Contextually relevant resources in speech-language therapy and audiology in South Africa-are there any?

In this editorial introduction we aim to explore the notion of contextually-relevant resources. We argue that it is the responsibility of Speech Language Therapists (SLTs) and Audiologists (As) working in South Africa to develop contextually relevant resources, and not to rely on the countries or cultures where the professions originated to do so. Language is often cited as the main barrier to contextually relevant resources: most SLTs and As are aware of the need for more resources in the indigenous local languages. However, the issue is not as straightforward as translating resources from English into other languages. The challenges related to culture, e.g. formal education, familiarity with the test situation, have to be considered; as well as the population on which norms were obtained; the nature of vocabulary or picture items. This paper introduces four original research papers that follow in this edition of the journal, and showcases them as examples of innovative development in our field. At the same time we call for the further development of assessment materials, intervention resources, and contributions to the evidence base in our context. We emphasise the importance of local knowledge to drive the development of these resources in innovative and perhaps unexpected ways, and suggest that all clinicians have an important role to play in this process

Configurations of self-identity formations of adults who stutter

The aims of this paper are twofold: Firstly, to describe the configuration of self-identity formations evident across and within research stories of adults living with stuttering; and secondly, to discuss the clinical implications of these findings. The study on which this paper is based used life history narratives to describe the types, processes and configurations of self-identity formations of adults who stuttered since childhood. Through open-ended, in-depth interviews 7 participants shared their experiences of living with stuttering. The interviews were analysed at a first level using narrative analysis and at a second level to further describe the types, processes and configurations of self-identity formations evident in the stories. The findings on configurations of self-identity formations were that the two types of self-identity formations Able and DisOther were present in singular and dual configurations. The dual self-identity formations occurred in co-existing, competing and coalescing relationships within particular time periods in their stories. The clinical implications of the findings are discussed

Are we there yet? on a journey towards more contextually relevant resources in speech-language therapy and audiology

Audiologists and speech-language therapists working in developing contexts like South Africa have the opportunity to address a range of needs through their research. One of these needs is the development of assessments and therapy materials that are appropriate for their clients’particular language needs and cultural background. This editorial paper aims to introduce original research in speech-language therapy and audiology, which has been carried out in South Africa and other developing contexts and is presented in this volume of the journal. In addition we suggest that while the focus of much research is on the destination or end product that is developed, there is a need to share the methodologies that are used to reach that goal so that more research can be carried out by a wider pool of students, researchers and clinicians. We describe some of the methods that we have used in our research – often in small scale projects with budgetary constraints, which would be feasible for clinicians in their routine clinical contexts. Our hope is that others can build on these approaches, critique and share their own strategies for the ultimate advancement of the professions in southern Africa

Are we there yet? On a journey towards more contextually relevant resources in speech-language therapy and audiology

Audiologists and speech-language therapists working in developing contexts like South Africa have the opportunity to address a range of needs through their research. One of these needs is the development of assessments and therapy materials that are appropriate for their clients’particular language needs and cultural background. This editorial paper aims to introduce original research in speech-language therapy and audiology, which has been carried out in South Africa and other developing contexts and is presented in this volume of the journal. In addition we suggest that while the focus of much research is on the destination or end product that is developed, there is a need to share the methodologies that are used to reach that goal so that more research can be carried out by a wider pool of students, researchers and clinicians. We describe some of the methods that we have used in our research – often in small scale projects with budgetary constraints, which would be feasible for clinicians in their routine clinical contexts. Our hope is that others can build on these approaches, critique and share their own strategies for the ultimate advancement of the professions in southern Africa

The need for speech and language therapy intervention for infants and toddlers with tracheostomies : a retrospective study

There has been a worldwide increase in the number of tracheostomies performed on the paediatric population, particularly during the first year of life, which has also been evident at Red Cross Children’s Hospital in South Africa. Infants and toddlers with tracheostomies present with multiple risk factors for having or developing dysphagia and/or communication difficulties, due to the effects of the tracheostomy on the development of feeding, speech and communication, as well as the underlying medical conditions that necessitated the tracheostomy, and associated medical, social and environmental factors. There is, however, a dearth of literature in the area of paediatric tracheostomies in the South African context, particularly with regard to feeding and communication. The purpose of this study was to determine the incidence and describe the nature of dysphagia and communication difficulties in infants and toddlers with tracheostomies in the South African context, and detail the need for speech-language therapy intervention. It also attempted to determine whether there was an association between the underlying medical condition and the incidence of dysphagia and/or communication difficulties. A retrospective, descriptive survey of the folders of infants and toddlers with tracheostomies within the age range of 0 – 3 years from 2002 – 2004 at Red Cross Children’s Hospital was conducted. A checklist for dysphagia and communication difficulties in infants and toddlers with tracheostomies was developed and used to collect data from participants’ medical records. Results indicated that 80% of the study population presented with dysphagia. Oral phase difficulties were documented in 81.25%, pharyngeal phase difficulties in 60.9% and oesophageal phase difficulties in 79.7% of the dysphagic sample. Communication difficulties were recorded in 94% of the sample population. Speech production difficulties were documented in 78%, receptive language delays in 87% and expressive language delays in 96% of the sample population with communication difficulties. No statistically significant association was established between the underlying medical condition and the incidence of either dysphagia or communication difficulties. The results in the present study support the limited available literature, and the need for early speech-language therapy intervention for infants and toddlers with tracheostomies.Dissertation (M (Communication Pathology))--University of Pretoria, 2007.Speech-Language Pathology and AudiologyM (Communication Pathology)unrestricte

