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Abstract Background The Paediatric Eosinophilic Oesophagitis Module (PedsQL-EoE) was developed in English as a valid and reliable questionnaire to assess health-related quality of life (HRQoL) in children with EoE. The aim of this study was to evaluate the validity and reliability of the PedsQL-EoE that was previously adapted to Spanish by our group. Methods This cross-sectional multicentre study was conducted in 36 paediatric gastroenterology units. Groups with and without dietary restrictions were studied separately. The PedsQL-EoE consists of 33 items divided into seven factors. Age-specific versions of the PedsQL-EoE were sent by e-mail to children and parents. Statistical analysis was used to study the questionnaire structure by means of exploratory factor analysis and interitem correlations. Confirmatory factor analysis (CFA) was applied to verify the proposed model as well as its psychometric properties through SMSR (standardized root mean square), outer loadings and R-square. To study construct validity and reliability, Cronbach´s alpha coefficient, convergent validity (AVE), discriminant validity (HTMT) and intraclass correlation coefficients (ICC) were used. Results A total of 341 children and 394 parents participated with 307 matched answers. The median age was 12 years, and 75% were male. The questionnaire structure explained 68% and 66% of the total variance for parents and children, respectively. Five items showed negative correlations and were removed from the questionnaire. CFA applied to the new model supported the following construct: SMRS was less than 0.08, outer loadings measured above 0.5, and R2 explained more than 89% of the total variance. Once the modifications were performed, good internal consistency was demonstrated, with Cronbach’s alpha values > 0.7, AVE values > 0.5 and HTMT

Background: Chronic diseases tend to affect the quality of life for older persons worldwide, especially in resource-constrained developing countries. Chronic diseases contribute to a large number of deaths among the population of South Africa. Aim: This study examines the determinants of self-reported chronic disease diagnoses among older persons in South Africa. Setting: The study setting was South Africa. Methods: Cross-sectional data from the 2019 South Africa General Household Survey were analysed (n [weighted] = 4 887 334). We fitted a binary logistic regression model to determine the relationship between socio-demographic factors and being diagnosed with self-reported chronic diseases. Results: We found that at least 5 in 10 older persons were diagnosed with self-reported chronic disease. The bivariate findings showed that age, population group, sex, marital status, level of education, disability status, household composition and province were significantly associated with self-reported chronic disease diagnoses. At the multivariate level, we found that age, sex, population group, marital status, educational level, disability status, household wealth status, household composition and province were key predictors of self-reported chronic disease diagnoses. Conclusion: We found that various factors were key determinants of being diagnosed with self-reported chronic diseases. This study offers important insights into the main correlations between older adults and self-reported chronic illness diagnoses. More study is required on the health of the elderly as it will help direct policy discussions and improve the development of health policies about the elderly. Contribution: This study highlights the need for a better understanding of, and continued research into, the determinants health among older populations to guide future healthcare strategies.

Introduction: A significant number of the South African population still rely on traditional medicines (TM) for their primary healthcare. However, little to no scientific data is available on the effects of most TM products on cytokine and cellular biomarkers of the immune response. We evaluated the impact of a TM [Product Nkabinde (PN)] in inducing cellular and cytokine biomarkers of immune response in peripheral blood mononuclear cells (PBMCs).Methods: PN, a combination of four indigenous South African plants was used in this study. The IC50 was established using the cell viability assay over 24 h. Luminex and flow cytometry assays were used to measure cytokine and cellular levels in PBMCs stimulated with PN and/or PHA over 24, 48, and 72 h, respectively. UPLC-HRMS was used to analyze an ethanol: water extract of PN to better understand the possible active compounds.Results: The IC50 concentration of PN in treated PBMCs was established at 325.3 μg/mL. In the cellular activation assay, the percentages of CD38-HLA-DR + on total CD4+ T cells were significantly increased in PBMCs stimulated with PN compared to unstimulated controls after 24 h (p = 0.008). PN significantly induced the production of anti-inflammatory IL-10 (p = < 0.001); proinflammatory cytokines IL-1α and IL-1β (p = < 0.001), TNF-α (p < 0.0001); and chemokine MIP-1β (p = < 0.001) compared to the unstimulated control after 24 h. At 48 h incubation, the production of proinflammatory cytokines IL-1α (p = 0.003) was significantly induced following treatment with PN, and IL-10 was induced (p = 0.006). Based on the UPLC-HRMS analysis, four daphnane diterpenoids viz., yuanhuacine A (1), gniditrin (2), yuanhuajine (3) and yuanhuacine (4) were identified based on their accurate mass and fragmentation pattern.Conclusion: The results show that PN possesses in vitro immunomodulatory properties that may influence immune and inflammatory responses. This study contributes to scientific knowledge about the immune effects of TM. More studies using PN are needed to further understand key parameters mediating induction, expression, and regulation of the immune response in the context of pathogen-associated infections.

Abstract This paper presents the results of ridge regression analysis of the relationship between government spending in emancipation programmes and multidimensional poverty, focusing on South Africa. Through the Principal Component analysis, we retained three variables of this relationship, affected by a range of factors, to determine the size and direction of the relationship. Besides health, we find no clear evidence that government spending on housing and social security significantly reduces multidimensional poverty. Co-production in housing, healthcare delivery, and social security should be encouraged.

(1) Background: The utilization of medicinal plants in the management of diabetes is of great importance to the health of the indigenous population on the African continent. The high cost of orthodox conventional medicines coupled with the perceived side effects encourages the high patronage of indigenous medicinal plants in the management of this metabolic disorder. We conducted a review on the indigenous African medicinal plants that could be useful in preclinical and clinical trials in the field of diabetes mellitus research. (2) Methods: Data were mined from research articles published and associated with the use of medicinal plants in the management of diabetes on the African continent (from January 2019 to March 2024). Literature from ethnobotanical studies on the African continent was searched from the Google Scholar, SCOPUS, Medline, Web of Science and PubMed databases. We employed the following keywords: “indigenous plants”, “diabetes in Africa” and “antidiabetic effect of medicinal plants”. (3) Results: A total of 52 medicinal plants belonging to 31 families were recorded in this study. Amaryllidaceae (14.28%), Fabaceae (9.52%) and Asteraceae (9.52%) were the most cited plant families. The frequently used indigenous medicinal plants on the African continent were Allium sativum L. (n = 6), Olea europaea L. (n = 6), Azadirachta indica A. Juss (n = 5), Allium cepa L. (n = 5) and Moringa oleifera Lam. (n = 5). The highly cited parts of the plant used in the management of diabetes were the leaves (45.55%), bark (14.44%) and bulbs (12.22%). The preferred methods of the preparation of herbal medicines were decoction (45.23%) and infusion (25%). Oral (52.32%) was the preferred route of the administration of herbal medicine on the African continent. (4) Conclusions: The data revealed some similarities in the way countries on the African continent manage diabetes. This interesting observation will assist in our quest towards obtaining a standardized protocol using indigenous medicinal plants to combat diseases on the African continent.

The treatment and management of diabetes mellitus (DM) with conventional therapies, such as insulin injections and oral hypoglycemic agents, present significant challenges due to their side effects and burdensome administration. Therapies often manage symptoms rather than addressing insulin regulation, akin to medications like thiazolidinediones and glinides, which resemble many medicinal plants. Medicinal plants offer potential alternative treatments due to bioactive compounds targeting diabetes causes. We aimed to explore the antidiabetic potential of two medicinal plants, Psidium guajava and Seriphium plumosum L., by investigating their phytochemical constituents, medicinal uses, pharmacological actions, and mechanisms. This review followed specific guidelines and searched databases including PubMed, Scopus, ScienceDirect, and Web of Science for studies on medicinal plants and DM. Eligible studies underwent quality assessment and were categorized based on their design and interventions for data synthesis. This review identified the phytochemical constituents in Psidium guajava and Seriphium plumosum L., including tannins, flavonoids, phenols, and steroids, exerting antidiabetic effects through various mechanisms like antioxidant activity, anti-inflammatory effects, stimulation of insulin secretion, glucose regulation, and inhibition of carbohydrate-digesting enzymes. Psidium guajava and Seriphium plumosum L. exhibit promising antidiabetic potential, offering alternative approaches to diabetes management. Polyherbalism, combining multiple plant extracts, may enhance therapeutic efficacy in diabetes treatment. Comprehensive research is needed to explore the combined therapeutic effects of these plants and develop more effective antidiabetic treatments. This review highlights the importance of harnessing natural resources to combat the global burden of DM. Further research is warranted to fully explore the combined therapeutic effects of these plants and develop novel treatments.

