Journal articles on the topic 'Bailliere, F F'

Abstract Introduction: We present a clinical case of a non-seminomatous germ cell choriocarcinoma producing human chorionic gonadotrophin (HCG) and inducing hyperthyroidism. Clinical Case: A 21-year-old male with recently diagnosed metastatic non-seminomatous germ cell choriocarcinoma presented with persistent tachycardia and anxiety. At diagnosis, his β- human chorionic gonadotrophin (β-HCG) was elevated to 6,435 mIU/mL (normal <1 in male) and thyroid-stimulating hormone (TSH) was within normal limits. At presentation, however, his β-HCG increased to 103,229 mIU/mL, TSH was suppressed <0.02 mcIU/mL (normal 0.3-4.7), and free thyroxine was elevated (FT4) 2.6 ng/dL (normal 0.8-1.7). His thyrotoxicosis improved with initiation of methimazole; however, his TSH remained undetectable due to persistently elevated β-HCG levels. His course was complicated by hemorrhagic shock and acute liver injury in the setting of a presumed intraluminal gastric metastasis, necessitating the discontinuation of methimazole. He was continued on steroids to try to minimize T4 to T3 conversion, but ultimately his thyroid hormones uptrended. He became stable enough to tolerate 5 days of chemotherapy, after which his FT4 quickly normalized. Unfortunately, he continued to suffer from vasodilatory shock and ultimately passed away. Discussion: It has been demonstrated that HCG can bind to the TSH receptor and has thyrotropic activity. The development of hyperthyroidism requires HCG levels >200,000 mIU/mL that are sustained for several weeks (1). It is unknown what the prevalence of hyperthyroidism is in choriocarcinoma, but it has been shown to greatly increase when serum HCG levels are greater than >50,000 mIU/mL (2). Conclusion: Hyperthyroidism can be difficult to recognize in patients suffering from cancer as many of the typical symptoms can also be seen with active malignancy. Patients with HCG-secreting tumors should be evaluated for hyperthyroidism and may benefit from treatment until the underlying cause can be managed. References: (1) Hershman, Jerome M. “Physiological and Pathological Aspects of the Effect of Human Chorionic Gonadotropin on the Thyroid.” Best Practice & Research Clinical Endocrinology & Metabolism, Baillière Tindall, 19 May 2004, www.sciencedirect.com/science/article/abs/pii/S1521690X0400020X.(2) Oosting, S F et al. “Prevalence of paraneoplastic hyperthyroidism in patients with metastatic non-seminomatous germ-cell tumors.” Annals of oncology: official journal of the European Society for Medical Oncology vol. 21,1 (2010): 104-8. doi:10.1093/annonc/mdp265

This study was conducted to identify of rodent species and the ectoparasites are widely recognized for the type prevalent in homes, at Esna District, Luxor Governorate, Egypt, during 2020 year. The results were revealed that the presence of three species of rats included gray-bellied rat, Rattusrattusalexandrinusthe dominant species from, Rattusrattusfrugivorusand the Nile grass rat, Arvicanthisniloticus. The results also indicated that the identification of two types of fleas, Xenopsyllacheopis&Pulexirritans, and one species of lice, Polyplaxspinulosa, associated with the gray-bellied was identified. The study reports the interest in making integrated control programs for rodents to get rid of them and the risks of their external parasites. Introduction Rodents play an important role as hosts for ectoparasites and as repositories for various types of viruses, bacteria, rickets, protozoa, and parasitic worms that cause zoonotic diseases (Durden and Page, 1991; Azad and Beard, 1998; Coleman et al., 2003; Salibay and Claveria, 2005). Some examples of such diseases are rodent-borne hemorrhagic fever, plague, Lyme disease, leptospirosis, salmonellosis, murine typhus, scrub typhus, toxoplasmosis, shistosomiasis, nematodes and tapeworms. The close association between commensal rodents and humans and domestic animals is a risk factor for transmission of these diseases (Kia et al., 2009). The aim of this study is to identify rodent species spread with a study of external parasites of the most dominant species in houses of study area. Materials and methods • Study Area The present study was carried out to inventory of the types of rodent spread in houses with a study of external parasites of the most dominant species at Esna area, Luxor Governorate, Egypt, during 2020 year. • Identification of the different species of rodents Rodent species were collected from the aforementioned sites using 10 common wire traps. Each trap was stabbed with bread and distributed twice every 15 days at 6 PM. The next morning at 7 a.m., traps were examined, rodents identified and recorded for data processing. Captured rodents were graded and recorded (Desoky, 2011). • IdentificationRattusrattusalexandrinusectoparasites: Five rats were taken all Month during the study period, rodent were anesthetized in jar containing a cotton pad with chloroform and then brushed in a deep white plate using a relatively hard brush. After collection of the ectoparasites, they were preserved in plastic bags containing 70% ethyl alcohol and labeled with necessary information. The parasites were sorted and transferred to the microscope slide for identification. The ectoparasites were classified.