Small bowel intussusception caused by a metastatic testicular germ cell tumour.

SUMMARY: Intussusception from a testicular germ cell tumour is extremely rare. Metastatic gastrointestinal implants outgrow their blood supply leading to central necrosis. This results in erosions and ulcerations, which can be visualised as submucosal polypoid masses. These masses can then serve as a lead point for intussusception. We report a case of a 25-year-old patient with small bowel obstruction due to an intussuscepted choriocarcinoma in the absence of any other apparent retroperitoneal disease. Urologists must exclude gastrointestinal tract (GIT) involvement in testicular cancers, and similarly, surgeons need to exclude testicular tumours in young men with unexplained GIT haemorrhage, bowel obstruction or intussusception.

Fate of anthropogenic radionuclides (90Sr, 137Cs, 238Pu, 239Pu, 240Pu, 241Am) in seawater in the northern Benguela upwelling system off Namibia.

A baseline study on anthropogenic radioactivity in the Namibian marine ecosystem, which is part of the northern Benguela upwelling system, known as one of the most productive ocean areas in the world, has been performed. A scientific cruise carried out in 2014 covering inshore and offshore areas, exhibiting different oceanographic features, has provided a basis for better understanding the distributions, ratios and inventories of six anthropogenic radionuclides (90Sr, 137Cs, 238Pu, 239Pu, 240Pu and 241Am) in seawater. Although 3H was also measured, due to extremely low levels, its behaviour was not studied. The main source of 90Sr, 137Cs, 239Pu, 240Pu and 241Am in the samples analysed was proven to be global fallout, a finding further confirmed by 240Pu/239Pu and 90Sr/137Cs ratios. Furthermore, the 238Pu SNAP-9A satellite accident signal was confirmed once again through the determination of the 238Pu/239+240Pu activity ratio. Inshore and offshore samples showed different patterns due to the unique oceanographic features of this upwelling system. The levels of anthropogenic radionuclides, comprehensively assessed for the first time in this region, are comparable with the few existing data and filled a critical gap for the Southern Atlantic Ocean.

Randomised controlled trial comparing marksmanship following application of a tourniquet or haemostatic clamp in healthy volunteers.

BACKGROUND: In a care under fire situation, a first line response to haemorrhage is to apply a tourniquet and return fire. However, there is little understanding of how tourniquets and other haemorrhage control devices impact marksmanship. METHODS: We compared the impact of the iTClamp and the Combat Application Tourniquet (CAT) on marksmanship. Following randomisation (iTClamp or CAT), trained marksmen fired an AR15 at a scaled silhouette target in prone unsupported position (shooting task). Subjects then attempted to complete the shooting task at 5, 10, 15, 30 and 60 min post-haemorrhage control device application. RESULTS: All of the clamp groups (n=7) completed the 60 min shooting task. Five CAT groups (n=6) completed the 5 min shooting task and one completed the 5 and 10 min shooting task before withdrawing. Four CAT groups were stopped due to unsafe handling; two stopped due to pain. When examining hits on mass (HOM) for the entire shooting task, there was no significant difference between tourniquet and iTClamp HOM at 5 min (p=0.18). However, there was a significant difference at 10 min, p=0.003 with tourniquet having significantly fewer HOM (1.7±2.7 HOM) than the iTClamp (8.1±3.3 HOM) group. The total effective HOM for the entire 60 min shooting task showed that the iTClamp group achieved significantly (p=0.001) more HOM than the tourniquet group. Over the entire 60 min shooting exercise, the iTClamp group achieved a median 72% (52/72) of available HOM while the tourniquet group obtained 19% (14/72). CONCLUSIONS: Application of a tourniquet to the dominant arm negates effective return of fire in a care under fire setting after a brief time window. Haemorrhage control devices that preserve function may have a role in care under fire situations, as preserving effectiveness in returning fire has obvious operational merits.

Rapid and specific detection of Salmonella in water samples using real-time PCR and High Resolution Melt (HRM) curve analysis.