This paper discussed how to improve the quality of education in rural schools in South Africa by advocating for the inclusion of community-based leaders (CBLs) such as traditional leaders, religious leaders and business leaders in school affairs by principals. The study was premised on the observation that principals lack the competencies and capabilities to share leadership with community-based leaders such as traditional, religious and business leaders. The exclusion of community-based leaders in crucial decision-making processes resulted in poor learner performance. The study was grounded on the assumption that sharing leadership expertise by principals would sustain quality learning and teaching culture in rural schools. The belief is that community-based leaders are the most respected people in their communities and therefore their voices can be heard when it comes to parent participation and combating social ills in schools. The study was conducted purposely in poor-performing rural schools whereby community-based leaders were excluded in school matters. A phenomenological study with an interpretive-constructivism paradigm was conducted to establish sustainable principals’ shared leadership roles for quality education. Data collected through interviews in three schools were thematically analysed and it revealed that: Principals lack competent and capable leadership skills to include community-based leaders in school matters. Also, social ills prevail which affect learning and teaching negatively. Furthermore, community based-leaders were only invited when there was a crisis and once the crisis solved, their input was no longer needed. Thus, the authors recommended that the Department of Basic Education could spend more resources on training rural school principals about the importance of including community-based leaders in crucial decision-making processes to improve and sustain quality education in rural areas. The authors also recommend ZiCBLs Model for the improvement of quality education in rural areas.

Conclusion: The results showed that age, population group, parity, ideal number of children, desire to delay childbearing, exposure to family planning messages/advice, and province were key predictors of women’s intention to use contraception. The findings suggest the need for targeted education initiatives about contraception, particularly among older women. There is also a need to involve community leaders and the local media in sexual and reproductive health campaigns.

Background: Dilating the eye with tropicamide may alter the intraocular pressure (IOP) because of an obstruction of the iridocorneal angle, resulting in decreased aqueous outflow drainage. Also, the repeated application of eyedrops and instrumentation could lead to increased central corneal thickness (CCT), consequently affecting IOP. Aim: This study aimed to determine the effect of 1% tropicamide on CCT and IOP post-mydriasis among the University of Limpopo optometry students. Setting: The data were collected at the optometry clinic of the University of Limpopo. Methods: A within-subject experimental study was conducted on 59 healthy subjects aged 18 years – 28 years. A computer assisted simple random probability sampling was used to identify a sample of participants from the study population (N = 200). Baseline and post-mydriasis IOP (20 min, 30 min, and 45 min intervals) were measured with a Goldmann applanation tonometer. Central corneal thickness and IOP were analysed using means, correlations and paired t-tests. Results: The mean CCT pre-mydriasis was 504.68 μm, and post-dilation was 507.90 μm, 510.08 μm and 509.25 μm at 20 min, 30 min, and 45 min, P = 026, p = 0.033, P = 0.004, respectively. Moreover, the mean IOP pre-mydriasis was 15.97 mmHg, and post-dilation was 16.85 mmHg, 16.46 mmHg and 16.85 mmHg over 20 min, 30 min, and 45 min of followed-up time, p = 0.140, p = 0.432, and p = 0.183, respectively. Conclusion: Measuring IOP post-dilation is still valid; however, CCT should be measured before the instillation of tropicamide. Contribution: This study analysed the effect of 1% tropicamide on CCT and IOP post-mydriasis in a clinical South African context.

The South African education system is currently experiencing various challenges such as school violence, drug abuse, vandalism and burning of school properties. Educationists, administrators, policy custodians and leaders of institutions are in a dilemma regarding effective managerial leadership of their organizations. This article discussed appropriate measures that institutional leaders must develop to ensure an open space for other community leaders to actively participate in the running of institutions. The rationale behind this paper was to come up with solutions that would help school leaders to lead and manage schools effectively and efficiently. A phenomenological study was conducted with an interpretive-constructivism approach in schools to establish the capabilities and competencies of school principals regarding the incorporation of other community leaders in their schools. Data was collected through face-to-face in-depth individual interviews with the School Governing Bodies (SGB) chairpersons, SMT members, LRC representing learners in the SGB, community leaders, religious leaders, and business leaders. Data was thematically analyzed and it revealed that: Principals have failed to open up space for community leaders to participate in school matters; Education leaders lack the competencies and capacities to share leadership with other community leaders. The study thus advocates firstly, for school principals through SGBs to accommodate Community Resource Centres (CRCs). Secondly, highly esteemed leaders from various community stakeholders should be involved in prominent school decision-making processes and problem-solving practices. Thirdly, training workshops should be conducted to help school leaders develop necessary leadership skills and to map out strategies to effectively involve community leaders in school matters. Fourthly, the institutional leaders must organize training workshops for both school and community leaders on how to work collaboratively and peacefully for effective school management. This article adds to the existing literature on enhancing the South African Educational System.

This paper explores the efficiency and potential of indirect freeze crystallization (IFC) as a valuable resource-recovery technology in wastewater treatment, particularly focusing on acid mine water and hazardous material wastewater-treatment plants. Wastewater treatment poses challenges to recovering valuable resources effectively, enforcing the need for sustainable and resource-efficient technologies like freeze crystallization. Through a thorough examination of IFC principles and mechanisms, this paper aims to highlight its applications, advantages, and limitations. The investigation includes a comprehensive literature review and detailed methodology from one of the IFC pilot plants, as well as a critical analysis of the environmental and economic implications of IFC. By addressing scaling challenges in reverse osmosis and proposing an environmentally friendly brine disposal method through IFC, this paper contributes to reducing the environmental footprint associated with wastewater treatment. Additionally, this paper highlights the importance of extracting valuable resources from highly saline water and emphasises the potential economic and environmental benefits of resource recovery, particularly focusing on the promising technology of IFC.

BackgroundAdolescents and young adults with HIV repeatedly demonstrate low rates of antiretroviral therapy (ART) adherence as well as low rates of viral suppression. Digital health interventions are a promising way to engage adolescents and young adults with HIV to support ART adherence. However, few digital health interventions have been developed and tested with adolescents and young adults in countries like South Africa, where the HIV burden among adolescents and young adults is greatest. Masakhane Siphucule Impilo Yethu (MASI; Xhosa for “Let's empower each other and improve our health”) is a comprehensive ART adherence-supporting app for South African adolescents and young adults with HIV. It was culturally adapted using the HealthMpowerment platform. ObjectiveThe aim of this paper is to describe the protocol for a pilot randomized controlled trial examining the feasibility, acceptability, and preliminary efficacy of MASI on self-reported ART adherence and social support. MethodsWe will enroll 50 adolescents and young adults with HIV ages 15-21 years. Participants will be recruited from public ART clinics linked to a large government-funded teaching hospital in Cape Town, South Africa. Participants will be randomized 1:1 into either the intervention arm receiving a full version of MASI or the control arm receiving an information-only version of the app (n=25 per arm). Participants will be asked to engage with MASI daily for 6 months. All participants will complete baseline and follow-up assessments at 3 and 6 months. ResultsStudy screening began in May 2022 and the first participant was enrolled on June 21, 2022. As of June 12, 2023, 81 participants have completed screeners, and 36 eligible participants have been enrolled in the pilot randomized controlled trial. Recruitment is anticipated to last through August 31, 2023, with study activities anticipated through February 29, 2024. ConclusionsThere is an urgent need for innovative interventions to improve ART adherence among adolescents and young adults in settings like South Africa. If found to be feasible and acceptable, MASI could be implemented with adolescents and young adults with HIV in other parts of the country. Trial RegistrationClinicalTrials.gov NCT04661878; https://clinicaltrials.gov/ct2/show/study/NCT04661878 International Registered Report Identifier (IRRID)DERR1-10.2196/47137

