Browsing by Subject "adults"

Now showing 1 - 5 of 5
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    Open Access
    Atypical pneumonia in adults in southern Africa
    (South African Academy of Family Physicians, 2012) Dlamini, S K; Mendelson, M
    The true incidence of Legionella pneumophilia, Mycoplasma pneumoniae, Chlamydophila pneumoniae and Coxiella burnetti, the so-called atypical pathogens that cause adult community-acquired pneumonia in southern Africa, is unknown. Although there are a lack of community-based studies, hospital-based studies suggest that the incidence may be as high as 30% in patients admitted to, but not requiring, an intensive care unit. A lack of specific clinical features that differentiate atypical pathogens, plus the lack of reliable, simple diagnostics, compound the uncertainty regarding the contribution of atypical pathogens to the sum total of community-acquired pneumonia in southern Africa. Without reliable diagnostic tests, macrolide or azalide antibiotics are widely used for in-patients with pneumonia, potentially fuelling the rise of antibiotic resistance to macrolides in other bacteria.
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    Open Access
    Collapse of an iconic conifer: long-term changes in the demography of Widdringtonia cedarbergensis using repeat photography
    (2016) White, J D M; Jack, S L; Hoffman, M T; Puttick, J; Bonora, D; Visser, V; February, E C
    BACKGROUND: Conifer populations appear disproportionately threatened by global change. Most examples are, however, drawn from the northern hemisphere and long-term rates of population decline are not well documented as historical data are often lacking. We use a large and long-term (1931-2013) repeat photography dataset together with environmental data and fire records to account for the decline of the critically endangered Widdringtonia cedarbergensis. Eighty-seven historical and repeat photo-pairs were analysed to establish 20th century changes in W. cedarbergensis demography. A generalized linear mixed-effects model was fitted to determine the relative importance of environmental factors and fire-return interval on mortality for the species. RESULTS: From an initial total of 1313 live trees in historical photographs, 74% had died and only 44 (3.4%) had recruited in the repeat photographs, leaving 387 live individuals. Juveniles (mature adults) had decreased (increased) from 27% (73%) to 8% (92%) over the intervening period. Our model demonstrates that mortality is related to greater fire frequency, higher temperatures, lower elevations, less rocky habitats and aspect (i.e. east-facing slopes had the least mortality). CONCLUSIONS: Our results show that W. cedarbergensis populations have declined significantly over the recorded period, with a pronounced decline in the last 30 years. Individuals that established in open habitats at lower, hotter elevations and experienced a greater fire frequency appear to be more vulnerable to mortality than individuals growing within protected, rocky environments at higher, cooler locations with less frequent fires. Climate models predict increasing temperatures for our study area (and likely increases in wildfires). If these predictions are realised, further declines in the species can be expected. Urgent management interventions, including seedling out-planting in fire-protected high elevation sites, reducing fire frequency in higher elevation populations, and assisted migration, should be considered.
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    Relationships between adolescents and adults: The significance of narrative and context.
    (Taylor & Francis, 2006) Shelmerdine, Sarah
    A substantial body of research links the developmental outcomes of young people to the relationships they have with adults. However, very little research provides insight into the mechanisms whereby relationships achieve their outcomes or the specific qualities of those relationships. This paper explores the construction of relationships between young people and adults in three different socio-cultural settings in Cape Town. Four young people in each setting, namely Ocean View, Fish Hoek and Masiphumelele were interviewed about their relationships with the most important adults in their lives. Where possible, the adults they identified were interviewed also. Interviews were unstructured and analysed thematically. Fundamentally, constructions of the relationships in all three settings were found to be similar. All adults encouraged young people to succeed and sought to protect them against risk. However, the nature of the opportunities and risks, and of the material context in general, differ between the three different study sites and have considerable import for the narratives of the relationships from each. The paper?argues that the differences between the three sites indicate the responsiveness and adaptation of ideals and discourses to environmental demands, rather than fundamental ideological discrepancies.
