Department of anaessthesia
School of Child and Adolescent Health
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School of Child and Adolescent HealthResearch Report 2006Director: Professor George Swingler SCHOOL OF CHILD AND ADOLESCENT HEALTH DIVISION OF ASSOCIATED PAEDIATRIC DISCIPLINES Head of Division: Dr Brenda Morrow Divisional Profile The Division of Associated Paediatric Disciplines is multi-disciplinary, including all the paediatric therapy professions of Physiotherapy, Occupational Therapy, Dietetics/Nutrition, Speech Therapy, Audiology and Social Work. The Division undertakes undergraduate and postgraduate teaching and training in all aspects of paediatric care, both acute and chronic. The Division is active in conducting research in Paediatric fields, often collaborating with members of other Divisions. Divisional Statistics Students
Permanent and long-term contract staff (PGWC)
Research Fields and Staff C. Brown Social work; paediatric end of life issues F. Camroodien-Sûrve Speech therapy; early communication intervention A. Ellis Speech therapy; augmentative and alternative communication L. Marino Dietetics; development of paediatric nutrition risk screening tool with special reference to the anti-retroviral programme B. Morrow Physiotherapy; endotracheal suctioning; lung recruitment; aetiology of pneumonia in PICU; ventilator associated pneumonia; constraint-induced movement therapy. V. Norman Speech therapy; paediatric tracheotomies in early communication intervention; paediatric dysphagia A. Parbhoo Physiotherapy; paediatric burns rehabilitation S. Rahim Physiotherapy; physiotherapy in paediatric haemophilia; ventilator associated pneumonia Contact Details Postal Address: School of Child and Adolescent Health, Red Cross Children’s Hospital, Klipfontein Road, Rondebosch, 7700 Telephone: +27 21 658 5111 Fax: +27 21 689 1287 E-mail: bmorrow@ich.uct.ac.za Web: http://web.uct.ac.za/depts/ich SCHOOL OF CHILD AND ADOLESCENT HEALTH DIVISION OF CHILD AND ADOLESCENT PSYCHIATRY Head of Division: Professor Alan Flisher Divisional Profile The clinical services associated with the Division of Child and Adolescent Psychiatry are offered in the following units: Adolescent Outpatient Unit; Adolescent Day Unit; Child Outpatient Unit; Consultation-Liaison Unit; Outreach Unit: Parent-infant Mental Health Service; Therapeutic Learning Centre; and Training Unit. Training is provided for psychiatric registrars and clinical psychology interns. In addition, the Division offers a two-year M. Phil. (Child and Adolescent Psychiatry) degree, which leads to registration as a sub-specialist in Child and Adolescent Psychiatry with the Health Professions Council of SA. In addition, staff members in the Division are supervising about 12 candidates for masters’ or doctoral degrees. Research interests of Division staff include adolescent and infant mental health, suicidality, mental health services research and behavioural manifestations of HIV infection. An interdepartmental Adolescent Health Research Institute (AHRI) has been established in the Schools of Adult Clinical Medicine, Child and Adolescent Health, and Public Health and Family Medicine (Director: Professor Alan Flisher). Members of the Division are involved in two cluster randomized control trials of school-based HIV prevention programmes and have recently completed a research-based set of guidelines for the development of child and adolescent mental health policy and plans under contract for the World Health Organisation. Divisional Statistics Permanent and long-term contract staff
