The Use of Complementary and Alternative Medicine Supplements of Potential Concern during Breast Cancer Chemotherapy

Objective. While many Complementary and Alternative Medicines (CAM) are unlikely to interact negatively with conventional oncology treatment, some ingestible CAM substances have biological activities that may reduce the effectiveness of chemotherapy or radiation. This study surveyed women with breast cancer in order to document the extent to which women with breast cancer use these CAM substances of concern concurrently with conventional treatments. Methods. A total of 398 women completed a survey describing their use of CAM at various time points in their cancer treatment. This report focuses on a subsample of 250 women receiving chemotherapy or radiation who reported using specific one or more of several chemotherapies. Results. Of those participating, 104 (43.7%) of those receiving chemotherapy (n=238) and 45 (32.3%) of those receiving radiation (139; 58.4% of all patients) reported using one or more CAM substances that could be cause for concern when taken concurrently. Conclusion. Research is needed to understand the real risks associated with CAM and conventional polypharmacy. If risks associated with CAM conventional polypharmacy use prove to be substantial then improved systems to assure all women get advice regarding herb and supplement use during breast cancer treatment appear to be needed

Testifying in court as a victim of crime for persons with little or no functional speech : vocabulary implications

People with disabilities are at a high risk of becoming victims of crime. Individuals with little or no functional speech (LNFS) face an even higher risk. One way of reducing the risk of remaining a victim of crime is to face the alleged perpetrator in court as a witness – therefore it is important for a person with LNFS who has been a victim of crime to have the required vocabulary to testify in court. The aim of this study was to identify and describe the core and fringe legal vocabulary required by illiterate victims of crime, who have little or no functional speech, to testify in court as witnesses. A mixed-method, exploratory sequential design consisting of two distinct phases was used to address the aim of the research. The first phase was of a qualitative nature and included two different data sources, namely in-depth semi-structured interviews (n=3) and focus group discussions (n=22). The overall aim of this phase was to identify and describe core and fringe legal vocabulary and to develop a measurement instrument based on these results. Results from Phase 1 were used in Phase 2, the quantitative phase, during which the measurement instrument (a custom-designed questionnaire) was socially validated by 31 participants. The results produced six distinct vocabulary categories that represent the legal core vocabulary and 99 words that represent the legal fringe vocabulary. The findings suggested that communication boards should be individualised to the individual and the specific crime, based on both the core and fringe legal vocabulary. It is believed that the vocabulary lists developed in this study act as a valid and reliable springboard from which communication boards can be developed. Recommendations were therefore made to develop an Alternative and Augmentative Communication (AAC) Resource Tool Kit to assist the legal justice system.http://www.sapsac.co.za/carsa.htmlam201

Identifying barriers in the South African Criminal Justice System : implications for individuals with severe communication disability

Individuals with severe communication disabilities and who are victims of crime, experience many access and opportunity barriers in the criminal justice system. The aim of this research was to identify the barriers experienced by this population in the South African Criminal Justice System as perceived by experts in the field. A qualitative research method, with 56 expert professionals in the criminal justice system divided into two different sequential data sources, was employed. The first data source included in-depth, semi-structured interviews (n=3), and these results informed the second data source, which was in the form of four focus groups (n=53).The results from both data sources (N=56) identified numerous barriers for individuals with a severe communication disability who had been victims of crime and needed access to the criminal justice system. The findings suggest that more support and resources need to be provided to individuals with severe communication disability. Additionally, disability training for all professionals working in the criminal justice system needs to be a top priority. Recommendations were made to develop an augmentative and alternative communication resource toolkit to assist these professionals, to ensure equal justice for one of the most vulnerable groups in society – those individuals with a severe communication disability who have been victims of crime.http://www.actacommercii.co.zaam2016Centre for Augmentative and Alternative Communication (CAAC

The Integrity and Yield of Genomic DNA Isolated from Whole Blood Following Long-Term Storage at -30°C.

Long-term storage of whole blood can affect the integrity of DNA if it is not done under optimal conditions. The aim of this study was to determine whether long-term storage (2-19 years) of whole blood samples at -30°C had a negative effect on the quality or quantity of genomic DNA that could be recovered at extraction. Genomic DNA was isolated from 2758 whole blood samples collected in 4 mL EDTA vacutainers from 1997 to 2012. DNA was extracted using the Qiagen® FlexiGene® DNA kit. The average storage duration at -30°C was 12 years. The quality and quantity of the isolated DNA were assessed using spectrophotometry (NanoDrop™), a fluorometric assay for double-stranded DNA (Qubit™), and agarose gel electrophoresis. The mean DNA yield per sample was found to be 114 μg from whole blood volumes that ranged from 0.5 to 4 mL. The mean A260/280 ratio and median A260/280 ratios were both 1.8. No correlation was found between the duration of storage and the total yield or the quality of DNA extracted. These data suggest that high-quality DNA can be extracted from whole blood samples that are stored at -30°C for up to 19 years

Adapting and translating the Mullen Scales of Early Learning for the South African context

