Stellenbosch University: SUNJournals
Not a member yet
4219 research outputs found
Sort by
The relationship between clinical parameters and the risk of mortality or requiring the insertion of a pacemaker in patients with bifascicular block
No full textIntroduction: Patients with bifascicular block (BFB) are at risk of progressing to high-degree atrioventricular block (AVB) and have a higher mortality risk. This study aimed to identify relationships between clinical parameters in patients with BFB and the risk of mortality and/or requiring permanent pacemaker (PPM) insertion, to better risk-stratify and appropriately investigate patients at the time of diagnosis in a resource-limited setting.
Method: A descriptive study was conducted via retrospective review of all patients who received an electrocardiogram (ECG) during 2014 at Tygerberg Hospital (TBH), South Africa. In total, 16 280 ECGs were assessed, accounting for 11 881 patients (some patients had more than 1 ECG), and those with BFB were identified. Patients’ records were assessed at the time of diagnosis and followed for 10 years to identify relationships between clinical parameters in patients with BFB and mortality or requiring a PPM.
Results: Of the 11 881 patient ECGs assessed, 140 patients with BFB were identified. The mean age at diagnosis was 62 ± 17 years. Of these patients, 37 (26%) died, and 9 (6%) required a PPM. The mean age at diagnosis of demised patients was 66 ± 12 years (p = 0.07). Significant relationships with mortality included diabetes mellitus (DM) (p = 0.04) and a reduced left ventricular ejection fraction (LVEF) (p = 0.05), with age and hypertension related at a lower level of significance (p = 0.07 and p = 0.06, respectively). Significant relationships with PPM insertion were symptom presence at diagnosis (p ≤ 0.01) and PR interval prolongation at a lower level of significance (p = 0.08).
Conclusion: In patients with BFB, DM, hypertension, age, and a reduced LVEF had the most significant relationships with mortality. Symptoms and a prolonged PR interval had the most significant relationships with requiring a PPM. Mortality in patients with BFB is more likely to be related to standard risk factors, such as DM, hypertension, age, and a reduced LVEF, than the conduction defect per se
Factors associated with deep vein thrombosis recurrence at a cardiology department in sub-Saharan Africa
No full textObjective: Deep vein thrombosis (DVT), once rare, has become increasingly common in Africa. This study aimed to identify factors associated with DVT recurrence.
Methodology: We conducted a descriptive and analytical cross-sectional study from 1 January 2020 to 31 December 2024 at the cardiology department of Bogodogo University Hospital (CHU-B). Patients admitted to the department for DVT on venous echo-Doppler were included. Epidemiological, clinical, and paraclinical parameters were crossed in univariate and multivariate analyses.
Results: During the study period, 164 cases of DVT were recorded out of 2 637 hospitalised patients, with a 6.22% hospital prevalence rate. The mean age was 51.4 years. Women were predominant (90, 55%), with a sex ratio of 0.8. Recurrences occurred in 27.44% of cases (n = 45). A sedentary lifestyle, prior DVT, and obesity were the most frequent thromboembolic risk factors. Multivariate analysis showed that a personal history of DVT (odds ratio [OR] 3; p = 0.03), obesity (OR 3.8; p = 0.005), and the femoral thrombus location (OR 2; p = 0.004) were significantly associated with DVT recurrence.
Conclusion: DVT recurrences are becoming increasingly frequent, and their management requires accurate identification of the risk factors
Children and the politics of psychological practice in South Africa: Dawes, A & Donald, D (eds) (1994) Children and adversity: Psychological perspectives on South African research. Cape Town: David Philip.
No full textThis book fulfils many functions at the same time. Not only does it provide a sustained focus on the problems and questions posed by supporting children's development in South Africa, but in so doing it also offers a vital perspective on the dominant approaches to developmental psychology. Each of the fourteen chapters follows a common structure which moves from general analysis of key concepts and methods to consider their relevance and applicability to the South African context. It is this sustained superordinate analytical stance which provides coherence to what is otherwise a very varied book, with chapters ranging across topics as diverse as the relation between health and psychological development (Kalsvig and Connolly), street children (Swart-Kruger and Donald), the emotional impact of political violence (Dawes) and child sexual abuse (Levett). More than this, the discussion of South African research and the particular questions posed by the project of making psychology "relevant" and transformative in moving beyond the ugly shadow of apartheid carries both a specific, and general, set of lessons about the politics of psychological practice. Given this dual address and effects, as structured by my perspective outside South Africa, I will concentrate on the relevance of this book for an international as well as South African audience
Notes On the Intervention with Men Who Use Violence Against Intimates
No full textThis article privileges the conception of violence as a political process that organises, shapes and arranges both intimate as well as social relationships. The specific form of arrangement produced by violence resonates with a "fascist"-type of organisation. Adopting such a perspective, the perpetrator of violence is understood to participate in the circulation and invigoration of particular discursive possibilities as ways through which he comes-into-being with others. The question of responsibility therefore shifts to address his participation in such forms of social negotiation and arrangement and the specific product that such participation engenders. A process of intervention with perpetrators is discussed from this perspective
Stigmatic Factors in Sexual Abuse and the Violence of Representation
No full textThere are four points to the argument which follows about child sexual abuse, rape and sexual assault (all referred to here as "sexual abuse"). The most common and widespread consequence of this kind of abuse in westernized societies is stigma. Stigma is not a simple matter of labelling, or being labelled, although it includes these. It is a major factor in the process referred to as "psychological trauma·, a complex subjective experience with a set of potent social meanings, also self-imposed. The stigma of sexual abuse constitutes a false boundary or barrier of difference between women who are known to have been and those who are not known to have been - or do not know they have been - sexually abused; it has paradoxical consequences in everyday life. Although no purposeful conspiracy is involved, this false barrier serves to divide women and to protect male power. There is a relationship between stigmatic effects, the silence of those subjected to sexual abuse, and the social control of women by men. Finally, the very notion of psychological trauma (or damage) as the only, major and universal consequence of sexual abuse is a text of stigmatization which in itself constitutes a violence of representation
Homosexuality and Psychoanalytic Training: Struggles in England and North America - What Implications for South Africa?
