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While the increased access to consumer credit has helped many families improve their welfare, the rising repayment burdens upon a background of chronically low saving rates have generated concerns that South African families are becoming ever more financially fragile and less able to meet their consumer debt repayment obligations. Using data from the Cape Area Panel Study, this article investigates whether consumer debt repayment problems are better explained by excessive spending which leaves households financially overstretched or by negative income shocks. The results indicate that households are significantly more likely to be delinquent on their financial obligations when they suffer negative events beyond their control rather than due to the size of the expenditure burden. This suggests that consumer repayment problems are likely to endure even when consumers borrow within their means. Thus, regulatory efforts to improve mechanisms for debt relief might be more meaningful than restrictions on lending. [ABSTRACT FROM AUTHOR]

The prevalence and ranking of non-timber forest products (NTFPs) as safety-nets has been well discussed, but rarely quantified. We report on group discussions and household interviews in two South African villages to assess the frequency and nature of shocks and stresses over a 2-year period and the coping strategies employed, stratified by household wealth and gender of the de jure household head. Overall, kinship was the most widely adopted coping strategy, and NTFPs were the fifth most prevalent (employed by 70% of households). There were relatively few differences in the nature of shocks or responses between male- and female-headed households. Wealth influenced the experience of shocks or stresses as well as responses. Poorer households have fewer options with the increased use or sale of NTFPs being the second most commonly adopted strategy. Increased use and sale of NTFPs is a common manifestation of the safety-net function. To reconcile long-term economic development and biodiversity conservation, it is important to understand people's use of natural resources and the factors that affect this use, including their responses to shocks and stresses. [ABSTRACT FROM AUTHOR]

Abstract: Babesia (canis) rossi infection is common in dogs in South Africa, and frequently causes severe, life-threatening disease. Acidemia, persistent hyperlactatemia, hemoconcentration, elevated creatinine, cerebral babesiosis, pulmonary edema and pancreatitis are all associated with mortality rates above 30%, compared with overall mortality of 12% in admitted cases. Although half the admitted cases are severely anemic, hemoconcentration is associated with far higher mortality. Cerebral babesiosis is uncommon, but carries a poor prognosis. The pathological mechanism has been suggested to be endothelial cell damage and necrosis, followed by segmental microvascular necrosis with perivascular edema and hemorrhage. Renal involvement in babesiosis resembles the functional renal failure of sepsis. Hypotension is common, and other cardiovascular disturbances have been documented. Cerebellar ataxia, rhabdomyolysis and pancreatitis are recently identified complications. While the previous categorization into “severe” (life-threatening anemia) and “complicated” (complications not directly attributable to anemia) disease has proved useful, the distinction is artificial and probably unnecessary. An updated approach to classification is suggested, aimed at grouping animals by severity and prognosis, and using simple measures, such as clinical collapse and abnormal breathing, as much as possible. Although inflammatory mechanisms are undoubtedly important in the pathophysiology of babesiosis, there can be little doubt that tissue hypoxia plays a major role in the disease process. [Copyright &y& Elsevier]

Current shock resuscitation strategies require titration of fluid in combination with inotropes and vasopressors to counteract the actual pattern of circulatory abnormality in the patient, and to restore the circulation to a level that is adequate to prevent organ ischaemia. Used incorrectly or in excessive doses, vasoactive agents may cause patient harm. The mechanisms of shock, appropriate resuscitation goals, and some aspects of how common available vasoactive agents in South Africa can be used for optimal safely to help to achieve these goals are discussed. [ABSTRACT FROM AUTHOR]

Background: This study comprised 304 patients with gunshot injuries of the liver, many of which from high-velocity firearms. The purpose of this study is to evaluate our management policy in gunshot injuries of the liver in light of our recent wider experience., Methods: All grade I and II injuries and most grade III injuries were managed by simple operative measures, without postoperative mortality directly related to the liver trauma., Results: Grade III, IV, and V injuries had 8.5%, 52%, and 16% resectional debridement rates and 8.5%, 38%, and 84% perihepatic packing rates, respectively. In the resectional debridement group the postoperative mortality rate was 15% (half the deaths were directly caused by the hepatic injury). The postoperative mortality rate in the perihepatic packing group was 31.5% of which 45% of deaths were due to ongoing bleeding, 27.5% to sepsis, and 27.5% to associated trauma. The septic complications were less common when packs were removed early., Conclusions: We suggest that resectional debridement and perihepatic packing should be liberally applied in the most severe grade III, most grade IV, and grade V gunshot injuries of the liver and that perihepatic packing should be removed as early as the physiologic derangements are corrected. Our experience with grade VI injuries is very limited, and their management should be studied in larger series.