(Soulsby, 1982&Meerburget al., 2009). Results and discussion The results showed in table 1 and figure 1 a survey of three types of rodents: It was also found that the gray-bellied rat is the most common species in the study area (Esna homes), because the gray-bellied rat is considered a household climbing rodentAbdel-Gawad (1974 and 2010). Table 1: survey of rodent species in houses at Esna area, Luxor Governorate, during 2020 year. Figure 1: Survey of rodent species in houses at Esna area, Luxor Governorate, during 2020 year. Data in table (2) the results showed that two types of fleas, Xenopsyllacheopis&Pulexirritans, and one lice, Polyplaxspinulosa, infested the captured Rattusrattusalexandrinus. Results similar withVatandoostet al. (2003) &Telmadarraiyet al. (2004) found that most medically important rodents belong to the families of Muridae and the Cricetidae. Rodents play a role in many diseases, such as plague, transmitted by the rat flea Xenopsyllacheopisand Weil's disease, a severe form of leptospirosis transmitted via infected rat urine, Dada (2016). The study showed that infecting rodents with external parasites, which have a serious importance in transmitting diseases to humans or animals, for example, the eastern mouse flea has been identified, which may be a carrier of the bacteria that causes plague. The transmission of these rat-borne parasites is exacerbated in societies where environmental and personal health standards are not maintained. From these results, an integrated control program for the gray bellied rat must be established inside the houses. Table 2: Types of external parasites identified onRattus r. alexandrinus Data in Table (3) and Figure (2) showed thatthe highest population density of rat ectoparasites was recorded during spring and summer months, followed by autumn, whereas the lowest density was recorded during winter months. Regardless of months, the results showed also, the highest average number of lice was in spring 18, followed by summer 15, followed by autumn 14, and the lowest of them was winter 4, where it was recorded. While the highest average number of fleas was in spring 5, followed by summer and winter 4, and the lowest of them were autumn 3. The results also showed that the numerical density of lice was higher than that of fleas on the body of a gray-bellied rat.Regardless of months, lice exhibited the highest population density, whereas, fleas showed the least population density, this may be attributed to that fleas visit rats for feeding only, but lice are permanent parasites on hosts. The results similar with Embarak (1997); Kia et al. (2009) &Desokyet al. (2010). Table 3: Density numerical of external parasites on Ratttusrattusalexandrinus at Esna area, Luxor Governorate, during 2020 year. Figure 2: Seasonal numbers of ectoparasites for the gray-belliedrat at Esna area, Luxor Governorate, during 2020 year. Conclusion The results are useful in identifying the types of rodents and their external parasites that may transmit many diseases to humans or animals. It also helps in the future to increase the research study on this topic with attention to the participation of society as a whole to get rid of rodents and their external parasites. References Abdel-Gawad, K. H. Ecological and toxicological studies on commensal and household rodents in Assiut area. M.Sc. Thesis, Fac. Agric., Assiut Univ. 1974. Abdel-Gawad K. H. Rodent species composition in the present compared with past, the fifth Scientific Conferences for Agric. Assiut Univ. Oct. 16-17, 2010, 159-167. Azad AF.; CB Beard. Rickettsial pathogens and their arthropod vectors. Emerg Infect Dis. 1998, 4, 179-186. Coleman R.E.; T. Monkannaand K.J. Linthicum. Occurrence of Orientiatsutsugamushi in small mammals from Thailand. Am Trop Med Hyg. 2003, 69, 519-524. Dada, E.O. Study on the Ectoparasites and Haemoparasites of Domestic Rats in Parts of Akure South Local Government Area of Ondo State. International Journal of Clinical Chemistry and Laboratory Medicine (IJCCLM). 2016, 2(1), 1-5. Desoky, A.S.S. Studies on certain ectoparasites associated with some farm animals and their control, Ph.D. Thesis, Fac., Agric., Assiut Univ., Assiut, Egypt, 179, 2011. Desoky ASS.; Maher Ali A.; KH Abd El-Gawad.; AA Nafady. Survey and population density of some ectoparasites associated with rodents in animal production farm, Assiut University. Assiut J. of Agric. Sci. 2010, 41, 207-215. Durden LA.; BF Page. Ectoparasites of commensal rodents in Sulawesi Utara, Indonesia, with notes on species of medical importance. Med Vet Entomol. 1991, 5(1), 1-7. Embarak MZ. Ecological and control studies on rodents and their ectoparasites in cultivated and newly-reclaimed areas. M.Sc. Thesis, Fac. Agric., Assiut Univ. 1997. Kia EB.; H Moghddas-Sani.; H Hassanpoor.; H Vatandoost.; F Zahabiun.; AA Akhavan.; AA Hanafi-Bojd.; Z Telmadarraiy. Ectoparasites of rodents captured in Bandar Abbas, Southern Iran. Iranian J. Arthropod-Borne Dis. 2009, 3, 44-49. Meerburg B.G.; G.R. Singleton.; A. Kijlstra. Rodent-borne diseases and their risks for public health. Rev. Microbiol. 2009, 35(3), 221–270. Soulsby E.J. Helminthes, Arthropods and Protozoa of domesticated animals. 7th Edition, Bailliere Tindal, London. 1982, 367–703. Salibay CC and FG Claveria. Serologic detection of Toxoplasma gondii infection in Rattusspp collected from three different sites in Dasmarinas, Cavite, Philippines. Southeast Asian J Trop Med Public Health. 2005, 36 Suppl 4, S46-S49. Telmadarraiy Z.; A. Bahrami.; H. Vatandoost. A survey on fauna of ticks in west Azerbaijan Province, Iran. Iranian J. Publ. Health. 2004, 33(4), 65-69. Vatandoost H.; A. Ghaderi.; E. Javadian.; A.H. Zahirnia.; Y. Rassi.; Y. Piazak.; E.B. Kia.; M. Shaeghi.; Z. Zelmodarreiy.; M. Aboulghasani. Distribution of soft ticks and their infection with Borrelia in Hamadan Province, Iran&quot. J. Publ. Health. 2003, 32(1), 22-24.

