MSc (Med), Child Health Neurodevelopment, Faculty of Health Sciences, University of the Witwatersrand / Background The early identification of developmental disorders facilitates early intervention, improving childhood outcomes. Parent-administered questionnaires have been recommended for this purpose. The PEDS COMBINED, which includes the Parents Evaluation of Developmental Status (PEDS) and PEDS Developmental Milestones (PEDS:DM), and the Ages and Stages Questionnaire (ASQ) are parent-administered questionnaires with good psychometric properties. It has not been determined if they identify the same infants at-risk for developmental delays however. It is also not know how South African paediatricians monitor childhood development. Objective To compare the ASQ, PEDS COMBINED and South African paediatricians’ subjective assessment (PSA) of neonatal intensive care graduates at 6-months corrected age. To identify trends in developmental screening practices, including the knowledge and use of parentadministered screening tools, in a diverse group of paediatricans working in Gauteng, South Africa. Methods Developmental screening and referral practices of paediatricians were ascertained by analysis of a short questionnaire sent to participating paediatricians. Concordance between the questionnaires and PSA was determined using the kappa coefficient (κ) and Test of Symmetry (κ ≤ 0.4 indicating poor agreement; κ ≥ 0.75 indicating excellent agreement). Results Concordance between the ASQ and PEDS COMBINED was 90.7% (κ = 0.82, ρ = 0.05). The PSA showed poor concordance with both PEDS COMBINED and ASQ (κ = 0.28, ρ = 0.03 and κ= 0.26, ρ = 0.01 respectively). The ASQ and PEDS COMBINED identified 40% and 42% of the cohort with developmental concerns and the PSA identified 6%. Only 13% of paediatricians used specific guidelines for developmental assessment and none used, or could name any parent-administered questionnaire. Conclusion There is excellent agreement between the ASQ and PEDS COMBINED in identifying the same children with developmental concerns. Paediatricians identified significantly fewer infants and showed statistically significant poor agreement with both questionnaires. Most paediatricians in Gauteng, South Africa are not using standardized screening tools to detect developmental delay and have poor knowledge regarding these tools.

Class of 2013 Abstract / Specific Aims: To evaluate the level of didactic and experiential pediatric education currently provided in ACPE-accredited Doctorate of Pharmacy (PharmD) programs throughout the United States by comparing geographic location and type of institution. Methods: Questionnaires were administered electronically to pediatric clinicians through the American College of Clinical Pharmacy (ACCP) Pediatric Practice and Research Network (PRN) listserve and consisted of demographic questions as well as questions regarding the number of hours of didactic pediatric education within courses, the number of hours of experiential education, and the specific pediatric experiences available to students. Main Results: Questionnaires were completed by 36 Colleges of Pharmacy (29%) and included 26 dedicated pediatric faculty, 9 adjunct pediatric faculty, and 1 non-pediatric faculty who were the primary instructors for pediatric education. The average reported number of pediatric didactic hours was 16.3±19.2 hours. Pediatric didactic education was similar between private and state funded institutions (p=0.24) as well as geographic location (p=0.74). The percentages of students taking the different types of experiential rotations were similar between state funded and private institutions (p=0.64). There was a significant difference between regions for the percentage of students participating in pediatric APPE rotations (p<0.001). Specifically, the Northeast and Midwest regions showed a higher percentage than the South Atlantic, South Central, and West regions (p<0.001). Programs commonly reported the following pediatric rotations: general pediatrics (78%), pediatric critical care (69%), neonatal critical care (67%), and pediatric ambulatory care (28%). Conclusion: Pediatric didactic and experiential education appears to be consistent between state and privately-funded institutions as well as between geographic regions with the exception of a higher percentage of students in the Northeast and Midwest participating in pediatric APPE.

Background: Periodontitis is an inflammatory condition rendering in degradation of tooth supporting tissue. In the inflammatory process cytokines, amongst others TNF-a, IL-1b and IL-6 play an important role in regulating the immune response. Periodontal Ehlers Danlos syndrome (pEDS) is a rare connective tissue disorder characterized by distinct oral manifestations such as periodontitis. Studies has shown that individuals with pEDS exhibit a mutation in the complement factors C1r and C1s. Aim: The aim of this study was to analyze the gene expression of C1r and C1s in human gingival fibroblasts and to investigate if the expression of these genes’ changes during inflammatory conditions. Methods: Human gingival fibroblasts (hGFBs) were cultured with TNF-a or IL-1b for 24h. RNA isolation, extraction and complementary DNA synthesis was made at the timepoint of 6h and 24h. An qRT-PCR analyses of the genes C1r, C1s and IL-6 were performed and the relative gene expression of C1r, C1s and IL-6 were calculated. Results: The expression of C1r and C1s increased after 24h in TNF-a and IL-1b compared to control by measuring the relative fold change of the genes by culturing fibroblast over time. The result was taken from three parallel samples and the result was significant. Conclusion: The findings point to a link between the inflammatory classical complement pathway and the connective tissue homeostasis. Hopefully, our findings will be one piece of the puzzle regarding the molecular events rendering in pEDS and thereby a potential treatment target.

