Applying integrated enhanced cognitive behaviour therapy (I-CBTE) to severe and longstanding eating disorders (SEED) Paper 2: An in-depth case study for clinicians.

Background: This case study examines the application of Integrated Enhanced Cognitive Behavioural Therapy (I-CBTE) for a patient with severe, longstanding anorexia nervosa and multiple comorbidities, including organic hallucinosis, complex post-traumatic stress disorder (CPTSD), and severe self-harm. Such complex presentations often result in patients falling between services, which can lead to high chronicity and increased mortality risk. Commentaries from two additional patients who have recovered from severe and longstanding anorexia nervosa are included.

Low-cost uncrewed aerial vehicles (UAVs) as a novel tool for welfare assessments on open pen commercial crocodile farms.

Background: The welfare of crocodiles on commercial farms in southern Africa requires precise assessment, focusing on stocking densities and pen conditions. However, disputes between animal welfare groups and farm owners persist due to inadequate methodologies for quantifying these factors.

Objectives: This study aimed to address these disputes and enhance crocodile welfare assessment by introducing a novel technique using a low-cost consumer uncrewed aerial vehicle (UAV) and open-source photogrammetry software.

A multi-year, multi-site study of the prevalence of fetal alcohol syndrome in South Africa.

Background: South Africa has the highest reported prevalence of fetal alcohol spectrum disorders (FASD) globally. The most recent study reported a weighted, estimated FASD prevalence of 310 per 1000 in a community in the Western Cape Province. Because there is as yet no reliable estimate of the national burden of FASD in South Africa, further epidemiological studies are needed in diverse settings.

The alarms should no longer be ignored: survey of the demand, capacity and provision of adult community eating disorder services in England and Scotland before COVID-19.

Aims/method: This national pre-pandemic survey compared demand and capacity of adult community eating disorder services (ACEDS) with NHS England (NHSE) commissioning guidance.

Results: Thirteen services in England and Scotland responded (covering 10.7 million population).

Patients' experiences of clinical team meetings (ward rounds) at an adult in-patient eating disorders ward: mixed-method service improvement project.

Aims: Ward rounds are key to treatment-related decision-making, but are often stressful. This project aimed to explore and improve patients' experiences of the clinical team meeting (CTM; historically known as ward round) in an adult in-patient eating disorders unit. A mixed-method approach was adopted with observations, two focus groups and an interview.

Integrated enhanced cognitive behavioural (I-CBTE) therapy significantly improves effectiveness of inpatient treatment of anorexia nervosa in real life settings.

Background: Inpatient treatment of anorexia nervosa can be lifesaving but is associated with high rates of relapse and poor outcomes. To address this, the Oxford service has adapted the enhanced cognitive behavioural treatment (CBTE) model, first developed for inpatients in Italy to a UK national health service (NHS) setting. In this study, we compared the outcomes from treatment as usual (TAU), integrated CBTE (I-CBTE), and alternative treatment models in routine UK clinical practice.

Risk, demand, capacity and outcomes in adult specialist eating disorder services in South-East of England before and since COVID-19.

Aims And Method: This is a longitudinal cohort study describing the demand, capacity and outcomes of adult specialist eating disorder in-patient services covering a population of 3.5 million in a South-East England provider collaborative before and since the COVID-19 pandemic, between July 2018 and March 2021.

Results: There were 351 referrals for admission; 97% were female, 95% had a diagnosis of anorexia nervosa and 19% had a body mass index (BMI) <13.

The Tensile Behaviour of Highly Filled High-Density Polyethylene Quaternary Composites: Weld-Line Effects, DIC Curiosities and Shifted Deformation Mechanisms.

The interactive effects between additives and weld lines, which are frequent injection-moulding defects, were studied in high-density polyethylene (HDPE) and compared to weld-line-free reference samples. These materials were formulated around a D- and I-optimal experimental design, based on a quadratic Scheffé polynomial model, with up to 60 wt% calcium carbonate, masterbatched carbon black and a stabiliser package. Where reasonable and appropriate, the behaviours of the systems were modelled using statistical techniques, for a better understanding of the underlying trends.

Comparing diagnostic outcomes of children with fetal alcohol syndrome in South Africa with diagnostic outcomes when using the updated Institute of Medicine diagnostic guidelines.

Introduction: During fetal alcohol spectrum disorder (FASD) prevalence studies in South Africa, cases of fetal alcohol syndrome (FAS) were identified that presented differently from the 2016 Hoyme et al. modified Institute of Medicine (IOM) criteria. We compared diagnostic outcomes of children diagnosed with FAS using a combination of the 2005 Hoyme et al.

Alcohol exposure during pregnancy altered childhood developmental trajectories in a rural South African community.

Aim: This study examined the effects of prenatal alcohol exposure on childhood development trajectories in a rural South African community between 2003 and 2008.

Methods: We assessed 121 children at 7-12 months (year one) and 5-6 years (year five) using the Griffiths Mental Developmental Scales - Extended Revised, which measures sensorimotor, cognitive and social development, with lower scores indicating developmental delay. We also interviewed their mothers or caregivers.

Osteogenesis imperfecta type 3 in South Africa: Causative mutations in FKBP10.

Background: A relatively high frequency of autosomal recessively inherited osteogenesis imperfecta (OI) type 3 (OI-3) is present in the indigenous black southern African population. Affected persons may be severely handicapped as a result of frequent fractures, progressive deformity of the tubular bones and spinal malalignment.

Objective: To delineate the molecular basis for the condition.

Nocturnal incontinence in children with fetal alcohol spectrum disorders (FASD) in a South African cohort.

Introduction: Fetal alcohol spectrum disorders (FASD) are one of the leading preventable causes of intellectual disabilities (ID). Not much is known about the topic of pediatric incontinence related to FASD, for example nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI). So far, incontinence problems have been examined among children with other specific syndromes.

