Editorial

Intellectual disability in the Esidimeni tragedy: Silent death

Patterns of distribution and spatial indicators of ecosystem change based on key species in the Southern Benguela

Several commercially and ecologically important species in the southern Benguela have undergone southward and eastward shifts in their distributions over previous decades, most notably the small pelagic fish sardine Sardinops sagax and anchovy Engraulis encrasicolus . Understanding these changes and their implications is essential in implementing an ecosystem approach to fisheries in the southern Benguela and attempting to appreciate the potential impacts of future environmental change. To investigate possible impacts of these shifts at an ecosystem level, distribution maps for before (1985-1991), during (1997-2000) and after (2003-2008) the shift in small pelagic fish were constructed for 14 key species from catch and survey data, and used to calculate spatial indicators including proportion east and west of Cape Agulhas, relative overlap in biomass and area, index of diversity, connectivity. Potential interactions on the south and west coasts were also compared. For several species (redeye; chub mackerel; kingklip; chokka squid; yellowtail), previously unidentified increases in the proportion of biomass east of Cape Agulhas were shown to have occurred over the same period as that of small pelagic fish, although none to the same degree. On average, overlap with small pelagic fish increased over time and overall system connectivity was lowest in the intermediate period, possibly indicating a system under transition. Connectivity declined over time on the west coast while increasing on the east coast. Distributions of other species have changed over time, with the region east of Cape Agulhas becoming increasingly important in terms of potential trophic interaction. Variations in distribution of biomass and structural complexity affect the trophic structure and hence functioning of the system, and implications should be considered when attempting to identify the possible ecosystem impacts of current and future system-level change

Evaluation of a locally produced rapid urease test for the diagnosis of Helicobacter pylori infection

Background. The rapid urease test (RUT) is used at Groote Schuur Hospital for diagnosing Helicobacter pylori infection. This is an in-house method, which has not been validated. Objective. To validate our practice of reading the RUT immediately after endoscopy (RUT0), by comparing this with a reading at 24 hours (RUT24) and with histological analysis. Design. Ninety consecutive patients undergoing upper endoscopy over a 6-week period from October 2005 to November 2005, and in whom rapid urease testing was indicated, were included in the study. Patients with recent exposure (within 2 weeks of endoscopy) to proton pump inhibitors (PPIs), histamine receptor antagonists (H2RAs) and antibiotics (confounders) were noted and included in the cohort. Two antral and two body biopsies were taken for histological examination and a third antral biopsy was placed in the RUT bottle. Both haematoxylin and eosin and modified Giemsa staining methods were used to identify H. pylori. The RUT was read immediately (within 5 minutes of upper endoscopy) (RUT0), as per our current practice, and each specimen was re-read at 24 hours (RUT24). Sensitivity, specificity, positive and negative predictive values and the impact of confounders were calculated. Results. Of the 90 patients undergoing rapid urease testing, 39% were male and 61% were female, with a mean age of 55 years (range 22 - 79 years). Histological examination revealed H. pylori in 67.8% (N=61) of the biopsy specimens. In the 65 patients without confounders, the sensitivity and specificity of the RUT0 were 65.9% and 100% respectively, and 90.9% and 100% for RUT24. After including the 25 patients with confounders, the sensitivity and specificity were 68.8% and 100% for RUT0, and 90.1% and 100% for RUT24 respectively. Thirteen RUT0 specimens (30.9%) that were initially negative became positive at the RUT24 reading. There were 6 (9.8%) RUT0- and RUT24-negative but histology-positive specimens. Four of these 6 false-negative RUT24 results could be accounted for by a low H. pylori density on histological analysis (2 patients were taking PPIs). Confounders did not alter the sensitivity and specificity outcomes or impact on the number of false-negative RUTs. Conclusions. Our locally prepared RUT is a specific test for the detection of H. pylori infection. The sensitivity is greatly enhanced by reading the test at 24 hours. The use of PPIs, H2RAs and antibiotics preceding endoscopy did not impact significantly on the results. South African Medical Journal Vol. 97 (12) 2007: pp. 1281-128

"Does anyone even notice us?" COVID-19’s impact on academics’ well-being in a developing country

In March 2020, the President of South African announced that the nation would go into full lockdown in the wake of an increase in COVID-19 infections. Academics had, in some instances, only one day to prepare for “emergency remote teaching”. Few academics had taught online before, as South Africa’s internet connectivity is not guaranteed in underprivileged areas, where 80 per cent of the population reside. The online move thus necessitated an entirely novel pedagogy for most academics, with high potential for an escalation of work-related stress and related illness, outcomes we have related in the wider sphere of workplace readjustment during COVID-19, to a state of “pandemia”. In this article, we report on an institutional case study where we surveyed n=136 academics from a university in the Western Cape, South Africa to learn more about impacts of COVID-19 on their work. The data analysis adopts Ryff’s (1995) theory of well-being. Findings indicate that the enforced lockdown due to COVID-19 and the subsequent move to online teaching has had a negative impact on academics’ sense of well-being. However, the emergence of positive, caring relationships between colleagues is reported as a significant outcome of the COVID-19 enforced move to online teaching