A real-time PCR assay combined with a pre-enrichment step for the specific and rapid detection of Salmonella in water samples is described. Following amplification of the invA gene target, High Resolution Melt (HRM) curve analysis was used to discriminate between products formed and to positively identify invA amplification. The real-time PCR assay was evaluated for specificity and sensitivity. The assay displayed 100% specificity for Salmonella and combined with a 16-18 h non-selective pre-enrichment step, the assay proved to be highly sensitive with a detection limit of 1.0 CFU/ml for surface water samples. The detection assay also demonstrated a high intra-run and inter-run repeatability with very little variation in invA amplicon melting temperature. When applied to water samples received routinely by the laboratory, the assay showed the presence of Salmonella in particularly surface water and treated effluent samples. Using the HRM based assay, the time required for Salmonella detection was drastically shortened to less than 24 h compared to several days when using standard culturing methods. This assay provides a useful tool for routine water quality monitoring as well as for quick screening during disease outbreaks.

Schizophrenia among Sesotho speakers in South Africa.

OBJECTIVE: The aim of this study is to investigate the clinical presentation of schizophrenia among Sesotho speakers. METHOD: A sample of 100 participants diagnosed with schizophrenia was evaluated using the Psychiatric Interview Questionnaire. RESULTS: Core symptoms of schizophrenia among Sesotho speakers do not differ significantly from other cultures. However, the content of psychological symptoms such as delusions and hallucinations is strongly affected by cultural variables. Somatic symptoms such as headaches, palpitations, dizziness and excessive sweating were prevalent among the Sesotho-speaking participants suffering from schizophrenia. CONCLUSION: In South Africa, as is the case throughout the African continent, health professionals are still trained in Western models, especially DSM-IV-TR and ICD-10. Certain changes should be made to these models to account for cultural differences that were found in this research.

Schizophrenia among Sesotho speakers in South Africa

Objective: The aim of this study is to investigate the clinical presentation of schizophrenia among Sesotho speakers. Method: A sample of 100 participants diagnosed with schizophrenia was evaluated using the Psychiatric Interview Questionnaire. Results: Core symptoms of schizophrenia among Sesotho speakers do not differ significantly from other cultures. However; the content of psychological symptoms such as delusions and hallucinations is strongly affected by cultural variables. Somatic symptoms such as headaches; palpitations; dizziness and excessive sweating were prevalent among the Sesothospeaking participants suffering from schizophrenia. Conclusion: In South Africa; as is the case throughout the African continent; health professionals are still trained in Western models; especially DSM-IV-TR and ICD-10. Certain changes should be made to these models to account for cultural differences that were found in this research

Depression and exposure to violence among Venda and Northern Sotho adolescents in South Africa.

OBJECTIVE: Despite the high levels of violence in South Africa, a lacunae in research exists regarding the influence of violence exposure on children. This study investigated the correlation between children's exposure to violence and the development of psychological problems such as depression. METHOD: 186 Venda and 151 Northern Sotho adolescents were studied in a questionnaire survey to determine this relationship. Two measuring instruments were used: The Children's Depression Inventory and the Child Exposure to Violence Form. RESULTS: When comparing gender, no significant differences were found in terms of overall exposure to violence between males and females. For depression, the total group of girls had a remarkably higher prevalence of depression. Regarding ethnic comparison, no significant differences were found in terms of overall exposure to violence or for witnessed events. However, the Venda adolescents had been victims significantly more often. Venda and Northern Sotho females had a similar prevalence of depression, but Northern Sotho boys had a higher depression rate than Venda boys. The correlation between victimisation and total group depression was relatively low for the Northern Sotho group, and non-existent for the Venda group. A significant correlation was found between total exposure to violence and depression for the overall group. CONCLUSION: This study indicates that adolescents' exposure to violence and subsequent mental health is an area of concern. However, adolescents could be taught effective coping and problem-solving techniques in schools to help empower them against stressors they might encounter.

Depression and exposure to violence among Venda and Northern Sotho adolescents in South Africa

Objective: Despite the high levels of violence in South Africa; a lacunae in research exists regarding the influence of violence exposure on children. This study investigated the correlation between children's exposure to violence and the development of psychological problems such as depression. Method: 186 Venda and 151 Northern Sotho adolescents were studied in a questionnaire survey to determine this relationship. Two measuring instruments were used: The Children's Depression Inventory and the Child Exposure to Violence Form. Results: When comparing gender; no significant differences were found in terms of overall exposure to violence between males and females. For depression; the total group of girls had a remarkably higher prevalence of depression. Regarding ethnic comparison; no significant differences were found in terms of overall exposure to violence or for witnessed events. However; the Venda adolescents had been victims significantly more often. Venda and Northern Sotho females had a similar prevalence of depression; but Northern Sotho boys had a higher depression rate than Venda boys. The correlation between victimisation and total group depression was relatively low for the Northern Sotho group; and non-existent for the Venda group. A significant correlation was found between total exposure to violence and depression for the overall group. Conclusion: This study indicates that adolescents' exposure to violence and subsequent mental health is an area of concern. However; adolescents could be taught effective coping and problem-solving techniques in schools to help empower them against stressors they might encounter

Depression among Sesotho speakers in Mangaung, South Africa.

