Synergies, tensions and challenges in HIV prevention, treatment and cure research: exploratory conversations with HIV experts in South Africa

Background: The ethical concerns associated with HIV prevention and treatment research have been widely explored in South Africa over the past 3 decades. However, HIV cure research is relatively new to the region and significant ethical and social challenges are anticipated. There has been no published empirical enquiry in Africa into key informant perspectives on HIV cure research. Consequently, this study was conducted to gain preliminary data from South African HIV clinicians, researchers and activists. Methods: In-depth interviews were conducted on a purposive sample of fourteen key informants in South Africa. Audiotaped interviews were transcribed verbatim with concurrent thematic analysis. The perspectives of HIV clinicians, researchers and activists were captured. Analyst triangulation occurred as the data were analysed by three authors independently. Results: The rapid evolution of HIV cure research agendas was prominent with participants expressing some concern that the global North was driving the cure agenda. Participants described a symbiotic relationship between cure, treatment and prevention research necessitating collaboration. Assessing and managing knowledge and expectations around HIV cure research emerged as a central theme related to challenges to constructing ‘cure’ - how patients understand the idea of cure is important in explaining the complexity of cure research especially in the South African context where understanding of science is often challenging. Managing expectations and avoiding curative misconception will have implications for consent processes. Unique strategies in cure research could include treatment interruption, which has the potential to create therapeutic and ethical conflict and will be perceived as a significant risk. Ethical challenges in cure research will impact on informed consent and community engagement. Conclusions: It was encouraging to note the desire for synergy amongst researchers and clinicians working in the fields of prevention, treatment and cure. Translation of complex HIV cure science into lay language is critical. Moving forward, RECs must be adequately constituted with scientific expertise and community representation when reviewing cure protocols. It is hoped that knowledge and resource sharing in the context of collaboration between research scientists working in cure and those working in treatment and prevention will accelerate progress towards cur

A comprehensive approach to the development of thinking skills

The development of independent and innovative thinking entails much more than merely the acquisition of a series of thinking skills. A comprehensive approach based upon inter-disciplinary cooperation between, among others, the disciplines of philosophy, education and pscychology is needed. In such a comprehensive approach to the development of thinking skills the following factors that have a bearing on the acquisition of thinking skills should be addressed:The cultivation of a positive disposition towards the development of thinking.The creation of conditions conducive to the development of thinking.The cultivation of virtues that will dispose a person towards good thinking.An understanding of what good thinking entails.The teaching and assessment of thinking skills.In this article, these various factors and their bearing on the development of thinking skills are explored. A general theoretical framework for the development of thinking skills is proposed that can and should be translated to specific domains of knowledge or to specific human enterprises

A quest for an integrated management system of children following a drowning incident: A review of the literature

Purpose: Management of children following a drowning incident is based on specific interventions which are used in the prehospital environment, the emergency department (ED) and the Paediatric Intensive Care Unit (PICU). This paper presents a review of the literature to map and describe the management and interventions used by healthcare professionals when managing a child following a drowning incident. Of specific interest was to map, synthesise and describe the management and interventions according to the different clinical domains or practice areas of healthcare professionals. Design and Methods: A traditional review of the literature was performed to appraise, map and describe information from 32 relevant articles. Four electronic databases were searched using search strings and the Boolean operators AND as well as OR. The included articles were all published in English between 2010 and 2022, as it comprised a timeline including current guidelines and practices necessary to describe management and interventions. Results: Concepts and phrases from the literature were used as headings to form a picture or overview of the interventions used for managing a child following a drowning incident. Information extracted from the literature was mapped under management and interventions for prehospital, the ED and the PICU and a figure was constructed to display the findings. It was evident from the literature that management and interventions are well researched, evidence-informed and discussed, but no clear arguments or examples could be found to link the interventions for integrated management from the scene of drowning through to the PICU. Cooling and/or rewarming techniques and approaches and termination of resuscitation were found to be discussed as interventions, but no evidence of integration from prehospital to the ED and beyond was found. The review also highlighted the absence of parental involvement in the management of children following a drowning incident. Practice Implications: Mapping the literature enables visualisation of management and interventions used for children following a drowning incident. Integration of these interventions can collaboratively be done by involving the healthcare practitioners to form a link or chain for integrated management from the scene of drowning through to the PICU

