score of ≥10 representing a diagnosis of MDD. Higher PHQ-9 scores translate into more severe MDD. A surrogate for glycaemic control, glycated haemoglobin (HbA1c) blood testing, was also performed. RESULTS: The majority of participants were female and suffered from DM2. The mean age was 54.4 years. The prevalence of MDD in the study population was 46.6%. A significantly positive linear relationship was shown between PHQ-9 score and HbA1c (p=0.018253). CONCLUSIONS: MDD appears to constitute a large burden of disease in our population of individuals with DM. A relationship between the severity of the MDD and HbA1c suggests that prompt intervention in both conditions is likely to improve health outcomes.

Atypical chest pain: Needles in a haystack.

A 20-year-old man presented with a 6-month history of intermittent chest pain. Initial imaging demonstrated approximately 15 sewing needles lodged in his myocardium, predominantly in the left ventricle. The patient has been referred to cardiothoracic surgery for further management. His progress will be monitored closely.

Genital ulceration in males at Ga-Rankuwa Hospital, Pretoria.

One hundred previously untreated Black male patients presenting with genital ulceration were seen as outpatients at Ga-Rankuwa Hospital, Pretoria. Syphilis was the commonest cause of ulceration, being present alone in 33% of patients. Chancroid occurred almost as frequently, being found alone in 28% of cases. A double infection with both syphilis and chancroid occurred in a further 16%. Herpes genitalis was found alone in 4% and together with chancroid in 1%. One patient was found to have granuloma inguinale and another had lymphogranuloma venereum. In 16% of the patients no cause for the ulcerations could be found.