Национальный парк «Салаир» – новая федеральная особо охраняемая природная территория, созданная в 2020 году в Алтайском крае. В статье анализируются и обобщаются ранее известные и новые (осуществлённые в течение первого года функционирования национального парка) наблюдения редких и исчезающих видов организмов, занесенных в Красную книгу Российской Федерации, Красную книгу Алтайского края, а также оценивается роль национального парка «Салаир» в защите популяций этих видов. Представлен и обсужден список охраняемых таксонов и точки их местонахождений в пределах национального парка «Салаир». В пределах парка и в непосредственной близости от его границ обнаружено двадцать четыре вида охраняемых на региональном уровне растений, лишайников и грибов, из которых 4 вида занесены в Красную книгу РФ. Среди редких и находящихся под угрозой исчезновения животных национального парка «Салаир» 17 видов занесены в Красную книгу Алтайского края, 10 из них занесены в Красную книгу РФ. Среди них эндемики Салаира и Алтая, а также реликтовые виды. В Алтайском крае эндемичный вид липы (Tilia sibirica) и эндемичный дождевой червь (Eisenia malevici) встречаются исключительно на территории национального парка «Салаир». Экспертная оценка важности рассматриваемой охраняемой территории для сохранения редких видов указывает на высокий потенциал национального парка в сохранении и поддержании популяций редких и исчезающих видов живых организмов. Наибольшие популяции в парке характерны для таких охраняемых видов как кандык сибирский, копытень европейский, волчеягодник обыкновенный – среди растений; медицинская пиявка, аполлон обыкновенный, сапсан, хохлатый осоед – среди животных. Список литературы Быков Н.И., Важов С.В., Гармс О.Я., Грибков А.В., Давыдов Е.А., Елесова Н.В., Зяблинцева М.В., Косачев П.А., Кузменкин Д.В., Маслова О.М., Пожидаева Л.В., Петров В.Ю., Сабаев А.А., Смирнова Л.Я., Черных Д.В., Щур А.В. 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<p><strong>List of abstracts and authors:</strong></p><p><strong>1. Antipsychotics in anxiety disorders</strong></p><p>Christer Allgulander</p><p><strong>2. Anxiety in somatic disorders</strong></p><p>Christer Allgulander</p><p><strong>3. Community rehabilitation of the schizophrenic patient</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera</p><p><strong>4. Dual diagnosis: A theory-driven multidisciplinary approach for integrative care</strong></p><p>David Blackbeard</p><p><strong>5. The emotional language of the gut - when 'psyche' meets 'soma'</strong></p><p>Helen Clark</p><p><strong>6. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>7. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>8. Developing and adopting mental health policies and plans in Africa: Lessons from South Africa, Uganda and Zambia</strong></p><p>Sara Cooper, Sharon Kleintjes, Cynthia Isaacs, Fred Kigozi, Sheila Ndyanabangi, Augustus Kapungwe, John Mayeya, Michelle Funk, Natalie Drew, Crick Lund</p><p><strong>9. The importance of relapse prevention in schizophrenia</strong></p><p>Robin Emsley</p><p><strong>10. Mental Health care act: Fact or fiction?</strong></p><p>Helmut Erlacher, M Nagdee</p><p><strong>11. Does a dedicated 72-hour observation facility in a district hospital reduce the need for involuntary admissions to a psychiatric hospital?</strong></p><p>Lennart Eriksson</p><p><strong>12. The incidence and risk factors for dementia in the Ibadan study of ageing</strong></p><p>Oye Gureje, Lola Kola, Adesola Ogunniyi, Taiwo Abiona</p><p><strong>13. Is depression a disease of inflammation?</strong></p><p><strong></strong>Angelos Halaris</p><p><strong>14. Paediatric bipolar disorder: More heat than light?</strong></p><p>Sue Hawkridge</p><p><strong>15. EBM: Anova Conundrum</strong></p><p>Elizabeth L (Hoepie) Howell</p><p><strong>16. Tracking the legal status of a cohort of inpatients on discharge from a 72-hour assessment unit</strong></p><p>Bernard Janse van Rensburg</p><p><strong>17. Dual diagnosis units in psychiatric facilities: Opportunities and challenges</strong></p><p>Yasmien Jeenah</p><p><strong>18. Alcohol-induced psychotic disorder: A comparative study on the clinical characteristics of patients with alcohol dependence and schizophrenia</strong></p><p>Gerhard Jordaan, D G Nel, R Hewlett, R Emsley</p><p><strong>19. Anxiety disorders: the first evidence for a role in preventive psychiatry</strong></p><p>Andre F Joubert</p><p><strong>20. The end of risk assessment and the beginning of start</strong></p><p>Sean Kaliski</p><p><strong>21. Psychiatric disorders abd psychosocial correlates of high HIV risk sexual behaviour in war-effected Eatern Uganda</strong></p><p>E Kinyada, H A Weiss, M Mungherera, P Onyango Mangen, E Ngabirano, R Kajungu, J Kagugube, W Muhwezi, J Muron, V Patel</p><p><strong>22. One year of Forensic Psychiatric assessment in the Northern Cape: A comparison with an established assessment service in the Eastern Cape</strong></p><p>N K Kirimi, C Visser</p><p><strong>23. Mental Health service user priorities for service delivery in South Africa</strong></p><p>Sharon Kleintjes, Crick Lund, Leslie Swartz, Alan Flisher and MHaPP Research Programme Consortium</p><p><strong>24. The nature and extent of over-the-counter and prescription drug abuse in cape town</strong></p><p>Liezl Kramer</p><p><strong>25. Physical health issues in long-term psychiatric inpatients: An audit of nursing statistics and clinical files at Weskoppies Hospital</strong></p><p>Christa Kruger</p><p><strong>26. Suicide risk in Schizophrenia - 20 Years later, a cohort study</strong></p><p>Gian Lippi, Ean Smit, Joyce Jordaan, Louw Roos</p><p><strong>27.Developing mental health information