Global Kids Online South Africa: barriers, opportunities and risks. A glimpse into South African children’s internet use and online activities

How do children use the internet? How do they access it? Does it present risks or opportunities for them, or both? What do parents think of their children’s online activities? Do they support it as an opportunity for learning? Or do they see it as harmful? We asked 913 children between nine and seventeen years, from three provinces in South Africa, and from different levels of household incomes, these questions and more. To compare their answers and find out more about the parents’ internet use, we asked 532 parents of the same children the same questions. Finally, we dug deeper into the children and parents’ answers with focus group discussions with 49 children and 20 of their parents. The report contains some of the things we found – some surprising, some not. It also makes some recommendations for opportunities for parents, teachers and schools, policy makers and reserachers, and mobile companies

The generation of consensus guidelines for carrying out process evaluations in rehabilitation research

Abstract Background Although in recent years there has been a strong increase in published research on theories (e.g. realist evaluation, normalization process theory) driving and guiding process evaluations of complex interventions, there is limited guidance to help rehabilitation researchers design and carry out process evaluations. This can lead to the risk of process evaluations being unsystematic. This paper reports on the development of new consensus guidelines that address the specific challenges of conducting process evaluations alongside clinical trials of rehabilitation interventions. Methods A formal consensus process was carried out based on a modified nominal group technique, which comprised two phases. Phase I was informed by the findings of a systematic review, and included a nominal group meeting with an expert panel of participants to rate and discuss the proposed statements. Phase II was an in depth semi-structured telephone interviews with expert panel participants in order to further discuss the structure and contents of the revised guidelines. Frequency of rating responses to each statement was calculated and thematic analysis was carried out on all qualitative data. Results The guidelines for carrying out process evaluations within complex intervention rehabilitation research were produced by combining findings from Phase I and Phase II. The consensus guidelines include recommendations that are grouped in seven sections. These sections are theoretical work, design and methods, context, recruitment and retention, intervention staff, delivery of the intervention and results. These sections represent different aspects or stages of the evaluation process. Conclusion The consensus guidelines here presented can play a role at assisting rehabilitation researchers at the time of designing and conducting process evaluations alongside trials of complex interventions. The guidelines break new ground in terms of concepts and theory and works towards a consensus in regards to how rehabilitation researchers should go about carrying out process evaluations and how this evaluation should be linked into the proposed trials. These guidelines may be used, adapted and tested by rehabilitation researchers depending on the research stage or study design (e.g. feasibility trial, pilot trial, etc.)

Endometrial glands as a source of nutrients, growth factors and cytokines during the first trimester of human pregnancy: a morphological and immunohistochemical study.

BACKGROUND: The maternal circulation to the human placenta is not fully established until 10-12 weeks of pregnancy. During the first trimester the intervillous space is filled by a clear fluid, in part derived from secretions from the endometrial glands via openings in the basal plate. The aim was to determine the activity of the glands throughout the first trimester, and to identify components of the secretions. METHODS: Samples of human decidua basalis from 5-14 weeks gestational age were examined by transmission electron microscopy and immunohistochemically. An archival collection of placenta-in-situ samples was also reviewed. RESULTS: The thickness of the endometrium beneath the implantation site reduced from approximately 5 mm at 6 weeks to 1 mm at 14 weeks of gestation. The glandular epithelium also transformed from tall columnar cells, packed with secretory organelles, to a low cuboidal layer over this period. The lumens of the glands were always filled with precipitated secretions, and communications with the intervillous space could be traced until at least 10 weeks. The glandular epithelium reacted strongly for leukaemia inhibitory factor, vascular endothelial growth factor, epidermal growth factor, transforming growth factor beta, alpha tocopherol transfer protein, MUC-1 and glycodelin, and weakly for lactoferrin. As gestation advanced uterine natural killer cells became closely approximated to the basal surface of the epithelium. These cells were also immunopositive for epidermal growth factor. CONCLUSIONS: Morphologically the endometrial glands are best developed and most active during early human pregnancy. The glands gradually regress over the first trimester, but still communicate with the intervillous space until at least 10 weeks. Hence, they could provide an important source of nutrients, growth factors and cytokines for the feto-placental unit. The endometrium may therefore play a greater role in regulating placental growth and differentiation post-implantation than previously appreciated.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Trial feasibility and process evaluation of a motivationally-embellished group peer led walking intervention in retirement villages using the RE- AIM framework: the residents in action trial (RiAT)