Changes in drinking patterns during and after pregnancy among mothers of children with fetal alcohol syndrome: A study in three districts of South Africa.

Background: Mixed ancestry populations in South Africa have amongst the highest rates of fetal alcohol syndrome (FAS) worldwide. Defining the drinking patterns of women with a FAS child guides FAS preventive interventions.

Methods: Data were drawn from FAS prevalence surveys conducted in three districts: Witzenberg (Cape Winelands), Frances Baard (inland mining town) and Saldanha Bay (coastal towns).

Fetal alcohol spectrum disorders: Prevalence rates in South Africa.

Background: Fetal alcohol spectrum disorder (FASD) is an under-diagnosed condition in South Africa (SA). Fetal alcohol syndrome and FASD community prevalence studies were undertaken in 17 towns in three of the nine provinces in SA.

Objective: The objective for all the studies was to determine the FASD prevalence rates by assessing the grade 1 learners in all the studies, using international FASD diagnostic criteria.

Prevalence of fetal alcohol syndrome in a South African city with a predominantly Black African population.

Background: Fetal alcohol spectrum disorder (FASD) and fetal alcohol syndrome (FAS) are common in some South African populations, notably those of mixed ancestry descent in rural areas and small towns. Little is known about FAS/FASD prevalence in the majority of South Africans: city dwellers of Black African ethnicity. This study describes the prevalence of FAS in a South African city, comparing 2 suburbs with predominantly mixed ancestry (Roodepan) and Black African (Galeshewe) populations that house over 60% of the city population.

Reduced DNA methylation at the PEG3 DMR and KvDMR1 loci in children exposed to alcohol in utero: a South African Fetal Alcohol Syndrome cohort study.

Fetal alcohol syndrome (FAS) is a devastating developmental disorder resulting from alcohol exposure during fetal development. It is a considerable public health problem worldwide and is characterized by central nervous system abnormalities, dysmorphic facial features, and growth retardation. Imprinted genes are known to play an important role in growth and development and therefore four imprinting control regions (ICRs), H19 ICR, IG-DMR, KvDMR1 and PEG3 DMR were examined.

Age-related injury and compensation claim rates in heavy industry.

Background: Although ageing workers face specific health and safety concerns, conflicting evidence exists regarding the effects of age on workplace injury rates and workers' compensation claims.

Aims: To examine injury and workers' compensation claim rates by age and injury type in an aluminium smelter over a 9-year period.

Methods: Routinely collected data for workplace injuries and workers' compensation claims were retrieved for the period from 1997 to 2005.

Burden of fetal alcohol syndrome in a rural West Coast area of South Africa.

Background: Fetal alcohol syndrome (FAS) is common in parts of South Africa; rural residence is a frequently cited risk factor. We conducted a FAS school prevalence survey of an isolated rural community in a West Coast village of Western Cape Province, so obtaining the first directly measured rate, focusing specifically on a South African rural area, of FAS and partial FAS (PFAS).

Methods: The study area (Aurora village), a community of about 2 500 people in a grain-producing region, has one primary school.

Developmental delay of infants and young children with and without fetal alcohol spectrum disorder in the Northern Cape Province, South Africa.

Objective: To describe the extent and nature of developmental delay at different stages in childhood in a community in South Africa, with a known high rate of Fetal Alcohol Spectrum Disorder (FASD).

Method: cohort of infants, clinically examined for FASD at two time periods, 7-12 months (N= 392; 45 FASD) and 17-21 months of age (N = 83, 35 FASD) were assessed using the Griffiths Mental Developmental Scales (GMDS).

Results: Infants and children with FASD perform worse than their Non-FASD counterparts over all scales and total developmental quotients.

Universal prevention is associated with lower prevalence of fetal alcohol spectrum disorders in Northern Cape, South Africa: a multicentre before-after study.

Aims: Prevalence of fetal alcohol spectrum disorders (FASDs) is remarkably high in several provinces of South Africa; yet population-level knowledge of the harms of maternal drinking remains low. In two heavily affected areas, we assessed effectiveness of interventions to heighten awareness of these harms and to alter social norms about drinking in pregnancy.

Methods: FASD prevalence, maternal knowledge and drinking behaviours were investigated in two Northern Cape Province towns, before and after interventions which included highlighting FASD using local media and health promotion talks at health facilities.

Comparative cost and performance of light-emitting diode microscopy in HIV-tuberculosis-co-infected patients.

Light-emitting diode (LED) microscopy has recently been endorsed by the World Health Organization (WHO). However, it is unclear whether LED is as accurate and cost-effective as Ziehl-Neelsen (ZN) microscopy or mercury vapour fluorescence microscopy (MVFM) in tuberculosis (TB)-HIV-co-infected subjects. Direct and concentrated sputum smears from TB suspects were evaluated using combinations of LED microscopy, ZN microscopy and MVFM.

Occupational asthma in the aluminum smelters of Australia and New Zealand: 1991-2006.

Objective: To examine the incidence of occupational asthma in the seven aluminum smelters of Australia and New Zealand from 1991 to 2006.

Methods: Incidence and exposure data were collected by survey from the smelters prospectively during the study period.

Results: The incidence of occupational asthma across all smelters combined was highest in 1992 at 9.

Improved injury management at an Australian aluminium smelter.

Objective: This longitudinal study sought to determine the effectiveness of interventions to improve injury management in an industrial setting.

Participants: Study participants were workers from three production departments of a large aluminium smelter.

Methods: The interventions introduced were to encourage active participation in rehabilitation procedures by injured workers, improve communication with all stakeholders, identify and manage psychosocial issues, and focus the workforce on occupational health and safety matters.