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*MBChB students rotate through the Division Research Fields and Staff Alan J. Flisher Professor; adolescent risk behaviour, adolescent suicidality, mental health services research, school-based interventions Brian Robertson Emeritus Professor; child and adolescent psychiatric epidemiology; impact of violence on children; development of community mental health services; integration of mental health services at primary care level; youthful perpetrators of violent crime; cultural psychiatry and indigenous healers Rod Anderson Senior Lecturer; analytic psychotherapy Astrid Berg Senior Lecturer; analytic psychotherapy; infant mental health; culture and mental health Willem de Jager Senior Lecturer; inpatient child psychiatry; group therapy; organisational dynamics Mona Roper Senior Lecturer; parenting practises, community-based interventions Nic Shortall Senior Lecturer; mental health services research Rene Nassen Lecturer; paediatric consultation-liaison psychiatry; pervasive developmental disorders; behavioural manifestations of HIV infection Marian Campbell the relationship between developmental and attachment theories and theory of mind leading to the ability in children and adolescents to symbolize and develop reflective functions. Contact Details Postal Address: Division of Child and Adolescent Psychiatry, School of Child and Adolescent Health, Red Cross Children’s Hospital, 46 Sawkins Road, Mowbray, 7700 Telephone: +27 21 685 4103 Fax: +27 21 685 4107 E-mail: alan@rmh.uct.ac.za Web: http://web.uct.ac.za/depts/ich
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Research Fields and Staff C. Adnams Fetal alcohol spectrum disorder: neuropsychology, behaviour and interventions; early detection and intervention in developmental disability; neurobehavioural and cognitive outcomes of children with other developmental disabilities including HIV and neurofibromatosis J. Wilmshurst Spinal muscular atrophy; limb girdle muscular dystrophy; peripheral neuropathies; congenital myopathies; complex epilepsies in childhood; role of video telemetry in paediatric neurology practice; neurofibromatosis; paediatric spinal pathologies; neuroradiological diagnostic and prognostic indicators of TBM, neurological manifestations of HIV; rare neuromuscular disorders; psychological impact of epilepsy surgery; ketogenic diet in epilepsy G. Fieggen Stereotaxis (development of the Cape Town Stereotactic Pointer [CTSP] and a Neuronavigation system [SIIGNS]); functional disorders (surgery for spasticity/ epilepsy surgery program); congenital abnormalities including spinal dysraphism (tethered spinal cord); neuro-oncology (craniopharyngioma, ependymoma); neuro-endoscopy A. Ndondo Hydatid disease of the spine; epilepsies in childhood; the role of neuromuscular biopsies in childhood; the ketogenic diet in the African context; Rett syndrome; optimal management of refractory status; non-polio enterovirus infections
Phenotype, neuroimaging and neurocognitive characteristics of children with neurofibromatosis type 1; DAX1 mutation A. Figaji Traumatic Brain Injury (pathophysiology and critical care management; decompressive craniectomy); cerebral haemodynamics; hydrocephalus; neuroendoscopy; tuberculous meningitis G. Riordan Mitochondrial disease; ADHD K. Walker Sydenham's chorea; post streptococcal movement disorders B. Schlegel Tuberous sclerosis P. Springer Management and outcome in tuberculous meningitis; neurodevelopment in children with HIV/Aids (with Stellenbosch University) F. van Bever Donker Botulinum therapy in cerebral palsy R. Govender Acquired demyelinating disorders; specific neurological complications of HIV-1 infection; amyoplasia of the cervical cord M. Richards Congenital myasthenia gravis; head injuries in childhood K. Donald Gillespie syndrome; molecular genetics of Duchenne Muscular Dystrophy in South Africa L. Jeavon Use of melatonin for sleep EEG studies Contact Details Postal Address: Division of Child Development and Neurosciences, School of Child and Adolescent Health, Rondebosch Mowbray Hospital (RMH), 46 Sawkins Rd, Rondebosch, 7700 Telephone: +27 21 685 4103 Fax: +27 21 689 5403 E-mail: colleen@rmh.uct.ac.za Web: http://web.uct.ac.za/depts/ich