Configurations of self-identity formations of adults who stutter

The aims of this paper are twofold: Firstly, to describe the configuration of self-identity formations evident across and within research stories of adults living with stuttering; and secondly, to discuss the clinical implications of these findings. The study on which this paper is based used life history narratives to describe the types, processes and configurations of self-identity formations of adults who stuttered since childhood. Through open-ended, in-depth interviews 7 participants shared their experiences of living with stuttering. The interviews were analysed at a first level using narrative analysis and at a second level to further describe the types, processes and configurations of self-identity formations evident in the stories. The findings on configurations of self-identity formations were that the two types of self-identity formations Able and DisOther were present in singular and dual configurations. The dual self-identity formations occurred in co-existing, competing and coalescing relationships within particular time periods in their stories. The clinical implications of the findings are discussed

New perspectives on strong z=0.5 MgII absorbers: are halo-mass and equivalent width anti-correlated?

We measure the mean halo-mass of z=0.5 MgII absorbers using the cross-correlation (over co-moving scales 0.05-13h^{-1}Mpc) between 1806 MgII quasar absorption systems and ~250,000 Luminous Red Galaxies (LRGs), both selected from the SDSS DR3. The MgII systems have rest-frame equivalent widths W_r(2796)>=0.3A. From the ratio of the MgII-LRG cross-correlation to the LRG-LRG auto-correlation, we find that the bias ratio between MgII absorbers and LRGs is 0.65+/-0.08, which implies that the absorber host-galaxies have a mean halo-mass 20-40 times smaller than that of the LRGs; the MgII absorbers have halos of mean mass =11.94+/-0.31(stat)+/-0.25(sys). We demonstrate that this statistical technique, which does not require any spectroscopic follow-up, does not suffer from contaminants such as stars or foreground and background galaxies. Finally, we find that the absorber halo-mass is anti-correlated with the equivalent width. If MgII absorbers were virialized in galaxy halos a positive M_h-W_r correlation would have been observed since W_r(2796) is a direct measure of the velocity spread of the MgII sub-components. Thus, our results demonstrate that the individual clouds of a MgII system are not virialized in the gaseous halos of the host-galaxies. We review past results in the literature on the statistics of MgII absorbers and find that they too require an M_h-W_r anti-correlation. When combined with measurements of the equivalent width distribution, the M_h-W_r anti-correlation naturally explains why absorbers with W_r(2796)>=2A are not seen at large impact parameters. We interpret the M_h-W_r anti-correlation within the starburst scenario where strong MgII absorbers are produced by supernovae-driven winds.Comment: 18 pages, 12 EPS figures, Accepted by MNRAS. Full table of MgII absorbers available at http://www.ast.cam.ac.uk/~mim/pub.html, minor changes to match the published tex

Complex diseases and co-morbidities: polycystic ovary syndrome and type 2 diabetes mellitus

Objective: Many complex diseases exhibit co-morbidities often requiring management by more than one health specialist. We examined cross-speciality issues that ultimately affect the health and wellbeing of patients with polycystic ovary syndrome (PCOS). PCOS was originally described as a reproductive condition but is now recognised to also be a metabolic and psychological condition affecting 8–13% of women of reproductive age. With a four-fold increased risk of type 2 diabetes (DM2), the Population Attributable Risk of DM2 that could be avoided if PCOS were eliminated is a substantial 19–28% of women of reproductive age. To determine the extent to which PCOS is an important consideration in diabetes development, we examined publications, funding, guidelines and predictors of risk of developing DM2. Results: We found that the topic of PCOS appeared in specialist diabetes journals at only 10% the rate seen in endocrinology journals – about 1 in 500 articles. We found research funding to be substantially less than for diabetes and found that diabetes guidelines and predictive tools for DM2 risk mostly ignore PCOS. This is surprising since insulin resistance in women with PCOS has a different aetiology and additionally women with PCOS are at increased risk of becoming overweight or obese – high risk factors for DM2. Conclusions: We consider the causes of these concerning anomalies and discuss current activities to address the co-morbidities of PCOS, including the recent development of international guidelines, an international PCOS awareness program and potentially changing the name of PCOS to better reflect its metabolic consequences

Prevalence and architecture of de novo mutations in developmental disorders.

The genomes of individuals with severe, undiagnosed developmental disorders are enriched in damaging de novo mutations (DNMs) in developmentally important genes. Here we have sequenced the exomes of 4,293 families containing individuals with developmental disorders, and meta-analysed these data with data from another 3,287 individuals with similar disorders. We show that the most important factors influencing the diagnostic yield of DNMs are the sex of the affected individual, the relatedness of their parents, whether close relatives are affected and the parental ages. We identified 94 genes enriched in damaging DNMs, including 14 that previously lacked compelling evidence of involvement in developmental disorders. We have also characterized the phenotypic diversity among these disorders. We estimate that 42% of our cohort carry pathogenic DNMs in coding sequences; approximately half of these DNMs disrupt gene function and the remainder result in altered protein function. We estimate that developmental disorders caused by DNMs have an average prevalence of 1 in 213 to 1 in 448 births, depending on parental age. Given current global demographics, this equates to almost 400,000 children born per year