OBJECTIVE: Depression will be the most common mental disorder by 2020, and it is also expected to be the second leading cause of disability, after cardiac diseases. Moreover, depression is likely to be a major public health burden in the future. This study evaluates the influences of culture on the symptoms of depression among Sesotho speakers. METHOD: An evaluation of a sample of 100 participants diagnosed with depression was conducted, using the Psychiatric Interview Questionnaire. RESULTS: It was found that depression among Sesotho speakers is manifested in three areas: somatic symptoms, perceptual disturbances and disturbances of the thought processes. CONCLUSION: Since it has become clear, on the basis of the investigation, that depression is a culturally diverse phenomenon, the authors also recommend that research in this regard should be conducted from a multidisciplinary perspective, so that other paradigms, including those of sociology and anthropology, can also be included.

Post-traumatic Stress Disorder and Exposure to Violence among Venda and Nothern Sotho Adolescents

In this study; two research questions were posed. In the first place; this study investigated the levels of exposure to violence among the adolescents as a total group (Venda- and Northern Sotho-speaking); as well as the exposure levels of the two ethnic groups. The relationship between the groups' exposure to violence and their post-traumatic stress disorder (PTSD) symptoms was investigated in the second place; as well as the question whether a difference existed between the two ethnic groups in respect of this relationship. The participants were comprised of 186 Venda and 151 Northern Sotho adolescents; who completed the Child PTSD Checklist (PTSDC) and the Child Exposure to Violence Form (CEVF). A large proportion of participants reported high levels of exposure to violence. Venda youth appeared to be subjected to a higher rate of victimisation than the Northern Sotho adolescents. A strong correlation was found between exposure to violence and PTSD symptoms

The effect of hypnotic training programs on the academic performance of students.

The main objective of the present study was to empirically verify the effect of hypnotic training programs on the academic performance of students. A pre and posttest design was used. Two experimental and two control groups (total sample N=119) of volunteer second year psychology students at the University of Stellenbosch in South Africa comprised the sample. One of the experimental groups was exposed to active alert hypnosis and the other to relaxation hypnosis. One control group was exposed to progressive relaxation, while the other did not receive any intervention. The participants' April grades were used as a pretest, while their June grades served as a posttest. The two hypnotic training programs had a significant effect on the academic achievement of the participants, which was not found in the control groups. Regarding the efficacy of the two programs, however, no significant difference was found.

The effect of confidence and method of questioning on eyewitness testimony.

Very often eyewitnesses are perceived as being accurate due to the confidence in the accuracy of their own testimony. The confidence displayed by an eyewitness may possibly be increased by the method of questioning used by legal professionals and police. The present study examines the confidence-accuracy relationship and the effect the method of questioning (open-ended versus closed-ended questions) may have on the confidence of eyewitnesses. The sample of 412 respondents consisted of scholars (11 to 14-year-olds), university students, the public and Police College students. A significant relationship between memory accuracy and confidence was found for more than 70% of the questions. Closed-ended questions provided a significantly higher rate of accuracy than open-ended questions. A significantly larger proportion of respondents to the closed-ended questions were more confident about their answers than those who responded to the open-ended questions.

Method of questioning and the accuracy of eyewitness testimony.

System variables are integrally part of factors that can be controlled by the legal system to enhance the accuracy of testimony by eyewitnesses. Apart from examining the relationship between questioning as system variable and the accuracy of testimony, the present study furthermore explores the relationship between type of questioning and certain biographical variables (occupation, age, gender and race). To achieve the aim of the study, 412 respondents consisting of 11 to 14-year-olds, university students, the public and Police College students participated and were exposed to open-ended or closed-ended questions. It was found that the participants who responded to the closed-ended questions were significantly more accurate than those who answered the open-ended questions. All the biographical groups, except the public, were more accurate in responding to the closed-ended questions. The scholars obtained the lowest scores (although not always significant) for both the open-ended and closed-ended questions. With respect to age the 18 to 25-year-olds obtained significantly higher scores than the other groups for the closed-ended questions. Whites performed significantly better than blacks in response to the open-ended and closed-ended questions.