Objective: The Residents in Action Trial (RiAT; ACTRN12616001177448) was a 16-week motivationally-embellished peer-led walking intervention designed to increase walking, reduce sitting, and improve mental health and well-being in insufficiently active residents in retirement villages. In this paper we report on 1) trial feasibility and acceptability, and 2) evaluate the processes involved in the implementation of the intervention using the RE- AIM framework. Method: A mixed methods design was employed, consisting of data from accelerometers, surveys, (individual, pair-based and focus group) interviews, and participant logbooks. Participants included 116 walkers (M(SD) age=78.37(8.30); 92% female), 8 peer leaders (i.e. ambassadors) and 3 retirement village managers from 14 retirement villages. Descriptives and linear mixed modelling were used to analyse the quantitative data and inductive thematic analyses were employed to analyse the interview data. Results: The intended cluster randomised controlled design became quasi-experimental due to insufficient numbers of recruited ambassadors. The perceived burden of the number and frequency of research assessments was a frequently mentioned reason for a poor recruitment. Facilitators to walking maintenance were the use of self-monitoring, goal setting, social support, and having a routine. Reach was modest (about 14% of eligible participants were recruited from each village), but retention was excellent (92%). The motivational strategies taught appeared to have been implemented, at least in part, by the ambassadors. The walkers in the main experimental condition increased marginally their step counts, but there were no group differences on mental health and well-being outcomes, partly because of low statistical power. Conclusions: Walkers and ambassadors who did take part in the study suggested that they enjoyed the programme and found it useful in terms of becoming more active and making social connections. However, the group format was not appealing to some participants, hence, other delivery options should be explored in the future

Exploring the use of Soft Systems Methodology with realist approaches:A novel way to map programme complexity and develop and refine programme theory

As the use of realist approaches gains momentum, there is a growing interest in how systems approaches can complement realist thinking. In this article, we discuss how the epistemology of Soft Systems Methodology is compatible with realist approaches. Both Soft Systems Methodology and realist approaches emphasize the necessity to engage stakeholders; through models, thedescription of contingencies and exploring the intricacies of how complex programmes really work. We outline the key elements of realist approaches and Soft Systems Methodology, and report on two novel case studies. Drawing on our own experiences, we make the case that, used in conjunction with a realist approach, Soft Systems Methodology can provide a useful tool to a) map programme complexity, and b) develop and refine stakeholders programme theories, thus increasing the transparency, reliability, validity and accuracy of the theory building and refining process in realist approaches. We highlight Soft Systems Methodology as a novel companion to realist approaches and detail the first case studies of its use

A Medical Student Foray into the Depths of Public Health: An Exploratory Investigation Toward a Community Dashboard Characterizing the Experiences of Frailty in Order to Guide Improvement

While it is known that there are many shortcomings in the care of the elderly, their rate and impact on the community and the elderly themselves is not well understood. In exploring the possibilities for using existing data and available informants, a dashboard could be created that would enable a geographic community to understand the experience of living with disabilities in old age, to prioritize problems, and to test improvements. The methods included a literature review to understand what and how easily information could be accessed, gathered, and presented. In regards to literature on data collection, CMS claims data, MDS, OASIS, and death certificate follow back interviews were examined. In addition, other databases and dashboards were explored to better understand methods and aims. Interviews were then pilot-tested with caregivers of frail elders, both alive and deceased. It was ultimately concluded that by using existing data from utilization and other required data sets, a geographic community could construct a useful dashboard to prioritize and monitor improvements in elder care. The biases, which would be fairly stable across time for any one community, could be estimated. The costs could be mitigated with inexpensive access and off-the-shelf analytic packages. Most importantly, by marrying the breadth of information from large data sources with the depth of caregiver interviews, a platform could be created that motivates communities to undergo a very necessary elder care reform

