We investigated whether an eight week, light resistance program could increase the muscular strength of the knee and elbow extensors and flexors in a group of hospitalized anorexic patients compared to anorexic controls (AC) who did not participate in the training program, but received the same caloric intake, and non-anorexic exercisers (NAE) who undertook the resistance training program. After the resistance training program, the seven anorexic exercisers (AE) significantly increased the peak torque (PT) of their knee extensors (p < 0.001), flexors (p < 0.0001) and elbow flexors (p < 0.01). In comparison, the seven anorexic non-exercisers (anorexic controls, AC) and seven non-anorexic exercisers (NAE), who performed the same program, showed no significant increase in peak torque after the program (p > 0.05). The study has demonstrated that an eight week, light resistance program increases the knee and elbow strength of the hospitalized anorexic patients.

Ritualised exercise commonly accompanies the clinical presentation of anorexia nervosa (AN) sufferers, but there is a paucity of research on structured exercise as a therapeutic intervention. This study examined the usefulness of resistance training as part of a treatment programme for hospitalized anorexics. The study sample consisted of 21 subjects: seven anorexics participating in the exercise programme, seven non-participating anorexics, and seven subjects unaffected by an eating disorder but who participated in the exercise programme. The results show that resistance training is associated with an improvement in body composition and psychological well-being and, although it does not confer an outcome advantage in this regard, it seems to be a useful adjunct in the treatment of hospitalized anorexics.

The rates at which a peptide hexamer and a peptide octamer interconvert between left- and right-handed helical forms in CD2Cl2 solution have been characterized by 13C dynamic NMR (DNMR) spectroscopy. The peptide esters studied are Fmoc-(Aib)n-OtBu (n = 6 and 8), where Fmoc is 9-fluorenylmethyoxycarbonyl and Aib is the strongly helix-forming residue alpha-aminoisobutyric acid. Because the Aib residue is itself achiral, homooligomers of this residue form a 50/50 mixture of enantiomeric 3(10)-helices in solution. It has been demonstrated (R.-P. Hummel, C. Toniolo, and G. Jung, Angewandte Chemie International Edition, 1987, Vol. 26, pp. 1150-1152) that oligomers of Aib interconvert on the millisecond timescale. We have performed lineshape analysis of 13C-NMR spectra collected for our peptides enriched with 13C at a single residue. Rate constants for the octamer range from 6 s(-1) at 196 K to about 56,500 s(-1) at 320 K. At all temperatures, the hexamer interconverts about three times faster than the octamer. Eyring plots of the data reveal experimentally indistinguishable DeltaH++ values for the hexamer and octamer of 37.8 +/- 0.6 and 37.6 +/- 0.4 kJ mol(-1) respectively. The difference in the rates of interconversion is dictated by entropic factors. The hexamer and octamer exhibit negative DeltaS++ values of -29.0(-1) +/- 2.5 and -37.3 +/- 1.7 J K(-1) mol(-1), respectively. A mechanism for the helix-helix interconversion is proposed. and calculated DeltaG++ values are compared to the estimate for a decamer undergoing a helix-helix interconversion.

The current bio-psycho-social approach in South African psychiatry refers to Engel's extended model of health care. It forms the basis of the existing collaboration between medicine, nursing, psychology, occupational therapy and social work. Psychiatry also has to bridge the multi-cultural, multi-religious and spiritual diverse reality of everyday practice. It has become important to establish how, within accepted boundaries, spirituality should be incorporated into the model for practice. Referring to methods described for nursing theory development, a defined core concept was used to construct a model. It may contribute to the discourse on spirituality in local psychiatry, health and mental health.

The South African Society of Psychiatrists (SASOP) Treatment Guidelines for Psychiatric Disorders have been developed in order to address the local need for guidelines in our unique clinical setting.

This view concurred with the international medical literature, recommending that spirituality has to be incorporated into specialist psychiatric practice and training, but within professional boundaries and with all faith traditions and belief systems considered equally.

This case illustrates that in AN, pathology may not manifest with obvious clinical features. A high level of clinical vigilance is required. The cause of death in AN cannot reliably be established from antemortem clinical features. We recommend that any AN death be reported and that, where possible, an autopsy be performed. This may lead to advances in knowledge and treatment practices.

BackgroundCommunity mental health services (CMHS) are a central objective of the National Mental Health Policy Framework and Strategic Plan. Three core components are described: residential facilities, day care and outpatient services. Primary mental health care with specialist support is required according to an intervention pyramid. Staffing norms provide for a minimum mental health service coverage of 2.7% of the population for adults and 1.5% for children and adolescents.AimThe aim of this study was to describe the existing CMHS in Southern Gauteng in terms of the National Mental Health Policy.MethodsThe CMHS of the City of Johannesburg, Ekurhuleni, Sedibeng and West Rand districts were studied. Information regarding service organisation and staffing was obtained via the Gauteng Directorate of Mental Health. Routinely collected District Health Information Systems data for the 2014/2015 year were analysed.ResultsThe organisation of services was not consistent with that recommended by the Mental Health Policy, and specialist CMHS were inappropriately situated within primary care. Only 2.23% of clinic visits were for mental health, and 80% of these were at specialist CMHS. Overall mental health coverage was approximately 0.3% of the population for adults and 0.02% for children and adolescents. Staffing, residential facilities and day care were far below the cited norms for minimal cover.ConclusionOur audit revealed that the CMHS in Southern Gauteng did not meet any of the norms cited by the Mental Health Policy. Barriers to implementation of this aspect of the Mental Health Policy need to be explored.