Magister Chirurgiae Dentium - MChD / Oral ulcers and oral thrush could be indicative of serious illnesses such as oral cancer, HIV and other sexually transmitted infections (STIs), among others. There are many different health care workers that can be approached for advice and/or treatment for oral ulcers and oral thrush (sometimes referred to as mouth sores by patients), including pharmacists. In fact, the mild and intermittent nature of oral ulcers and oral thrush may most likely lead the patient to present to a pharmacist for immediate treatment. In addition, certain aspects of access are exempt at a pharmacy such as long queues and waiting times, the need to make an appointment and the cost for consultation. Thus pharmacies may serve as a reservoir of undetected cases of oral cancer, HIV and other STIs. Aim: To determine how community pharmacists in the Western Cape manage oral ulcers and oral thrush. Objectives: The data set included the prevalence of oral complaints confronted by pharmacists, how they manage oral ulcers, oral thrush and mouth sores, their knowledge about these conditions, and the influence of socio-economic status (SES) and metropolitan location (metro or non-metro) on recognition and management of the lesions. Method: A cross-sectional survey of community pharmacists in the Western Cape was conducted. A random sample of pharmacies was stratified by SES (high and low), and metropolitan location. A structured questionnaire was used to conduct a telephonic interview. The questionnaire was faxed to pharmacists 24 hours prior to the interview. Pharmacists were also telephoned 24 hours prior to the interview, but after the questionnaire was faxed, in order to gain informed consent for participation in the study, and to confirm a convenient time to conduct the interview. Results: Two thirds (63%) of pharmacists managed oral problems nearly everyday, and 30% managed these more than once a week. More pharmacists in high SES (73%) areas managed oral problems nearly everyday (Fisher Exact, p=0.0005). Just over half (56%) and 49.2% of pharmacists said that ulcers and thrush, respectively, was the most common oral problem that they encounter. The prevalence of oral thrush was significantly higher in non-metro areas (58%) (RR=0.7 (0.5-1.0) ChiSquared=4.0, p=0.04), and it was also significantly lower in low SES areas (RR=1.6 (1.1-2.4), Chi Squared=6.5, p=0.01). Half the pharmacists reported that they would manage the patient comprehensively. Most would take a history but the quality of the history is poor, thereby compromising their ability to manage these cases appropriately. Only a third would refer a simple oral ulcer, thrush or mouth sore to a doctor/dentist but all pharmacists would have referred a longstanding ulcer to a doctor/dentist. In terms of knowledge, only 33% of pharmacists were aware that oral ulcers and thrush could be indicative of HIV infection, and only 8% linked oral ulcers with oral cancer. There was no discernable pattern of management of oral ulcers and thrush, or of knowledge of the link between these lesions with underlying diseases, by SES and metropolitan locations (Chi Squared, Fisher Exact, p>0.05). Conclusion: The result of this study strengthens the current view of pharmacists as oral health advisors as they encounter oral problems regularly, most commonly oral ulcers and oral thrush. Therefore, the pharmacist can play an important role in the early detection of HIV and oral cancer. However many pharmacists fail to refer these cases to a dentist. Most pharmacists lacked specific knowledge about the relationship of oral ulcers and thrush with underlying conditions, which may explain why many pharmacists are not managing these cases correctly. There is a definite need to train pharmacists at both an under- and post-graduate level with specific emphasis on the proper management of oral ulcers, oral thrush and mouth sores, as well as comprehensive training that outlines why vigilant management of oral ulcers and oral thrush is necessary. / South Africa

No description available.

Amongst the diversity of taxa that occur in the Neotropics, 200 migratory bird species that breed in temperate North America can be found. Many of these populations have seen significant declines since the 1960s. The Wood Thrush, Hylocichla mustelina, is one such species. Shade coffee and other agroforestry practices show potential for benefiting migratory species, but the quality of coffee habitat and optimal habitat characteristics for Wood Thrushes remain unknown. I surveyed a spatially complex, agricultural landscape in Honduras outside the recognized winter range of the Wood Thrush and radio-tagged 46 individuals within rustic coffee farms during the winters of 2012 and 2013. I used telemetry data to calculate metrics of habitat quality based on survival and persistence while also collecting detailed vegetation measurements across the landscape and within each home-range. Mixed-effects models were used to explore the relationship of survival, transience, movement, and home-range size to habitat class and microhabitat variables. Estimates for all four habitat quality metrics fell within the range of previous studies and were significantly related to habitat attributes. Structure, edge habitat, and shade coffee played a key role determining habitat quality. The variables associated with higher habitat quality in this study suggest that rustic coffee farms have potential to support wintering wood thrush populations. However, estimates of survival may be overly optimistic in the presence of transients, transforming highly fragmented landscapes into winter sinks. This study highlights several gaps in current scientific knowledge about some of the most essential questions of Wood Thrush winter ecology.