systems in South Africa: Lessons from pilot projects in Northern Cape and KwaZulu-Natal</strong></p><p>Crick Lund, S Skeen, N Mapena, C Isaacs, T Mirozev and the Mental Health and Poverty Research Programme Consortium Institution</p><p><strong>28. Mental health aspects of South African emigration</strong></p><p>Maria Marchetti-Mercer</p><p><strong>29. What services SADAG can offer your patients</strong></p><p>Elizabeth Matare</p><p><strong>30. Culture and language in psychiatry</strong></p><p>Dan Mkize</p><p><strong>31. Latest psychotic episode</strong></p><p>Povl Munk-Jorgensen</p><p><strong>32. The Forensic profile of female offenders</strong></p><p>Mo Nagdee, Helmut Fletcher</p><p><strong>33. The intra-personal emotional impact of practising psychiatry</strong></p><p>Margaret Nair</p><p><strong>34. Highly sensitive persons (HSPs) and implications for treatment</strong></p><p>Margaret Nair</p><p><strong>35. Task shifting in mental health - The Kenyan experience</strong></p><p>David M Ndetei</p><p><strong>36. Bridging the gap between traditional healers and mental health in todya's modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>37. Integrating to achieve modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>38. Non-medical prescribing: Outcomes from a pharmacist-led post-traumatic stress disorder clinic</strong></p><p>A Parkinson</p><p><strong>39. Is there a causal relationship between alcohol and HIV? Implications for policy, practice and future research</strong></p><p>Charles Parry</p><p><strong>40. Global mental health - A new global health discipline comes of age</strong></p><p>Vikram Patel</p><p><strong>41. Integrating mental health into primary health care: Lessons from pilot District demonstration sites in Uganda and South Africa</strong></p><p>Inge Petersen, Arvin Bhana, K Baillie and MhaPP Research Programme Consortium</p><p><strong>42. Personality disorders -The orphan child in axis I - Axis II Dichotomy</strong></p><p><strong></strong>Willie Pienaar</p><p><strong>43. Case Studies in Psychiatric Ethics</strong></p><p>Willie Pienaar</p><p><strong>44. Coronary artery disease and depression: Insights into pathogenesis and clinical implications</strong></p><p>Janus Pretorius</p><p><strong>45. Impact of the Mental Health Care Act No. 17 of 2002 on designated hospitals in KwaZulu-Natal: Triumphs and trials</strong></p><p>Suvira Ramlall, Jennifer Chipps</p><p><strong>46. Biological basis of addication</strong></p><p>Solomon Rataemane</p><p><strong>47. Genetics of Schizophrenia</strong></p><p>Louw Roos</p><p><strong>48. Management of delirium - Recent advances</strong></p><p>Shaquir Salduker</p><p><strong>49. Social neuroscience: Brain research on social issues</strong></p><p>Manfred Spitzer</p><p><strong>50. Experiments on the unconscious</strong></p><p>Manfred Spitzer</p><p><strong>51. The Psychology and neuroscience of music</strong></p><p>Manfred Spitzer</p><p><strong>52. Mental disorders in DSM-V</strong></p><p>Dan Stein</p><p><strong>53. Personality, trauma exposure, PTSD and depression in a cohort of SA Metro policemen: A longitudinal study</strong></p><p>Ugashvaree Subramaney</p><p><strong>54. Eating disorders: An African perspective</strong></p><p>Christopher Szabo</p><p><strong>55. An evaluation of the WHO African Regional strategy for mental health 2001-2010</strong></p><p>Thandi van Heyningen, M Majavu, C Lund</p><p><strong>56. A unitary model for the motor origin of bipolar mood disorders and schizophrenia</strong></p><p>Jacques J M van Hoof</p><p><strong>57. The origin of mentalisation and the treatment of personality disorders</strong></p><p>Jacques J M Hoof</p><p><strong>58. How to account practically for 'The Cause' in psychiatric diagnostic classification</strong></p><p>C W (Werdie) van Staden</p><p><strong>POSTER PRESENTATIONS</strong></p><p><strong>59. Problem drinking and physical and sexual abuse at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>60. Prevalence of alcohol drinking problems and other substances at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>61. Lessons learnt from a modified assertive community-based treatment programme in a developing country</strong></p><p>Ulla Botha, Liezl Koen, John Joska, Linda Hering, Piet Ooosthuizen</p><p><strong>62. Perceptions of psychologists regarding the use of religion and spirituality in therapy</strong></p><p>Ottilia Brown, Diane Elkonin</p><p><strong>63. Resilience in families where a member is living with schizophreni</strong></p><p>Ottilia Brown, Jason Haddad, Greg Howcroft</p><p><strong>64. Fusion and grandiosity - The mastersonian approach to the narcissistic disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>65. Not being allowed to exist - The mastersonian approach to the Schizoid disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>66. Risky drug-injecting behaviours in Cape Town and the need for a needle exchange programme</strong></p><p>Volker Hitzeroth</p><p><strong>67. Neuroleptic malignant syndrome in adolescents in the Western Cape: A case series</strong></p><p>Terri Henderson</p><p><strong>68. Experience and view of local academic psychiatrists on the role of spirituality in South African specialist psychiatry, compared with a qualitative analysis of the medical literature</strong></p><p>Bernard Janse van Rensburg</p><p><strong>69. The role of defined spirituality in local specialist psychiatric practice and training: A model and operational guidelines for South African clinical care scenarios</strong></p><p>Bernard Janse van Rensburg</p><p><strong>70. Handedness in schizophrenia and schizoaffective disorder in an Afrikaner founder population</strong></p><p>Marinda Joubert, J L Roos, J Jordaan</p><p><strong>71. A role for structural equation modelling in subtyping schizophrenia in an African population</strong></p><p>Liezl Koen, Dana Niehaus, Esme Jordaan, Robin Emsley</p><p><strong>72. Caregivers of disabled elderly persons in Nigeria</strong></p><p>Lola Kola, Oye Gureje, Adesola Ogunniyi, Dapo Olley</p><p><strong>73. HIV Seropositivity in recently admitted and long-term psychiatric inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>74. Syphilis seropisitivity in recently admitted longterm psychiatry inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>75. 