Objective: Gastrointestinal parasites (GIPs) negatively impact small ruminant production and pro¬ductivity nationwide, particularly in tropical and sub-tropic regions. Amongst other nematodes, Haemonchus contortus, Trichostrongylus colubriformis, and Teladorsagia circumcincta are the most common species in small ruminants animals. Thus, this study aimed to investigate communal sheep farmer's knowledge and attitudes toward GIPs in the Eastern Cape Province, South Africa. Materials and Methods: A cross-sectional survey was conducted between September and November 2018 from three agro-ecological zones, namely, arid region, semi-humid, and humid. All data from this study were analysed with the Statistical Analysis System. Results: Of the total of 107 farmers who participated in the study, 69% were males, and 38% were females. Most livestock owners (85%) were aged >46 years old across all the study areas. The majority of farmers (83%) perceived that their animals are susceptible to wireworm (H. contortus) during the hot-wet season, followed by the hot-dry season (14%), with relatively low during the cold season (2%). Most farmers (85%) interviewed revealed that lambs are more exposed to para¬sitic infection, than mature sheep (15%) across all agro-ecological zones. An insignificant number of farmers (8%) with knowledge about GIPs life cycle and its biology (92%) across all agro-eco¬logical zones. This study reveals a significant increase in the occurrence of GIPs over the past few years across all agro-ecological, with largely (67%) attributed to the resistance of the strain to deworming remedies and changes in climatic weather patterns (33%). The farming experience was strongly (p < 0.05) associated with the farmer's gender and age. Helminths were reported significantly higher (p < 0.05) in humid zones than in other agro-ecological zones. Conclusions: This study concludes that most farmers perceived lambs as more susceptible to GIPs than old sheep. Therefore, farmers should be enlightened about the infection and transmission dynamics of the GIPs to develop appropriate control measures against worm infection to boost sheep production in the study area. It was also suggested that farmers should adhere to remedial instruction and adopt rotational deworming programs to avoid anthelmintic resistance. [J Adv Vet Anim Res 2022; 9(3.000): 351-358]

BackgroundNovel smartphone app–delivered interventions have the potential to improve HIV treatment adherence among adolescents with HIV, although such interventions are limited. Our team has developed Masakhane Siphucule Impilo Yethu (MASI; Xhosa for “Let's empower each other and improve our health”), a smartphone app–delivered intervention to improve treatment adherence among adolescents with HIV in South Africa. MASI was adapted to the South African cultural context using the HealthMpowerment platform, an evidence-based digital health intervention developed for and with youth in the United States. ObjectiveWe conducted this beta-testing study to (1) explore the initial usability of MASI, (2) examine engagement and experiences using MASI features, and (3) inform refinements to the app and intervention implementation plan prior to a subsequent pilot randomized controlled trial (RCT). MethodsThis study was conducted from August 2021 to December 2021 in Cape Town, South Africa. Beta-testing participants received access to MASI for 3 weeks. A mixed methods approach was used, with brief questionnaires and semistructured in-depth interviews conducted prior to app installation and after 1 week to 2 weeks of app testing. Engagement with MASI was measured through analysis of back-end app paradata, and follow-up in-depth interview guides were tailored to each participant based on their app use. ResultsParticipants in the beta-testing study (6 male participants, 6 female participants; ages 16-19 years) collectively spent 4.3 hours in MASI, averaging 21.4 minutes per participant over the 3-week period (range 1-51.8 minutes). Participants logged into MASI an average of 24.1 (range 10-75) times during the study period. The mean System Usability Scale score was 69.5 (SD 18), which is considered slightly above average for digital health apps. Thematic analysis of qualitative results revealed generally positive experiences across MASI features, although opportunities to refine the app and intervention delivery were identified. ConclusionsInitial usability of MASI was high, and participants described having a generally positive experience across MASI features. Systematically analyzing paradata and using the interview findings to explore participant experiences allowed us to gain richer insights into patterns of participant engagement, enabling our team to further enhance MASI. The results from this study led to a few technological refinements to improve the user experience. Enhancements were also made to the intervention implementation plan in preparation for a pilot RCT. Lessons learned from the conduct of this beta-testing study may inform the development, implementation, and evaluation of similar app-delivered interventions in the future.

Metal halide perovskites are currently making notable strides in the development of next-generation optoelectronic and photovoltaic devices. Prototype lab-based devices have exhibited high efficiencies for photovoltaic applications. However, the high performance cannot be maintained for practically useful lengths of time due to degradation of the perovskite layer on exposure to environmental factors such as moisture, oxygen, and heat. This limits the widespread use of these materials in commercial devices. This review of hybrid perovskite-polymer nanocomposites begins by highlighting the significant structural and optoelectrical properties of metal halide perovskites. The discourse moves on to the elucidation of the deleterious effects of environmental stressors on the movement of charge carriers in photovoltaic devices based on these materials. Various mitigatory measures are then considered, with the narrative eventually narrowing down to perovskite-polymer nanocomposites, where the synergistic combination of the two materials is critically analyzed. The conclusion looks at the challenges and opportunities presented by polymer-metal halide perovskite nanocomposites and the potential role they may play in the development of low-cost photovoltaic and optoelectronic devices.

Abstract This paper focuses on modifying a PES membrane with acid-functionalised carbon nanotubes (CNT) for industrial wastewater treatment. Embedding acid functionalised carbon nanotubes (CNTs) within the membrane matrix would increase the membrane flux by increasing the membrane pore size and surface area, rejection and thermal stability. Pure PES membranes were prepared by phase inversion method and infused with CNTs at 2.5, 5, 7.5 and 10 wt% loading to fabricate PES/2.5 wt% CNT, PES/5 wt% CNT, PES/7.5 wt% CNT and PES/10 wt% CNT membranes respectively. Characterisation was performed using Transmission Electron Microscopy (TEM) to determine CNT morphology, X-ray Diffraction (XRD) to determine the functional groups attached to CNTs, Thermogravimetric Analysis (TGA) to determine the thermal stability of the membranes, Scanning Electron Microscope (SEM) to determine membrane morphology, Bunauer-Emmett-Teller (BET) method to obtain pore size information and Contact Angle (CA) to determine the membrane hydrophilicity. Membrane performance was then evaluated with a dead-end stirred cell using industrial wastewater containing traces of Cu, Fe, Ni, Zn and Cl. Permeate flux results showed a direct proportion relationship with increasing CNT loading and increasing pressure (100 kPa, 300 kPa, 500 kPa, 700 kPa, 900 kPa and 1100 kPa). PES/5 wt% CNT membrane showed the most enhanced performance compared to the other membranes, achieving reasonably high flux of 43.7 L/m2h and rejection of 89.6% Cu, 100% Fe, 90.5% Ni, 68.8% Zn and 99.99% Cl at 300 kPa. The results obtained showed that the PES membrane embedded with functionalised CNTs could be used for the treatment of industrial wastewater.

Power grids of the future will likely incorporate more renewable energy distributed generation (REDG), also known as alternative energy systems. REDG units are increasingly being used in electrical transmission networks because of the positive effects they have on power networks. REDG systems are the backbone of smart electric networks and are essential to the operation of the smart grid. These REDG systems can additionally improve system reliability by providing some customers with a backup generator in the event of power interruptions. This review offers a thorough evaluation of the existing body of information on the topic of electric vehicles’ (EVs’) future interactions with smart grids. The combination of the potential deployment of EVs and the smart grid’s conceptual goal presents challenges for electric grid-related infra-structure, communication, and control. The proposal for connecting EVs to the grid is based on research into cutting-edge smart metering and communication systems. In the context of the vehicle-to-grid (V2G) phenomenon, the possibilities, benefits, and limitations of various EV smart-charging systems are also fully examined. A quickly growing percentage of distributed energy is derived from wind and solar (photovoltaic) energy. The variable power output of wind and solar energy introduces fresh challenges for those responsible for organizing, operating, and controlling the power grid. While fluctuations in the electric grid are problematic, they may be mitigated by the entry of EVs into the energy market. As such, we performed a comprehensive review of the literature to learn more about this exciting research gap that needs to be filled and to identify recently developed solutions to the problems related to EVs. Additionally, in this review article, we take a close look at the practicality of V2G technology. The smart grid is a developing concept that will likely have large implications for the world’s energy infrastructure, and this study thoroughly analyzes how EVs interact with it.