The relationship between memory and the recall of specific details.

When eyewitnesses are exposed to an event, certain details tend to capture their attention more than other details, which ensures the better recall of the details that were observed. As little research has focussed on the relationship between certain biographical variables (occupation, age, gender, race and retention period) and specific event details, the present study attempts to shed some light on this area. A sample of 295 participants was obtained from 12- to 14-year-olds, university students, the public and Police College students that were divided into a short-term and long-term memory group. The details that were focussed on in the questionnaire were divided into obvious physiognomic, less pronounced physiognomic, clothing, circumstantial, and action-related details. Between the short-term and long-term memory groups it was found that significant differences were indicated for only certain items related to obvious physiognomic details, clothing details, circumstantial evidence and action-related details. For all the different biographical groups significant differences were found for certain items belonging to the different groups of details.

Memory accuracy of a real-life simulated incident.

Due to an awareness that both laboratory and real-life research present limitations, the present study attempts to combine the two research approaches, making use of the strengths of both methodologies. A real-life situation was created in a classroom and combined with laboratory conditions to determine the influence of certain variables (occupation, age, gender, race and retention interval) on the accuracy of eyewitness reporting. A total of 295 participants consisting of 12- to 14-year-olds, University students, the public and Police College students were divided into a short- and long-term memory group. The short-term group were assessed immediately after witnessing the incident, while the long-term group were only assessed five to six weeks later. It was found that the effect of passage of time was insubstantial; however, the performance of the short-term group had already been disconcertingly poor. The school children did not perform significantly less well than other occupational groups, and the members of the Police did not perform significantly better than the other groups. No significant differences were found for the different gender and racial groups.

The effect of violent versus non-violent incidents on eyewitness memory.

As South Africans are daily subjected to violent incidents for which they are summoned to testify about in court, months or years after the event in question occurred, it is of importance to determine the effect violence has on memory after an extended period of time. The present study not only aimed to determine the accuracy of short-term and long-term memory after exposure to a violent and non-violent incident, but also the relationship between short-term and long-term memory and different biographical variables (occupation, age, gender and race). Four-hundred-and-seventy-four respondents consisting of university students, the business sector and Police College students participated and were divided into a short-term and long-term memory group. After a five to six week retention period a significant decrease in the accuracy scores for both the violent and non-violent incident occurred. Significant higher average scores for all the biographical groups in the short-term memory group in comparisons with the long-term memory groups were obtained.

Intraoperative MR at 1.5 Tesla--experience and future directions.

The objective of this report is to present and contrast the development of the different intraoperative MR systems that are currently in use. The manuscript focuses on the design and clinical experience of a 1.5 Tesla MR system, based on a movable magnet. This configuration is similar to the operating microscope and other surgical adjuncts, with MR technology moved to and from the patient as needed. The system has been used to monitor 294 neurosurgical procedures. including CNS neoplasia. epilepsy, cervical spine disorders, arteriovenous malformations, cavernomas and aneurysms. In many cases the surgical procedure was significantly altered by intraoperatively acquired MRI. Future developments include the construction of a 3 Tesla intraoperative MR system and an ambidextrous MR-compatible robot. This seamless integration of robotic technology into an intraoperative MR environment may well revolutionize neurosurgery.

Pastoral hermeneutics and the challenge of a global economy: care to the living human Web.

The author discusses the relationship between a pastoral hermeneutics and the current social context as determined by international communication and globalization. He explores the influence of telecommunications on the human quest for meaning and the implication of this for pastoral care and counseling. A paradigm shift is proposed in terms of care to the living human web. A pastoral assessment which interprets the undergirding philosophy and belief system of globalization and its influence on human dignity is suggested; and a pastoral ministry which takes up its prophetic task and voices the needs of people in terms of a "globalization from below" is explicated.

A brief history of aneurysm clips.

In this communication the authors outline the development of aneurysm clips from those originally used by Walter Dandy to those currently in use. The history is rich in contributions from neurosurgical pioneers and innovators. As a result, the modern neurosurgeon has a wide selection of biocompatible aneurysm clips with known closing pressure, of variable sizes and shapes, and a selection of clip applicators that do not obstruct the surgical field.