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Research Fields and Staff M. Hendricks Development of paediatric food-based dietary guidelines in South Africa; Vitamin A supplementation at primary health care clinics in the Western Cape; evaluation of tactile stimulation in infants born to HIV-infected mothers; management of children with severe malnutrition; review of nutrition policies and programmes in South Africa; human rights and nutrition. G. Hussey BCG vaccine efficacy in infancy and identifying correlates of immune protection; safety and immunogenicity of Hexavac in infants; natural history of TB and HIV infection in children and defining the optimal duration of therapy; efficacy of Lactobacillus in the treatment of diarrhoeal disease; interaction between nutrition, immunity and HIV infection V. Ramanjam Clinical and neurocognitive characteristics of children with neurofibromatosis type 2 M. Richardson Outcome of head injury in children R. Petersen An audit of the management of children with severe malnutrition C. Adnams Fetal alcohol spectrum disorder: neuropsychology, behaviour and interventions; early detection and intervention in developmental disability; neurobehavioural and cognitive outcomes of children with developmental disabilities including HIV and neurofibromatosis. J. Shea Health promotion and education D. Stupar (University of Oslo, Norway) Human rights and nutrition Contact Details Postal Address: Child Health Unit, Children’s Centre, School of Child and Adolescent Health, University of Cape Town, 46 Sawkins Road, Rondebosch, 7700 Telephone: +27 21 685 4103 Fax: +27 21 689 5403 E-mail: colleen@rmh.uct.ac.za Web: http://web.uct.ac.za/depts
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Research Fields and Staff Kashifa Abrahams Child health policy; child disability Lizette Berry Child socio-economic rights indicators; child poverty Mira Dutshcke Child rights; legislative review; law reform Katharine Hall Child poverty; socio-economic rights Annie Leatt Child poverty; child socio-economic rights indicators; social security for children Tasneem Matthews Child health services; firearm injuries and fatalities among children Helen Meintjes Children & HIV/AIDS; social policy; child participation, media Double-Hugh Marera Child poverty; Child socio-economic rights indicators; Survey data analysis Namhla Mniki Children affected by HIV/AIDS; child participation Sue Moses Residential care for children; children and HIV/AIDS; child participation Wanjirŭ Mŭkoma Children & HIV/AIDS policies & interventions Paula Proudlock Child rights; legislative review; law reform; socio-economic rights for children Norma Rudolph Child rights, action research & appreciative inquiry, education, HIV/AIDS and children, evaluation Solange Rosa Child rights; legislative review; law reform; socio-economic rights for children Prinslean Mahery Child rights: socio economic rights; children’s right to health care services, legislative review; law reform Maylene Shung-King Child health services and policies Contact Details Postal Address: Children’s Institute, Children’s Centre, University of Cape Town, 46 Sawkins Road, Rondebosch, 7700 Telephone: +27 21 689 5404 Fax: +27 21 689 8330/1287 E-mail: info@ci.org.za Web: www.ci.org.za
training in general paediatric, surgical, and cardiac intensive care, with 6 rotating registrars and 1-3 sub-specialist paediatric critical care trainees. Staff affiliated from other Departments, including Clinical Technology, Physiotherapy, Psychiatry, and Primary Health Care, are co-workers in research fields of joint interest.