Background: Early identification and intervention for infants and young children with developmental delays may negate or minimise the negative effect of a disability on a child's development. Poor follow-up on early detection referrals, however, undermines the effectiveness of early intervention programmes. Objectives: To identify factors, including text message reminders, that influence follow-up adherence for early intervention after developmental screening in primary health care. A secondary objective surveyed reasons for follow-up default. Methods: The PEDS Tools was used to screen 247 high-risk children. A risk assessment questionnaire was completed with caregivers whose children were referred for speech-language and/or occupational therapy (n=106, 43%). A quasi-experimental study was employed to identify risk factors for defaulting on appointments. A thematic analysis of telephonic interviews was also employed to determine reasons for follow-up defaults. Results: Follow-up adherence was 17%. Participants who were divorced, widowed or never married were 2.88 times more likely to attend a follow-up appointment than those who were married or living together (95%, CI 0.97- 8.63). Text message reminders did not significantly improve follow-up. More than half (58%) of participants who defaulted on appointments could be reached for telephonic interviews. During the telephonic interviews 87% of participants did not report concern about their child's development. Reasons for defaulting were employment, logistical issues, other responsibilities and forgetfulness. Conclusions: Detecting possible developmental delays did not lead to acceptable follow-up adherence for early intervention services at primary health care levels. Increased awareness and education regarding the importance of development for educational success is needed. / Dissertation (M Communication Pathology)--University of Pretoria, 2016. / Speech-Language Pathology and Audiology / MCommunication Pathology / Unrestricted

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In this paper, I seek to determine whether the current ban on performance-enhancing drugs (PEDs) in professional sport is justified. I look at two of the most common categories of arguments in favor of the ban, which I term the Harm Category and The Nature of Sport Category, and ultimately determine that neither is strong enough to justify the current ban. I determine, however, that a third and less common category of arguments, which I term the Dehumanization Category, provides good reason to justify the ban by appealing to our intuitions about why the use of PEDs in professional sport is wrong.

Background: Sports have a significant impact on people all around the world. Although sport brings a lot of joy, a sense of togetherness, and pride, it also involves ethically difficult issues such as doping. Doping in sports is a growing global concern that jeopardizes sports ethics, values, and integrity (The World Anti-Doping Agency WADA, a). Previous research has mainly approached the topic by understanding athletes’ motivation behind the decision to dope. Hence, there is a growing need to understand athletes’ attitudes and beliefs towards clean sports. Aim: This study aimed to comprehensively understand athletes’ attitudes and beliefs on reaching the top without doping and their beliefs on whether doping affects the results of competitions at the national and international levels. Also, it was examined whether variables such as age, gender, testing history, and sports have any distinguished matter on athletes’ attitudes towards clean sports. Method: A cross-sectional mixed-methods study explored athletes' attitudes and beliefs on clean sports. A total of 73 tested athletes (response rate 14,4%) completed a web-based "Assessments of Doping Control and FINCIS Activities" -survey. Results: In this research, athletes’ age, gender, testing history, and sports did not show any significance concerning athletes' attitudes towards reaching the national and international tops without doping. In the open-ended questions, athletes expressed trust in national-level competitions but had more suspicions about international competitions. Conclusion: The results suggest that the athletes in this research reported positive attitudes and beliefs in competing clean. However, it is challenging to determine whether athletes feel that they need to answer “correctly” and according to the values of clean sports. Therefore, it is important to continue studying athletes’ attitudes and clean sports.