'The Great Suppression'</strong></p><p>Sarah Lamont, Joel Shapiro, Thandi Groves, Lindsey Bowes</p><p><strong>76. Not being allowed to grow up - The Mastersonian approach to the borderline personality</strong></p><p>Daleen Macklin, W Griffiths</p><p><strong>77. Exploring the internal confirguration of the cycloid personality: A Rorschach comprehensive system study</strong></p><p>Daleen Macklin, Loray Daws, M Aronstam</p><p><strong>78. A survey to determine the level of HIV related knowledge among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p><strong></strong> T G Magagula, M M Mamabolo, C Kruger, L Fletcher</p><p><strong>79. A survey of risk behaviour for contracting HIV among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p>M M Mamabolo, T G Magagula, C Kruger, L Fletcher</p><p><strong>80. A retrospective review of state sector outpatients (Tara Hospital) prescribed Olanzapine: Adherence to metabolic and cardiovascular screening and monitoring guidelines</strong></p><p>Carina Marsay, C P Szabo</p><p><strong>81. Reported rapes at a hospital rape centre: Demographic and clinical profiles</strong></p><p>Lindi Martin, Kees Lammers, Donavan Andrews, Soraya Seedat</p><p><strong>82. Exit examination in Final-Year medical students: Measurement validity of oral examinations in psychiatry</strong></p><p>Mpogisheng Mashile, D J H Niehaus, L Koen, E Jordaan</p><p><strong>83. Trends of suicide in the Transkei region of South Africa</strong></p><p>Banwari Meel</p><p><strong>84. Functional neuro-imaging in survivors of torture</strong></p><p>Thriya Ramasar, U Subramaney, M D T H W Vangu, N S Perumal</p><p><strong>85. Newly diagnosed HIV+ in South Africa: Do men and women enroll in care?</strong></p><p>Dinesh Singh, S Hoffman, E A Kelvin, K Blanchard, N Lince, J E Mantell, G Ramjee, T M Exner</p><p><strong>86. Diagnostic utitlity of the International HIC Dementia scale for Asymptomatic HIV-Associated neurocognitive impairment and HIV-Associated neurocognitive disorder in South Africa</strong></p><p>Dinesh Singh, K Goodkin, D J Hardy, E Lopez, G Morales</p><p><strong>87. The Psychological sequelae of first trimester termination of pregnancy (TOP): The impact of resilience</strong></p><p>Ugashvaree Subramaney</p><p><strong>88. Drugs and other therapies under investigation for PTSD: An international database</strong></p><p>Sharain Suliman, Soraya Seedat</p><p><strong>89. Frequency and correlates of HIV Testing in patients with severe mental illness</strong></p><p>Hendrik Temmingh, Leanne Parasram, John Joska, Tania Timmermans, Pete Milligan, Helen van der Plas, Henk Temmingh</p><p><strong>90. A proposed mental health service and personnel organogram for the Elizabeth Donkin psychiatric Hospital</strong></p><p>Stephan van Wyk, Zukiswa Zingela</p><p><strong>91. A brief report on the current state of mental health care services in the Eastern Cape</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri, Heloise Uys, Mo Nagdee, Maricela Morales, Helmut Erlacher, Orlando Alonso</p><p><strong>92. An integrated mental health care service model for the Nelson Mandela Bay Metro</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri</p><p><strong>93. Traditional and alternative healers: Prevalence of use in psychiatric patients</strong></p><p>Zukiswa Zingela, S van Wyk, W Esterhuysen, E Carr, L Gaauche</p>

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During his speech in Plato’s The Symposium, Aristophanes explains that humans were originally round, composed of two people joined together in a perfect sphere with four arms, four legs, and two faces. Unfortunately, humans grew arrogant and ambitious; as a result, Zeus punished them by cleaving them in two. Now altered from their natural form, humans yearn for their former selves: “It is from this situation, then, that love for one another developed in human beings. Love collects the halves of our original nature, and tries to make a single thing out of the two parts so as to restore our natural condition. Thus, each of us is the matching half of a human being, since we have been severed like a flatfish, two coming from one, and each part is always seeking its other half” (191d). So it is that what we call “love” is but the “desire for wholeness” (193a). Love is not, for Aristophanes, a union but a re-union/reuniting. While Aristophanes’ account is simultaneously comedic and horrific, and consequently also absurdly ridiculous, there persists an undercurrent of some nebulous tickle, a recognition of something tangibly familiar in his myth, even now. Were space-time not linear and Plato could have Barbara Streisand speak next at that Athenian table (though of course he wouldn’t, as she’s a woman), he would undoubtedly have her sing “People”: “Lovers are very special people. They’re the luckiest people in the world. With one person, one very special person, a feeling deep in your soul, says you were half, now you’re whole.” “You complete me,” Jerry (played by Tom Cruise) says to Dorothy (played by Renée Zellweger) in the movie Jerry Maguire. How many