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Research Fields and Staff Andrew Argent Respiratory mechanics in croup; respiratory mechanics and endotracheal suctioning; care practices and inter-personal relationships in ICU; quality of care and mortality risk scoring Shamiel Salie Infection in the PICU Brenda Morrow Broncho-alveolar lavage; endotracheal tube suctioning; human metapneumovirus Infection; ventilator associated pneumonia in paediatrics
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Research Fields and Staff John Lawrenson Myocarditis and cardiomyopathy – a retrospective review of patients admitted to Red Cross Hospital since 1989; rheumatic fever in South African children; Thoracopagus conjoined twins
22q deletion; genetic associations with cardiac disease in children Steve Shipton Myocarditis and cardiomyopathy; surgical management of patients with a single ventricle; rheumatic fever in South African children
Resource allocation and cardiovascular disease; Trisomy 21 and cardiovascular disease; surgical management of patients with a single ventricle
Postal Address: Division of Critical Care and Children’s Heart Disease, School of Child and Adolescent Health, University of Cape Town, Red Cross Children’s Hospital, Klipfontein Road, Rondebosch, 7700 Telephone: +27 21 658 5242/5103/5113 Fax: +27 21 689 1287 E-mail: aargent@ich.uct.ac.za Web: http://web.uct.ac.za/depts/ich SCHOOL OF CHILD AND ADOLESCENT HEALTH DIVISION OF NEONATAL MEDICINE Head of Division: Prof Clarissa H. Pieper Divisional Profile The Division of Neonatal Medicine provides care to 34 000 infants annually at Groote Schuur Hospital (GSH), Mowbray Maternity Hospital (MMH) and New Somerset Hospital (NSH) and 6 Midwife Obstetric Units in the Peninsula Maternal and Neonatal Service. All three hospitals have neonatal intensive care units and provide all levels of care while only level I care is offered at the MOUs. While GSH cares for infants born in the tertiary maternal unit, Retreat and the quatrinary services needed in the Peninsula, MMH and NSH care for most infants born to mothers needing level II care as well as most infants referred from the MOUs. The clinical follow-up and developmental assessment of infants cared for in hospital is done at the MOUs. In this way the PMNS continues to provide all three levels of neonatal care in an integrated fashion (a true seamless service). This is a very efficient, cost effective and extensively evaluated model of health care, which must not be fragmented but be protected at all costs. The Comprehensive Heath Care plan has underlined the severe shortage of staff in this service. The value of midwives and neonatal nurses as highly trained professionals must be respected and guarded. Lack of appropriate remuneration and promotions have led to ever reducing numbers of neonatally trained nurses and this continues to threaten the future of the PMNS. This is of great concern as the principles of the PMNS should be extended into a Perinatal service throughout the whole Province. Research has concentrated on the early recognition, management and follow-up of infants exposed to intra-partum hypoxia, infection risks and respiratory distress. Divisional Statistics Permanent and long-term contract staff
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Research Fields and Staff Clarissa Pieper Neonatal epidemiology; infection control; neonatal outcomes David Woods Perinatal distance education; wind up monitoring technology Geoff Moller Neonatal jaundice Lucy Linley Kangaroo mother care; HIE and the effect of head cooling Clare Thomson Follow-up of the high risk infant; HIE and the effect of head cooling Adrie Bekker Feeding of the neonate, Fetal Abnormality Group Max Kroon Mother-to-child transmission of HIV Alan Horn HIE and the effect of head cooling; cerebral function monitoring, Surfactant treatment therapeutic protocols Natasha Rhoda Therapeutic options for third world countries, outreach Tharina van Heerden Perinatal audit; Kangaroo mother care Anika (Niki) van Niekerk Neonatal cardiology Marc Richards Developmental medicine Contact Details Division of Paediatric Neonatal Medicine, School of Child and Adolescent Health, University of Cape Town, H 46-63 OMB, Groote Schuur Hospital, Observatory, 7528 Telephone: +27 21 404 6025 Fax: +27 21 447 1660 E-mail: cpieper@uctgsh1.uct.ac.za Web: http://web.uct.ac.za/depts SCHOOL OF CHILD AND ADOLESCENT HEALTH DIVISION OF PAEDIATRIC ANAESTHESIA Head of Division: Professor Jenny Thomas Divisional Profile The Division of Paediatric Anaesthesia, a division of the Department of Anaesthetics (UCT) and SCAH, is responsible for the provision of