No description available.

Birds are a major pest in vineyards both in New Zealand and overseas. There is a need for new behavioural research on birds' foraging habits and feeding preferences in vineyards, as much of the literature to date is anecdotal. Research on cues to birds' feeding will provide a basis on which new deterrent and control strategies can be devised. Spatial-and temporal bird damage in a small vineyard block was mapped to find if damage was correlated with grape maturity and environmental factors. Vineyard and field observations of bird behaviour using video technology combined with preference experiments aimed to establish the relative roles of grape sugar concentration and colour in avian selection. Proximity of vineyards to bird roosts affects damage levels, regardless of differing maturity between locations. The rate of damage tends to increase exponentially once grape maturity has passed a threshold of 13 °Brix. Bunches positioned closest to the ground receive more damage if blackbirds or song thrushes are the predominant pests. Both sugar concentration and grape colour were found to affect birds' feeding preference, but the importance of the two factors varied between years. Black and green grape varieties were differentially preferred by blackbirds (Turdus merula) and song thrushes (Turdus philomelos) while silvereyes (Zosterops lateralis) appeared to have no strong colour preference. It was apparent that there were other, not assessed, grape factors that also affect selection. In small unprotected vineyards that are adjacent to bird roosts the entire grape crop can be taken by bird pests. Besides removing the roosts, which can be beneficial shelterbelts in regions exposed to high winds, growers currently may have no alternative other than to use exclusion netting to keep crops intact. The differential preferences between bird species for variety characteristics suggest that any new deterrents and other strategies to deflect birds from grape crops may need to be species-specific.

On t.p.: Degree MSc Dental Science (Community Dentistry) / Thesis (MSc)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: The purpose of this review was to investigate the management of oral candidiasis in HIV/AIDS patients and to evaluate the different guidelines that are available for its management. To achieve this aim, three objectives were identified: (i) to identify and report on the different interventions used to manage oral candidiasis, in patients with HIV/AIDS, (ii) to determine the efficacy of these interventions, and (iii) to provide guidelines for management. A thorough systematic search of the literature was carried out and all relevant papers were graded into three levels of evidence (A, B, and C) and scored for quality according to set criteria. A number of topical and systemic antifungal medications are used to treat oral candidiasis in HIV-positive patients. These include the poleyne antibiotics, nystatin and amphotericin B. Milder episodes of oral candidiasis respond to topical therapy with nystatin, clotrimazole troches or oral ketoconazole. Fluconazole has been extensively evaluated as a treatment for candidiasis. With HIV-infection, a cure rate of 82% has been achieved with a daily oral dose of 50 mg. Fluconazole was found to be a better choice of treatment for relapsing oropharyngeal candidiasis, resulting in either better cure rates or better prevention of relapse. Intravenous amphotericin B has been found to be effective therapy in azole refractory candidiasis where it was shown to be safe and well tolerated. Topical therapies were found to be effective treatment for uncomplicated oropharyngeal candidiasis, however patients relapsed more quickly than those treated with oral systemic antifungal therapy. Overall, nystatin appears less effective than clotrimazole and the azoles in the treatment of oropharyngeal candidiasis. With regard to the resolution of clinical symptoms, clotrimazole was found to be just as effective as the azoles, except when patient compliance was poor. Fluconazole-treated patients were more likely to remain disease-free during the fluconazole follow-up period than with those treated with other interventions. Relatively few studies were qualified to address the provision of guidelines for the management of oral candidiasis in primary health care settings. Most of the studies found were of moderate and low quality level of evidence. These studies included the assessment of different guidelines for identification, treatment and dental needs. They stressed that patients with HN need dentists who will act as primary health care providers, together with other providers to ensure adequate overall care. Given the level of interest and importance of candidiasis associated with treatment of HN -positive patients, it is surprising to find that little high quality research has been undertaken. As such, it is hoped that this review would provide researchers, oral health care workers and other health care providers with an overview of the management of oral candidiasis associated with HN/AIDS. / AFRIKAANSE OPSOMMING: Die doelstelling van die oorsig was om ondersoek in te stel na die hantering van orale kandidiase in HIV/AIDS pasiënte asook om die verskillende beskikbare riglyne vir die behandeling daarvan te evalueer. Ter verwesenliking van hierdie doelstelling is drie doelwitte geïdentifiseer: (i) om die intervensies wat gebruik word in die hantering van orale kandidiase behandeling te identifiseer, (ii) om die effektiwiteit van hierdie intervensies te identifiseer en (iii) om op grond hiervan riglyne vir die hantering voor te stel. 'n Sistematiese literatuursoektog is uitgevoer en alle relevante artikels is in drie groepe geklassifiseer (A, B en C) op grond van die data kwaliteit. 'n Verskeidenheid topikale en sistemiese antifungale middels word gebruik om orale kandidiase in HIV-positiewe pasiënte te behandel. 'n Sukseskoers van 82% is met die gebruik van 'n daaglikse dosis van 50 mg medikament gerapporteer. Fluconazole was die beter keuse van middel vir die behandeling van terugkerende orofaringeale kandidiase. Topikale behandeling was effektief in die behandeling van ongekompliseerde orofaringeale kandidiase, hoewel die kans op terugkeer van die toestand groter was as met die sistemiese middels. Pasiënte wat met flukonasool behandel is, het 'n groter kans gehad om siektevry te bly vergeleke met pasiënte op die ander intervensies. Meeste van die studies was van middelmatige tot lae kwaliteit en gevolglik was dit moeilik om behandelingsriglyne te stel. Wat egter wel duidelik is, is dat HIV pasiënte primêre mondsorg benodig wat saam met ander versorging omvattende sorg sal verseker.