Electric vehicles (EVs) are gaining more and more traction as a viable option in the automotive sector. This mode of transportation is currently on track, according to current trends, to totally replace internal combustion engine (ICE) cars in the not-too-distant future. The economic system, the energy infrastructure, and the environment are just a few of the areas where electric vehicles could have a major impact. The transportation industry produces the second-most carbon dioxide gas from the combustion of fossil fuels, making it the second-highest contributor to global warming. A lot of people are looking to EVs, or electric vehicles, as a possible game-changing answer to this problem. Since an electric motor drives the electric vehicle’s propeller instead of an internal combustion engine, electric vehicles can reduce their carbon dioxide (CO2) emissions compared to traditional automobiles. If coupled with renewable energy sources, EVs might theoretically become emission-free automobiles. In this paper, we will examine the various EV drive circuit types, including their construction and the benefits and drawbacks of employing each. This article discusses the current state of battery technology with an emphasis on EV batteries. This article discusses the best electric motor for EVs in terms of efficiency, power density, fault tolerance, dependability, cost, and more. Next, we conduct in-depth research into the difficulties and potential rewards of EV adoption in the future. While improvements in areas like charging times and battery performance are encouraging, government regulation of EVs remains a big non-technical barrier.

IntroductionThe COVID-19 pandemic in Mexico began at the end of February 2020. An essential component of control strategies was to reduce mobility. We aimed to evaluate the impact of mobility on COVID- incidence and mortality rates during the initial months of the pandemic in selected states.MethodsCOVID-19 incidence data were obtained from the Open Data Epidemiology Resource provided by the Mexican government. Mobility data was obtained from the Observatory for COVID-19 in the Americas of the University of Miami. We selected four states according to their compliance with non-pharmaceutical interventions and mobility index. We constructed time series and analyzed change-points for mobility, incidence, and mortality rates. We correlated mobility with incidence and mortality rates for each time interval. Using mixed-effects Poisson models, we evaluated the impact of reductions in mobility on incidence and mortality rates, adjusting all models for medical services and the percentage of the population living in poverty.ResultsAfter the initial decline in mobility experienced in early April, a sustained increase in mobility followed during the rest of the country-wide suspension of non-essential activities and the return to other activities throughout mid-April and May. We identified that a 1% increase in mobility yielded a 5.2 and a 2.9% increase in the risk of COVID-19 incidence and mortality, respectively. Mobility was estimated to contribute 8.5 and 3.8% to the variability in incidence and mortality, respectively. In fully adjusted models, the contribution of mobility to positive COVID-19 incidence and mortality was sustained. When assessing the impact of mobility in each state compared to the state of Baja California, increased mobility conferred an increased risk of incident positive COVID-19 cases in Mexico City, Jalisco, and Nuevo León. However, for COVID-19 mortality, a differential impact of mobility was only observed with Jalisco and Nuevo León compared to Baja California.ConclusionMobility had heterogeneous impacts on COVID-19 rates in different regions of Mexico, indicating that sociodemographic characteristics and regional-level pandemic dynamics modified the impact of reductions in mobility during the COVID-19 pandemic. The implementation of non-pharmaceutical interventions should be regionalized based on local epidemiology for timely response against future pandemics.

IntroductionOf the 1.75 million adolescents aged 10–19 years living with HIV globally, 84% reside in sub-Saharan Africa. This problem is most acute in South Africa, where there are 720,000 adolescents living with HIV (ALHIV). ALHIV navigate the same challenges as other adolescents—such as puberty and first relationships—as well as challenges specific to their HIV-status—including stigma, disclosure, and concerns about HIV transmission. This dual burden calls for tailored sexual and reproductive health (SRH) programs. Here, we qualitatively explore the reflections of South African ALHIV on SRH education, communication, and discussion provided by adults in schools, clinics, and the home related to their unique SRH needs.MethodsThis paper reports on qualitative data from a mixed-methods study to inform interventions that meet the SRH needs of ALHIV. In-depth interviews (N = 20) were conducted with ALHIV recruited from two clinics in Cape Town, South Africa. Nine males and 11 females aged 16–19 participated in semi-structured in-depth interviews to discuss their sexual health as ALHIV. The interview guide explored 1) perceived SRH needs; 2) healthy living with HIV; 3) future goals; 4) intimate relationships; 5) psychosocial challenges; and 6) preferred interventions. Data were thematically applied to an iteratively-developed codebook and analyzed by the cross-cultural research team using NVivo 12.ResultsThese qualitative data reveal the pressing needs among ALHIV for open communication and accurate information about sexuality and HIV, given the risk to themselves and their partners as they enter intimate relationships. Three themes emerged from the data: 1) Intergenerational pressures coming from caregivers, clinicians, and teachers often stigmatize the sexual heath behaviors of ALHIV; 2) When present, open intergenerational communication can provide ALHIV with crucial information, resources, and social support that supports healthy decisions, and 3) ALHIV offer specific ideas about how adults can support their decision-making in the transition to adulthood.ConclusionsFindings highlight adolescents' recommendations for programs involving open communication, stigma-reduction around sexuality, and support from both peer and adult mentors. This study lays the foundation for strategies to improve intergenerational communication about sexual health to promote positive approaches to sexuality for ALHIV.

Abstract Background An animal model of prediabetes that has been developed in our laboratory using a high fat high carbohydrate diet and lack of physical activity displays risk factors for cardiovascular complications. The effect of exercise against these risk factors in this animal model remains unknown. Therefore, we evaluated the effect of intermittent and regular exercise treatment on the risk factors for cardiovascular complications in this animal model of prediabetes. Methods Following prediabetes induction, animals were randomly assigned to the following groups (n = 6): non-diabetic, prediabetic, intermittently exercising prediabetic and regularly exercising prediabetic. Exercise exposure was 7 weeks long. Body weight changes, caloric intake, blood glucose, total cholesterol, and triglyceride concentration was measured after 20 and 29 weeks while blood pressure was only measured after 29 weeks. Plasma endothelial nitric oxide synthase, malonaldehyde, glutathione peroxidase, tumour necrosis factor-alpha and C-reactive protein concentration from the heart were measured 2 weeks post-exercise termination (week 30). Results We found increased body weight, caloric intake and mean arterial pressure in the prediabetic group by comparison to the non-prediabetic group. The same trend was observed in blood glucose and triglyceride concentrations. However, all of these parameters were reduced in the intermittently exercising prediabetic and regularly exercising prediabetic groups. This reduction was further accompanied by a decrease in the endothelial nitric oxide synthase, tumour necrosis factor-alpha and C-reactive protein concentration with improved oxidative stress biomarkers. Conclusions The progression of pre-diabetes to diabetes is slowed or possibly stopped by exercise (regular or intermittent). Additionally, biomarker profiles indicative of cardiovascular disease in pre-diabetics are improved by exercise.

Schizophrenia is a debilitating psychiatric disorder comprising positive, negative, and cognitive impairments. Most of the animal models developed to understand the neurobiology and mechanism of schizophrenia do not produce all the symptoms of the disease. Therefore, researchers need to develop new animal models with greater translational reliability, and the ability to produce most if not all symptoms of schizophrenia. This review aimed to evaluate the effectiveness of the rodent “double hit” (post-weaning social isolation and N-methyl-D-aspartate (NMDA) receptor antagonist) model to produce symptoms of schizophrenia. This systematic review was developed according to the 2020 PRISMA guidelines and checklist. The MEDLINE (PubMed) and Ebscohost databases were used to search for studies. The systematic review is based on quantitative animal studies. Studies in languages other than English that could be translated sufficiently using Google translate were also included. Data extraction was performed individually by two independent reviewers and discrepancies between them were resolved by a third reviewer. SYRCLE’s risk-of-bias tool was used to test the quality and biases of included studies. Our primary search yielded a total of 47 articles, through different study selection processes. Seventeen articles met the inclusion criteria for this systematic review. Ten of the seventeen studies found that the “double hit” model was more effective in developing various symptoms of schizophrenia. Most studies showed that the “double hit” model is robust and capable of inducing cognitive impairments and positive symptoms of schizophrenia.