lovers today claim their relationship with their beloved was meant to be? Even in a postmodern world, we seemingly have not strayed far from the Platonic ideal in which “lovers are incomplete halves of a single puzzle, searching for each other in order to become whole” (Ackerman 95). Implied by this model—described by Irving Singer as the “idealist tradition” (Modern 12)—is an uncomplicated conception of self. A self posited as fundamentally incomplete must be viewed as fixed and virtually invariable; otherwise, a multiplicity of ways in addition to a soul mate might be found to give the impoverished self what it needs. Viewed as yearning for his or her “other half,” the individual is positioned outside of/separated from the wider culture because only the “one true love” can make the person “whole.” Even biological impulses and psychological factors can be dismissed as irrelevant or possibly even dangerous distractions when all that truly matters is finding one’s “better half.” A self thus conceived also suggests a rather simplistic view of romantic love, which becomes merely the desire to achieve wholeness by connecting—or reconnecting, as Plato’s Aristophanes would have it—with a complementary lover. Unfortunately, the idealist model’s emphasis on deficiency codifies an ontology of lack that tends to foster omissions, oversimplifications, and misinterpretations. But, as numerous influential thinkers have convincingly argued, identity is neither uniform nor stable—nor even uncontested. Subjectivity is more accurately characterised by complexity and multiplicity than by simplicity and singularity. What, then, of romantic love? Is romantic love in contemporary Western cultures similarly complex, and if so, so what? How would (re)conceptualising romantic love as complex extend our knowledge and understanding of complex systems? I want to contribute to this themed issue of M/C Journal on complex by approaching romantic love as a point of departure, as an analytical methodology. I maintain that a critical study of romantic love—one that begins rather than concludes with romantic love’s complexity—helps illustrate the productive nature of complex and the utility of employing complex as a conceptual/theoretical point of origin and inquiry. Crucially, my formulation configures complex as a productive process that is itself a product. In other words, complex can be usefully defined as an effect that produces other effects—including potentially subversive ones. While other definitions are certainly valid, conceiving complex as an outcome that generates further outcomes not only emphasises the dynamic, multifaceted nature of systems but also helps to explain that multifaceted dynamism. Romantic love illustrates well this conception of complex (as productive product) because romantic love only has meaning, only works, because it is complex to begin with. In this manner, romantic love is a process of creating complexity from complexity. An examination that begins from a point of complexity gains much, I feel, by beginning with a historicisation of that complexity, for complex, as outcome/effect, is always already contextualised, situated, and diachronic. Historicising romantic love is particularly crucial because the idealist model tends to dismiss the past (what matters the past once one has finally met the love of one’s life?) and confuse history—especially its own—with nature (as with the supposedly natural passivity of the feminine). According to Singer, the idealist tradition, first codified by Plato, was taken up by medieval theologians who, drawn by the tradition’s ideal of merging, sought to produce a mystical oneness with the divine (Courtly 23). Emphasis eventually moved from merging to the experience of merging, a move that facilitated the rise of courtly love. Transmuting religious reverence into human devotion, courtly love introduced such revolutionary and potentially heretical notions as the belief that “love is an intense, passionate relationship that establishes a holy oneness between man and woman” (23). The desire for oneness appears even more prominently in the Romanticism of the 19th century (288). Importantly, erotic love becomes for the first time conjoined with romantic love in a causal rather than antithetical or consequential relation: “To the Romantic, sexual desire is usually more than just a vehicle or concomitant of love; it is a prerequisite” (Modern 10). Little wonder, given such a trajectory, that romantic love today has virtually no meaning independent of sexual love (though sexual desire may or may not be linked to romantic love). Little wonder as well that romantic love is so complex. But there’s more. As Stephanie Coontz explains, marriage in the West was until only about two centuries ago a political and economic institution having little or nothing to do with romantic love (33). Anthony Giddens also points out the relatively recent shift from an economic to a romantic basis for marriage (26). Giddens associates this shift with the emergence of what he terms “plastic sexuality”: “decentered sexuality, freed from the needs of reproduction” (2). Plastic sexuality resulted from a combination of factors, most notably societal trends toward limiting family size coupled with advances in contraceptive and reproductive technologies (27). Allowing for greater freedom and pleasure (especially for women), plastic sexuality is for Giddens linked not only to romantic love but also, intrinsically, to self-identity (2, 40). This connection—along with the plastic sexuality that undergirds it—creates narratives of self (and other) that can project “a course of future development” (45), lead