Withdrawn, strong, kind, but de-gendered: Non-disabled South Africans’ stereotypes concerning persons with physical disabilities

The present paper examines stereotyping in relation to physical disability and gender in the South Africa. Cross-sectional data for the present study were gathered using free response items in a large survey (n = 1990) examining the attitudes of people without disability towards different facetsof sexuality and disability. The most prominent stereotypes found in thepresent study were those which characterised PWPD as withdrawn and shy, SuperCrips, or happy, funny, and kind. The findings in the present papersuggest that stereotypes of PWPD are not overwhelmingly de-sexualising, but are undifferentiated by gender

Impact of disease, cognitive and behavioural factors on caregiver outcome in amyotrophic lateral sclerosis

Up to 50% of patients with amyotrophic lateral sclerosis (ALS) show mild to moderate cognitive-behavioural change alongside their progressive functional impairment. This study examines the relative impact of patients' disease symptoms, behavioural change and current executive function and social cognition abilities on psychosocial outcomes in spouse caregivers of people with ALS. Thirty-five spouse caregivers rated their own levels of depression and anxiety, subjective burden and marital satisfaction. Caregivers also rated their partner's everyday behaviour. The patients were assessed for disease severity and cognitive function, with composite scores derived for executive function and social cognition. Regression analyses revealed that caregiver burden was predicted by the severity of patients' limb involvement and behavioural problems. Depression was predicted by patients' limb involvement, while behavioural problems and patient age predicted caregiver anxiety. Current marital satisfaction was predicted by patient behavioural problems beyond the level of pre-illness marital satisfaction. In conclusion, the study highlights the potential impact of ALS patients' functional impairment and behavioural change on ALS caregivers' psychosocial functioning. Clinical communication with ALS families should emphasise both physical and psychological challenges presented by the disease

The development and validation of a digital biomarker for remote assessment of Alzheimer's diseases risk

Background: Digital cognitive assessment is becoming increasingly widespread in ageing research and care, especially since the COVID19 pandemic. Remote online collection provides opportunities for ageing and dementia professionals to collect larger datasets, increase the diversity of research participants and patients and offer cost-effective screening and monitoring methods for clinical practice and trials. However, the reliability of self-administered at-home tests compared to their lab-based counterparts often goes unexamined, compromising the validity of adopting such measures. Objective: Our aim is to validate a self-administered web-based version of the visual short-term memory binding task (VSTMBT), a potential digital biomarker sensitive to Alzheimer’s Disease processes, suitable for use on personal devices. Methods: A final cross-sectional sample of 37 older-adult (51 – 77 years) participants without dementia completed our novel self-administered version of the VSTMBT, both at home on a personal device and in the lab, under researcher-controlled conditions. Results: ANOVA and Bayesian T-test found no significant differences between the task when it was remotely self-administered by participants at home compared to when it was taken under controlled lab conditions. Conclusions: These results indicate the VSTMBT can provide reliable data when self administered at-home using an online version of the task and on a personal device. This finding has important implications for remote screening and monitoring practices of older adults, as well as supporting clinical practices serving diverse patient communities. Future work will assess remote administration in older adults with cognitive impairment and diverse socio-economic and ethno-cultural backgrounds as well as a bench-to-bedside application

High temperatures and human pressures interact to influence mortality in an African carnivore

The impacts of high ambient temperatures on mortality in humans and domestic animals are well-understood. However much less is known about how hot weather affects mortality in wild animals. High ambient temperatures have been associated with African wild dog Lycaon pictus pup mortality, suggesting that high temperatures might also be linked to high adult mortality.We analyzed mortality patterns in African wild dogs radio-collared in Kenya (0°N), Botswana (20°S), and Zimbabwe (20°S), to examine whether ambient temperature was associated with adult mortality.We found that high ambient temperatures were associated with increased adult wild dog mortality at the Kenya site, and there was some evidence for temperature associations with mortality at the Botswana and Zimbabwe sites.At the Kenya study site, which had the highest human impact, high ambient temperatures were associated with increased risks of wild dogs being killed by people, and by domestic dog diseases. In contrast, temperature was not associated with the risk of snare-related mortality at the Zimbabwe site, which had the second highest human impact. Causes of death varied markedly between sites. Pack size was positively associated with survival at all three sites.These findings suggest that while climate change may not lead to new causes of mortality, rising temperatures may exacerbate existing anthropogenic threats to this endangered species, with implications for conservation. This evidence suggests that temperature-related mortality, including interactions between temperature and other anthropogenic threats, should be investigated in a greater number of species to understand and mitigate likely impacts of climate change