The lower yield of tomatoes grown in tunnels, due to the limited space, remains a challenge. Stem training has long been identified as one of the most important horticultural practices used to improve the yield and fruit quality of tomatoes grown in commercial tunnels; however, there is little information available on the dome-shaped tunnels that are used, particularly by smallholder farmers. The common stem-training methods used in tunnels include the Single-Stem (SS), the Double-Stem (DS) and the Two-Plants-per-Pot (TPP) methods. Their effect on the plants’ growth, development and physiology varies significantly, and hence, it affects crop productivity. The experiment was conducted in an 8 m × 30 m dome-shaped tunnel and the treatment included the single-stem, double-stem and two-plants-per-pot methods. A higher photosynthetic rate was observed in the SS treatment, followed by the DS treatment. Similar trends were found in the growth, yield and fruit quality parameters of the SS and DS treatments. However, the DS and TPP treatments exhibited, on average, a higher number of fruits, as well as a higher colour index, TSS, TA and Brima per harvest, than the SS treatment. The study indicated that the double-stem and two-plants-per-pot training methods are the best for farmers who seek to optimize their yields and maximize their profits for this cultivar.

Thadei S Mlughu,1 Amani Anaeli,2 Renatha Joseph,1 Nathanael Sirili2 1Department of Bioethics and Health Professionalism, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 2Department of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaCorrespondence: Nathanael Sirili Department of Developmental StudiesMuhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaEmail nsirili@yahoo.co.ukBackground: Regardless, the known benefits of voluntary testing and counseling (VCT) in the fight against HIV/AIDS, its uptake is still low among youth. This study explored ethical challenges facing voluntary counseling and testing for HIV/AIDS among youth engaged in commercial motorcycling in Kinondoni municipality, Dar es Salaam city.Methods: Qualitative exploratory study was carried out to 35 people using key informants’ interviews (KIIs), in-depth interviews (IDIs), and focus group discussions (FGDs). Key informants were purposefully selected based on their roles in VCT services, while the FGD participants and in-depth interview respondents were purposefully selected among youth commercial motorcyclists. Qualitative content data analysis was used to analyze the gathered information.Findings: Results of this study show that lack of privacy during counseling and treatment, fear of HIV status disclosure to others by counselors and difficulties in counseling are the main ethical challenges facing VCT services among youth in Kinondoni municipality. Shortage of counselors to match the number of VCT services’ clients and lack of on-job training on HIV/AIDS testing and counseling among counselors partly contributed to the revealed ethical challenges. In an attempt to address the ethical challenges, youth peer educators and routine supervision were the available initiatives on improving VCT services among youth.Conclusion: VCT services face ethical challenges which are either health facility-based, community-based or are at the national level. Addressing the ethical challenges is necessary in order to improve the uptake of VCT services and thus strengthen the fight against HIV/AIDS. Deployment of enough counselors, refresher training to counselors, and raising community awareness on HIV/AIDS and the negative impacts of stigma are among the initial strategies for remedying the situation.Keywords: ethical challenges, voluntary, counseling, testing, HIV/AIDS, youth and HIV, Tanzania, commercial motorcyclists, shortage of counselors

The need to understand and manage biological invasions has driven the development of frameworks to circumscribe, classify, and elucidate aspects of the phenomenon. But how influential have these frameworks really been? To test this, we evaluated the impact of a pathway classification framework, a framework focussing on the introduction-naturalisation-invasion continuum, and two papers that outline an impact classification framework. We analysed how these framework papers are cited and by whom, conducted a survey to determine why people have cited the frameworks, and explored the degree to which the frameworks are implemented. The four papers outlining these frameworks are amongst the most-cited in their respective journals, are highly regarded in the field, and are already seen as citation classics (although citations are overwhelmingly within the field of invasion science). The number of citations to the frameworks has increased over time, and, while a significant proportion of these are self-citations (20–40%), this rate is decreasing. The frameworks were cited by studies conducted and authored by researchers from across the world. However, relative to a previous citation analysis of invasion science as a whole, the frameworks are particularly used in Europe and South Africa and less so in North America. There is an increasing number of examples of uptake into invasion policy and management (e.g., the pathway classification framework has been adapted and adopted into EU legislation and CBD targets, and the impact classification framework has been adopted by the IUCN). However, we found that few of the citing papers (6–8%) specifically implemented or interrogated the frameworks; roughly half of all citations might be viewed as frivolous (“citation fluff”); there were several clear cases of erroneous citation; and some survey respondents felt that they have not been rigorously tested yet. Although our analyses suggest that invasion science is moving towards a more systematic and standardised approach to recording invasions and their impacts, it appears that the proposed standards are still not applied consistently. For this to be achieved, we argue that frameworks in invasion science need to be revised or adapted to particular contexts in response to the needs and experiences of users (e.g., so they are relevant to pathologists, plant ecologists, and practitioners), the standards should be easier to apply in practice (e.g., through the development of guidelines for management), and there should be incentives for their usage (e.g., recognition for completing an EICAT assessment).

Background Sierra Leone is one of the countries with poor health outcomes. The country has made some progress in the uptake of maternal health services. Despite improvements in the national coverage rates, there is no evidence of how equal these improvements have been. Objective To estimate inequalities in maternal healthcare use in Sierra Leone. Methods Using cross-sectional study data from 2008, 2013, and 2019 Demographic and Health Surveys (DHS), we study inequalities in maternal health services by computing rate ratios, and concentration indices (as well as concentration curves) using selected inequality stratifiers such as household wealth index, maternal education, and rural/urban place of residence. Results We found that considerable progress has been made in increasing the uptake of maternal health services as well as reducing inequalities over time. We also found that inequalities in the selected health indicators favoured women from wealthy households, educated women, as well as women from urban areas. Although inequalities declined over time, the use of delivery services was highly unequal. However, of the selected health interventions, the use of four or more antenatal visits was almost at perfect equality in 2013 and 2019. Conclusion Although efforts have been made to increase the use of maternal healthcare services among women with a lower socioeconomic status, the use of maternal health services remains favourable to women with a higher socioeconomic standing. Therefore, policy initiatives need to prioritise women of lower socioeconomic status through projects aimed at increasing women’s educational levels as well as focusing on poverty reduction.

Abstract The Decade on Ecosystem Restoration aims to provide the means and incentives for upscaling restoration efforts worldwide. Although ecosystem restoration is a broad, interdisciplinary concept, effective ecological restoration requires sound ecological knowledge to successfully restore biodiversity and ecosystem services in degraded landscapes. We emphasize the critical role of knowledge and data sharing to inform synthesis for the most robust restoration science possible. Such synthesis is critical for helping restoration ecologists better understand how context affects restoration outcomes, and to increase predictive capacity of restoration actions. This predictive capacity can help to provide better information for evidence‐based decision‐making, and scale‐up approaches to meet ambitious targets for restoration. We advocate for a concerted effort to collate species‐level, fine‐scale, ecological community data from restoration studies across a wide range of environmental and ecological gradients. Well‐articulated associated metadata relevant to experience and social or landscape contexts can further be used to explain outcomes. These data could be carefully curated and made openly available to the restoration community to help to maximize evidence‐based knowledge sharing, enable flexible re‐use of existing data and support predictive capacity in ecological community responses to restoration actions. We detail how integrated data, analysis and knowledge sharing via synthesis can support shared success in restoration ecology by identifying successful and unsuccessful outcomes across diverse systems and scales. We also discuss potential interdisciplinary solutions and approaches to overcome challenges associated with bringing together subfields of restoration practice. Sharing this knowledge and data openly can directly inform actions and help to improve outcomes for the Decade on Ecosystem Restoration.