to greater reflexivity for the body and the self (31), and transform intimacy in ways potentially subversive and emancipative (3, 194). In any case, our (inter)personal existence is currently undergoing active transfiguration, Giddens asserts, to the point that “personal life has become an open project, creating new demands and anxieties” (8). My reading of Giddens places this continuous, reflexive project of self (what one might alternatively term the ongoing production of selves-in-process) against the plastic sexuality and pure relationships that engendered the project. Only a view of romantic love as productive, evolving, and full—in other words, complex—can account for the complex transformations of intimacy and self described by Giddens. Viewed more broadly, romantic love corresponds—in both the analogous and communicative meanings of the term—to/with the very poststructural/postmodern subject it helps to enact. Tamsin Lorraine’s lucid articulation of embodied subjectivity is worth quoting at length in this context: I assume that the selves we experience as our own are the product of a historically conditioned process involving both corporeal and psychic aspects of existence, that this process needs to be instituted and continually reiterated in a social context in order to give birth to and maintain the subject at the corporeal level of embodiment as well as the psychic level of self, and that language and social positioning within a larger social field play a crucial role in this process. In taking up a position in the social field as a speaker of language, a human being takes up a perspective from which to develop a narrative of self. (ix-x) Others have theorised identity as a narrative construct (Holstein and Gubrium; Rosenwald and Ochberg). What is significant here in reading Lorraine’s embodied subjectivity through the interpretative lens provided by Giddens is the particular kind of narrative suggested by such a reading. After all, not just any narrative will do. The “perspective” taken up by the reflexive subject (as described by Giddens) in the process of constructing a storied self necessarily requires a productive integration of the many “aspects of existence.” Otherwise, no such “position” could be taken, no agency established; the particular self would not even be. As such, the perspective is a product of complexity even as it attempts to compose its own complex product (a narrative identity). Additionally, romantic love conceived as complex, as a productive force, opens up possibilities for new stories and new selves, even when, as in Lacanian theory, desire is correlated with lack. Lacan maintains that “desire is neither the appetite for satisfaction nor the demand for love, but the difference which results from the subtraction of the first from the second—the very phenomenon of their splitting” (287). Lack presented thusly is positive inasmuch as lack causes desire, which in turn produces the subject as a subjectivity. “Without lack,” Bruce Fink asserts, “the subject can never come into being, and the whole efflorescence of the dialectic of desire is squashed” (103). For clarification, Fink provides a simple illustration: “Why would a child even bother to learn to speak if all its needs were anticipated?” (103). Desire here is correlated with lack in a manner that suggests movement and change, bringing to mind Anne Carson’s famous quip, “Desire moves. Eros is a verb” (17). Keeping in mind that romantic love has become inextricably entwined with sexual desire in the West, designs that interrogate desire vis-à-vis lack (a strategy that also characterises the approaches taken by Hegel and Sartre) operate equally well in regards to self-identities formed via romantic love. Certainly, then, if desire constituted as lack can produce complexity by remaining unsatisfied and unfilled, what then of an approach that configures desire itself as production? Such a theoretical grounding is central to the work of Gilles Deleuze and Felix Guattari. For them, “everything is production” (Anti-Oedipus 4). In this view, life, the self, and even the body are not unified things but rather processes characterised by flow and multiplicity. Deleuze and Guattari emphasise the dynamic process of various sorts of “becoming” (Thousand 279). Becoming, in relation to romantic love and to other processes, involves not just individuals but assemblages. In this, Deleuze and Guattari present a collaborative conception of self involving the multiplicity of the two selves as well as the multiplicity “formed through the collaboration” (Lorraine 134). As Deleuze and Guattari explain, multiplicity “is continually transforming itself into a string of other multiplicities” (Thousand 249). To my mind, this “string” of multiplicities directly parallels the complex. Luce Irigaray’s project similarly views subjectivity as embodied, potentially collaborative, and creative. Specifically, however, Irigaray seeks to challenge the masculine specular subjectivity that fosters divisive dualisms and a sexual division of labour that privileges the masculine. She critiques the subject-object distinction that has always defined female sexuality “on the basis of masculine parameters” (This 204) and relegated the feminine to the role of other to the masculine subject. One of the more interesting aspects of Irigaray’s enterprise is her project of symbolic transformation, an attempt to symbolise an alternative feminine subjectivity: “Irigaray insists that we need to acknowledge two genders and work on providing the hitherto impoverished gender the symbolic support it needs to become more than the counterpart of