Characterization of culture-positive adenovirus serotypes from respiratory specimens in Toronto, Ontario, Canada: September 2007–June 2008

This study describes the prevalence of culture-positive adenovirus serotypes in culture-positive respiratory specimens sent to the Central Public Health Laboratory, Toronto, Ontario, Canada for the period September 2007–June 2008. Total nucleic acid was extracted from virus cultures using an automated extraction method followed by polymerase chain reaction and Sanger sequencing of the adenovirus hexon gene hypervariable region 7. 73% of specimens (n = 70) were from patients ≤ 4 years of age. Of the 96 adenovirus isolates, the most common identified serotypes were serotype 3 (n = 44, 46%), serotype 2 (n = 25, 26%), serotype 1 (n = 17, 18%), and serotype 21 (n = 5, 5%). Adenovirus serotype 14 was not found in this study group. The leading serotype, Ad3, was identified throughout the duration of the study period. Molecular methods allow for the determination of circulating adenovirus serotypes and be used to document the spread of highly virulent adenoviral serotypes into a region

The mutation rate of mycobacterial repetitive unit loci in strains of M. tuberculosis from cynomolgus macaque infection

Background: Mycobacterial interspersed repetitive units (MIRUs) are minisatellites within the Mycobacterium tuberculosis (Mtb) genome. Copy number variation (CNV) in MIRU loci is used for epidemiological typing, making the rate of variation important for tracking the transmission of Mtb strains. In this study, we developed and assessed a whole-genome sequencing (WGS) approach to detect MIRU CNV in Mtb. We applied this methodology to a panel of Mtb strains isolated from the macaque model of tuberculosis (TB), the animal model that best mimics human disease. From these data, we have estimated the rate of MIRU variation in the host environment, providing a benchmark rate for future epidemiologic work. Results: We assessed variation at the 24 MIRU loci used for typing in a set of Mtb strains isolated from infected cynomolgus macaques. We previously performed WGS of these strains and here have applied both read depth (RD) and paired-end mapping (PEM) metrics to identify putative copy number variants. To assess the relative power of these approaches, all MIRU loci were resequenced using Sanger sequencing. We detected two insertion/deletion events both of which could be identified as candidates by PEM criteria. With these data, we estimate a MIRU mutation rate of 2.70 × 10-03 (95% CI: 3.30 × 10-04- 9.80 × 10-03) per locus, per year. Conclusion: Our results represent the first experimental estimate of the MIRU mutation rate in Mtb. This rate is comparable to the highest previous estimates gathered from epidemiologic data and meta-analyses. Our findings allow for a more rigorous interpretation of data gathered from MIRU typing

Refining fine sediment source identification through integration of spatial modelling, concentration monitoring and source tracing: A case study in the Great Barrier Reef catchments

Excess fine sediment delivery is a major contributor to the declining health of the Great Barrier Reef and identifying the dominant source areas of fine sediment has been critical to prioritising erosion remediation programs. The Bowen River catchment within the Burdekin Basin has been recognised as a major contributor and hence received considerable research investment over the last two decades. This study adopts a novel approach to integrate three independently derived sediment budgets produced from a catchment scale sediment budget model (Dynamic SedNet), targeted tributary water quality monitoring and geochemical sediment source tracing to refine and map the sediment source zones within the Bowen catchment. A four year study of water quality monitoring combined with modelled discharge estimates and geochemical source tracing both identified that the Little Bowen River and Rosella Creek were the largest sources of sediment in the Bowen River catchment. Both data sets contradicted initial synoptic sediment budget model predictions due to inadequate representation of hillslope and gully erosion. Recent improvements in model inputs have resulted in predictions that are consistent with the field data and are of finer resolution within the identified source areas. Priorities for further investigation of erosion processes are also revealed. Examining the benefits and limitations of each method indicates that these are complimentary methods which can effectively be used as multiple lines of evidence. An integrated dataset such as this provides a higher level of certainty in the prediction of fine sediment sources than a single line of evidence dataset or model. The use of high quality, integrated datasets to inform catchment management prioritisation will provide greater confidence for decision makers when investing in catchment management