SUMMARY In a house-to-house study of 994 urban Zulus the prevalence of hypertension according to WHO criteria was 25% (23% men, 27% women). In a rural Zulu study of 987 the prevalence age corrected to the urban distribution was 9 4% (8.7% men, 10% women). Thus there was a pronounced difference between the prevalence of hypertension in the urban and rural Zulu (p <0.0005). There was an earlier onset of hypertension in the urban compared with the rural

This study has highlighted a high prevalence of non-insulin-dependent diabetes mellitus in South African Indians and bimodality in the plasma glucose distribution.

BackgroundThere is currently conflicting evidence surrounding the effects of obesity on postoperative outcomes. Previous studies have found obesity to be associated with adverse events, but others have found no association. The aim of this study was to determine whether increasing body mass index (BMI) is an independent risk factor for development of major postoperative complications.MethodsThis was a multicentre prospective cohort study across the UK and Republic of Ireland. Consecutive patients undergoing elective or emergency gastrointestinal surgery over a 4‐month interval (October–December 2014) were eligible for inclusion. The primary outcome was the 30‐day major complication rate (Clavien–Dindo grade III–V). BMI was grouped according to the World Health Organization classification. Multilevel logistic regression models were used to adjust for patient, operative and hospital‐level effects, creating odds ratios (ORs) and 95 per cent confidence intervals (c.i.).ResultsOf 7965 patients, 2545 (32·0 per cent) were of normal weight, 2673 (33·6 per cent) were overweight and 2747 (34·5 per cent) were obese. Overall, 4925 (61·8 per cent) underwent elective and 3038 (38·1 per cent) emergency operations. The 30‐day major complication rate was 11·4 per cent (908 of 7965). In adjusted models, a significant interaction was found between BMI and diagnosis, with an association seen between BMI and major complications for patients with malignancy (overweight: OR 1·59, 95 per cent c.i. 1·12 to 2·29, P = 0·008; obese: OR 1·91, 1·31 to 2·83, P = 0·002; compared with normal weight) but not benign disease (overweight: OR 0·89, 0·71 to 1·12, P = 0·329; obese: OR 0·84, 0·66 to 1·06, P = 0·147).ConclusionOverweight and obese patients undergoing surgery for gastrointestinal malignancy are at increased risk of major postoperative complications compared with those of normal weight.

The development of psychological services for South Africa's 30 million black people has been stunted by the mystical view, allegedly derived from cross-cultural psychology, that 'first-world' psychology is culturally inappropriate for a 'third-world clientele', and that for effective service delivery, psychologists must undergo a radical acculturation process before they can join with the epistemology of this clientele. A theoretical base is developed to challenge the simplistic and desocialized notions of culture and race advanced by the crosscultural mystics, and to propose a pragmatic alternative by drawing attention to the dynamics of oppression and cultural transformation, and to issues of power and social class. It is argued that empowerment in the process of psychotherapy lies in creating a shared language of negotiation and respect which in turn allows for the appropriate use of a problem-oriented family therapy model.Die ontwikkeling van sielkundige dienste vir Suid-Afrika se 30 miljoen swart mense is belemmer deur die mistieke siening, wat sogenaamd vanuit die kruis-kulturele sielkunde ontwikkel is, dat 'eerste wereld' sielkunde kultureel ontoepaslik is vir 'derde wereld kliente'. Daar word voorts ook beweer dat sielkundiges 'n radikale akkulturasieproses moet ondergaan voordat hulle hul met die epistemologie van hul kliente kan identifiseer om sodoende effektiewe dienste te lewer. 'n Teoretiese basis word ontwikkel aan die hand waarvan die simplistiese en gedesosialiseerde begrippe van kultuur en ras wat deur die kruis-kulturele mistici gepropageer word, tot verantwoording geroep word. Eweneens word daar aan die hand van hierdie basis 'n pragmatiese alternatief voorgestel deur die aandag te vestig op die dinamika van onderdrukking en kulturele transformasie en ook op sake wat verband hou met mag en sosiale klas. Daar word betoog dat die bemagtiging ('empowerment') in die psigoterapeutiese proses daarin gelee is om 'n gedeelde taal van onderhandeling en respek te skep wat weer op sy beurt die toepaslike benutting van 'n probleem-georienteerde gesinsterapie model moontik maak.

No abstract