A number of algorithms that aim to reduce power system losses and improve voltage profiles by optimizing distributed generator (DG) location and size have already been proposed, but they are still subject to several limitations. Hence, new algorithms can be developed or existing ones can be improved so that this important issue can be addressed more appropriately and effectively. This study proposes a reconfiguration methodology based on a hybrid optimization algorithm, consisting of a combination of the genetic algorithm (GA) and the improved particle swam optimization (IPSO) algorithm for minimizing active power loss and maintaining the voltage magnitude at about 1 p.u. The buses at which DGs should be injected were identified based on optimal real power loss and reactive power limit. When applying the proposed optimization algorithm for DGs allocation in power system, the search space or number of iterations was reduced, increasing its convergence rate. The proposed reconfiguration methodology was test in an IEEE-30 bus electrical network system with DGs allocations and the simulations were conducted using MATLAB software compared to other optimization algorithms, such as GA, PSO, and IPSO, the combination of GA and IPSO or Hybrid GA & IPSO (HGAIPSO) method has a smaller number of iterations and is more effective in optimization problems. The effectiveness of the proposed HGAIPSO has been tested on IEEE-30 bus network system with DGs allocations, and the obtained test results have been compared to those from other methods (i.e., GA, PSO, and IPSO). The simulation results show that the proposed HGAIPSO can be an efficient and promising optimization algorithm for distribution network reconfiguration problems. The IEEE-30 bus test system with DGs integrated at various location revealed reductions in overall real power loss of 40.7040%, 36.2403%, and 42.9406% for type 1, type 2, and type 3 DGs allocation, respectively. The highest bus voltage profile goes to 1.01 pu in the IEEE-30 bus.

The introduction of effective vaccines in December 2020 marked a significant step forward in the global response to COVID-19. Given concerns with access, acceptability, and hesitancy across Africa, there is a need to describe the current status of vaccine uptake in the continent. An exploratory study was undertaken to investigate these aspects, current challenges, and lessons learnt across Africa to provide future direction. Senior personnel across 14 African countries completed a self-administered questionnaire, with a descriptive analysis of the data. Vaccine roll-out commenced in March 2021 in most countries. COVID-19 vaccination coverage varied from low in Cameroon and Tanzania and up to 39.85% full coverage in Botswana at the end of 2021; that is, all doses advocated by initial protocols versus the total population, with rates increasing to 58.4% in Botswana by the end of June 2022. The greatest increase in people being fully vaccinated was observed in Uganda (20.4% increase), Botswana (18.5% increase), and Zambia (17.9% increase). Most vaccines were obtained through WHO-COVAX agreements. Initially, vaccination was prioritised for healthcare workers (HCWs), the elderly, adults with co-morbidities, and other at-risk groups, with countries now commencing vaccination among children and administering booster doses. Challenges included irregular supply and considerable hesitancy arising from misinformation fuelled by social media activities. Overall, there was fair to reasonable access to vaccination across countries, enhanced by government initiatives. Vaccine hesitancy must be addressed with context-specific interventions, including proactive programmes among HCWs, medical journalists, and the public.

Polyethersulfone (PES) is commonly used to fabricate ultrafiltration (UF) membranes applied during the treatment of wastewater due to its high permeability and tensile properties, chemical and thermal stability. However, PES has low hydrophilicity due the sulfonyl functional group and therefore becomes susceptible to fouling, resulting in reduced membrane performance and lifespan. In this study, 10 wt% PES/CNT membranes were prepared by infusing 2.5, 5, 7.5 and 10 wt% Carbon nanotubes (CNTs) into PES to produce PES/2.5 wt% CNT, PES/5 wt% CNT, PES/7.5 wt% CNT and PES/10 wt% CNT membranes by phase inversion. The membranes were immersed in 1 wt% PVA solution to coat a hydrophilic PVA layer on the surface of the membranes to fabricate PES/2.5 wt% CNT/PVA, PES/5 wt% CNT/PVA, PES/7.5 wt% CNT/PVA and PES/10 wt% CNT/PVA membranes. A 10 wt% pure PES reference membrane was also prepared for comparison purposes. This research focused on evaluating the effect of coating a PVA layer on the performance of a PES/CNT/PVA membrane. TEM characterization revealed that the CNTs are MWCNT, PSD was done to obtain CNT particle size, FTIR confirmed the formation of –COOH and –OH functional groups on the surface of CNTs, SEM confirmed porous membrane structures, BET showed an increase in pore size at higher CNTs loading, tensile properties showed a decrease when CNTs were added, and contact angle studies showed significant increase in hydrophilicity with the addition of CNTs and PVA. Filtration experiments were conducted using a dead-end stirred cell. PES/7.5 wt% CNT/PVA showed the most improved results with a good trade-off balance between membrane flux and rejection, generating a flux of 7.94 L/m2h and rejection of 88.56% Cu2+, 96.15% Fe2+, 89.06% Ni2+, 100% Zn2+ and 99.93% Cl−. Anti-fouling tests for PES/7.5 wt% CNT/PVA conducted using a cross-flow filtration rig showed that only 70.77% of the flux could be recovered. These results showed that a PES membrane that has been infused with functionalized CNTs and coated with a layer of PVA membrane can effectively remove Cu2+, Fe2+, Ni2+, Zn2+ and Cl− from industrial wastewater.

Summary: Background: There has been remarkable progress in the treatment of HIV throughout sub-Saharan Africa, but there are few data on the prevalence and overlap of other significant causes of disease in HIV endemic populations. Our aim was to identify the prevalence and overlap of infectious and non-communicable diseases in such a population in rural South Africa. Methods: We did a cross-sectional study of eligible adolescents and adults from the Africa Health Research Institute demographic surveillance area in the uMkhanyakude district of KwaZulu-Natal, South Africa. The participants, who were 15 years or older, were invited to participate at a mobile health camp. Medical history for HIV, tuberculosis, hypertension, and diabetes was established through a questionnaire. Blood pressure measurements, chest x-rays, and tests of blood and sputum were taken to estimate the population prevalence and geospatial distribution of HIV, active and lifetime tuberculosis, elevated blood glucose, elevated blood pressure, and combinations of these. Findings: 17 118 adolescents and adults were recruited from May 25, 2018, to Nov 28, 2019, and assessed. Overall, 52·1% (95% CI 51·3–52·9) had at least one active disease. 34·2% (33·5–34·9) had HIV, 1·4% (1·2–1·6) had active tuberculosis, 21·8% (21·2–22·4) had lifetime tuberculosis, 8·5% (8·1–8·9) had elevated blood glucose, and 23·0% (22·4–23·6) had elevated blood pressure. Appropriate treatment and optimal disease control was highest for HIV (78·1%), and lower for elevated blood pressure (42·5%), active tuberculosis (29·6%), and elevated blood glucose (7·1%). Disease prevalence differed notably by sex, across age groups, and geospatially: men had a higher prevalence of active and lifetime tuberculosis, whereas women had a substantially high prevalence of HIV at 30–49 years and an increasing prevalence of multiple and poorly controlled non-communicable diseases when older than 50 years. Interpretation: We found a convergence of infectious and non-communicable disease epidemics in a rural South African population, with HIV well treated relative to all other diseases, but tuberculosis, elevated blood glucose, and elevated blood pressure poorly diagnosed and treated. A public health response that expands the successes of the HIV testing and treatment programme to provide multidisease care targeted to specific populations is required to optimise health in such settings in sub-Saharan Africa. Funding: Wellcome Trust, Bill & Melinda Gates Foundation, the South African Department of Science and Innovation, South African Medical Research Council, and South African Population Research Infrastructure Network. Translation: For the isiZulu translation of the abstract see Supplementary Materials section.

Adherence to antiretroviral therapy (ART) and psychosocial support to manage stigma and disclosure is essential for adolescents living with HIV (ALHIV). Peer support groups can help ALHIV and their families live successfully with HIV. This qualitative study aimed to examine adolescent and caregiver perspectives on peer support groups. Three themes emerged: (1) peer support encouraged adherence to ART, (2) serostatus disclosure outside the family was perceived as difficult, and (3) the peer support group fostered fundamental and meaningful peer relationships for ALHIV. Caregivers felt peer support groups increased self-acceptance and adherence for ALHIV across 3 domains: (1) as motivation for families and adolescents, (2) to increase adolescent independence and maturity, and (3) to help adolescents accept their HIV status and live successfully with HIV. These data highlight the importance of psychosocial support groups for ALHIV and caregivers, illustrating the benefits of a safe space with trusted relationships and open communication.