Ouers se dissiplinering van vyf- tot sesjariges

Parents’ disciplining of five to six-year-old children. The home is the basis of development in the preschool years and parenting skills are therefore crucial for the prevention of behaviour that can negatively affect the child’s future. This article reports on research conducted through the analysis of the opinions of a group of South African parents regarding the behaviour of their five to six-year-old children that they experienced as being problematic, as well as the effect of the behaviour on the parents, the strategies that they applied, and the nature of the support that they chose. The conceptual-theoretical framework in which the research was embedded explains the construct of socio-emotional development, the parent’s role therein and understanding the disciplining of the five to six-year-old child from a bio-ecological perspective (as postulated by Bronfenbrenner) with an accompanying critical perspective from the Christian worldview

Gauteng freeway development and the impact on freight logistics.

Paper presented at the 32nd Annual Southern African Transport Conference 8-11 July 2013 "Transport and Sustainable Infrastructure", CSIR International Convention Centre, Pretoria, South Africa.Traffic congestion remains an issue of major concern for all South Africans and is a problem that requires resolution should we not wish to add to our travel time each year. This paper explores tolling as a possible solution - with money generated from tolling utilised for road maintenance and upgrades. More importantly, effective and intelligent tolling can shape driver behaviour and benefit logistics and supply chain management immensely. Whilst this perspective remains largely unpopular and emotionally charged, the author is of the firm belief that if we can achieve the shift towards efficient public transport and/or higher density private passenger transport (i.e. sharing), congestion can be avoided and the life of the Gauteng Freeway system can be extended. If not, more than 90% of freeway usage in Gauteng will remain by passenger vehicles that use the national infrastructure investment without paying, only to win a few minutes of convenience whilst they hamper the economy.This paper was transferred from the original CD ROM created for this conference. The material was published using Adobe Acrobat 10.1.0 Technology. The original CD ROM was produced by Document Transformation Technologies Postal Address: PO Box 560 Irene 0062 South Africa. Tel.: +27 12 667 2074 Fax: +27 12 667 2766 E-mail: nigel@doctech URL: http://www.doctech.co.zamv201

Human brucellosis in South Africa: Public health and diagnostic pitfalls

Human brucellosis in South Africa (SA) is under-diagnosed and under-reported. This is because many clinicians have little or no experience in managing affected patients, and in part because of the nonspecific and insidious nature of the disease. A case of human brucellosis caused by Brucella melitensis in a patient from the Western Cape Province of SA is described, and the resulting exposure of staff members at two medical microbiology laboratories, as well as the public health investigation that was conducted, are discussed. The objective of this article is to highlight the need for strengthening integration between public health, medical and veterinary services and exposing deficiencies in public health, veterinary and laboratory practices

Ethical challenges in developing an educational video to empower potential participants during consent processes in future HIV cure research in South Africa

Obtaining consent for HIV research is complex, particularly in low- and middle-income countries. Low levels of education, complexity of science and research processes, confusion about basic elements of research, and socio-economic conditions that make access to medical care difficult have collectively led to concerns about the adequacy of the consent process. Given the exponential growth of HIV prevention and treatment research in South Africa, HIV researchers are increasingly facing challenges obtaining authentic informed consent from potential participants. It is anticipated that HIV cure research, despite being in its infancy in South Africa, will introduce a new discourse into a population that is often struggling to understand the differences between ‘cure’, ‘preventive and therapeutic vaccines’ and other elements of the research process. Coupled with this, South Africa has a complex history of ‘illegitimate’ or ‘false cures’ for HIV. It is therefore logical to anticipate that HIV cure research may face significant challenges during consent processes. HIV prevention research in South Africa has demonstrated the importance of early community engagement in educating potential research participants and promoting community acceptance of research. Consequently, in an attempt to extrapolate from this experience of engaging with communities early regarding cure research, a 15-minute educational video entitled ‘I have a dream: a world without HIV’ was developed to educate and ultimately empower potential research participants to make informed choices during consent processes in future HIV cure clinical trials. To aid others in the development of educational interventions, this paper discusses the challenges faced in developing this educational video

