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Common Mental Disorders Among Adolescents Accessing HIV Treatment In Cape Town, South Africa
(2020) Mtukushe, Bulelwa; Sorsdahl, Katherine; Hoare, Jacqueline
Background: At the present time, data on the prevalence of common mental disorders (CMD) among adolescents living with HIV (ALHIV) in South Africa (SA) is limited. Studies that exist focus mainly on HIV-infected adults with mental health problems besides a few studies investigating depression and anxiety in children and adolescents living in SA. Research on the mental health of this vulnerable population remains very limited. Therefore, this study aims to address this gap by assessing the prevalence of CMD among adolescents living with HIV in SA; and determining the factors associated with CMD among this vulnerable population. Specific objectives: Specific objectives included, assessing the CMD among adolescents accessing ARV treatment; and determining factors associated with CMD among adolescents accessing HIV treatment. Methods: 121 Participants were recruited into the study through convenience sampling and interviewed. To be included in the study, participants had to be 10 to 19 years old; have knowledge of their own HIV-positive status; and presently on HIV treatment. Participants over 18 years were excluded if they did not provide informed consent and those under 18 were excluded if parent consent or adolescent assent was not obtained. Interviews with participants were conducted by study research assistants using a survey questionnaire which included the following mental health measures; Beck Depression Inventory for youth (BDI-Y), Beck Anxiety Inventory for youth (BAI-Y). Data collection for the study took place at two HIV treatment clinics in Cape Town, Groote Schuur hospital and Kuyasa clinic. Two logistic regression models were developed. Unadjusted and adjusted associations between socio-demographics, SES, food insecurity, alcohol use, years child known status and the presence of anxiety and depression were explored through logistic regression. Age, gender and variables that were significant in the unadjusted associations were included in the adjusted logistical regression models. Significance was set at p<0.05. Results: Four main findings emerged from the current study: 13.2% of participants were at risk for anxiety and 13.2% were at risk for depression; 6.6% participants were at risk for both anxiety and depression; the only variable associated with anxiety was socio-economic status and this was only significant in the unadjusted model; and the only variable associated with depression was highest level of schooling completed (i.e. currently in high school/completed high school) and this was significant in both unadjusted and adjusted models. Overall, adolescents with a higher educational level were less likely to develop depressive symptoms (adjusted model: OR=0.10, 95% CI 0.02-0.68). Conclusion: The present study assessed the prevalence of CMD, including determining the factors associated with CMD among adolescents accessing HIV treatment in Cape Town. Findings revealed that participants were at risk for anxiety, depression and comorbid anxiety and depression. Only highest level of schooling completed was found to be a protective factor against depression for this vulnerable population. Based on these findings, considerations for improving mental health outcomes for this population should include, screening for mental health conditions in ARV clinics, early identification and treatment of mental health problems, and evidence-based mental health counselling
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Open Access
The spatial distribution of Antarctic krill (Euphausia superba Dana) aggregations
(1994) Miller, Denzil George Maxwell; Field, John G
In nature, many biota exhibit recognisable spatial groupings, commonly termed "clumps" or "patches" (Hutchinson 1953; Diggle 1983; Wilson 1978). Attempts to devise measures of such aggregation are usually based on statistically determining the frequency distributions of selected organism parameters (Morisita 1959; Pielou 1977; Okubo 1980). In their field study of the spatial distribution of some 102 species (ranging from protozoa to humans), Taylor et al. (1979) concluded that such data were on average significantly more clumped than random. Since theoretically derived contagious distributions are often fitted to observed frequency distributions of this kind (Bliss 1971), the underlying spatial patterns are therefore usually concluded to be "patchy" (i.e. the organism is unevenly distributed in space). This, however, does not allow for concrete conclusions to be drawn about the underlying mechanism(s) inducing the observed distribution(s) and provides little more than sample statistics for, or at best a static picture of, the spatial pattern of the organism(s) concerned (Okubo 1980). Fmihermore, unless patches are essentially discrete their resulting distributions are often difficult to discern objectively (Skellam 1952; Waters and Henson 1959).