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    Open Access
    The Epidemiology of Auditory Dysfunction in Type 2 Diabetic Adults in Africa: 4 A Systematic Review and Meta-analysis
    (2022) Fihla, Achuma; Engel, Mark; Petersen, Lucretia; Hohlfeld, Ameer
    Background: There is a growing rate of diabetes related hearing loss (HL) worldwide. However, in under-developed countries, HL is still under-recognised as a complication of type 2 diabetes mellitus (T2DM). Although Africa presents a significant rise in T2DM every year, it is met with limited resources to assist its growing and ageing population. Objectives: This systematic review and meta-analysis brings awareness to diabetes-related HL in the form of reliable medical evidence measuring the prevalence of T2DM-related HL in an African population. Methods: Studies were screened using Rayyan QCRI. STATA software and the random-effects metaanalysis model was used to aggregate prevalence estimates with a 95% confidence interval. The Freeman Tukey Transformation was used to account for between study variability. The study protocol is published in PROSPERO international Register of Systematic Reviews (registration number CRD42021227801). Results: We identified a total of 99 studies, 14 duplicates were removed and 67 were excluded. After full review only five studies were included for quantitative synthesis. All the studied were crosssectional and used purposive sampling as their recruitment method. Conclusions: Findings show most participants with T2DM experienced mild HL and slight delays in objective hearing assessments. Audiometric resources and qualified Audiologists are scarce in Africa. Therefore, the available evidence does not justify the added costs needed for routine audiometric assessments for patients with T2DM. However, it does serve to recommend prioritising further research regarding risk factors associated with developing auditory disorders in people with T2DM.
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    Towards the development and validation of an isiXhosa tool for the assessment of apraxia speech in adults: A descriptive study
    (2024) Allie, Nasreen; Singh, Shajila; Pascoe, Michelle
    South Africa is a culturally and linguistically diverse country. Serving isiXhosa speakers is a challenge for many Speech-Language Pathologists as there is a lack of appropriate assessment tools for this population. Current methods of adapting existing English tools are not appropriate as this does not allow the isiXhosa linguistic features to be assessed. Changing the method of scoring renders the tool invalid and unreliable. This project consisted of 3 sequential studies based in an exploratory quantitative framework. Each study has its own methodology and sub-aims with the overall aim to develop and determine the validity and reliability of isiXhosa speech stimuli for the assessment of Apraxia of Speech (AOS) in adults. Study 1 aimed to describe and generate criteria and corresponding speech stimuli for an assessment of AOS in isiXhosa. IsiXhosa has distinguishing linguistic features – such as additional phonemes, alternate places and manners of articulation (e.g. ejectives), as well as phonetic features unique to the language (e.g. prenasalised consonants and tonal contrasts). Inclusion of these features were considered to be important in the creation of the tool. Study 2 aimed to determine the face, content and construct validity of the generated criteria and speech stimuli. The speech stimuli which consisted of words, phrases and sentences were found to be culturally appropriate and to have face, content and construct validity as judged by a group of isiXhosa speakers and a Delphi panel. The speech stimuli met the criteria for an assessment of AOS as set out in Study 1. Study 3 assessed the theoretical constructs outlined in Study 1 and Study 2 determined whether the revised criteria, which generated the newly devised speech stimuli, was valid and reliable in diagnosing AOS. The speech stimuli were based on criteria for the assessment of AOS and considered the isiXhosa linguistic features. There was high inter-rater reliability (79.2 – 98.4%) for determining the presence of features of AOS. Many of the error patterns displayed were similar to that documented in the literature for AOS, such as a higher number of errors were present on less frequently used speech stimuli and stimuli with an increasing number of syllables. It was it was hypothesized that the differences in the language such as clicks and tonal contrasts may add to complexity. Clicks presented with a higher number of errors whereas tonal contrasts had fewer errors suggesting tone was less affected by AOS. Results further suggested that the first consonant of the stimulus rather than the initial phoneme in words add to complexity in isiXhosa. Further research in this area and refinement of the speech stimuli are required to create a comprehensive tool for assessment of AOS in adults.