Home About us Contact
|
Home About us Contact | ||
|
|
||
South African Context (south + african_context)
Selected AbstractsNeuropsychiatric movement disorders following streptococcal infectionDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2005K G Walker MB BS The aim of this study was to describe post-streptococcal movement disorders that form part of the acute rheumatic fever complex. The clinical records of patients diagnosed with Sydenham's chorea were analyzed retrospectively to investigate epidemiology, the significance of socioeconomic deprivation, clinical manifestations, treatments, outcomes, long-term morbidity, and disease evolution. Forty-two patients (21 males, 21 females) were diagnosed with Sydenham's chorea. The median presentation age was 9 years 8 months (range 3y 5mo to 13y 2mo). Nineteen patients were of indigenous African ancestry; 23 were of mixed ancestry. All patients lived in poverty and had poor access to medical care. Twelve of the total group had disabling symptoms for longer than 2 years; six of these patients developed paediatric autoimmune neuropsychiatric disorder associated with Streptococcus (Paediatric autoimmune neuropsychiatric disorder associated with Streptococcus [PANDAS]), five Tourette syndrome (TS), and one learning difficulties. Poor outcome was significantly more prevalent in patients of mixed ancestry, in those with a positive family history, previous behavioural problems, or a failure to complete 10 days of penicillin and ,bed-rest'/hospitalization. Sydenham's chorea is one manifestation of post-streptococcal neuropsychiatric movement disorders. This study demonstrates that patients can present with one diagnosis and evolve other neuropsychiatric conditions such as TS and PANDAS. In the South African context, it is important to delineate neuropsychiatric movement disorders associated with streptococcal infections. The potential genetic susceptibility should be explored. [source] A systematic review of counselling for HIV testing of pregnant womenJOURNAL OF CLINICAL NURSING, Issue 13 2009Karin S Minnie Background., Evidence-based strategies have made it possible to limit mother-to-child transmission of the HI-virus to a large extent and enable HIV-positive women to stay healthy for longer, provided their HIV status is known. Although voluntary counselling and testing for HIV is part of routine antenatal care in South Africa, the uptake of testing varies and a large number of pregnant women's HIV status is not known at the time of birth. Aim., The aim of the study was to establish research evidence regarding factors influencing counselling for HIV testing during pregnancy by means of systematic review, forming part of a larger study using a variety of evidence to develop best practice guidelines. Design., Systematic review. Methods., The question steering the review was: ,What factors influence counselling for HIV testing during pregnancy?'. A multi-stage search of relevant research studies was undertaken using a variety of sources. A total of 33 studies were retrieved and critically appraised. Data were extracted from the studies and assessed according to its applicability in the South African context. Results., The results are presented according to the following themes: effects of counselling, quality of counselling, group vs. individual counselling, ways of offering HIV testing, rapid testing, counselling and testing during labour, couple counselling and testing, counsellor and organisational factors. Conclusions., According to research evidence, factors such as whether counselling is presented in a group or individually, different ways to present HIV testing as well as counsellor and organisational factors can influence counselling for HIV testing during pregnancy. When developing best practice guidelines for settings very dissimilar from where the research was done, research evidence must be contextualised. Relevance to clinical practice., Implementation of the best practice guidelines may lead to the increased uptake of HIV testing in pregnancy in developing countries like South Africa and thus to an increase in the number of women whose status is known when their babies are born. [source] The status of fish conservation in South African estuariesJOURNAL OF FISH BIOLOGY, Issue 9 2010A. K. Whitfield Estuary-dependent fish species are defined as those taxa whose populations would be adversely affected by the loss of estuarine habitats. Of the 155 species regularly recorded in South African estuaries, only 32 (21%) are completely dependent on these systems, but this figure increases to 103 species (66%) if partially dependent taxa are included in the analysis. The conservation of fishes in estuaries on the subcontinent is threatened by a number of factors, including habitat degradation, disruption of essential ecological processes, hydrological manipulations, environmental pollution, overexploitation due to fishing activities and, more recently, climate change and the effects of introduced aquatic animals. Although major threats to fishes are usually linked to environmental degradation, there is increasing evidence that the stocks of certain fish species are overexploited or collapsed. Fish conservation and fisheries management does not depend on the implementation of a single action, but rather the co-ordination of a detailed plan, often in a multidisciplinary context. Some examples of innovative means of contributing to estuarine fish conservation in a South African context include the determination and implementation of the ecological freshwater requirements for estuaries, the zoning of estuaries for different uses and the recognition that the maintenance of ecological processes are vital to aquatic ecosystem health. Apart from the designation of protected areas, the main direct means of conserving fish species and stocks include habitat conservation, controls over fishing methods, effort, efficiency and seasonality, pollution control and the prevention of artificial manipulation of estuary mouths. Since becoming a democracy in 1994, environmental legislation, policy and institutional arrangements in South Africa have undergone some major changes, which, if fully implemented, will be very positive for fish conservation in estuaries on the subcontinent. [source] Cooperation at different scales: challenges for local and international water resource governance in South AfricaTHE GEOGRAPHICAL JOURNAL, Issue 1 2010N MIRUMACHI Theory on environmental governance and water governance emphasises decentralised, devolved forms of interaction between stakeholders. As previously excluded actors are empowered to take part in governance, new forms of cooperation are created. This paper examines how the cooperative principle has influenced stakeholder interaction at the local and international scales of water governance in South Africa. Water policies and initiatives have been set up to promote multi-level governance that emphasises cooperation between various stakeholders. The emphasis on cooperation and inclusiveness is particularly pertinent to the South African context because of its apartheid past. The paper asks whether there have been new forms of cooperation between a wider array of actors, as the theory proposes. By using the case studies of the Sabie catchment and the Lesotho Highlands Water Project to examine local and international level governance, the paper finds challenges related to power disparity and interdependence of actors, and risk perceptions of inclusive decision-making. It is found that at both the local and international level, the state, which is a ,traditional' actor, still plays an influential role in decision-making. ,New' actors such as businesses, civil society, and regional institutions are more visible but have limited decision-making power. Non-linear, time-consuming forms of cooperation occur in water governance. [source] | ||||||||||