The incomplete cone in carcinoma in situ of the cervix : a prospective study in a developing country

The original publication is available at http://www.samj.org.zaThe diagnostic procedures and treatment of carcinoma in situ and severe dysplasia of the cervix are becoming more conservative. In a developing country special problems make such an approach more hazardous. During a 15-months period the diagnosis in 25 of 206 patients (12,1%) with a smear positive for carcinoma in situ could not be confirmed histologically at Tygerberg Hospital. A prospective study of 147 cases (71,4%) in which the diagnosis was confirmed revealed that they were mostly young patients of relatively high gravidity. The difficulty of assessing the completeness of a cervical cone and of evaluating a postconization smear is confirmed. The danger of a too conservative approach in our patients is confirmed by the fact that only 8,2% of patients came for regular follow-up examinations and that 34,7% did not return for follow-up smears. The high incidence of total hysterectomy (51,7%) as the definitive form of treatment is defended, and a more conservative future approach of confirming the diagnosis and reducing the incidence of cervical conization is suggested.Publishers' versio

A fresh perspective on historical sexual abuse: the case of Hewitt v S 2017 1 SACR 309 (SCA)

Sexual crimes continues to be a scourge in our society. It is therefore not surprising that the prevention and criminalisation of sexual crimes in South Africa has received a large amount of attention over the last few years. Contrarily, the matter of historical sexual abuse has received only occasional consideration. Cases of historical sexual abuse present numerous challenges to all parties involved. The victims of historical sexual abuse, often children at the time, are now adults. Some of these victims might not want to relive the experience or confront the offender. On the other hand, the offender might have been rehabilitated and become a respected citizen. In Hewitt v S 2017 1 SACR 309 (SCA) the Supreme Court of Appeal heard the appeal against the sentence of Bob Hewitt, a retired tennis champion. He was convicted of committing numerous sexual offences against young girls. The first of these crimes was committed more than three decades ago. This case note analyses the decision by the SCA while it also examines historical sexual abuse more generally in South Africa as well as in England and Wales, in order to establish whether any lessons can be learned from previous cases and laws as implemented in these countries

Dealing with a traumatic past: the victim hearings of the South African truth and reconciliation commission and their reconciliation discourse

In the final years of the twentieth and the beginning of the twenty-first century, there has been a worldwide tendency to approach conflict resolution from a restorative rather than from a retributive perspective. The South African Truth and Reconciliation Commission (TRC), with its principle of 'amnesty for truth' was a turning point. Based on my discursive research of the TRC victim hearings, I would argue that it was on a discursive level in particular that the Truth Commission has exerted/is still exerting a long-lasting impact on South African society. In this article, three of these features will be highlighted and illustrated: firstly, the TRC provided a discursive forum for thousands of ordinary citizens. Secondly, by means of testimonies from apartheid victims and perpetrators, the TRC composed an officially recognised archive of the apartheid past. Thirdly, the reconciliation discourse created at the TRC victim hearings formed a template for talking about a traumatic past, and it opened up the debate on reconciliation. By discussing these three features and their social impact, it will become clear that the way in which the apartheid past was remembered at the victim hearings seemed to have been determined, not so much by political concerns, but mainly by social needs

Comparing laboratory costs of smear/culture and Xpert(®) MTB/RIF-based tuberculosis diagnostic algorithms