The purpose of the study was to identify factors associated with the HIV transmission rate in 18 to 24 month-old children enrolled in the PMTCT programme at two selected City of Tshwane clinics. Mother-to-child transmission of HIV during labour and breastfeeding accounts for 40% of all HIV infection in children. The prevention of mother-to-child transmission of HIV programme is one effective strategy to reduce the rate of HIV infection in children. The HIV transmission rate was low at six weeks of age but increases at 18 to 24 months of age due to several factors. The researcher selected a descriptive retrospective correlational research design. A structured questionnaire was used to collect data from 60 mothers of children aged 18 to 24 months on the PMTCT programme and a data-collection form to collect data from 152 clinic records of children of the same age on the programme. The study found that the PMTCT guidelines were not properly adhered to by the nurses and the respondents. Prophylactic treatment was not provided as required and mixed feeding was prominent. The uptake of HIV test at 18 to 24 months was low compared to at 6 weeks. The transmission rate was high at 18 to 24 months compared to at 6 weeks. No factors were associated with the transmission rate / Health Studies / M.A. (Public Health)

MSc (Microbiology) / Department of Microbiology

The purpose of the study was to identify factors associated with the HIV transmission rate in 18 to 24 month-old children enrolled in the PMTCT programme at two selected City of Tshwane clinics. Mother-to-child transmission of HIV during labour and breastfeeding accounts for 40% of all HIV infection in children. The prevention of mother-to-child transmission of HIV programme is one effective strategy to reduce the rate of HIV infection in children. The HIV transmission rate was low at six weeks of age but increases at 18 to 24 months of age due to several factors. The researcher selected a descriptive retrospective correlational research design. A structured questionnaire was used to collect data from 60 mothers of children aged 18 to 24 months on the PMTCT programme and a data-collection form to collect data from 152 clinic records of children of the same age on the programme. The study found that the PMTCT guidelines were not properly adhered to by the nurses and the respondents. Prophylactic treatment was not provided as required and mixed feeding was prominent. The uptake of HIV test at 18 to 24 months was low compared to at 6 weeks. The transmission rate was high at 18 to 24 months compared to at 6 weeks. No factors were associated with the transmission rate / Health Studies / M.A. (Public Health)