anaesthesia for all children and neonates undergoing surgery or investigative procedures, provision of acute and chronic pain management in children and to assist in intensive care. The Unit is jointly managed by Principal Specialist, Dr A. Butt and assisted by two senior specialists, Drs Thomas and Ing. Professor Bösenberg, the 2nd Chair in Anaesthesia at UCT, is the Departmental representative for SCAH. He also manages the Departmental staffing portfolio and provides clinical assistance together with three rotating specialists. We are fortunate to have a good relationship with private sector who provide sessional back-up for an understaffed department. The department has no secretarial support and therefore no permanent office, telephone or fax. In addition to training and teaching of postgraduate and undergraduate students members of the department have lectured both nationally and internationally. They have also been involved with training and teaching in other disciplines; lecture general practitioners, pharmacists, emergency medicine students, paramedics, APLS instructors and Palliative care personnel. Divisional Statistics Permanent and long-term contract staff
Research Fields and Staff Adrian Bösenberg Regional anaesthesia (RA) in neonates and children: use of ultrasound in RA; postoperative pain management; difficult airway: bronchoscopic findings in oesophageal atresia; muscle disease and anaesthesia including MH, anaesthesia in children with syndromes and metabolic disorders; anaesthesia audit Jenny Thomas Pain management in general but particular in children with burns; HIV; drug interactions in HIV pain management (HAART, TB statics, analgesics) Tony Butt Fluid management; epidural analgesia Contact Details Postal Address: Division of Paediatric Anaesthesia, School of Child and Adolescent Health, University of Cape Town, Red Cross Children’s Hospital, Klipfontein Road, Rondebosch, 7700 Telephone: +27 21 658 5003 Fax: +27 21 447 5206 E-mail: bosie@cormack.uct.ac.za Web: http://web.uct.ac.za/depts/ich SCHOOL OF CHILD AND ADOLESCENT HEALTH DIVISION OF PAEDIATRIC MEDICINE Head of Division: Professor G. Swingler Divisional Profile Paediatric Medicine is one of the largest divisions in the School of Child and Adolescent Health. It accommodates the substantial field of general paediatrics as well as the paediatric medical subspecialties with the exceptions of critical care, cardiology, neonatology, neurosciences and developmental paediatrics. The Division has extensive clinical responsibilities located at the Red Cross War Memorial Children’s Hospital, Groote Schuur Hospital, Somerset Hospital, and Victoria Hospital. As well as providing clinical services these venues provide the major teaching sites for undergraduate and postgraduate training in Paediatrics and Child Health. The clinical scope of the division is broad and the research interests of its members are diverse. The leading child health problems of our society are well represented, particularly infectious diseases. Divisional Statistics Permanent and long-term contract staff
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Research Fields and Staff D.W. Beatty Primary immune deficiency disorders; tuberculosis in childhood; paediatric infectious disease
Paediatric HIV/AIDS, paediatric infectious diseases H. Buys Ambulatory, emergency and outreach care; paediatric HIV disease and nutrition; diarrhoeal disease A. Davidson Management of HIV-associated malignancy; Wilms tumour management; the role of minimal residual disease in ALL risk stratification; outpatient management of febrile neutropaenia S. Delport Paediatric endocrinology; advance diabetes F. Desai Paediatric oncology R. Diedericks Respiratory disease; pulmonology; clinical diagnostic issues in tuberculosis; diagnosis of pertussis in infants B.S. Eley Primary immune deficiency disorders; paediatric tuberculosis; paediatric HIV/AIDS; paediatric infectious disease
Cystinosis; bladder incontinence E. Goddard Paediatric liver disease; transplantation in children; immunology; paediatric infectious disease; paediatric gastroenterology and nutrition P. Hartley All aspects of paediatric oncology L. Henley Ethics affecting children; HIV/AIDS; chronic disorders in children adolescent medicine J. Ireland Diarroheal disease in children; paediatric liver disease; cystic fibrosis M. Levin Epidemiology of asthma and allergies in Xhosa school children; efficacy of a metered dose inhaler with bottle spacer for bronchodilator therapy in acute lower airways obstruction; methacholine challenge testing in the assessment of bronchial hyper-responsiveness in the field; evaluation of the consumption of