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Sanele Buthelezi,1,2 Berna Gerber3 1Department of Optometry, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa; 2Department of Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 3Division of Speech-Language and Hearing Therapy, Faculty of Medicine and Health Sciences, Cape Town, South AfricaCorrespondence: Sanele Buthelezi, Department of Optometry, Faculty of Health Sciences, University of Johannesburg, P.O Box 17077, Doornfontein, Johannesburg, 2028, South Africa, Tel +27 11 559 6387, Email saneleb@uj.ac.zaPurpose: Understanding and acknowledging cultural diversity in healthcare is essential in providing culturally competent care. Higher education institutions are critical to providing students with the necessary knowledge, attitudes, and skills to respond to cultural diversity in various contexts. Cultural competence teaching in ophthalmic dispensing education has emerged as an essential concept that needs to be included in the curriculum. This study explored ophthalmic dispensing lecturers’ understandings, experiences, and attitudes in teaching cultural competence.Methods: This study used a qualitative approach within an interpretivist paradigm by conducting semi-structured interviews with lecturers (n = 7) in the ophthalmic dispensing program. Braun and Clarke’s framework for thematic analysis was utilized. The research was conducted at an ophthalmic dispensing department at a South African university.Results: The analysis of the semi-structured interviews indicated three main themes of importance regarding factors influencing cultural competence education in the ophthalmic dispensing curriculum: the interplay between experiences and understandings of cultural competence, cross-cultural exposure and teaching practices, and inclusion of cultural competence into the curriculum. The participants recognized that cultural competence was not explicitly included in the curriculum. Including culture in education was rather unsystematic and, in most cases, unplanned.Conclusion: Further training of lecturers on cultural competence skills and evidence-based teaching and assessment strategies are required to assist in developing curricula that include cultural competence.Keywords: ophthalmic education, cross-cultural exposure, cultural competence, ophthalmic dispensing teachers, South Africa

The proliferation of forest edges and invasive predators have been identified as two primary threats to carnivore populations globally. These threats often occur in unison, facilitated by anthropogenic activities (e.g., fragmentation), and together may pose a greater influence than when they occur separately. Targeted conservation actions for forest carnivores, including Madagascar carnivores, have been hindered by a failure to understand the relative contributions of these factors in driving species declines. To fill this gap, we conducted an extensive camera survey along the edge of intact, continuous protected rainforests in eastern Madagascar to evaluate the extent invasive predators and forest edge separately and in combination affect native carnivore space use. We hypothesized that structural vegetation changes at the forest edge interact with invasive predator trap success and occurrence to reduce native carnivore space use near the forest edge and separately have less influence than when combined. In contrast to findings in fragmented and degraded forests of Madagascar, we found hard forest edge and invasive predators alone do not indiscriminately reduce native carnivore space use in continuous intact forest. Instead, we found free‐roaming dogs and cats interact with their surrounding environment (i.e., forest edge) in unique ways that shape species response differently than within interior forest. At the forest edge, vegetational changes of increasing shrub cover and the occurrence of dogs reduce space use of three of four native carnivores. However, we found greater effects of proximity to villages, especially with high invasive predator activity (free‐roaming cats). Ultimately, native carnivores showed variable sensitivities to pressures we examined, providing support for species‐specific management actions to maximize conservation outcomes. We encourage future studies to consider evaluating the magnitude of separate and combined threats to carnivores. In doing so, conservationists can better identify when threats can be managed in isolation and when they require simultaneous mitigation. [ABSTRACT FROM AUTHOR]

Lesley Jean Burgess,1,2 Berna Gerber,3 Kathleen Coetzee,1 Marli Terblanche,1 Gareth Agar,1 Theunis JvW Kotze21TREAD Research CC, Cardiology Unit, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Parow, South Africa; 2University of Liverpool/Laureate Online Education, Liverpool, UK; 3Division of Speech-Language and Hearing Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University Stellenbosch, South AfricaIntroduction: The informed consent process is a fundamental part of clinical trials and is driven by both a legal and ethical agenda. The process may be seriously compromised if trial participants sign the informed consent document without fully understanding its contents. In developing countries such as South Africa, this concern is important due to the potential vulnerability of these patients and their risk for research exploitation.Aim: To evaluate the understanding of 11 important components and concepts related to clinical research by adult trial participants in a developing country at the time of providing consent for trial participation.Methods: 46 consecutive adult patients who qualified and consented to being enrolled in ongoing cardiovascular risk clinical trials at TREAD Research in the Western Cape, South Africa, were included in this study. After giving informed consent, participants were subjected to both a close-ended (self-report) and an open-ended method (descriptive narrative) to assess their understanding of various components and concepts related to clinical research pertaining to the initial informed consent document. The descriptive narrative was recorded and then later transcribed and assessed by two independent assessors.Results: There was a marked difference between the two methodologies used to assess patient comprehension of the various components. With the exception of concepts voluntariness and right to withdraw, trial participants’ understanding of the informed consent document was poor – especially with regard to the following concepts: randomization, risks, placebo and blinding. Higher levels of comprehension were obtained for the participant self-reports and lower levels for the narrative descriptions.Conclusion: The participant comprehension at this site was poor, and the process for taking informed consent subsequently needs to be modified so as to improve informed consent comprehension.Keywords: clinical trials, informed consent comprehension

Identifying conservation actions to recover threatened species can be challenging due to many ecological uncertainties. For example, major threats to a species’ conservation are commonly known or suspected, but the specific impacts on population or metapopulation dynamics can be uncertain. This is frequently the case with emerging infectious diseases, including chytridiomycosis, a global driver of amphibian population declines caused by the fungal pathogens Batrachochytrium dendrobatidis (Bd) and Batrachochytrium salamandrivorans. While these diseases are known to cause amphibian declines and extirpations, the mechanisms of their landscape-scale spread are still largely unknown. Such uncertainty can lead to inaction which may jeopardize timely recovery of a species. Decision analysis is a pragmatic approach to making transparent and defensible decisions while dealing with uncertainties. We investigated whether optimal actions aimed at recovering boreal toad (Anaxyrus boreas boreas) metapopulations in the southern Rocky Mountains are robust to the unknown dynamics of Bd spread using value of information and regret analyses. Value of information is a decision-analytic tool for calculating the value of new information in terms of performance on management objectives, while regret measures the cost of acting under incorrect information. We further conducted a stochastic sensitivity analysis to identify the relative effects of metapopulation parameters on system dynamics. We found optimal actions were robust to the unknown dynamics of Bd spread. While boreal toad breeding occurrence is highly sensitive to Bd distribution, the optimal decision is not. Resolving the unknown dynamics of Bd spread would lead to a minimal gain of less than one breeding toad subpopulation at the end of 50 years, given the currently available management actions. Applying a decision-analytic framework coupled with value of information and regret analyses can help frame how uncertainties affect decisions in a way that empowers decision makers. [ABSTRACT FROM AUTHOR]