masculinity. If the feminine were given the support of a gender in its own right, then feminine subjectivity could finally emerge” (Lorraine 91). What Irigaray advocates is a dialectical interaction between subjects that embraces both difference and corporeality, that is temporal, playful, reciprocal, and mutually nourishing (I Love 148). Elizabeth Grosz’s refiguring of desire somewhat echoes Irigaray’s stance. Drawing upon Deleuze and Guattarai, Grosz also conceptualises desire as productive and full. She insists that in order to understand this expanded conception of desire we must first “abandon our habitual understanding of entities as the integrated totality of parts, and instead focus on the elements, the parts, outside their integration or organisation; we must look beyond the organism to the organs comprising it” (78). Totalities remain and must be recognised, but an understanding of the dynamics of those totalities is better accomplished through an investigation of the parts rather the whole. In her privileging of parts I see reflections of Irigaray’s respect for difference and dialectical creation. Indeed, one can easily see themes of fluidity and multiplicity running through the work of the theorists we have examined. This thematic/analytical consistency, I would argue, is at least partially explained by their active engagement in the complexity of romantic love. How not to theorise subjectivities formed via narratives of romantic love in a manner that resists dualisms when romantic love itself overflows with multiplicities? This is not, of course, to downplay the role of other factors, contingencies, and motivations. Still, that some feminists are critical of certain aspects of Foucauldian theory (his failure to adequately account for unequal power relations; his seeming denial that one group or class may dominate another) strikes me as directly related to issues located (if not exclusively) within the contemporary concept of romantic love (see Hartsock; Ramazanoğlu; Sedgwick). That such is the case is, for me, no surprise. Ultimately, in spite of its long history of repression and inequity, romantic love’s ever-increasing complexity points to possible future transformations (as Giddens details). My optimism stems from the fact that romantic love’s productive force can potentially open up whole new ranges of (complex) possibilities. In the theories of Giddens, Deleuze, Irigaray, Grosz, and numerous others, we witness some of these emerging possibilities. Framing complex as an outcome that produces other complex outcomes allows me to envision the possibility of even more possibilities—something akin to Irigaray’s “expanding universe” (This 209). In the final (for now) analysis, let us follow Grosz’s lead and privilege parts over the whole. Viewed from this perspective, a given system cannot be considered as a complex thing, as though it were an isolated singularity. Focusing on the specific, the particular, and the concrete serves to highlight the contingencies, fragments, flows, shifts, multiplicities, instabilities, and relations that constitute and produce the complex. In saying this, I am not simply asserting a tautology: the complex is complex. Because the components of something complex interact in ways both provisional and productive, the complex must inevitably produce new components, parts that constitute and change the system, as well as other parts that eventually form and/or alter other complex systems. Put another way, the individual parts of a complex are themselves complex. Consequently, a deeper understanding can be gained by stepping back and re-visioning the parts-to-the-whole paradigm as complexoutcomes-ofcomplex-outcomes. Romantic love, I believe, is such an example, and an especially ubiquitous and influential one at that. Only by beginning with an understanding of love as complex can we adequately explain how it operates and produces the kinds of effects that it does. Nothing simple could produce such profoundly complex effects as identities, discourses, and material objects. Something simple may very well produce simple outcomes that eventually conjoin into something complex, a whole composed of many individual parts. But only something already complex (i.e., an existing outcome of outcomes) can produce complex outcomes instantly and automatically as a matter of course in an intricate unfolding of relationships that, like love, circulate, bond, motivate, and potentially transform. References Ackerman, Diane. A Natural History of Love. New York: Random House, 1994. Carson, Anne. Eros the Bittersweet: An Essay. Princeton, NJ: Princeton UP, 1986. Coontz, Stephanie. Marriage, a History: From Obedience to Intimacy, or How Love Conquered Marriage. New York: Viking, 2005. Deleuze, Gilles, and Félix Guattari. Anti-Oedipus: Capitalism and Schizophrenia. 1972. Trans. Robert Hurley, Mark Seem, and Helen R. Lane. Minneapolis: U of Minnesota P, 1983. ———. A Thousand Plateaus: Capitalism and Schizophrenia. 1980. Trans. Brian Massumi. 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Chicago: Chicago UP, 1984. ———. The Nature of Love: The Modern World. Vol. 3. Chicago: Chicago UP, 1987. Streisand, Barbra. “People.” By Bob Merrill and Jule Styne. People. Columbia, 1964. Citation reference for this article MLA Style Carpenter, Richard. "The Heart of the Matter: Complex as Productive Force." M/C Journal 10.3 (2007). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0706/02-carpenter.php>. APA Style Carpenter, R. (Jun. 2007) "The Heart of the Matter: Complex as Productive Force," M/C Journal, 10(3). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0706/02-carpenter.php>.