No full textIn May 1995 a Letter of Concern (LOC), signed by 180 psychotherapists (Appendix A), with a covering letter from Andrew Samuels (1995a), a training analyst of the Society of Analytical Psychology, was sent to The Secretary of State for Health in Britain. The LOC expressed concern about issues related to negative and defensive attitudes towards training homosexuals as psychotherapists I obtained a copy of this correspondence whilst visiting in July 1995. Later that year, In October 1995, at an International Psychoanalytic Association conference in America, I overheard a discussion between a senior training and supervising analyst at an extremely prestigious Institute for Psychoanalysis (Dr T), and a Clinical Faculty member of the Department of Psychiatry at the University of California (Sharone Abramowitz), in which the latter refused again, an invitation to train as an analyst. This was because of the negative attitude towards homosexuality held by training analysts
These circumstances, together with Young's interesting and provocative article "Is 'perversion' obsolete?" (PINS 21, 1996) have prompted me to report something of their content. My aim is to generate discussion leading to some theorising around concrete issues of the well known, though covert, widespread exclusion of homosexuals from psychoanalytic training. Given that this topic, as far as I know, has never been raised for public debate in South Africa, it seems timely to draw attention to it now, particularly since we are the first country in the world which has a constitutional clause prohibiting discrimination of any sort on the basis of a person's identification as a lesbian or a gay man.
I will first cover the discussion I overheard between Dr T and Sharone Abramowitz who, together with Betsy Kaskoft (a psychotherapist in San Francisco) presented at a workshop entitled "The self and orientation: New perspectives on psychoanalysis and homosexuality: Female homosexuality, presentation and response" at the 18th Annual Conference on the Psychology of the Self - Crosscurrents in Self Psychology, held in San Francisco (ironically the so-called gay capital of the world) in October last year. I will then summarise the documents (quoting extensively from them) which I obtained In England, adding academic weight to some of the comments by referring to other literature in the field
Introducing Winnicott: Jacobs, M (1995) Winnicott. London: Sage 163 pages ISBN 0-8039-8596-7
No full textThis little book on Winnicott, by Michael Jacobs, is part of the Sage series - "Key figures in counselling and psychotherapy". It follows the same structure as other titles in the series and begins with a biographical sketch. This is followed by a review of Winnicott's major contributions to theory and practice, a chapter on criticisms and rebuttals of his work, and an evaluation of his influence The book ends with a select bibliography of Winnicott's works
"Telling It Like It Is ... ": Understanding the Truth and Reconciliation Commission from the Perspective of Survivors
No full textThe article focuses on survivors' perspectives of the Truth and Reconciliation Commission (TRC). It probes their feelings, thoughts and views both before and after interacting with the Commission. Their feelings and opinions about issues such as justice, punishment and amnesty are explored. This information, which forms the backbone of this article, was obtained from interviews with twenty survivors of political violence committed under the apartheid government. The article shows that healing, truth, justice and reconciliation are interrelated. For survivors the relationships between the concepts is not linear, that is truth does not automatically lead to reconciliation. The article demonstrates that those who interacted with the TRC held a range of largely legitimate expectations; most expected, at the very least, that they would get some truth about their case. Many are currently feeling let down by the TRC process, despite its successes at publicising the atrocities of the past and fostering national reconciliation
Playing Rugby With The Truth
No full textThis paper attempts to think about the Truth and Reconciliation Commission (TRC) in a different way, by examining a particular event that happened in South Africa while the TRC was in process, namely, the court battle between President Mandela and the South African Rugby and Football Union (SARFU) over racism. This exploration flows into an argument about a political struggle the TRC was caught up in, over who would construct memory. To illustrate this struggle, selected media portrayals of the TRC are compared with ways in which the TRC portrayed itself. Important to these considerations was an examination of the cost (to survivors) of notions of "reconciliation", "truth" and "healing", especially when reparations are not paid. Finally, the paper uses various psychoanalytic lenses to explore the TRC process as a way of seeing the construction of so called white and black psyche
EDITORIAL: Critical psychology
No full textIt will not have escaped the attention of PINS subscribers and readers that the journal has been appearing irregularly for some time. More accurately, PINS has been appearing regularly, albeit too infrequently. There are many complex reasons behind this state of affairs, and in this special issue on Critical Psychology, it is worth commenting on some of the issues and problems that inform the production of certain intellectual projects