SETTING: Cape Town, South Africa, where Xpert® MTB/RIF was introduced as a screening test for all presumptive tuberculosis (TB) cases. OBJECTIVE: To compare laboratory costs of smear/culture- and Xpert-based tuberculosis (TB) diagnostic algorithms in routine operational conditions. METHODS: Economic costing was undertaken from a laboratory perspective, using an ingredients-based costing approach. Cost allocation was based on reviews of standard operating procedures and laboratory records, timing of test procedures, measurement of laboratory areas and manager interviews. We analysed laboratory test data to assess overall costs and cost per pulmonary TB and multidrug-resistant TB (MDR-TB) case diagnosed. Costs were expressed as 2013 Consumer Price Index-adjusted values. RESULTS: Total TB diagnostic costs increased by 43%, from US$440 967 in the smear/culture-based algorithm (April–June 2011) to US$632 262 in the Xpert-based algorithm (April–June 2013). The cost per TB case diagnosed increased by 157%, from US$48.77 (n = 1601) to US$125.32 (n = 1281). The total cost per MDR-TB case diagnosed was similar, at US$190.14 and US$183.86, with 95 and 107 cases diagnosed in the respective algorithms. CONCLUSION: The introduction of the Xpert-based algorithm resulted in substantial cost increases. This was not matched by the expected increase in TB diagnostic efficacy, calling into question the sustainability of this expensive new technology

Die strafregtelike aanspreeklikheid van regspersone: Lesse uit Kanada

This contribution investigates the basis for the criminal liability of juristic persons in Canada in an attempt to gain lessons for South Africa. The Canadian position acknowledges both the fragmented nature of corporate decision-making and the reality that the collective efforts of a number of corporate role players may cause criminal conduct. Furthermore, the conduct and fault elements of corporate criminal misconduct do not have to be found in one individual. The conduct of a representative of the corporate entity may be regarded as the conduct of the corporation, whilst the fault requirement may be found to be the level of management. This approach, although not entirely ‘realistic’, takes into account the nature of modern corporate entities much better than traditional individualistic approaches to corporate criminal liability

Why Read (Diffractively)?

Academics should produce quality scholarly research. However, the demands of the marketised, neoliberal higher education institution and the increase in the academic’s bureaucratic and administrative tasks do not allow for adequate engagement with the deep work and slow forms of scholarship that are needed to produce cutting-edge and insightful research. Many academics find it challenging to think critically and creatively under such conditions, yet they are unwilling to fill their time with shallow work instead. Thus, they are torn between producing an institutionally-determined number of research outputs, and striving towards producing quality scholarly work that advances knowledge in the academic’s discipline. Reading groups serve to rework this tension by providing a communal and scheduled place and mind-space for reading major academic works. Reading takes time and persistence. We find that setting aside time and creating creative spaces for reading groups offer an opportunity for silent revolt against the pressures of the higher education institution. In this (post)qualitative inquiry we diffractively read – “through one another” – two autoethnographical accounts to experiment with our experiences of various reading groups over a period of three years while positioning ourselves in relation to Barad’s notion of diffraction. This speculative experimentation entails a myriad of ideas and methods that serve to decentre hegemonic, monolithic knowledge systems through seeking alternative ways of knowing, and recognises the importance of the entanglement of matter and meaning in tracing (and countering) the social relations produced in neoliberalist contexts. Such (re)thinking is thus a vital counterpoint to the neoliberal obsessions of the higher education context, (re)directing the scholar to new non-autonomous and mutable landscapes

Shaft Mucker Design

The mucking principle employed in the design of this mucking machine is that of a continuous operation instead of an intermittent one. The mucker was primarily designed for operation in shafts (vertical or inclined) and winzes but the mucker is not restricted to these

Die stelsel van bedryfsvryheid

Daar is in die modeme ekonomieë twee fundamentele verskillende maniere waar op die ekonomiese prosesse gekoordineer kan word: deur die staatsadministrasie en deur die markmeganisme. Die sentraal geadministreerde of geleide ekonomie steun oor die hele linie op owerheidsvoorskrifte en owerheidsbeplanning, vir die koordinasie van die ekonomiese bedrywigheid. Ekonomies word alle bedrywighede voorgeskryf, gelei en beheer. Wat die beheer betref, is die burokrasie gesentraliseerd: inligting stroom na bo, beslissings na benede. Polities is die kader van die sisteem monolities: die staat stel in beginsel belang in alle aktiwiteite van sy onderdane en kan geen enkele eienskap daarvan duld wat nie strook met sy eie aard nie. Hierdie toestand van sake word kragtig gesteun deur ’n geskikte ideologie