A new species of Polemanniopsis (Apiaceae) from Namibia

AbstractA new species of woody Apiaceae, Polemanniopsis namibensis B-E. Van Wyk, A. Burke & C. Mannheimer, is described. The species is allied to Polemanniopsis marlothii but differs in the much smaller habit of (up to 0.6m vs 1.5–4m in Polemanniopsis marlothii), the white or greyish colour of the twigs (brown in Polemanniopsis marlothii), the 3-foliolate leaves (predominantly 5-foliate in Polemanniopsis marlothii), the smaller inflorescences with persistent involucral bracts (caducous in Polemanniopsis marlothii) and anatomical details of the leaves. The species is endemic to Namibia and is known only from a localised area in the southern Namib desert near Lüderitz, where it is relatively common

Evaluation of protein purification techniques and effects of storage duration on lc-ms/ms analysis of archived ffpe human crc tissues

To elucidate cancer pathogenesis and its mechanisms at the molecular level, the collecting and characterization of large individual patient tissue cohorts are required. Since most pathology institutes routinely preserve biopsy tissues by standardized methods of formalin fixation and paraffin embedment, these archived FFPE tissues are important collections of pathology material that include patient metadata, such as medical history and treatments. FFPE blocks can be stored under ambient conditions for decades, while retaining cellular morphology, due to modifications induced by formalin. However, the effect of long-term storage, at resource-limited institutions in developing countries, on extractable protein quantity/quality has not yet been investigated. In addition, the optimal sample preparation techniques required for accurate and reproducible results from label-free LC-MS/MS analysis across block ages remains unclear. This study investigated protein extraction efficiency of 1, 5, and 10-year old human colorectal carcinoma resection tissue and assessed three different gel-free protein purification methods for label-free LC-MS/MS analysis. A sample size of n 17 patients per experimental group (with experiment power 0.7 and α 0.05, resulting in 70% confidence level) was selected

Blind source separation aided characterization of the γ′ strengthening phase in an advanced nickel-based superalloy by spectroscopic 4D electron microscopy

The γ’ strengthening phase in an advanced nickel-based superalloy, ATI 718Plus, was characterized using a blind source separation applied to a four dimensional X-ray microanalysis dataset obtained by scanning transmission electron microscopy. Selected patterns in the X-ray spectra identified by independent component analysis were found to be spatially and chemically representative of the matrix (γ) and precipitate phases (γ’) present in the superalloy, enabling their size, shape and distribution to be determined. The three dimensional chemical reconstruction of the microstructure may provide insight into the role of the various alloying elements in the evolution of the microstructure at the nano-scale.The research leading to these results has received funding from the European Union Seventh Framework Programme under Grant Agreement 312483 - ESTEEM2 (Integrated Infrastructure Initiative-I3), as well as from the European Research Council under the European Union's Seventh Framework Programme (FP/2007-2013)/ERC grant agreement 291522 - 3DIMAGE. D.R. acknowledges support from the Royal Society’s Newton International Fellowship scheme. RKL acknowledges a Junior Research Fellowship at Clare College. RK acknowledges financial support from Rolls-Royce, EPSRC and the BMWi under EP/H022309/1, EP/H500375/1 and grant number 20T0813. F.d.l.P. and C.D. acknowledge 26 funding from the ERC under grant no. 259619 PHOTO EM. Special thanks to Giorgio Divitini and Lech Staniewicz for preparation of the FIB needle specimen and to Stephen A Croxall for SEM/FIB imaging.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.actamat.2016.01.04