This Commentary is a response to a Commentary published in the May/June 2020 issue: Nattrass N. Why are black South African students less likely to consider studying biological sciences? S Afr J Sci. 2020;116(5/6), Art. #7864, 2 pages. https://doi.org/10.17159/sajs.2020/7864 Responses to the Commentary in the May/June 2020 issue have been published collectively in a special issue of Volume 116.

This paper examines the extent to which three local communities neighbouring Addo Elephant National Park (AENP) have benefitted from the tourism development and business activities in the park in terms of women and youth empowerment, business and job opportunities, skills development and other people and community development. The paper further examines the relationship between communities and AENP with its concessionaires, and the pros and cons of private sector involvement in a public park. Data for the study was gathered from 42 participants through observation, document review, key informant interviews with AENP officials, Municipal officials and Community Trust personnel; and focus group discussions with members of three participating communities, namely: Colchester, Valentia and Nomathamsanqa. Participants were selected purposively. Local beneficiation was generally found to be minimal characterised by exclusion of black Africans from concessionary agreements; marginalisation of women in business contracts which are in any case typically low income and short term; inequalities in entrepreneurship and other local community development support (and funding); lack of consultation and communication with communities, particularly regarding their own development; inconsistencies in and misguided funding of development projects, including skills development not tailored towards people’s needs; low wage employment opportunities; and undemocratic rather than humanist approaches to people development, among others. This defies Sustainable ethical tourism development principles.

The main purpose of this paper is to document some challenges faced by Independent Development Trust (IDT) in infrastructure delivery of the provincial government of KwaZulu-Natal. Infrastructure delivery has a significant effect on the local budgets or budgets of projects in the province. The main focus of the study was the root causes of delays, budgetary overruns and the resultant effect on service delivery back-logs and socio-economic impact caused by such delays. The study setting comprised of professional stakeholders in the built environment and these include specialists and professionals in the engineering, construction management, civil and general building fields. The objectives of this study were achieved by means of a self-administered questionnaire that was distributed to a group of participants, composed of project managers, quantity surveyors, engineers, architects and project managers working with IDT. The nature of the research was quantitative and data analysis used descriptive and a bit of inferential statistics to arrive at some generalizations and conclusions. The study was able to affirm that there are major inefficiencies in the current infrastructure delivery model of the South African government. Major causes identified include factors such as delays in payments, poor planning, subsiding levels of professional ethics and standards exercised by professionals in the built environment, and so forth. The study also made some recommendations from the research findings. Clearly the infrastructure delivery model requires a new trajectory in tackling the under-development and triple challenges of poverty, unemployment and slow economic growth.

The aim of this study was to analyze the phenolic content and antioxidant activity of five cowpea cultivars after processing and in vitro digestion. Raw cowpea samples showed a significant decrease in total phenolic content (TPC) when compared with the processed samples, however an increase was subsequently observed in digested samples. The antioxidant activity determined using, DPPH, ABTS, ferric reducing antioxidant power (FRAP) assay, and total peroxyl radical-trapping antioxidant parameter showed a similar trend to the phenolic content with a significant decrease in activity upon processing and an increase after digestion. In conclusion, all cowpea cultivars showed a high TPC content as well as an increased antioxidant activity after digestion indicating the potential health benefits which cowpea could provide to consumers. Therefore, this study shows that in vitro digestion improves the digestion and absorption of beneficial components of processed cowpea at the intestinal level.

Background: Most funders require non-governmental organisations to evaluate the effectiveness of their programmes. However, in our experience, funders seldom fund evaluation endeavours and organisational staff often lack evaluation skills. Aim: In this outcome evaluation of Living through Learning’s (LTL) class-based English-medium Coronation Reading Adventure Room programme, we addressed two evaluation questions: whether Grade 1 learners who participated in the programme attained LTL’s and the Department of Basic Education’s (DBE) literacy standards at the end of the programme and whether teacher attributes contributed to this improvement. Setting: The evaluation was conducted in 18 different no-fee schools in Cape Town. Participants comprised 1090 Grade 1 learners and 54 teachers. Methods: We used Level 2 (programme design and theory) and part of Level 4 (outcome) of an evaluation hierarchy to assess the effectiveness of the programme. Results: Evaluation results showed that most schools, except three, attained the 60% performance standard set by the LTL on all quarterly assessments. Most schools, except two, attained the 50% performance standard of the DBE for English first language on all quarterly assessments. We also found that in terms of teacher attributes, only teacher experience in literacy teaching was significant in predicting learner performance in literacy in the first term of school. Conclusion: We explain why our results should be interpreted with caution and make recommendations for future evaluations in terms of design, data collection and levels of evaluation.

Global control of tuberculosis (TB) has been seriously impacted by the emergence and transmission of its drug-resistant forms. Delayed detection and incomplete characterisation of drug-resistant tuberculosis (DR-TB) contributes to morbidity and mortality, and to ongoing transmission of drug-resistant strains. Current culture-based and molecular diagnostic tools for TB present numerous disadvantages that could potentially lead to misdiagnosis, inappropriate treatment initiation and the amplification of drug resistance. The detection of drug-resistant tuberculosis (DR-TB) in South Africa relies on molecular diagnostic assays such as the Xpert MTB/RIF and line probe assays (MTBDRplus and MTBDRsl). However, these molecular assays are limited to detecting resistance to only a few first-line and second-line drugs. It is for this reason that next-generation sequencing (NGS) and bioinformatics pipelines have been developed for rapid detection of M. tuberculosis drug resistance, with the added advantage that sequence data could also have public health applications through understanding transmission patterns. This review highlights some of the challenges that are currently hampering the diagnosis and control of DR-TB in a high burden setting of the KwaZulu-Natal (KZN) province in South Africa. Shortfalls of current diagnostic techniques for DR-TB are discussed in detail and we also propose how these might be overcome with an accurate and rapid NGS system. Keywords: Drug-resistant tuberculosis, Rapid TB diagnostics, Sequencing

Quiero compartir aquí con ustedes algunas reflexiones sobre aspectos de la política exterior de Sudáfrica, este Congreso en Ri del IRI. Mis breves observaciones girarán en torno a los siguientes temas: 1) El significado del año 2004 para Sudáfrica; 2) Los funda- mentos de la política exterior de Sudáfrica; 3) La política de relaciones exteriores de Sudáfrica dentro del sistema mundial; y 4) La dirección de la política de relaciones exteriores durante la primera década de democracia.

Background: Continuous improvement is a topic that organisations sometimes avoid since it identifies areas lacking business excellence. Continuous improvement is possible in organisations that take a holistic approach to managing knowledge, which gives them the ability to continue to innovate and sustain their value creation to their stakeholders. Aim: The levels of knowledge management maturity in the Tax Audit Business Unit of a revenue services institution had to be identified in order to provide guidance on how to improve and contribute to future information and communication technology (ICT) strategy planning. Setting: The ICT strategy planning process at the revenue services institution identified a gap in how it managed information and knowledge. This indicated a discrepancy in knowledge management (KM) maturity. Method: A deductive approach was followed, motivated by analysis of tested and well-researched theories to create a theoretical framework. This was then tested against empirical research conducted in a specific business unit. Descriptive statistics in the form of frequencies, proportions, and means were obtained from the data, to describe the patterns and trends in the data set. Results: The key findings confirm that generally the value of KM is well regarded. Barriers exist and levels of consensus generally drop as the levels progress towards the highest KM maturity level, mostly lacking in terms of continuous improvement. Conclusion: The conceptual KM framework developed from this study will give revenue services institutions insights on how to innovate and sustain their value creation to their stakeholders. The desired activities for adoption of the framework will help achieve continuous improvement of a revenue services institution.