Yes / Growing evidence suggests that fatigue associated with listening difficulties is particularly problematic for children with hearing loss (CHL). However, sensitive, reliable, and valid measures of listening-related fatigue do not exist. To address this gap, this paper describes the development, psychometric evaluation, and preliminary validation of a suite of scales designed to assess listening-related fatigue in CHL- the pediatric Vanderbilt Fatigue Scales (VFS-Peds). Test development employed best practices, including operationalizing the construct of listening-related fatigue from the perspective of target respondents (i.e., children, their parents, and teachers). Test items were developed based on input from these groups. Dimensionality was evaluated using exploratory factor analyses. Item response theory (IRT) and differential item functioning (DIF) analyses were used to identify high-quality items which were further evaluated and refined to create the final versions of the VFS-Peds. The VFS-Peds is appropriate for use with children aged 6-17 years and consists of a child self-report scale (VFS-C), parent proxy- (VFS-P), and teacher proxy-report (VFS-T) scales. Exploratory factor analyses of child self-report and teacher proxy data suggested listening-related fatigue was unidimensional in nature. In contrast, parent data suggested a multidimensional construct, comprised of mental (cognitive, social, and emotional) and physical domains. IRT analyses suggested items were of good quality, with high information and good discriminability. DIF analyses revealed the scales provided a stable measure of fatigue regardless of the child’s gender, age, or hearing status. Test information was acceptable over a wide range of fatigue severities and all scales yielded acceptable reliability and validity. This paper describes the development, psychometric evaluation, and validation of the VFS-Peds. Results suggest the VFS-Peds provide a sensitive, reliable, and valid measure of listening-related fatigue in children that may be appropriate for clinical use. Such scales could be used to identify those children most affected by listening-related fatigue; and given their apparent sensitivity, the scales may also be useful for examining the effectiveness of potential interventions targeting listening-related fatigue in children. / Research Development Fund Publication Prize Award winner, Mar 2022.

In recent years, knowledge graphs(KGs) have become essential tools for visualizing concepts and retrieving contextual information. However, constructing KGs for new and specialized domains like Positive Energy Districts (PEDs) presents unique challenges, particularly when dealing with unstructured texts and ambiguous concepts from academic articles. This study focuses on various strategies for constructing and inferring KGs, specifically incorporating entities related to PEDs, such as projects, technologies, organizations, and locations. We utilize visualization techniques and node embedding methods to explore the graph's structure and content and apply filtering techniques and t-SNE plots to extract subgraphs based on specific categories or keywords. One of the key contributions is using the longest path method, which allows us to uncover intricate relationships, interconnectedness between entities, critical paths, and hidden patterns within the graph, providing valuable insights into the most significant connections. Additionally, community detection techniques were employed to identify distinct communities within the graph, providing further understanding of the structural organization and clusters of interconnected nodes with shared themes. The paper also presents a detailed evaluation of a question-answering system based on the KG, where the Universal Sentence Encoder was used to convert text into dense vector representations and calculate cosine similarity to find similar sentences. We assess the system's performance through precision and recall analysis and conduct statistical comparisons of graph embeddings, with Node2Vec outperforming DeepWalk in capturing similarities and connections. For edge prediction, logistic regression, focusing on pairs of neighbours that lack a direct connection, was employed to effectively identify potential connections among nodes within the graph. Additionally, probabilistic edge predictions, threshold analysis, and the significance of individual nodes were discussed. Lastly, the advantages and limitations of using existing KGs(Wikidata and DBpedia) versus constructing new ones specifically for PEDs were investigated. It is evident that further research and data enrichment is necessary to address the scarcity of domain-specific information from existing sources.

Urban neighborhoods that work toward carbon-free, climate-neutral goals, attain apositive energy balance, and aspire for excess renewable energy production aredefined as Positive Energy Districts (PEDs). PEDs are designed to contribute tosustainable urban growth, and it is also true that sustainable urban growth can leadto the creation of PEDs. Essentially, PEDs can be achieved by developing andfollowing sustainable infrastructure and urban planning practices including spatial,transportation, and social planning. As per JPI Urban Europe, the key aspects ofPEDs along with the funding include implementation strategies, stakeholders,climate transition, governance, legal frameworks, as well as technological andsystem innovation. As the name suggests, PED mainly comprises positive energy (energy management)and district (neighborhood) elements. The district aspect encompasses urbanplanning that constitutes strategic planning for sustainability implicationsconsisting of environmental, social, economical, mobility, andtransportation-related factors, all of which involve the users and its people. Thepositive energy aspect of a PED enables local energy production resulting in energyefficiency and potential cost savings for its residents. The thesis examines the performance of urban planning factors with the potential todevelop an existing neighborhood toward a PED. This research study explores theoverall sustainability of a neighborhood in terms of mobility, social, economic, andenvironmental factors. The performance of these factors is measured through KeyPerformance Indicators (KPIs), which measure the attributes of sustainability. Thesecontributing KPIs have been studied on a scale through a case study of HammarbySjöstad (HS) in Stockholm. The perception of stakeholders is collected for evaluatingKPIs. These KPIs have been thoroughly analyzed as designed during the planningstage and post-implementation to evaluate their success. The findings of this thesiscan be employed as guidelines for setting benchmarks and goals for the developmentof PEDs in cities throughout the world.