peanut-containing foods amongst 4 to 36 month old black South African infants; significance of potato allergy in children with atopic eczema; language as a barrier to care for Xhosa-speaking patients; different use of medical terminology and culture-specific models of disease affecting communication between Xhosa-speaking patients and English-speaking doctors M. Mann Nuclear medicine M. McCulloch Renal disease; paediatric organ transplantation or; paediatric hypertension including Takayasu's Arteritis; acute renal failure and peritoneal dialysis; renal and liver transplantation especially infectious complications; paediatric HIV, nephropathy; adolescent medicine C. Motala Chronic urticaria; cytokine profiles in allergic asthmatic Xhosa children; latex allergy in Spina bifida patients; peanut allergy; measles immunization in egg-allergic children; anaphylaxis; allergy and asthma in pregnancy J. Nuttall Infectious diseases A. Philotheou Paediatric diabetes; adolescent medicine L. Reynolds End of life decision-making; home care of technology dependent children; clinical priority setting M. Richards Traumatic brain injuries; congenital myasthenia syndromes P. Roux Paediatric HIV/AIDS; ethics; palliative care A. Spitaels Paediatric endocrinology, metabolism and diabetes; social circumstances, diabetes control, intersex G. Swingler Systemic literature reviews; clinical epidemiology/evidence-based health care; epidemiology of clinical research; research methods; diagnostic test accuracy; diarrhoeal disease; respiratory infections A.T. Westwood First time seizures in paediatrics; epidemiology of cystic fibrosis in the Western Cape; epidemiology of chronic illness in South Africa; management of faecal loading; health systems for children with long-term health conditions; policy perspectives on children with long-term health conditions; clinical aspects of cystic fibrosis in South Africa H. Zar Paediatric pulmonology in particular childhood pneumonia, HIV-associated lung disease; cotrimoxazole and INH prophylaxis in HIV infected children; P jirovecii pneumonia; sputum induction; low cost spacer devices for children with asthma; epidemiology of childhood asthma Contact Details Postal Address: Division of Paediatric Medicine, School of Child and Adolescent Health, University of Cape Town, Red Cross Children’s Hospital, Rondebosch, 7700 Telephone: +27 21 658 5324 Fax: +27 21 689 1287 E-mail: swingler@ich.uct.ac.za Web: http://web.uct.ac.za/depts/ich SCHOOL OF CHILD AND ADOLESCENT HEALTH DIVISION OF PAEDIATRIC PATHOLOGY Head of Division: Associate Professor Colin C. Sinclair-Smith Divisional Profile The Division of Paediatric Pathology is primarily an NHLS laboratory service unit to Red Cross Children’s Hospital and to paediatric, neonatal and fetal services to other Western Cape Health Care Institutions. The pathology service functions as an amalgum of three sub units comprising: Anatomical Pathology, Chemical Pathology and Haematology. Undergraduate teaching activities are largely undertaken through equivalent disciplines at Groote Schuur Hospital and the Medical School of the University of Cape Town to medical and physiotherapy students. Post-graduate teaching is undertaken to MPhil (Paediatric Pathology), MMed (in all the pathology disciplines), BSc (hons), MSc and PhD students at UCT. Research activities are related to laboratory aspects of child health and molecular mechanisms underlying paediatric disease. This research is undertaken through collaborative projects at a national and international level, and which provides collaborative support to clinical colleagues, mainly in paediatrics and paediatric surgery. Divisional Statistics Permanent and long-term contract staff
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Research Fields and Staff Associate Professor Colin C. Sinclair-Smith Pathology of Muscle; Congenital myopathies; renal neoplasms Professor Ronald O.C. Kaschula Paediatric gastroenterology; infections; nephroblastoma Professor Langley R. Purves Iron protein structure; genetics of diseases Dr Margareth H.G. Shuttleworth Immunophenotyping and cytogenetics of paediatric leukaemia; congenital coagulation disorders; Von Willebrand multimers; paediatric myelodysplastic syndromes; cytogenetics of paediatric lymphomas and neuroblastomas Contact Details Postal Address: Paediatric Pathology, School of Child and Adolescent Health, University of Cape Town, Red Cross Children’s Hospital, Klipfontein Rd, Rondebosch, 7700 Telephone: +27 21 658 5208/49 Fax: +27 21 658 5249 or 689 1287 E-mail: cs-smith@ich.uct.ac.za Web: http://web.uct.ac.za/depts/ich/
Students
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