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Open Access
Alteration reactions which affect the geochemistry of kimberlite and its xenoliths, and the search for unaltered mantle materials
(1994) Berg, Gerhard Wolfgang
[Volume 1 - needs to have volume 2 incorporated.] This thesis records a series of attempts to elicit from bulk kimberlites and their xenoliths, geochemical and mineralogical information meaningful with respect to the primary composition of their source in the mantle. Some of these attempts were successful and some controversial, whilst others were modified significantly to cater for secondary alteration processes (metasomatic events) which took place either in the mantle, or during, or after the emplacement of the rocks in the crust. These secondary events document those stages of the history of the rocks which overwrite and disguise their primary state. It is important to understand the details of these secondary alteration processes so that their record is not erroneously attributed to the primary state of the rocks in the mantle.
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Open Access
Student well-being, academic performance, and life satisfaction during the COVID-19 pandemic
(2023) Mbuma, Nokulunga Winnie; Bagraim, Jeffrey
Well-being includes emotional, psychological, and social well-being. Our wellbeing is inspired by our thoughts, feelings, actions, and how we react to stress, interact with others, and decision making. Well-being has the potential to negatively affect academic achievement and be a significant public health challenge. This study investigated the relationship between student mental health and life satisfaction, and academic performance during the Covid-19 pandemic. The study also assessed the extent of first-year university students flourishing and languishing. Cross-sectional survey data were collected from the first-year University of Cape Town Commerce students. A total of 395 first-year commerce students completed the questionnaire; however, after cleaning the data and applying the sample frame criteria, only 242 questionnaires were used N = 242; 132 females and 110 males for this study. Student wellbeing, resilience, and life satisfaction was measured using the Mental Health ContinuumShort Form (MHC-SF), Brief Resilience Scale (BRS), and Satisfaction with Life Scale (SWLS), respectively. Demographic variables were also included in the survey. Multiple regression analyses were performed to assess the relationship between the three well-being dimensions, academic performance, and life satisfaction. Only emotional well-being (EWB) significantly explained the difference in academic performance. The results also show that increasing student well-being leads to positive outcomes such as higher perceived life satisfaction and improved academic performance. Resilience did not moderate the relationship between the three well-being dimensions of positive mental health and academic performance. Based on the results of this study, it appears that there is a need to explore ways to improve student well-being by providing universities and students with opportunities to access well-being interventions. Keywords: Mental health, well-being, university students, academic performance, life satisfaction.
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Open Access
Clinical outcomes in patients with paracetamol ingestion treated with a two-bag n-acetylcysteine regimen in the emergency centre of khayelitsha hospital
(2023) Mbanga, Kedibone; Khan, Waseela
Introduction: Paracetamol is frequently ingested for intentional self-poisoning. N-acetylcysteine (NAC) is administered to patients at risk of developing hepatotoxicity and was historically administered using a three-bag intravenous regimen. A change towards a two-bag NAC regimen was initiated at Khayelitsha Hospital. The aim of the study was to describe the clinical outcomes in patients with a history of paracetamol ingestion who were treated with the two-bag NAC regimen. A descriptive comparison to a historical cohort of patients treated with the three-bag NAC regimen was also made. Methods: A retrospective chart review was conducted to assess a 6-month clinical audit. Summary statistics were used to describe all variables. Results: Overall, 57 patients were included (mean age 26 years, 83% female). The median ingested dose (10 g) was similar between the regimens. An empiric indication occurred more in patients receiving the two-bag regimen (84.0% versus 50.0%). The median paracetamol level (231 umol/L) and the proportion of confirmed paracetamol toxicity (32%) were less in the two-bag regimen. A delay in initiating the first NAC infusion occurred in 22 (38.6%) patients. Forty adverse effects were recorded in 22 (38.6%) patients and a higher proportion occurred in the two-bag regime (44.0% vs. 34.4%). Nausea and vomiting occurred frequently (n=30, 52.7%), which were comparable for both regimens. The prevalence of hepatotoxicity after receiving NAC was 8.8% (n=5). Conclusion: A large number of patients were empirically started on NAC with a higher incidence of adverse reactions in the two-bag NAC than in the three-bag NAC regimen in contrast to existing evidence. However, there was a reduction in treatment delay in the two-bag NAC regimen compared to the three-bag NAC regimen.