Mycobacterium tuberculosis drug resistance is a threat to global tuberculosis (TB) control. Comprehensive and timely drug susceptibility determination is critical to inform appropriate treatment of drug-resistant tuberculosis (DR-TB). Phenotypic drug susceptibility testing (DST) is the gold standard for M. tuberculosis drug resistance determination. M. tuberculosis whole genome sequencing (WGS) has the potential to be a one-stop method for both comprehensive DST and epidemiological investigations. We discuss in this review the tremendous opportunities that next-generation WGS presents in terms of understanding the molecular epidemiology of tuberculosis and mechanisms of drug resistance. The potential clinical value and public health impact in the areas of DST for patient management and tracing of transmission chains for timely public health intervention are also discussed. We present the current challenges for the implementation of WGS in low and middle-income settings. WGS analysis has already been adapted routinely in laboratories to inform patient management and public health interventions in low burden high-income settings such as the United Kingdom. We predict that the technology will be adapted similarly in high burden settings where the impact on the epidemic will be greatest.

The traditional medicines sector in South Africa is still largely unregulated despite legislation aimed at regulating the practice being in place. The HIV and AIDS epidemic has fuelled demand for traditional medicines, with many patients consulting traditional health practitioners who offer different treatments, including herbal immune boosters. This study investigated the mutagenic and antioxidant effects of the widely sold herbal immune booster, uMakhonya®. The Ames test was used for analysis of the genototoxic effects while the adenosine triphosphate (ATP) assay was used to evaluate cell cytotoxicity in peripheral blood mononuclear cells (PBMCs) and THP-1 monocytes. To evaluate the antioxidant effects the malondialdehyde (MDA) quantification, the nitric oxide and 1,1-diphenyl-2-picryl-hydrazyl (DPPH) assays were used. UMakhonya® doses of up to 5000 μg/mL were not genotoxic in the Ames test. UMakhonya® was shown to induce dose-dependent cytotoxicity in both PBMCs and THP-1 cells with doses ranging from 500 μg/ mL to 1000 μg/mL, showing significant (p

Abstract Background The number of people newly infected with human immunodeficiency virus (HIV) has been decreasing in sub-Saharan Africa, but prevalence of the infection remains unacceptably high among young people. Despite the alarming pervasiveness of the virus, young people in this region continue to engage in risky sexual behaviors including unprotected sexual intercourse. In developed countries, parents can play important roles in protecting young people from such behaviors, but evidence regarding the impact of parental involvement is still limited in sub-Saharan Africa. Therefore, we conducted this study to examine the magnitude of risky sexual behaviors and the association of parental monitoring and parental communication with condom use at last sexual intercourse among secondary school students in Dar es Salaam, Tanzania. Methods We conducted this cross-sectional study among 2,217 male and female students aged 15 to 24 years from 12 secondary schools in Dar es Salaam. From October to November 2011, we collected data using a self-administered questionnaire. Multiple logistic regression analyses were conducted to examine the association of parental monitoring and parental communication with condom use at last sexual intercourse, adjusting for potential confounders. Results A total of 665 (30.3%) secondary school students reported being sexually active within the year prior to data collection. Among them, 41.7% had multiple sexual partners, 10.5% had concurrent sexual partners, and 41.1% did not use a condom at last sexual intercourse. A higher level of parental monitoring was associated with increased likelihood of condom use at last sexual intercourse among male students (AOR: 1.56, 95% CI: 1.05-2.32; p = 0.03) but not among female students (AOR: 1.54, 95% CI: 0.71-3.37; p = 0.28). The association between parental communication and condom use at last sexual intercourse among both male and female students was not statistically significant. Conclusions A high level of parental monitoring is associated with more consistent condom use among male students in Dar es Salaam, Tanzania -- many of whom have engaged in high-risk sexual behaviors such as multiple sexual partnerships, concurrent sexual partnerships, and unprotected sexual intercourse in the past one year. Interventions should thus be strengthened to reduce multiple sexual partnerships, concurrent sexual partnerships, and to improve parental monitoring among such students toward increasing condom use.

Abstract Background HIV/AIDS is associated with an increased burden of undernutrition among children even under antiretroviral therapy (ART). To treat undernutrition, WHO endorsed the use of Ready to Use Therapeutic Foods (RUTF) that can reduce case fatality and undernutrition among ART-naïve HIV-positive children. However, its effects are not studied among ART-treated, HIV-positive children. Therefore, we examined the association between RUTF use with underweight, wasting, and stunting statuses among ART-treated HIV-positive children in Dar es Salaam, Tanzania. Methods This cross-sectional study was conducted from September-October 2010. The target population was 219 ART-treated, HIV-positive children and the same number of their caregivers. We used questionnaires to measure socio-economic factors, food security, RUTF-use, and ART-duration. Our outcome variables were underweight, wasting, and stunting statuses. Results Of 219 ART-treated, HIV-positive children, 140 (63.9%) had received RUTF intervention prior to the interview. The percentages of underweight and wasting among non-RUTF-receivers were 12.4% and 16.5%; whereas those of RUTF-receivers were 3.0% (P = 0.006) and 2.8% (P = 0.001), respectively. RUTF-receivers were less likely to have underweight (Adjusted Odd Ratio (AOR) =0.19, CI: 0.04, 0.78), and wasting (AOR = 0.24, CI: 0.07, 0.81), compared to non RUTF-receivers. Among RUTF receivers, children treated for at least four months (n = 84) were less likely to have underweight (P = 0.049), wasting (P = 0.049) and stunting (P Conclusions Among HIV-positive children under ART, the provision of RUTF for at least four months was associated with low proportions of undernutrition status. RUTF has a potential to improve undernutrition among HIV-positive children under ART in the clinical settings in Dar es Salaam, Tanzania.

Abstract Background The prevalence of HIV/AIDS has exacerbated the impact of childhood undernutrition in many developing countries, including Tanzania. Even with the provision of antiretroviral therapy, undernutrition among HIV-positive children remains a serious problem. Most studies to examine risk factors for undernutrition have been limited to the general population and ART-naive HIV-positive children, making it difficult to generalize findings to ART-treated HIV-positive children. The objectives of this study were thus to compare the proportions of undernutrition among ART-treated HIV-positive and HIV-negative children and to examine factors associated with undernutrition among ART-treated HIV-positive children in Dar es Salaam, Tanzania. Methods From September to October 2010, we conducted a cross-sectional survey among 213 ART-treated HIV-positive and 202 HIV-negative children in Dar es Salaam, Tanzania. We measured the children's anthropometrics, socio-demographic factors, food security, dietary habits, diarrhea episodes, economic status, and HIV clinical stage. Data were analyzed using both univariate and multivariate methods. Results ART-treated HIV-positive children had higher rates of undernutrition than their HIV-negative counterparts. Among the ART-treated HIV-positive children, 78 (36.6%) were stunted, 47 (22.1%) were underweight, and 29 (13.6%) were wasted. Households of ART-treated HIV-positive children exhibited lower economic status, lower levels of education, and higher percentages of unmarried caregivers with higher unemployment rates. Food insecurity was prevalent in over half of ART-treated HIV-positive children's households. Furthermore, ART-treated HIV-positive children were more likely to be orphaned, to be fed less frequently, and to have lower body weight at birth compared to HIV-negative children. In the multivariate analysis, child's HIV-positive status was associated with being underweight (AOR = 4.61, 95% CI 1.38-15.36 P = 0.013) and wasting (AOR = 9.62, 95% CI 1.72-54.02, P = 0.010) but not with stunting (AOR = 0.68, 95% CI 0.26-1.77, P = 0.428). Important factors associated with underweight status among ART-treated HIV-positive children included hunger (AOR = 9.90, P = 0.022), feeding frequency (AOR = 0.02, p < 0.001), and low birth weight (AOR = 5.13, P = 0.039). Factors associated with wasting among ART-treated HIV-positive children were diarrhea (AOR = 22.49, P = 0.001) and feeding frequency (AOR = 0.03, p < 0.001). Conclusion HIV/AIDS is associated with an increased burden of child underweight status and wasting, even among ART-treated children, in Dar es Salaam, Tanzania. In addition to increasing coverage of ART among HIV-positive children, interventions to ameliorate poor nutrition status may be necessary in this and similar settings. Such interventions should aim at promoting adequate feeding patterns, as well as preventing and treating diarrhea.