BACKGROUND : South African speech-language therapists have identified the need for culturally valid and sensitive assessment tools that can accommodate multiple languages and cover a reasonable age range. The Mullen Scales of Early Learning (MSEL) extend from birth to 68 months, contain five separate subscales including receptive language, expressive language, gross motor, fine motor and visual reception scale, are straightforward to administer and have been successfully used in other African countries, such as Uganda. It also identifies a child’s strengths and weaknesses and provides a solid foundation for intervention planning. OBJECTIVES : This research aimed to demonstrate the appropriateness and usefulness of the translated and culturally and linguistically adapted MSEL across four South African languages (Afrikaans, isiZulu, Setswana and South African English) through two sub-aims: (1) to describe differences, if any, in MSEL performance across language groups and (2) to describe differences, if any, in MSEL performance between age groups. METHOD : A total of 198 typically developing children between the ages of 21 and 68 months spread across the four language groups were individually assessed with the culturally and linguistically adapted and translated MSEL. RESULTS : A one-way analysis of variance (ANOVA) showed no statistically significant differences between the four language groups for total MSEL scores. A Welch’s one-way ANOVA showed that the total MSEL scores were significantly different between age groups. CONCLUSION : The translation and adaptation of the MSEL was successful and did not advantage or disadvantage children based on their home language, implying that linguistic equivalence was achieved. The MSEL results differed between age groups, suggesting that the measure was also successful in differentiating the performance of children at different developmental levels.Funding for the study was provided by the National Institutes of Health’s Fogarty International Center through grant number TW-008999 to MaryAnn Romski. This research was supported by the United States National Institutes of Health’s Fogarty International Center (grant number TW-008999) to MaryAnn Romski.https://sajcd.org.za/index.php/sajcdam2018Centre for Augmentative and Alternative Communication (CAAC

Language assessment for children with a range of neurodevelopmental disorders across four languages in South Africa

PURPOSE : The purpose of this study is (a) to examine the applicability of a culturally and linguistically adapted measure to assess the receptive and expressive language skills of children with neurodevelopmental disorders (NDDs) in South Africa and then (b) to explore the contributions of 2 additional language measures. METHOD : In Part 1, 100 children with NDD who spoke Afrikaans, isiZulu, Setswana, or South African English were assessed on the culturally and linguistically adapted Mullen Scales of Early Learning (MSEL). Clinicians independently rated the children's language skills on a 3-point scale. In Part 2, the final 20 children to be recruited participated in a caregiver-led interaction, after which the caregiver completed a rating scale about their perceptions of their children's language. RESULTS : Performance on the MSEL was consistent with clinician-rated child language skills. The 2 additional measures confirmed and enriched the description of the child's performance on the MSEL. CONCLUSIONS : The translated MSEL and the supplemental measures successfully characterize the language profiles and related skills in children with NDD in multilingual South Africa. Together, these assessment tools can serve a valuable function in guiding the choice of intervention and also may serve as a way to monitor progress.The National Institutes of Health Fogarty International Center grant number TW-008999 to MaryAnn Romski.http://ajslp.asha.orghj2018Centre for Augmentative and Alternative Communication (CAAC

Applied utility and the auto-ethnographic short story: persuasions for, and illustrations of, writing critical social science

In some quarters it is argued that, narrative researchers might be classified as being either storyanalysts or storytellers. They go on to suggest that one feature of storytellers is that they undertake a form of analysis as the process of writing unfolds. With these sentiments in mind, in the present paper, we consider how auto-ethnographical accounts of traumatic and challenging life events might, through the analysis contained within, demonstrate value within the realm of applied pedagogy. In making our case we embrace and adapt the literary genre of storytelling, more specifically, the short story. The story presented here, ‘Travel Writer’, offers an opaque, multicontextualised and lifelong view of career transition. The present paper, in more general terms, considers the capacity of auto-ethnography and, more specifically, the short storied version of it, to engender critical reader engagement, to encourage personal reflection in others, and to act as a point of stimulus for the enactment of applied debate through the lens of critical social science. With regards to the assumptions of critical social science, the final discussion also considers how the auto-ethnographic text, as a pedagogic tool, might help others to contest and challenge the meta-narratives that, we argue, risk stagnating established thinking

Investigating mortality and morbidity associated with UrINary incontinence during Older Womens Secondary Care Admissions and exploring nurses experiences of delivering related care (U-INconti): a mixed methods research protocol

Introduction: Urinary incontinence (UI) is associated with increasing age and is more frequently experienced by women. Despite 40% prevalence in the community, little is known about the prevalence/incidence of UI in older women during hospital admission. UI during hospital admissions, within this group, has also been under-researched in terms of its relationship to specific clinical conditions and mortality rates. Given that UI has serious implications for both patient care and women’s general health and well-being on discharge, this protocol describes a planned research project which aims to determine mortality, morbidity, prevalence and incidence of UI in older women (≥55 years) during hospital admission to inform nursing practice. Additionally, it aims to explore the experience of nurses who deliver women’s care. Methods and analysis: This is an explanatory mixed-methods study consisting of two phases: (1) retrospecitive analysis of electronic patient care records (EPCR) to determine prevalence/incidence of UI, clinical conditions most likely associated with UI and any associations between UI and death, (2) nurse interviews to explore views, knowledge and perceptions of performing the nursing assessment and providing care for older women (≥55 years) with UI during admission. EPCR will be gained from a National Health Service (NHS) teaching hospital. Nurse interviews will be conducted with nurses from an alternative but similar-sized NHS hospital. Ethics and dissemination: Ethical approval is provided by the University of Salford Ethics Committee and regulatory approval by the NHS Health Research Authority (Integrated Research Application System project ID: 303118). Local NHS trust approval to access electronic care records for the purposes of analysis of anonymised data has been provided by one of the two collaborating NHS hospitals. Findings will be disseminated through open-access geriatric or urogynaecology journals and presented to relevant stakeholders at local, national and international meetings including scientific meetings such as the UK Continence Society and International Continence Society